26
|
Escudier B, Porta C, Schmidinger M, Rioux-Leclercq N, Bex A, Khoo V, Gruenvald V, Horwich A. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016; 27:v58-v68. [DOI: 10.1093/annonc/mdw328] [Citation(s) in RCA: 368] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
|
27
|
Hafeez S, Horwich A, Omar O, Mohammed K, Thompson A, Kumar P, Khoo V, Van As N, Eeles R, Dearnaley D, Huddart R. Selective organ preservation with neo-adjuvant chemotherapy for the treatment of muscle invasive transitional cell carcinoma of the bladder. Br J Cancer 2016; 114:e24. [PMID: 27228294 PMCID: PMC4984461 DOI: 10.1038/bjc.2016.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
28
|
Henderson D, Ostler P, Tree A, Hoskin P, Dankulchai P, Taylor H, Khoo V, van As N. First UK Prostate Stereotactic Body Radiotherapy (SBRT) Cohort: Prospective Outcomes with 2.5 Years’ Median Follow-up. Clin Oncol (R Coll Radiol) 2016. [DOI: 10.1016/j.clon.2015.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
29
|
Chaw C, Henderson D, Khoo V, Tree A, Eeles R, Van As N. OC-0447: Stereotactic Body Radiotherapy (SBRT) in oligometastatic prostate cancer patients. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
Khoo V. SP-0507: Bladder variability for pelvic radiotherapy: its approaches and impact. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
31
|
Mansfield DC, Kyula JN, Rosenfelder N, Chao-Chu J, Kramer-Marek G, Khan AA, Roulstone V, McLaughlin M, Melcher AA, Vile RG, Pandha HS, Khoo V, Harrington KJ. Oncolytic vaccinia virus as a vector for therapeutic sodium iodide symporter gene therapy in prostate cancer. Gene Ther 2016; 23:357-68. [PMID: 26814609 PMCID: PMC4827015 DOI: 10.1038/gt.2016.5] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/07/2015] [Accepted: 01/13/2016] [Indexed: 12/16/2022]
Abstract
Oncolytic strains of vaccinia virus are currently in clinical development with clear evidence of safety and promising signs of efficacy. Addition of therapeutic genes to the viral genome may increase the therapeutic efficacy of vaccinia. We evaluated the therapeutic potential of vaccinia virus expressing the sodium iodide symporter (NIS) in prostate cancer models, combining oncolysis, external beam radiotherapy and NIS-mediated radioiodide therapy. The NIS-expressing vaccinia virus (VV-NIS), GLV-1h153, was tested in in vitro analyzes of viral cell killing, combination with radiotherapy, NIS expression, cellular radioiodide uptake and apoptotic cell death in PC3, DU145, LNCaP and WPMY-1 human prostate cell lines. In vivo experiments were carried out in PC3 xenografts in CD1 nude mice to assess NIS expression and tumor radioiodide uptake. In addition, the therapeutic benefit of radioiodide treatment in combination with viral oncolysis and external beam radiotherapy was measured. In vitro viral cell killing of prostate cancers was dose- and time-dependent and was through apoptotic mechanisms. Importantly, combined virus therapy and iodizing radiation did not adversely affect oncolysis. NIS gene expression in infected cells was functional and mediated uptake of radioiodide both in vitro and in vivo. Therapy experiments with both xenograft and immunocompetent Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) mouse models showed that the addition of radioiodide to VV-NIS-infected tumors was more effective than each single-agent therapy, restricting tumor growth and increasing survival. In conclusion, VV-NIS is effective in prostate cancer models. This treatment modality would be an attractive complement to existing clinical radiotherapy practice.
