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Background: The PI3K/Akt/mTOR pathway in part impacts tumorigenesis through modulation of host immune activity. To assess the effects of Akt inhibition on the tumor micro-environment (TME), we analyzed tumor tissue from patients with operable hormone receptor positive, HER2 negative breast cancer (BC) treated on a presurgical trial with the Akt inhibitor MK-2206.Methods: Quantitative multiplex immunofluorescence (qmIF) was performed using CD3, CD8, CD4, FOXP3, CD68, and pancytokeratin on biopsy and surgical specimens of MK-2206 and untreated, control patients. nanoString was performed on surgical specimens to assess mRNA expression from MK-2206-treated vs. control patients.Results: Increased CD3+CD8+ density was observed in post vs. pre-treatment tissue in the MK-2206-treated vs. control patients (87 vs. 0.2%, p < 0.05). MK-2206 was associated with greater expression of interferon signaling genes (e.g., IFI6, p < 0.05) and lower expression of myeloid genes (CD163, p < 0.05) on differential expression and gene set enrichment analyses. Greater expression of pro-apoptotic genes (e.g., BAD) were associated with MK-2206 treatment (p < 0.05).Conclusion: Akt inhibition in operable BC was associated with a favorable immune profile in the TME, including increased CD3+CD8+ density and greater expression of interferon genes. Additional studies are warranted, as this may provide rationale for combining Akt inhibition with immunotherapy.

Breast conserving surgery (BCS) has become the preferred surgical option for the management of patients with nonmetastatic breast cancer in high-income countries. However, little is known about the distribution and determinants of BCS in low-and middle-income countries, especially those with high HIV prevalence.We compared demographic and clinical characteristics of female patients who received BCS and those who received total mastectomy (TM) for nonmetastatic invasive carcinoma of the breast in Soweto, South Africa, 2009-2011. We also developed a multivariable logistic regression model of predictors of type of surgery.Of 445 patients, 354 (80%) underwent TM and 91 (20%) BCS. Of 373 patients screened for HIV, 59 (15.8%) tested positive. Eighty-two of 294 patients with stage I/II disease (28%), but just 9 of 151 (6%) with stage III disease had BCS (p

Throughout the 1900s in the United States of America, many new towns and settlements in Florida and the Southwest used tourism to attract wealthy visitors, causing conflict between the needs of local residents and the resort economy. This paper looks at the role of the elite San Marcos Hotel in the small farming town of Chandler, 25 miles south of Phoenix, Arizona, during the first three decades of the town's life. The study traces evolving responses among the town's white farming community, noting a shift over 30 years from an enthusiastic identification with the hotel and associated luxuries, to a simpler farm ethic. The study contributes to growing research about resort architecture and themed environments, both in the context of US history and as a growing concern in today's world of accelerating global tourism. Throughout the late 1800s and early 1900s in the United States, many new towns in Florida and the Southwest used tourism to attract wealthy visitors for investment and potential settlement. Common resort elements included ambitiously designed luxurious hotels, themes of luxurious living, and a focus on wealthy clients, often creating sharp contrasts with ordinary residents (Moehring, 1989; Dodrill, 1993; Nicolaides, 1998).