e23518 Background: Osteosarcoma (OS) is the most common bone malignancy in children and young adults. Treatment with perioperative systemic chemotherapy has improved patient outcome but a third of patients will eventually develop incurable metastatic disease. Currently, there are no biomarkers for monitoring patients’ response to neo-adjuvant (NA) chemotherapy or for patients under active surveillance following treatments. Procollagen C-Proteinase Enhancer-1 (PCPE-1) is an extra-cellular matrix glycoprotein which promotes the maturation of pro-collagen into collagen in various tissues. Elevated serum levels of PCPE-1 are found in bone diseases such as Paget’s disease and Osteoporosis and in patients with breast cancer with bone metastases. Serum PCPE-1 has not been described in patients with OS. We aimed to describe PCPE-1 serum levels in patients with OS compared with healthy volunteers, and across different time points in their treatment and disease course. Methods: We collected serum samples from the Israeli national biobank of 18 adult OS patients. Serum samples were also collected from 6 healthy individuals. Additionally, we obtained serial samples from 4 OS patients prior to and after initiating NA therapy. Quantification of serum PCPE-1 levels was performed using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Results: We successfully analyzed serum PCPE-1 levels from all patients and healthy volunteers. Mean PCPE-1 levels of 553ng/ml (range 479-614ng/ml) were observed in OS patients, compared with 313ng/ml (285-339ng/ml) in healthy volunteers. Of 4 patients undergoing treatment who had serial samples, a decrease in serum levels was observed 2 responding patients, while an increase in PCPE-1 levels were observed in one patient after NA treatment who had no response to treatment at the time of surgery. Of notice, serum levels nearly doubled in a patient during active surveillance who experienced local disease recurrence (274ng/ml and 423ng/ml, respectively). Conclusions: This is the first study to show elevated PCPE-1 serum levels in patients with OS. Our study also demonstrates potential changes in PCPE-1 levels in response to treatment. We are expanding our study to include a pediatric population to investigate the role of PCPE-1 as a potential tumor biomarker for monitoring treatment and surveillance of OS.

e14665 Background: Malignant peritoneal mesothelioma (MPM) is a rare malignancy of the peritoneum. In patients with advanced disease, therapeutic options are limited, and prognosis is usually poor. While the role of immune-checkpoint inhibitors (ICI) in MPM is evolving, clinical data is scarce and there are currently no biomarkers to predict response to ICI therapy in this population. Methods: Patients treated at the Sheba Medical Center between 2016-2022 have been examined with the aim of delineating the clinical and immunopathologic characteristics of MPM, including programmed-death ligand-1 (PDL-1) status. Results: Forty-two patients with MPM were treated at Sheba during the study period. Eight patients (19%) have received immunotherapy as a single treatment in our cohort, all as ≥2 line of treatment. Of these patients, 3 patients (37.5%) had complete response (CR) or partial response (PR) as their best response, 3 patients (37.5%) had stable disease (SD), and 2 patients (25%) had progressive disease. Median overall survival (OS) among responding patients (CR/PR) and patients with clinical benefit (CR/PR/SD) were 6.8 years and 5.2 years, respectively, noticeably higher than the median OS for MPM (2.5 years). PDL-1 status was available for 23 patients: 17/23 (74%) had negative PDL-1 status and 6/23 (26%) had positive PDL-1 status. No correlation was observed in PDL-1 status among patients experiencing clinical benefit from treatment with ICIs. Conclusions: ICI therapy could be considered as a reasonable option for second-line therapy and beyond for MPM, with selected patients who may substantially benefit from these treatments. PDL-1 status did not correlate with treatment benefit, which highlights the limitation of this biomarker as a predictor of response in MPM patients.

