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Twumasi C, Moore S, Sadler R, Jeans S, Varghese S, Turner A, Agarwal G, Larham J, Gray N, Carty O, Barrett J, Bowcock S, Oppermann U, Gamble V, Cook G, Kyriakou C, Drayson M, Basu S, McDonald S, McKinley S, Gooding S, Javaid MK, Ramasamy K. Determinants of durable humoral and T cell immunity in myeloma patients following COVID-19 vaccination. Eur J Haematol 2024; 112:547-553. [PMID: 38116695 DOI: 10.1111/ejh.14143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To describe determinants of persisting humoral and cellular immune response to the second COVID-19 vaccination among patients with myeloma. METHODS This is a prospective, observational study utilising the RUDYstudy.org platform. Participants reported their second and third COVID-19 vaccination dates. Myeloma patients had an Anti-S antibody level sample taken at least 21 days after their second vaccination and a repeat sample before their third vaccination. RESULTS 60 patients provided samples at least 3 weeks (median 57.5 days) after their second vaccination and before their third vaccination (median 176.0 days after second vaccine dose). Low Anti-S antibody levels (<50 IU/mL) doubled during this interval (p = .023) and, in the 47 participants with T-spot data, there was a 25% increase negative T-spot tests (p = .008). Low anti-S antibody levels prior to the third vaccination were predicted by lower Anti-S antibody level and negative T-spot status after the second vaccine. Independent determinants of a negative T-spot included increasing age, previous COVID infection, high CD4 count and lower percentage change in Anti-S antibody levels. CONCLUSIONS Negative T-spot results predict low Anti-S antibody levels (<50 IU/mL) following a second COVID-19 vaccination and a number of biomarkers predict T cell responses in myeloma patients.
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Affiliation(s)
- Clement Twumasi
- School of Public Health, Imperial College London, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sally Moore
- Bath Royal United Hospitals, Oxford University Hospitals NHS Trust, Bath, UK
| | - Ross Sadler
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Sherin Varghese
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Alison Turner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gaurav Agarwal
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Jemma Larham
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Nathanael Gray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Oluremi Carty
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Joe Barrett
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stella Bowcock
- Department of Haematology, King's College Hospital NHS Trust, London, UK
| | - Udo Oppermann
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Vicky Gamble
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gordon Cook
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Chara Kyriakou
- Department of Haematology, University College London Hospitals NHS Trust, London, UK
| | - Mark Drayson
- Division of Immunity and Infection, University of Birmingham, Birmingham, UK
| | - Supratik Basu
- Department of Haematology, University of Wolverhampton, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | | | | | - Sarah Gooding
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
- MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Karthik Ramasamy
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
- Radcliffe Department of Medicine, Oxford University, Oxford, UK
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2
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Song K, Shrestha R, Delaney H, Vijjhalwar R, Turner A, Sanchez M, Javaid MK. Diagnostic journey for individuals with fibrous dysplasia / McCune albright syndrome (FD/MAS). Orphanet J Rare Dis 2024; 19:50. [PMID: 38326833 PMCID: PMC10851567 DOI: 10.1186/s13023-024-03036-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Reducing delayed diagnosis is a significant healthcare priority for individuals with rare diseases. Fibrous Dysplasia/ McCune Albright Syndrome (FD/MAS) is a rare bone disease caused by somatic activation mutations of NASA. FD/MAS has a broad clinical phenotype reflecting variable involvement of bone, endocrine and other tissues, distribution and severity. The variable phenotype is likely to prolong the diagnostic journey for patients further. AIM To describe the time from symptom onset to final diagnosis in individuals living with FDMAS. METHODS We used the UK-based RUDY research database ( www.rudystudy.org ), where patients self-report their diagnosis of FD/MAS. Participants are invited to complete the diagnostic journey based on the EPIRARE criteria. RESULTS 51 individuals diagnosed with FD/MAS were included in this analysis. Among them, 70% were female, and the median age was 51.0 years (IQR 34.5-57.5]. 12 (35%) individuals reported McCune Albright Syndrome, 11 (21.6%) craniofacial and 11(21.6%) for each of poly- and mono-ostotic FD and 6 (11.8%) did not know their type of FD/MAS. Pain was the commonest first symptom (58.8%), and 47.1% received another diagnosis before the diagnosis of FD/MAS. The median time to final diagnosis from the first symptom was two years with a wide IQR (1,18) and range (0-59 years). Only 12 (23.5%) of individuals were diagnosed within 12 months of their first symptoms. The type of FD/MAS was not associated with the reported time to diagnosis. Significant independent predictors of longer time to final diagnosis included older current age, younger age at first symptom and diagnosis after 2010. CONCLUSION Individuals with FDMAS have a variable time to diagnosis that can span decades. This study highlights the need for further research on how to improve diagnostic pathways within Orthopaedic and Ear, Nose and Throat (ENT)/Maxillofacial services. Our data provides a baseline to assess the impact of novel NHS diagnostic networks on reducing the diagnostic odyssey.