Collapse
|
32
|
Khoo V, Pabary R, Lund Palau H, Turnbull A, Madden N, Schelenz S, Jones A, Morales S, Alton EWFW, Davies JC. S112 Variability in susceptibility to antibiotics and bacteriophages between individual colonies of Pseudomonas aeruginosa from cystic fibrosis sputum samples: implications for future clinical trial design. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Dearnaley D, Syndikus I, Mossop H, Birtle A, Bloomfield D, Cruickshank C, Graham J, Hassan S, Khoo V, Logue J, Mayles H, Money-Kyrle J, Naismith O, Panades M, Patterson H, Scrase C, Staffurth J, Tremlett J, Griffin C, Hall E. 8LBA 5 year outcomes of a phase III randomised trial of conventional or hypofractionated high dose intensity modulated radiotherapy for prostate cancer (CRUK/06/016): report from the CHHiP Trial Investigators Group. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31932-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
Aitken K, Tree A, Thomas K, Nutting C, Hawkins M, Tait D, Mandeville H, Ahmed M, Lalondrelle S, Miah A, Taylor A, Ross G, Khoo V, van As N. Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm? Clin Oncol (R Coll Radiol) 2015; 27:411-9. [PMID: 25912366 DOI: 10.1016/j.clon.2015.03.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 03/10/2015] [Accepted: 03/19/2015] [Indexed: 12/21/2022]
Abstract
AIMS To retrospectively review the toxicity and early outcome data from patients who have received stereotactic body radiotherapy (SBRT) for extracranial oligometastases at a single UK institution. MATERIALS AND METHODS Eligible patients had ≤3 extracranial metastases and performance status ≤2. Prior systemic therapy and radical treatment of oligometastastic relapse with any standard treatment modality was permitted. Patients with synchronous metastatic disease were excluded unless they had evidence of controlled primary disease after radical therapy. Follow-up consisted of clinical examination, biochemical and radiological assessments in accordance with standard clinical care. Progression events were defined using RECIST. Toxicity was evaluated using CTCAE v4.0. Local control, progression-free survival (PFS), freedom from widespread distant metastasis (defined as disease not amenable to further radical salvage therapy) and overall survival were calculated. RESULTS Between July 2011 and April 2014, 73 patients with 87 metastases received SBRT (range 1-3 per patient). The median follow-up was 14.5 months (range 0-26.4). The median PFS was 14.5 months (1 year PFS 57%, 2 year 28%); 1 year overall survival 96%, 2 year 79.8%; 2 year local control 88%. At 2 years, 46% of patients were free from widespread distant metastases. No ≥ grade 3 acute or late toxicity was observed. CONCLUSION At this time point, observed toxicity is minimal with excellent local control rates. This promising treatment paradigm requires further investigation in the context of a randomised controlled trial to establish if the addition of SBRT to standard care improves survival outcomes.
Collapse
|
35
|
Hafeez S, Horwich A, Omar O, Mohammed K, Thompson A, Kumar P, Khoo V, Van As N, Eeles R, Dearnaley D, Huddart R. Selective organ preservation with neo-adjuvant chemotherapy for the treatment of muscle invasive transitional cell carcinoma of the bladder. Br J Cancer 2015; 112:1626-35. [PMID: 25897675 PMCID: PMC4430712 DOI: 10.1038/bjc.2015.109] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 02/12/2015] [Accepted: 02/23/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Radiotherapy for muscle invasive bladder cancer (MIBC) aims to offer organ preservation without oncological compromise. Neo-adjuvant chemotherapy provides survival advantage; response may guide patient selection for bladder preservation and identify those most likely to have favourable result with radiotherapy. METHODS Ninety-four successive patients with T2-T4aN0M0 bladder cancer treated between January 2000 and June 2011 were analysed at the Royal Marsden Hospital. Patients