Translating preclinical studies to effective treatment protocols and identifying specific therapeutic responses in individuals with cancer is challenging. This may arise due to the complex genetic makeup of tumor cells and the impact of their multifaceted tumor microenvironment on drug response. To find new clinically relevant drug combinations for colorectal cancer (CRC), we prioritized the top five synergistic combinations from a large in vitro screen for ex vivo testing on 29 freshly resected human CRC tumors and found that only the combination of mitogen-activated protein kinase kinase (MEK) and proto-oncogene tyrosine-protein kinase Src (Src) inhibition was effective when tested ex vivo. Pretreatment phosphorylated Src (pSrc) was identified as a predictive biomarker for MEK and Src inhibition only in the absence of KRAS G12 mutations. Overall, we demonstrate the potential of using ex vivo platforms to identify drug combinations and discover MEK and Src dual inhibition as an effective drug combination in a predefined subset of individuals with CRC.

Castration-resistant prostate cancer (CRPC) is a devastating and incurable disease. Combined therapy using conventional anticancer drugs and a proprietary medical nutriment, fermented wheat germ extract (FWGE), also known as Avemar, has been suggested as a treatment for progressing prostate cancer (PCa) patients, who have become resistant to first line hormonal therapy (gonadotropin releasing hormone, GnRH). The primary aim of this study was to test if this combined therapy would slow down disease progression in CRPC patients. We tested the nontoxic, readily available, inexpensive FWGE, together with the conventional treatment, GnRH analogue, in 36 CRPC patients. Although this is a pilot study, with the drawback of a statistically small sample size, some anticancer clinical activity of FWGE could be seen in the CRPC patients, as measured by prostate specific antigen doubling time (PSADT). We found that the intake of GnRH with FWGE for at least 4 months, improved the overall health as well as the quality of life (QOL) in 4 patients (11%) and was instrumental in extending the PSADT in about 17 (out of 26) patients (65.4%), six of whom were significant. Since no mentionable adverse events were noticed, this treatment may permit the postponement of chemotherapy for these patients.

Background: Metaplastic carcinoma of the breast is a general definition referring to a heterogeneous group of neoplasms characterized by a mixture of adenocarcinoma with areas of spindled, squamous or mesenchymal differentiation. Metaplastic breast carcinoma comprising of both epithelial and melanocytic elements is rare, with just nine cases reported in medical literature so far. “metaplastic breast carcinoma with melanocytic differentiation” does not exist as a separate entity on the WHO classification. Case description: Patient reported is a woman diagnosed with having invasive ductal carcinoma in 1997, with new skin lesions appearing in 2009 and 2019. These lesions were biopsied and reviewed for histopathology. On microscopic examination, we observed skin involved by a malignant tumor, showing clusters of atypical cells with solid architecture and focal duct differentiation. Immunohistochemistry revealed tumor cells were positive for breast and melanocytic markers. Given the patient’s clinical history, the possibility of metaplastic breast carcinoma with focal melanocytic differentiation was suggested. Discussion: In our case report, we were able to show dermal breast lesions from the same patient during a 10-year span, showing change and evolution of the lesion to its current form. Recurrent biopsies of similar malignant lesions showing evolution have been described scarcely in the medical literature. From immune-histochemical stains performed on blocks obtained from 2009, we were able to show the development of melanocytic markers over time in similar samples resected ten years apart.

Purpose: Ki-67 is a marker of cellular proliferation that is commonly used for the assessment of rhabdomyosarcoma. The aim of this study was to investigate the associations between Ki-67 expression and primary tumor diameter with CT evidence of lymph node and solid organ metastatic spread in rhabdomyosarcoma. Materials and methods: An institutional review board approval was granted for this study. A retrospective search for rhabdomyosarcoma patients was conducted. Pathology reports were examined for Ki-67 expression. Chest-abdomen CT was assessed for radiological evidence of lymph node and metastatic spread. The maximal primary tumor diameter (termed tumor size) was also measured in different modalities CT, MRI, PET-CT and US. Ki-67 levels and primary tumor maximal diameters were compared to CT evidence of lymph node and organ metastatic spread. Results: Twenty-four patients with rhabdomyosarcoma were included. CT evidence of lymph node spread was associated with Ki-67 levels (AUC = 0.896, p = 0.006) and to a lesser extent with tumor size (AUC = 0.790, p = 0.030). However, organ metastatic spread was associated only with tumor size (AUC = 0.854, p = 0.006) and not with Ki-67 levels (AUC = 0.604, p = 0.469). A combination of tumor size >= 50 mm and Ki-67 levels >= 60% was significantly associated with CT evidence of lymph node spread (p = 0.004). Conclusion: In conclusion, this study demonstrates radiological-pathological correlation in RMS. Lymph node spread detected by radiological images is associated with Ki-67 values. Lymph node and metastatic spread are associated with primary tumor size.