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Affiliation(s)
- Kaiyang Song
- Medical Sciences Division, University of Oxford, Headley Way, OX3 9DU, Oxford, USA.
| | | | | | - Rohit Vijjhalwar
- Medical Sciences Division, University of Oxford, Headley Way, OX3 9DU, Oxford, USA
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Agarwal G, Moore S, Sadler R, Varghese S, Turner A, Chen LY, Larham J, Gray N, Carty O, Barrett J, Koshiaris C, Kothari J, Bowcock S, Oppermann U, Gamble V, Cook G, Kyriakou C, Drayson M, Basu S, McDonald S, McKinley S, Gooding S, Javaid MK, Ramasamy K. Longitudinal dynamics and clinically available predictors of poor response to COVID-19 vaccination in multiple myeloma. Haematologica 2024. [PMID: 38268439 DOI: 10.3324/haematol.2023.284286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Indexed: 01/26/2024] Open
Abstract
Not available.
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Affiliation(s)
- Gaurav Agarwal
- Division of Haematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | | | - Ross Sadler
- Oxford University Hospitals NHS Trust, Oxford
| | | | - Alison Turner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford
| | | | | | - Nathanael Gray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford
| | | | - Joe Barrett
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford
| | | | | | | | - Udo Oppermann
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford
| | - Vicky Gamble
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford
| | - Gordon Cook
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds
| | | | | | - Supratik Basu
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK; University of Wolverhampton, Wolverhampton
| | | | | | - Sarah Gooding
- Oxford University Hospitals NHS Trust, Oxford, UK; MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford
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Turner A, Levien A. Primary anastomosis of segmental external auditory canal atresia in one dog. Aust Vet J 2023; 101:449-452. [PMID: 37587768 DOI: 10.1111/avj.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/28/2023] [Accepted: 07/29/2023] [Indexed: 08/18/2023]
Abstract
This report describes a case of canine segmental external auditory canal atresia (EACA). The dog was managed medically with non-steroidal anti-inflammatory drugs until clinical deterioration, at which time a novel and successful end-to-end anastomosis surgical repair was performed. At the 30 day postoperative re-examination, the dog was clinically well and otoscopy confirmed that there was no evidence of auditory canal stenosis. The patient remained free of ongoing issues 20 months after the surgery. End-to-end anastomosis should be considered for treatment of developmental segmental EACA in the canine.
