Apoptosis associated genes and their role in predicting responses to neoadjuvant breast cancer therapy D. Tvrdík * , H. Skálová, P. Dundr, L. Stanek, C. Povýšil, L. Petruželka * General University Hospital, Institute of Pathology, Prague, Czech Republic Objective: Neoadjuvant chemotherapy is used in the treatment of breast carcinoma because it substantially reduces the size of the primary tumor and lymph node metastases. This present study is aimed at the investigation of biomarkers that can predict a pathologic response to the therapy. Method: The transcriptional profile of 84 key apoptosis genes was evaluated in both pre-therapeutically obtained tumor tissue by core needle biopsy and in specimens removed by final surgery, using a pathway-specific Real-Time PCR assay. Results: On the basis of a hierarchical cluster analysis of 13 significantly changed genes, we divided patients into good and bad prognosis groups, which correlate well with progression-free survival. In the good prognosis group, we found a statistically significant downregulation of the expression of MCL1 and IGF1R genes after neoadjuvant treatment. We also found a statistically significant overexpression of BCL2L10, BCL2AF1, CASP8, CASP10, CASP14, CIDEB, FADD, HRK, TNFRSF25, TNFSF8 and CD70 genes. In contrast, we found upregulation of IGF1R after the treatment in the group with poor prognosis. Conclusion: As we have shown, gene expression profiling after neoadjuvant chemotherapy is a valuable research tool for investigating molecular markers, which may better reflect tumor biology and treatment response than standard prognostic and predictive factors. Objective: Non-Small Cell Lung Carcinoma (NSCLC) is one of the most serious cancers. Identification of genetic changes (mutations, amplifications or rearrangements) within EGFR, KRAS and ALK oncogenes, associated with NSCLC, allows choosing the patients, benefit from biological therapy with tyrosin kinase inhibitors. Method: DNA is isolated from formalin fixed paraffin embedded specimens or cytology specimens. Mutation detection is performed by real-time PCR, fragment analysis, primerextension analysis and mutant-enriched PCR. Wt-EGFR patients (e.g. with no mutation detected) are tested for ALK gene rearrangement and EGFR gene polysomy or amplification using the fluorescence in situ hybridization (FISH) method. Results: Since 10/2010 till 2/2012, 238 DNA samples were analyzed. Out of these, 17 patients (7,14 %) were found to be positive for activating mutations within EGFR gene. Since 07/2011 till 2/2012, 80 patients were analyzed for ALK gene rearrangement, EGFR gene polysomy or amplification. ALK gene rearrangement has been proven in 5 (6,25 %) cases, ALK gene amplification in 2 (2,5 %) cases and EGFR gene polysomy or amplification in 35 (43,75 %) cases. Conclusion: Determination of genetics changes in tumor can provide powerful tool for setting up strategy and therapeutic protocols in NSCLC patients. Objective: A 61 year old gentleman, ex-smoker with a history of asbestos exposure presented to the emergency department with a 1 day attack of severe abdominal pain and bilious vomiting. History of abdominal pain, lethargy, and weight loss over the last 12 months and 4 years of recurrent pleural effusion. Pleural aspirates and a videoassisted thoracic biopsy were negative. Method: X-ray confirmed small bowel obstruction and an emergency laparotomy performed. The terminal ileum was intussuscepted into the caecum causing proximal obstruction. A right hemi-colectomy was performed. Results: On gross examination there was intussusception of the terminal ileum secondary to a polypoid mass at the ileo-caecal valve. Histology showed an oncocytic tumour with neuroendocrine features arising from the serosa of the small bowel. The tumour cells were positive for CK7, calretinin, and vimentin but negative for CK20, chromograninA, CD56 and TTF-1. The features were in keeping with a malignant peritoneal mesothelioma infiltrating the small bowel wall. Conclusion: Peritoneal malignant mesothelioma is an uncommon tumour which rarely causes mechanical small bowel obstruction. To our knowledge this is the first case of localised primary peritoneal mesothelioma presenting with intussusceptions.