BACKGROUND:Homeopathy has the potential to reduce symptoms related to cancer treatment. The present study examined the feasibility of a homeopathic consultation and treatment program, provided as part of an integrative oncology service. METHODS:The electronic medical files of patients undergoing a homeopathic consultation in an integrative oncology service clinic were examined retrospectively. Adherence to the homeopathic treatment regimen and perceived response to the treatment were evaluated. RESULTS:The files of 124 patient (34 males, 90 females) were examined, of which two-thirds reported acquiring and self-administering the homeopathic remedy as prescribed, and nearly three-quarters reporting a beneficial effect. Adherence to the homeopathic treatment regimen was greatest among patients attending a second visit, as opposed to having only telephone/e-mail follow-up ( P < .005). An association was found between a perceived beneficial effect of treatment with attending a follow-up visit ( P = .04), female gender ( P = .02), younger age ( P = .048), diagnosis of breast cancer ( P = .014), and current radiation treatment (vs chemotherapy; P = .003). Patients reporting chemotherapy-induced peripheral neuropathy were also more likely to report a beneficial effect ( P = .004), as were female patients reporting hot flashes ( P = .005) and those referred by an oncologist ( P = .046). No adverse effects were attributed to the homeopathic treatment. CONCLUSIONS:Homeopathy can be successfully incorporated within a supportive care integrative oncology service. In addition to demographic and cancer-related characteristics, as well as symptoms, patients attending a second visit (vs only telephone/e-mail follow-up) were more likely to adhere to and perceive a beneficial effect from the homeopathic regimen.

e14549 Background: Pembrolizumab (pembro), an anti-PD1 monoclonal antibody, was recently approved for melanoma and NSCLC. Early signals of pembro activity were observed in several other solid cancers. Following this, and in accord with the concept of ‘the patient’s right to try’, our institutional ethical board approved it for off—label use in metastatic heavily pretreated cancer patients (pts). Our primary aim was to retrospectively assess the subjective clinical and radiological responses to pembro in this heterogeneous population. Methods: All non-hematological, non-melanoma adult ( > 18 years) cancer pts who received pembro (1-2 mg/kg, every 3 weeks) off-trial were retrospectively identified using pharmacy and electronic medical records. Radiological response was defined as a complete or partial decrease in tumor burden on computerized scans that was deemed clinically meaningful. Descriptive statistics were calculated with medians and percentages (Excel, Microsoft). Results: From Sep-14 to Dec-15, 96 pts received pembro off-trial. Pts were generally heavily pretreated (a median of 2 prior treatment lines) with compromised performance status. Pts were treated for a wide range of malignancies, including urothelial (17%), gastric (13%), ovarian (12%), NSCLC (13%) and cervical (9%) cancers. Median number of treatment cycles was 3 (range 1-13). Treatment was stopped in 54 pts (56%) due to clinical deterioration or death before radiological assessment. Fourteen pts (15%) had subjective clinical benefit on treatment. Two pts (2%) had radiological complete response and seven (7%) had partial radiological response; The response rate (RR) for the entire cohort was 9%. No responses were observed in 35 pts with ECOG PS = 3/4 (table). The RR associated with pembro when given as first or second line was 16% (7/43 pts) and 4% (2/51 pts) when given as third line or higher. Conclusions: Pembro has modest activity in non-selected, heavily pre-treated pts with metastatic solid malignancies. Poor performance status is associated with lack of response to Pembro. 3/4 (n = 35, 41%) 2 (n = 30, 35%) 0/1 (n = 20, 24%) ECOG PS % n % n % n response 0 0 0 0 10 2 CR 0 0 7 2 25 5 PR 1 1 3 mixed 0 1 1 SD 34 26 9 PD/not applicable 0 0 7 2 35 7 RR (CR+PR)