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Affiliation(s)
- A Turner
- Veterinary Specialists of Sydney, Sydney, New South Wales, Australia
| | - A Levien
- Veterinary Specialists of Sydney, Sydney, New South Wales, Australia
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Guo C, Sharp A, Gurel B, Crespo M, Figueiredo I, Jain S, Vogl U, Rekowski J, Rouhifard M, Gallagher L, Yuan W, Carreira S, Chandran K, Paschalis A, Colombo I, Stathis A, Bertan C, Seed G, Goodall J, Raynaud F, Ruddle R, Swales KE, Malia J, Bogdan D, Tiu C, Caldwell R, Aversa C, Ferreira A, Neeb A, Tunariu N, Westaby D, Carmichael J, Fenor de la Maza MD, Yap C, Matthews R, Badham H, Prout T, Turner A, Parmar M, Tovey H, Riisnaes R, Flohr P, Gil J, Waugh D, Decordova S, Schlag A, Calì B, Alimonti A, de Bono JS. Targeting myeloid chemotaxis to reverse prostate cancer therapy resistance. Nature 2023; 623:1053-1061. [PMID: 37844613 PMCID: PMC10686834 DOI: 10.1038/s41586-023-06696-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
Inflammation is a hallmark of cancer1. In patients with cancer, peripheral blood myeloid expansion, indicated by a high neutrophil-to-lymphocyte ratio, associates with shorter survival and treatment resistance across malignancies and therapeutic modalities2-5. Whether myeloid inflammation drives progression of prostate cancer in humans remain unclear. Here we show that inhibition of myeloid chemotaxis can reduce tumour-elicited myeloid inflammation and reverse therapy resistance in a subset of patients with metastatic castration-resistant prostate cancer (CRPC). We show that a higher blood neutrophil-to-lymphocyte ratio reflects tumour myeloid infiltration and tumour expression of senescence-associated mRNA species, including those that encode myeloid-chemoattracting CXCR2 ligands. To determine whether myeloid cells fuel resistance to androgen receptor signalling inhibitors, and whether inhibiting CXCR2 to block myeloid chemotaxis reverses this, we conducted an investigator-initiated, proof-of-concept clinical trial of a CXCR2 inhibitor (AZD5069) plus enzalutamide in patients with metastatic CRPC that is resistant to androgen receptor signalling inhibitors. This combination was well tolerated without dose-limiting toxicity and it decreased circulating neutrophil levels, reduced intratumour CD11b+HLA-DRloCD15+CD14- myeloid cell infiltration and imparted durable clinical benefit with biochemical and radiological responses in a subset of patients with metastatic CRPC. This study provides clinical evidence that senescence-associated myeloid inflammation can fuel metastatic CRPC progression and resistance to androgen receptor blockade. Targeting myeloid chemotaxis merits broader evaluation in other cancers.
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Affiliation(s)
- Christina Guo
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Adam Sharp
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Bora Gurel
- The Institute of Cancer Research, London, UK
| | | | | | - Suneil Jain
- Northern Ireland Cancer Centre, Belfast, UK
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Ursula Vogl
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | | | | | | | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | | | - Khobe Chandran
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Alec Paschalis
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Ilaria Colombo
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Anastasios Stathis
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | | | - George Seed
- The Institute of Cancer Research, London, UK
| | | | | | - Ruth Ruddle
- The Institute of Cancer Research, London, UK
| | | | - Jason Malia
- The Institute of Cancer Research, London, UK
| | | | - Crescens Tiu
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | - Antje Neeb
- The Institute of Cancer Research, London, UK
| | - Nina Tunariu
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Daniel Westaby
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Juliet Carmichael
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | | | - Toby Prout
- The Institute of Cancer Research, London, UK
| | | | - Mona Parmar
- The Institute of Cancer Research, London, UK
| | - Holly Tovey
- The Institute of Cancer Research, London, UK
| | | | - Penny Flohr
- The Institute of Cancer Research, London, UK
| | - Jesus Gil
- MRC London Institute of Medical Sciences (LMS), London, UK
- Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, London, UK
| | - David Waugh
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
- Centre for Cancer Biology, University of South Australia, Adelaide, South Australia, Australia
| | | | - Anna Schlag
- The Institute of Cancer Research, London, UK
| | - Bianca Calì
- Institute of Oncology Research, Bellinzona, Switzerland
| | - Andrea Alimonti
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
- Institute of Oncology Research, Bellinzona, Switzerland
- Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), Zurich, Switzerland
- Department of Medicine, Veneto Institute of Molecular Medicine, University of Padova, Padua, Italy
| | - Johann S de Bono
- The Institute of Cancer Research, London, UK.
- The Royal Marsden NHS Foundation Trust, London, UK.