received platinum-based chemotherapy following transurethral resection of bladder tumour; repeat cystoscopy (± biopsy) was performed to guide subsequent management. Responders were treated with radiotherapy. Poor responders were recommended radical cystectomy. Progression-free survival (PFS), disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meier method; univariate and multivariate analyses were performed using the Cox proportional hazard regression model. RESULTS Response assessment was performed in 89 patients. Seventy-eight (88%) demonstrated response; 53 (60%) achieved complete response (CR); 74 responders had radiotherapy; 4 opted for cystectomy. Eleven (12%) demonstrated poor response, 10 received cystectomy. Median survival for CR was 90 months (95% CI 64.7, 115.9) compared with 16 months (95% CI 5.4, 27.4; P < 0.001) poor responders. On multivariate analysis, only response was associated with significantly improved PFS, OS and DSS. After a median follow-up of 39 months (range 4-127 months), 14 patients (16%) required salvage cystectomy (8 for non-muscle invasive disease, 5 for invasive recurrence, 1 for radiotherapy related toxicity). In all, 82% had an intact bladder at last follow-up after radiotherapy; 67% had an intact bladder at last follow-up or death. Our study is limited by its retrospective nature. CONCLUSIONS Response to neo-adjuvant chemotherapy is a favourable prognostic indicator and can be used to select patients for radiotherapy allowing bladder preservation in >80% of the selected patients.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carcinoma, Transitional Cell/drug therapy
- Carcinoma, Transitional Cell/pathology
- Carcinoma, Transitional Cell/radiotherapy
- Carcinoma, Transitional Cell/surgery
- Chemotherapy, Adjuvant
- Cisplatin/administration & dosage
- Cystectomy/methods
- Disease-Free Survival
- Female
- Humans
- Male
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/radiotherapy
- Neoplasm Recurrence, Local/surgery
- Organ Preservation/methods
- Retrospective Studies
- Salvage Therapy/methods
- Treatment Outcome
- Urinary Bladder/drug effects
- Urinary Bladder/pathology
- Urinary Bladder/radiation effects
- Urinary Bladder/surgery
Collapse
|
36
|
Hafeez S, McDonald F, Lalondrelle S, McNair H, Warren-Oseni K, Jones K, Harris V, Taylor H, Khoo V, Thomas K, Hansen V, Dearnaley D, Horwich A, Huddart R. EP-1240: Clinical outcomes of image guided adaptive radiotherapy (IGART) for hypofractionated treatment of bladder cancer. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
37
|
Khoo V. SP-0589: Lymph nodes. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40583-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
38
|
Henderson D, Tree A, Taylor H, Khoo V, Van As N. EP-1241: SBRT for localised prostate cancer: an evaluation of toxicity with frequent prospective assessment. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
39
|
Anderson N, Jackson J, Khoo V, Schneider M, Rolfo M, Gan H, Kaegi K, Sneyd F, Lim Joon D, Wada M. Gross Tumor Volume Size and Oral Cavity Dose Drive Dysphagia in Definitive (Chemo) IMRT for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
40
|
Escudier B, Porta C, Schmidinger M, Algaba F, Patard J, Khoo V, Eisen T, Horwich A. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014; 25 Suppl 3:iii49-56. [DOI: 10.1093/annonc/mdu259] [Citation(s) in RCA: 284] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
41
|
Tree A, Siu B, Townsend-Thorn D, Murray D, Riley U, Khoo V, van As N. The Incidence of Ciprofloxacin Resistance in Patients Undergoing Gold Seed Insertion for Image-guided Prostate Radiotherapy. Clin Oncol (R Coll Radiol) 2014. [DOI: 10.1016/j.clon.2014.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
42
|
Tree A, Ostler P, Hoskin P, Dankulchai P, Khoo V, van As N. First UK Cohort of Prostate Stereotactic Body Radiotherapy (SBRT): Acute Toxicity and Early Prostate-specific Antigen (PSA) Outcomes. Clin Oncol (R Coll Radiol) 2014. [DOI: 10.1016/j.clon.2013.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