BACKGROUND The VEGFR/PDGFR inhibitor sunitinib was approved in Israel in 2008 for the treatment of metastatic renal cell carcinoma (mRCC), based on an international trial. However, the efficacy of sunitinib treatment in Israeli mRCC patients has not been previously reported. OBJECTIVES To report the outcome and associated factors of sunitinib treatment in a large cohort of Israeli mRCC patients. METHODS We conducted a retrospective study of an unselected cohort of mRCC patients who were treated with sunitinib during the period 2006-2013 in six Israeli hospitals. Univariate and multivariate analyses were performed to determine the association between treatment outcome and clinicopathologic factors. RESULTS We identified 145 patients; the median age was 65 years, 63% were male, 80% had a nephrectomy, and 28% had prior systemic treatment. Seventy-nine percent (n = 115) had clinical benefit (complete response 5%, n = 7; partial response 33%, n = 48; stable disease 41%, n = 60); 21% (n = 30) were refractory to treatment. Median progression-free survival (PFS) was 12 months and median overall survival 21 months. Factors associated with clinical benefit were sunitinib-induced hypertension: [odds ratio (OR) 3.6, P = 0.042] and sunitinib dose reduction or treatment interruption (OR 2.4, P = 0.049). Factors associated with PFS were female gender [hazard ratio (HR) 2, P = 0.0041, pre-sunitinib treatment neutrophil-to-lymphocyte ratio < or = 3 (HR 2.19, P = 0.002), and active smoking (HR 0.19, P < 0.0001). Factors associated with overall survival were active smoking (HR 0.25, P < 0.0001) and sunitinib-induced hypertension (HR 0.48, P = 0.005). To minimize toxicity, the dose was reduced or the treatment interrupted in 39% (n = 57). CONCLUSIONS The efficacy of sunitinib treatment for mRCC among Israeli patients is similar to that in international data.

1028 Background: Relapsed/metastatic TNBC is an aggressive form of the disease that typically responds initially to chemotherapy, but eventually progresses in the majority of patients (pts). We hypothesized that a comprehensive NGS assay (FoundationOne) could identify novel therapy targets not routinely interrogated in TNBC pts. Methods: Hybridization capture of 3,769 exons from 236 cancer-related genes and 47 introns of 19 genes commonly rearranged in cancer was applied to ≥ 50 ng of DNA extracted from 26 TNBC FFPE specimens and sequenced to high, uniform coverage. Genomic alterations (GA) including base substitutions, small indels, copy number alterations, and select gene fusions, were characterized and reported for each pt sample. Actionable GAs were defined as those identifying anti-cancer targeted therapies on the market or in registered clinical trials. Results: The 26 TNBC pts had a mean age of 49.6 yrs (range, 28-74). All 26 tumors were ER-/PR-/HER2- on routine slide-based testing. Samples used for NGS originated from breast (42%), lymph nodes and axilla (23%), chest wall and muscle (12%), skin (8%) and serous effusion (4%). All 26 cases harbored ≥1 GA, with a total of 113 GAs and a mean of 4.35 GAs per tumor. The most frequent currently unactionable GAs were TP53 (21, 81%) and MYC (8, 31%). Twenty two cases (85%) harbored ≥1 actionable GA; mean, 2.73 actionable GAs per tumor. The most common actionable GAs were PIK3CA (7, 27%), MCL1 (4,15%), PTEN (3,12%), BRCA1 (3,12%), and BRCA2 (2,8%). One pt (4%) had ALK amplification. Activating ERBB2 point mutations not detectable by IHC/FISH, potentially targetable with anti-HER2 therapies were identified in 2 pts; EGFR amplifications, potentially treatable with anti-EGFR TKI were identified in 2 pts (1 pt had both of these GAs). One pt with ERBB2mutation received neratinib monotherapy and one pt with EGFR amplification received capecitabine plus cetuximab; both had partial response lasting 8+ months. Conclusions: For TNBC, comprehensive genomic profiling can identify a significant number of actionable GAs not currently tested for in routine practice. Results point to the potential of MTOR, anti-HER2, and anti-EGFR targeted therapies for a significant subset of pts.