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Turner A, Abbott E. Combined Radiotherapy Using a Method for Biologically Informed IMRT Planning. Int J Radiat Oncol Biol Phys 2023; 117:e729. [PMID: 37786122 DOI: 10.1016/j.ijrobp.2023.06.2246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiotherapy (RT) regimens routinely employ multiple courses that vary by delivery modality and/or fractionation schedule as part of initial or follow up treatment. The combination of RTs ideally should consider the biological effect of the total composite dose distribution. Biological effect can be quantified by biological effective dose (BED) which is a function of the RT modality, dose fractionation, and tissue radiosensitivity. This work describes a method of optimizing a follow up intensity modulated RT (IMRT) plan that considers BED from prior RT. MATERIALS/METHODS Required inputs for this method are the desired composite BED objectives (BEDref) for target volume(s) and organs at risk (OARs). First, the physical dose in each CT voxel from prior RT (Dprior) is converted to BED (BEDprior). The difference between BEDref and BEDprior gives the optimal BED distribution for the follow up IMRT plan (BEDIMRT). Next, the optimal physical dose (DIMRT) corresponding to BEDIMRT is calculated for each voxel as a function of the number of IMRT fractions (nIMRT). Commercial IMRT treatment planning systems require optimization objectives to be specified for contoured structures, not individual voxels, so a workaround is proposed: 1) for each structure, BEDref is converted to physical dose (Dopti) as a function of nIMRT, and 2) for each voxel, the difference of Dopti and DIMRT is calculated. The result is a "base dose distribution" (Dbase) that is used with standard inverse optimization tools to optimize an IMRT plan so that the sum of Dbase and the IMRT dose approaches Dopti for each voxel. This method was implemented using a custom software workflow to calculate Dbase as a function of Dprior and input BEDref values. Validation was performed by comparing the workflow output with hand calculated Dbase values at randomly selected points within clinically significant regions. Satisfactory agreement was considered to be within 5%. RESULTS Feasibility of the method was demonstrated using an RT trial protocol for glioblastoma multiforme that combines permanent low dose rate brachytherapy (BT) using collagen tiles embedded with 131Cs seeds and follow-up IMRT (20 fractions). The Dbase distribution was obtained from the software as a function of the BT dose and BEDref for one patient model. Comparison of Dbase values from the software and hand calculated values resulted in agreement within 5% for 22/25 points and within 10% for 3/25 points. Discrepancies >5% (max 9.4%) were attributed to data precision resolution effects inherent in the DICOM standard. The resulting IMRT plan was deemed clinically acceptable and the composite dose distribution achieved dosimetric objectives for all target and OARs. CONCLUSION A method for optimizing a follow up IMRT plan that considers dose from prior RT to produce a desired composite BED distribution was derived and proof of concept was successfully demonstrated. Further validation of this method with additional patients and multimodality RT protocols will be performed.
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Affiliation(s)
- A Turner
- GT Medical Technologies, Tempe, AZ
| | - E Abbott
- MIM Software, Inc, Cleveland, OH
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7
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Whitten C, Turner A, Howell B, Sparkes B, Ricciardelli R, Daley P. Retrospective review of rates of sexually transmitted and blood-borne infection (STBBI) testing in provincial corrections facilities in Newfoundland and Labrador. J Assoc Med Microbiol Infect Dis Can 2023; 8:141-149. [PMID: 38250290 PMCID: PMC10795699 DOI: 10.3138/jammi-2022-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/27/2023] [Indexed: 01/23/2024]
Abstract
Background Sexually transmitted and blood borne infection (STBBI) testing is recommended for people who are incarcerated (PWAI). We sought to determine the rate of STBBI testing during admissions to provincial correctional institutions in Newfoundland and Labrador (NL). Methods This retrospective cohort study collected the identification of all admissions records in provincial correctional facilities in NL between July 1, 2020 and June 31, 2021 using the Provincial Corrections Offender Maintenance System database. Admissions to provincial detention centers were excluded. Records were linked with STBBI results, when available, within the electronic medical record (Meditech) using demographics. Testing rates, STBBI positivity rates, and univariate analysis of predictors for STBBI testing were completed. Results Of the 1,824 admissions identified, 1,716 were available for linkage to laboratory results. Admissions to detention centers (n = 105) were excluded. Any STBBI test result was available for 72 (4.5%) of admissions. No admission had complete testing for all STBBI. Facility testing rates ranged from 1.9 to 11.2% and 37.5% of STBBI tests had any positive results. Sixteen out of the 21 (76.2%) hepatitis C virus (HCV) antibody positives received HCV RNA testing, and 11/16 (88.8%) were HCV RNA positive. Institution (p = 0.001) and sex (p = 0.004) were found to be significant predictors of STBBI testing, while age was not significant (p = 0.496). Conclusions STBBI testing rates were low in provincial correctional facilities in NL, and STBBI prevalence, especially for HCV, was high among those tested. Strategies to increase the rate of testing could contribute to STBBI control in corrections facilities.