43
|
Khoo V. SP-0113: Do we need elective nodal irradiation in prostate cancer? Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
44
|
Anderson N, Jackson J, Wada M, Schneider-Kolsky M, Rolfo M, Gan H, Kaegi K, Sneyd F, Lim Joon D, Khoo V. Creating Guidelines for Reactive and Prophylactic Enteral Feeding in Definitive (Chemo) IMRT for Head-and-Neck Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
45
|
McDonald F, Lalondrelle S, Taylor H, Warren-Oseni K, Khoo V, McNair H, Harris V, Hafeez S, Hansen V, Thomas K, Jones K, Dearnaley D, Horwich A, Huddart R. Clinical Implementation of Adaptive Hypofractionated Bladder Radiotherapy for Improvement in Normal Tissue Irradiation. Clin Oncol (R Coll Radiol) 2013; 25:549-56. [DOI: 10.1016/j.clon.2013.06.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/15/2013] [Accepted: 04/16/2013] [Indexed: 11/25/2022]
|
46
|
|
47
|
Creak A, Hall E, Horwich A, Eeles R, Khoo V, Huddart R, Parker C, Griffin C, Bidmead M, Warrington J, Dearnaley D. Randomised pilot study of dose escalation using conformal radiotherapy in prostate cancer: long-term follow-up. Br J Cancer 2013; 109:651-7. [PMID: 23880826 PMCID: PMC3738135 DOI: 10.1038/bjc.2013.394] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 06/10/2013] [Accepted: 06/22/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Radical three-dimensional conformal radiotherapy (CFRT) with initial androgen suppression (AS) is a standard management for localised prostate cancer (PC). This pilot study evaluated the role of dose escalation and appropriate target volume margin. Here, we report long-term follow-up. METHODS Eligible patients had T1b-T3b N0 M0 PC. After neoadjuvant AS, they were randomised to CFRT, giving (a) 64 Gy with either a 1.0- or 1.5-cm margin and (b) ±10 Gy boost to the prostate alone. RESULTS One hundred and twenty-six men were randomised and treated. Median follow-up was 13.7 years. The median age was 66.6 years at randomisation. Median presenting prostate-specific antigen (PSA) was 14 ng ml(-1). Sixty-four out of 126 patients developed PSA failure. Forty-nine out of 126 patients restarted AS, 34 out of 126 developed metastases and 28 out of 126 developed castrate-resistant prostate cancer (CRPC). Fifty-one out of 126 patients died; 19 out of 51 died of PC. Median overall survival (OS) was 14.4 years. Although escalated dose results were favourable, no statistically significant differences were seen between the randomised groups; PSA control (hazard ratio (HR): 0.77 (95% confidence interval (CI): 0.47-1.26)), development of CRPC (HR: 0.81 (95% CI: 0.40-1.65)), PC-specific survival (HR: 0.59 (95% CI:0.23-1.49)) and OS (HR: 0.81 (95% CI: 0.47-1.40)). There was no evidence of a difference in PSA control according to margin size (HR: 1.01 (95% CI: 0.61-1.66)). INTERPRETATION Long-term follow-up of this small pilot study is compatible with a benefit from dose escalation, but confirmation from larger trials is required. There was no obvious detriment using the smaller radiotherapy margin.
Collapse
|
48
|
Tree A, Alexander E, Van As N, Dearnaley D, Khoo V. Biological Dose Escalation and Hypofractionation: What is There to be Gained and How Will it Best be Done? Clin Oncol (R Coll Radiol) 2013; 25:483-98. [DOI: 10.1016/j.clon.2013.05.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/09/2013] [Indexed: 12/12/2022]
|
49
|
Khoo V, Loblaw DA. Prostate cancer: current status, new developments and applications in radiotherapy. Clin Oncol (R Coll Radiol) 2013; 25:449-50. [PMID: 23756325 DOI: 10.1016/j.clon.2013.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 05/09/2013] [Indexed: 11/15/2022]
|
50
|
Tree A, Wells E, Khoo V, van As N. Hypofractionated Radiotherapy with Cyberknife for Localised Prostate Cancer: Early Experience. Clin Oncol (R Coll Radiol) 2013. [DOI: 10.1016/j.clon.2012.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|