BACKGROUND:Obesity, smoking, hypertension, and diabetes are risk factors for renal cell carcinoma development. Their presence has been associated with a worse outcome in various cancers. We sought to determine their association with outcome of sunitinib treatment in metastatic renal cell carcinoma (mRCC). METHODS:An international multicenter retrospective study of sunitinib-treated mRCC patients was performed. Multivariate analyses were performed to determine the association between outcome and the pretreatment status of smoking, body mass index, hypertension, diabetes, and other known prognostic factors. RESULTS:Between 2004 and 2013, 278 mRCC patients were treated with sunitinib: 59 were active smokers, 67 were obese, 73 were diabetic, and 165 had pretreatment hypertension. Median progression-free survival (PFS) was 9 months, and overall survival (OS) was 22 months. Factors associated with PFS were smoking status (past and active smokers: hazard ratio [HR]: 1.17, p = .39; never smokers: HR: 2.94, p < .0001), non-clear cell histology (HR: 1.62, p = .011), pretreatment neutrophil-to-lymphocyte ratio >3 (HR: 3.51, p < .0001), use of angiotensin system inhibitors (HR: 0.63, p = .01), sunitinib dose reduction or treatment interruption (HR: 0.72, p = .045), and Heng risk (good and intermediate risk: HR: 1.07, p = .77; poor risk: HR: 1.87, p = .046). Factors associated with OS were smoking status (past and active smokers: HR: 1.25, p = .29; never smokers: HR: 2.7, p < .0001), pretreatment neutrophil-to-lymphocyte ratio >3 (HR: 2.95, p < .0001), and sunitinib-induced hypertension (HR: 0.57, p = .002). CONCLUSION:Active smoking may negatively affect the PFS and OS of sunitinib-treated mRCC. Clinicians should consider advising patients to quit smoking at initiation of sunitinib treatment for mRCC.

e15597 Background: Several studies have suggested the existence of a “trial effect”, in which for a given treatment, participation in a clinical trial is associated with a better outcome of cancer patients. The VEGFR inhibitor sunitinib is a standard treatment for mRCC. The effect of clinical trial participation on the outcome of sunitinib treatment in mRCC is poorly defined. Aims: To study the effect of clinical trial participation on outcome of mRCC patients treated with sunitinib. Methods: Records from 275 mRCC patients treated with sunitinib from 2004 to 2012 in 7 centers across 2 countries were reviewed. We compared the response rate, progression free survival, and overall survival, between clinical trial participants (n=49) and a matched cohort of non participants (n=49) who who received standard therapy. Each patient participating in a clinical trial was individually matched with a non participant by clinicopathologic factors. Progression free survival and overall survival were determined by Cox regression. Results: The groups were matched by age (median 64), gender (male 67%), Heng risk (favorable 24%, intermediate 60%, poor 16%), ECOG performance status (0-1 92%), prior nephrectomy (92%), renal cell carcinoma histology (clear cell 80%), sunitinib induced hypertension (56%), and sunitinib dose reduction/treatment interruption (41%). In clinical trial participants versus non participants, objective response was partial response/stable disease 80% (n=39) versus 73% (n=36), and progressive disease at first imaging evaluation within the first 3 months (mos) 20% (n=10) versus 27% (n=13) (p=0.63, OR 1.2). Median progression free survival was 10 versus 11 mos (HR=0.96, p=0.84), and median overall survival 23 versus 24 mos (HR=0.97, p=0.89). Conclusions: In mRCC patient treated with sunitinib, the outcome of clinical trial participants was similar to matched non participants who received standard therapy.