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Affiliation(s)
- Cindy Whitten
- Eastern Health, St. John’s, Newfoundland and Labrador, Canada
- Memorial University, Faculty of Humanities and Social Sciences, St. John’s, Newfoundland and Labrador, Canada
| | - Alison Turner
- Eastern Health, St. John’s, Newfoundland and Labrador, Canada
| | - Brittany Howell
- Eastern Health, St. John’s, Newfoundland and Labrador, Canada
| | | | - Rosemary Ricciardelli
- Memorial University, Faculty of Humanities and Social Sciences, St. John’s, Newfoundland and Labrador, Canada
| | - Peter Daley
- Eastern Health, St. John’s, Newfoundland and Labrador, Canada
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Ho TNT, Turner A, Pham SH, Nguyen HT, Nguyen LTT, Nguyen LT, Dang TT. Cysteine-rich peptides: From bioactivity to bioinsecticide applications. Toxicon 2023; 230:107173. [PMID: 37211058 DOI: 10.1016/j.toxicon.2023.107173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/23/2023]
Abstract
Greater levels of insect resistance and constraints on the use of current pesticides have recently led to increased crop losses in agricultural production. Further, the health and environmental impacts of pesticides now restrict their application. Biologics based on peptides are gaining popularity as efficient crop protection agents with low environmental toxicity. Cysteine-rich peptides (whether originated from venoms or plant defense substances) are chemically stable and effective as insecticides in agricultural applications. Cysteine-rich peptides fulfill the stability and efficacy requirements for commercial uses and provide an environmentally benign alternative to small-molecule insecticides. In this article, cysteine-rich insecticidal peptide classes identified from plants and venoms will be highlighted, focusing on their structural stability, bioactivity and production.
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Affiliation(s)
- Thao N T Ho
- Institute of Applied Materials Science, Vietnam Academy of Science and Technology, 1B TL29, District 12, Ho Chi Minh City, Viet Nam
| | - A Turner
- Molecular Biology Department, University of Texas, 100 E 24th St. Austin, USA
| | - Son H Pham
- Institute of Applied Materials Science, Vietnam Academy of Science and Technology, 1B TL29, District 12, Ho Chi Minh City, Viet Nam
| | - Ha T Nguyen
- National Key Laboratory of Polymer and Composite Materials, Department of Energy Materials, Faculty of Materials Technology, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet Street, District 10, Ho Chi Minh City, Viet Nam; Vietnam National University Ho Chi Minh City, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, Viet Nam
| | - Linh T T Nguyen
- Department of Chemistry, Ho Chi Minh City University of Education, 280 an Duong Vuong Street, District 5, Ho Chi Minh City, Viet Nam
| | - Luan T Nguyen
- National Key Laboratory of Polymer and Composite Materials, Department of Energy Materials, Faculty of Materials Technology, Ho Chi Minh City University of Technology (HCMUT), 268 Ly Thuong Kiet Street, District 10, Ho Chi Minh City, Viet Nam; Vietnam National University Ho Chi Minh City, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, Viet Nam
| | - Tien T Dang
- Institute of Applied Materials Science, Vietnam Academy of Science and Technology, 1B TL29, District 12, Ho Chi Minh City, Viet Nam.
