Modulation of Premetastatic Niche by the Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor Pazopanib in Localized High-Risk Prostate Cancer Followed by Radical Prostatectomy: A Phase II Randomized Trial.

LESSONS LEARNED: Pazopanib was not effective in altering the premetastatic niche in the neoadjuvant setting.Pazopanib was safe and well tolerated without any new safety signals. BACKGROUND: Vascular endothelial growth factor receptor 1 (VEGFR1) expressing myeloid-derived suppressor cells (VEGFR1+ MDSCs) potentially foster metastases by establishing a premetastatic niche. In a preclinical study, VEGFR1+ clustering in lymph nodes (LNs) independently predicted time to biochemical recurrence (TTBR) in localized prostate cancer [1]. The hypothesis was that neoadjuvant pazopanib therapy will decrease VEGFR1+ clusters in pelvic lymph nodes and improve outcomes. METHODS: This is a phase II trial (NCT01832259) of neoadjuvant pazopanib 800 mg versus placebo daily for 4 weeks in high-risk localized prostate cancer. The primary endpoint was a decrease in VEGFR1+ MDSC clustering assessed by immunohistochemistry (IHC) analysis. Secondary endpoints were safety, feasibility, and TTBR. RESULTS: Thirty patients were randomized to pazopanib versus placebo, with 15 patients randomized to each arm. Demographic and disease characteristics were similar in both arms. There was no difference in the VEGFR1+ clustering between the treatment arms (p = .345). Neoadjuvant therapy with pazopanib was well tolerated, and surgical complications were similar in both arms. CONCLUSION: Neoadjuvant pazopanib therapy did not alter the premetastatic niche; however, treatment targeting vascular endothelial growth factor (VEGF) in the preoperative period was safe and feasible, which may open up the avenue to investigate novel combinatorial regimens, including a VEGF inhibitor in combination with immune checkpoint inhibitor in this setting.

Young urban women and the nutrition transition in China: a familiar pattern emerges.

The purpose of this study was to assess the nutrition transition being experienced by urban Chinese college females. The self-administered cross-sectional survey was given to female students attending universities in the urban area of Xi'an, China. The survey was a collection of previously validated instruments measuring motivations for eating, disordered attitudes and behaviors, societal and media influences on body image and eating disturbances, body esteem, body dissatisfaction, and demographic questions. Results from 207 Chinese college females indicated that they had high levels of dietary restraint, despite the large proportion of participants who were considered underweight and normal weight. In addition, the results indicated that these college females ate primarily based on hunger cues. They also had a strong desire to lose weight sometimes to ultra thin and unhealthy levels, but with only moderate levels of disordered eating attitudes and behaviors. It appears that for participants in this study, at their current point in the nutrition transition, the full negative impact of Americanized media may not yet be fully internalized. The study has revealed a need for the development of health education programs to promote healthy eating styles and appropriate dieting behaviors. Future research needs to develop strategies for better understanding the impact of Americanization on the body image of women in this type of transitional population.