PURPOSE:Studies suggested the existence of a 'trial effect', in which for a given treatment, participation in a clinical trial is associated with a better outcome. Sunitinib is a standard treatment for metastatic renal cell carcinoma (mRCC). We aimed to study the effect of clinical trial participation on the outcome of mRCC patients treated with sunitinib, which at present, is poorly defined.MATERIALS AND METHODS:The records of mRCC patients treated with sunitinib between 2004-2013 in 7 centers across 2 countries were reviewed. We compared the response rate (RR), progression free survival (PFS), and overall survival (OS), between clinical trial participants (n=49) and a matched cohort of non-participants (n=49) who received standard therapy. Each clinical trial participant was individually matched with a non-participant by clinicopathologic factors. PFS and OS were determined by Cox regression.RESULTS:The groups were matched by age (median 64), gender (male 67%), Heng risk (favorable 25%, intermediate 59%, poor 16%), prior nephrectomy (92%), RCC histology (clear cell 86%), pre-treatment NLR (>3 in 55%, n=27), sunitinib induced hypertension (45%), and sunitinib dose reduction/treatment interruption (41%). In clinical trial participants versus non-participants, RR was partial response/stable disease 80% (n=39) versus 74% (n=36), and progressive disease 20% (n=10) versus 26% (n=13) (p=0.63, OR 1.2). The median PFS was 10 versus 11 months (HR=0.96, p=0.84), and the median OS 23 versus 24 months (HR=0.97, p=0.89).CONCLUSIONS:In mRCC patients treated with sunitinib, the outcome of clinical trial participants was similar to that of non-participants who received standard therapy.

tinib treatment for 2 weeks before and after the operation. A routine physical follow-up examination in the oncology department after the operation revealed an exposed necrotic bone in the central-posterior part of the hard palate, 3–5 mm in diameter with a communication to his nasal cavity, and three more lesions on his lower and upper alveolar ridges [Figure]. There was no sign of soft tissue infection around the oro-nasal fistula. Positron emission tomography/computed tomography demonstrated local fluorine-18 absorption without fludeoxyglucose absorption, consistent with local bone remodeling without local infection or tumor. The lesions were diagnosed as osteonecrosis with a secondary oro-nasal fistula. The patient was treated with antiseptic irrigation, conservative debridement, and d rug-induced osteonecrosis is a welldocumented side effect of agents that have anti-angiogenic and anti-osteoclastic activity, for example bisphosphonates, bevacizumab and denosumab [1]. In many cases it is associated with dentoalveolar surgery, such as tooth extraction, placement of dental implants, etc. [2]. We present a rare case of osteonecrosis of the hard palate secondary to functional endoscopic sinus surgery and submucous resection.

Computerized Tomography (CT) images are High Dynamic Range (HDR) images of the X-ray attenuation coefficients of the body's tissues. The inability to see abnormalities in tissues with marked differences in their X-ray attenuation coefficients, in a single CT window, poses a significant clinical problem in radiology. In order to provide proper contrast, which reveals all the required clinical details within each specifically imaged tissue, a single CT slice must be viewed by a radiologist four times: the first viewing focuses on the lung window; the second viewing focuses on the soft tissues window; the third viewing focuses on the liver window; and the fourth viewing focuses on the bone window. In order to enhance the ability to perform a complete diagnosis, while decreasing diagnostic time, we developed the BACCT (Biologically-based Algorithm for Companding CT images) method. Our algorithm compresses and expands (compands) the HDR CT image into a single, low dynamic range image. Before performing the companding procedure, unique processing is required which involves operations that enhance and stretch the image. The performance of our algorithm has been demonstrated on a large repertoire of CT body images. All the clinically required CT information is exposed in each CT slice in a single image. The algorithm compands the CT images in a fully automatic way. Collaborating radiologists have already tested the results of our algorithmic method, and reported that the images seem to provide all the necessary information. However, clinical tests for statistical reliability are still required.