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van Balkom ID, Burdeus-Olavarrieta M, Cooke J, de Cuba AG, Turner A. Consensus recommendations on mental health issues in Phelan-McDermid syndrome. Eur J Med Genet 2023; 66:104770. [PMID: 37085014 DOI: 10.1016/j.ejmg.2023.104770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 04/23/2023]
Abstract
Phelan-McDermid syndrome is a rare genetic condition caused by a deletion encompassing the 22q13.3 region or a pathogenic variant of the gene SHANK3. The clinical presentation is variable, but main characteristics include global developmental delay/intellectual disability (ID), marked speech impairment or delay, along with other features like hypotonia and somatic or psychiatric comorbidities. This publication delineates mental health, developmental and behavioural themes across the lifetime of individuals with PMS as informed by parents/caregivers, experts, and other key professionals involved in PMS care. We put forward several recommendations based on the available literature concerning mental health and behaviour in PMS. Additionally, this article aims to improve our awareness of the importance of considering developmental level of the individual with PMS when assessing mental health and behavioural issues. Understanding how the discrepancy between developmental level and chronological age may impact concerning behaviours offers insight into the meaning of those behaviours and informs care for individuals with PMS, enabling clinicians to address unmet (mental health) care needs and improve quality of life.
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Affiliation(s)
- Ingrid Dc van Balkom
- Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, the Netherlands; Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands.
| | - Monica Burdeus-Olavarrieta
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; School of Psychology, Universidad Autónoma, Madrid, Spain
| | - Jennifer Cooke
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, United Kingdom
| | - A Graciela de Cuba
- Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, the Netherlands
| | - Alison Turner
- Phelan-McDermid Syndrome Foundation UK, 99 Highgate W Hill, London, N6 6NR, United Kingdom
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Carbonell Rosselló G, Turner A, Macias C, Ramírez JM. Combined transposition of internal obturator and superficial gluteal muscles for perineal hernia treatment in dogs: 17 cases (2017-2020). J Small Anim Pract 2023; 64:96-102. [PMID: 36317668 DOI: 10.1111/jsap.13563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To report the results of the combined transposition of the internal obturator muscle and superficial gluteal muscle for perineal hernia treatment in dogs. MATERIALS AND METHODS Retrospective case series of dogs treated with this technique from November 2017 to May 2020, including pre- and post-operative clinical findings, outcome and complications. RESULTS Seventeen dogs were included in the study. Twelve dogs were presented with unilateral perineal hernia and five dogs with bilateral perineal hernias. Mean duration of clinical signs before presentation was 9 months. All perineal hernias were successfully repaired using a transposition of the internal obturator muscle to cover the ventral aspect of the perineal hernia and the superficial gluteal muscle to cover the dorsal aspect of the hernia with minimal tension. All dogs regained normal defecation within 24 hours post-surgery. Average follow-up time was 16 months. No recurrence of clinical signs or rectal deviation was observed. Five dogs developed a superficial minor partial necrosis of the T-shaped incision and two had surgical site infections. CLINICAL SIGNIFICANCE Perineal herniorrhaphy using a combined transposition of the internal obturator and the superficial gluteal muscles is feasible and offered excellent results in this cohort of dogs. It may be considered as a technique for repairing chronic and extensive unilateral and bilateral perineal hernias.
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Affiliation(s)
- G Carbonell Rosselló
- Hospital Veterinari del Mar, C/Marina 69, 08005, Barcelona, Spain.,La Merced Veterinary Specialists, C/Malta, 103710 Calpe, Alicante, Spain
| | - A Turner
- Veterinary Specialists of Sydney, 106 Parraweena Road, Miranda, Sydney, NSW, Australia
| | - C Macias
- Anicura Referencia Veterinaria Bahía de Málaga, Parque Empresarial Laurotorre, 25. Alhaurin de la Torre, 29130, Málaga, Spain
| | - J M Ramírez
- Anicura Referencia Veterinaria Bahía de Málaga, Parque Empresarial Laurotorre, 25. Alhaurin de la Torre, 29130, Málaga, Spain
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S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Turner A, Jones A, Ong J, Tu A, Crawford M. The effects of Cognitive Behaviour Therapy for insomnia and Continuous Positive Airway Pressure on neurocognitive functioning in individuals with comorbid insomnia and sleep apnea (COMISA). Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Turner A, Brachman D. A Proposed Formalism for Target Volume Delineation for Permanently Implanted Collagen Tile Embedded Cs-131 Brachytherapy in the Brain. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Banerjee S, Michalarea V, Ang JE, Ingles Garces A, Biondo A, Funingana IG, Little M, Ruddle R, Raynaud F, Riisnaes R, Gurel B, Chua S, Tunariu N, Porter JC, Prout T, Parmar M, Zachariou A, Turner A, Jenkins B, McIntosh S, Ainscow E, Minchom A, Lopez J, de Bono J, Jones R, Hall E, Cook N, Basu B, Banerji U. A Phase I Trial of CT900, a Novel α-Folate Receptor-Mediated Thymidylate Synthase Inhibitor, in Patients with Solid Tumors with Expansion Cohorts in Patients with High-Grade Serous Ovarian Cancer. Clin Cancer Res 2022; 28:4634-4641. [PMID: 35984704 PMCID: PMC9623233 DOI: 10.1158/1078-0432.ccr-22-1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/07/2022] [Accepted: 08/17/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE CT900 is a novel small molecule thymidylate synthase inhibitor that binds to α-folate receptor (α-FR) and thus is selectively taken up by α-FR-overexpressing tumors. PATIENTS AND METHODS A 3+3 dose escalation design was used. During dose escalation, CT900 doses of 1-6 mg/m2 weekly and 2-12 mg/m2 every 2 weeks (q2Wk) intravenously were evaluated. Patients with high-grade serous ovarian cancer were enrolled in the expansion cohorts. RESULTS 109 patients were enrolled: 42 patients in the dose escalation and 67 patients in the expansion cohorts. At the dose/schedule of 12 mg/m2/q2Wk (with and without dexamethasone, n = 40), the most common treatment-related adverse events were fatigue, nausea, diarrhea, cough, anemia, and pneumonitis, which were predominantly grade 1 and grade 2. Levels of CT900 more than 600 nmol/L needed for growth inhibition in preclinical models were achieved for >65 hours at a dose of 12 mg/m2. In the expansion cohorts, the overall response rate (ORR), was 14/64 (21.9%). Thirty-eight response-evaluable patients in the expansion cohorts receiving 12 mg/m2/q2Wk had tumor evaluable for quantification of α-FR. Patients with high or medium expression had an objective response rate of 9/25 (36%) compared with 1/13 (7.7%) in patients with negative/very low or low expression of α-FR. CONCLUSIONS The dose of 12 mg/m2/q2Wk was declared the recommended phase II dose/schedule. At this dose/schedule, CT900 exhibited an acceptable side effect profile with clinical benefit in patients with high/medium α-FR expression and warrants further investigation.
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Affiliation(s)
- Susana Banerjee
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Vasiliki Michalarea
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joo Ern Ang
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alvaro Ingles Garces
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Andrea Biondo
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ionut-Gabriel Funingana
- Cambridge University Hospitals NHS Foundation Trust and University of Cambridge, Cambridge, United Kingdom
| | - Martin Little
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Ruth Ruddle
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Florence Raynaud
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ruth Riisnaes
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Bora Gurel
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sue Chua
- Radiology and Nuclear Medicine Department, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nina Tunariu
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Radiology and Nuclear Medicine Department, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joanna C. Porter
- UCL Respiratory, University College London and Interstitial Lung Disease Service, University College London NHS Foundation Trust, London, United Kingdom
| | - Toby Prout
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mona Parmar
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Anna Zachariou
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alison Turner
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ben Jenkins
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | | | | | - Anna Minchom
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Juanita Lopez
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann de Bono
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Robert Jones
- Cardiff University, School of Medicine, Velindre University NHS Trust, Cardiff, United Kingdom
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Natalie Cook
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
| | - Bristi Basu
- Cambridge University Hospitals NHS Foundation Trust and University of Cambridge, Cambridge, United Kingdom
| | - Udai Banerji
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
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Brooten J, Turner A, Speiser J, Gabbard J, Cline D. 12 Early Mortality Risk Assessment Modeling by Random Forest Analysis of Patients Presenting to a Tertiary Medical Center Emergency Department. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Montague G, Obrezanova O, Liddell J, Turner A, Aldington S, Graham J, Racher A, Joerg S. Knowledge elicitation as a route to understanding the decision making landscape in monoclonal antibody manufacturing. Food and Bioproducts Processing 2022. [DOI: 10.1016/j.fbp.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Khaleeq T, Lo N, King J, Turner A, Howland E, Graham T. 656 Making an Effective Ward Round Model in the Department of Trauma and Orthopaedic Surgery for University Hospitals of Birmingham Trust. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background
Ward rounds in hospitals are crucial for decision-making in the context of patient treatment processes.