Background: Procollagen C-proteinase enhancer 1 (PCPE1), a glycoprotein secreted from differentiating osteoblast, enhances the rate-limiting step of collagen type I fibrillar formation. It is expressed and secreted by cells that produce collagen type I and has the potential to be a marker for bone pathologies.Methods: We developed an assay to quantify PCPE glycopattern based on isoelectric focusing (IEF) and detection with a bio-imaging camera (coefficient of variation within and between assays, 15% and 20%, respectively).Results: PCPE was quantified in 39 serum samples from healthy subjects (17 females and 22 males). The concentration in the serum was 305(274) ng/ml, median(IQR). The level of the PCPE isoforms and their relative distribution were altered in patients with bone disorders.Conclusions: The data generated by our system, support our hypothesis that combined data on PCPE concentration and isoforms may be useful for the diagnosis and follow-up of bone diseases. Further research, on larger cohorts of both normal subjects and patients, must be done. (C) 2011 Elsevier B.V. All rights reserved.

Recently, we have seen the development of diagnostic tools based on the rationale that the measurement of electrical impedance of specific dermal zones might reflect the occurrence of pathological states in corresponding internal organs. Studies published lately have shown the diagnostic potential of this technique. We set out to evaluate the accuracy of this tool in diagnosing cancer. Our study group was composed of cancer patients visiting the Oncology clinic for a routine follow-up. All patients underwent conventional medical history and physical examination by a physician. We evaluated a device manufactured by Medex Screen Ltd. The device analysis was carried out by a physician who was blinded to the previous diagnosis. A third researcher compared the "conventional" diagnosis with the Medex device output using standard statistical analysis. Overall, 125 cancer patients were included in the study. When comparing Medex Screen diagnostic technique with the conventional methods of diagnosis for the various disorders we found a sensitivity of 76.2%, 78.7%, and 92.9% and a specificity of 95.0%, 90.7%, and 90.4% for lung, breast, and prostate cancer, respectively. Existence of metastatic disease or specific treatment did not affect the diagnostic properties of the described device. Although the exact mechanism is not entirely clear, measurement of electrical impedance of dermal-visceral zones has the potential to serve as a diagnostic and perhaps a screening tool for neoplastic pathologies. Further research should be conducted to create more evidence to support or dispute the use of this technique as a reliable diagnostic tool.

Numerous studies have examined the association between body weight, nutritional factors, physical activity and the risk for primary breast cancer. Relatively few studies, however, have examined the associations between these issues and the recurrence of the disease and cure of the primary tumor. Today, three areas of focus are actively being researched for breast cancer survivors: body weight, diet composition and physical activity with specific emphasis on the risk for recurrence, survival and quality of life. Increased body weight or BMI (Body Mass Index) at diagnosis was found to be a significant risk factor for recurrent disease, decreased survival, or both. Overall obesity has been shown to adversely affect prognosis. Appropriate weight control may be particularly beneficial for breast cancer survivors. Breast cancer survivors should be encouraged to achieve and maintain a healthy weight. Limiting fat intake can reduce the risk of breast cancer recurrence. Increasing consumption of vegetables and fruits seems to have possible beneficial effects during and after treatments. To date physical activity after breast cancer diagnosis has been found to reduce the risk of death. The greatest benefit occurred in women who performed the equivalent of walking 3-5 hours per week at an average pace. Safe weight loss via increased physical activity and healthful food choices should be encouraged for normal, overweight or obese breast cancer survivors in order to improve survival and life quality.