Objectives
Improve the standard of ward rounds with a review of care and planning.
Method
6 key elements were established using the Modern ward rounds report by the Royal College of Physicians and Nursing. This includes daily ward rounds which will be multidisciplinary, documented clearly and handed over to relevant staff; consisting of a board, bedside ward round and debrief; using Prompts in the form of REMIND mnemonic : R = Respect form, E = Electronic Prescribing, M = Mental Capacity, mobility status, I = Investigations, N = Nutrition and Hydration, NBM status, D=DVT assessment and Thromboprophylaxis; with practices being audited.
Results
After running a successful pilot in Respiratory in August 2021 the quality improvement project (QIP) was introduced in Trauma and Orthopaedic surgery.
88 patients were included in the initial audit prior to implementation and 91 in the re-audit. There was a 85% improvement seen in completion of respect and dementia forms with a 90% improvement in electronic prescribing. There was an 75% improvement in documentation of mobility status, investigations performed and NBM status. Fluid prescription, DVT assessment and LMWH prescription also improved by 85%.
Conclusions
A successful Pilot in Respiratory and Trauma and Orthopaedic Surgery shows the feasibility of the QIP in other departments. However, Education should also include Consultant and nurses. We are overcoming this but establishing a virtual module that can be made mandatory for induction of junior doctors, consultants, and nurses.
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Affiliation(s)
- T Khaleeq
- Queen Elizabeth Hospital , Birmingham , United Kingdom
| | - N Lo
- Queen Elizabeth Hospital , Birmingham , United Kingdom
| | - J King
- Queen Elizabeth Hospital , Birmingham , United Kingdom
| | - A Turner
- Queen Elizabeth Hospital , Birmingham , United Kingdom
| | - E Howland
- Queen Elizabeth hospital , Birmingham , United Kingdom
| | - T Graham
- Queen Elizabeth Hospital , Birmingham , United Kingdom
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Papadatos-Pastos D, Yuan W, Pal A, Crespo M, Ferreira A, Gurel B, Prout T, Ameratunga M, Chénard-Poirier M, Curcean A, Bertan C, Baker C, Miranda S, Masrour N, Chen W, Pereira R, Figueiredo I, Morilla R, Jenkins B, Zachariou A, Riisnaes R, Parmar M, Turner A, Carreira S, Yap C, Brown R, Tunariu N, Banerji U, Lopez J, de Bono J, Minchom A. Phase 1, dose-escalation study of guadecitabine (SGI-110) in combination with pembrolizumab in patients with solid tumors. J Immunother Cancer 2022; 10:jitc-2022-004495. [PMID: 35717027 PMCID: PMC9240883 DOI: 10.1136/jitc-2022-004495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
Background Data suggest that immunomodulation induced by DNA hypomethylating agents can sensitize tumors to immune checkpoint inhibitors. We conducted a phase 1 dose-escalation trial (NCT02998567) of guadecitabine and pembrolizumab in patients with advanced solid tumors. We hypothesized that guadecitabine will overcome pembrolizumab resistance. Methods Patients received guadecitabine (45 mg/m2 or 30 mg/m2, administered subcutaneously on days 1–4), with pembrolizumab (200 mg administered intravenously starting from cycle 2 onwards) every 3 weeks. Primary endpoints were safety, tolerability and maximum tolerated dose; secondary and exploratory endpoints included objective response rate (ORR), changes in methylome, transcriptome, immune contextures in pre-treatment and on-treatment tumor biopsies. Results Between January 2017 and January 2020, 34 patients were enrolled. The recommended phase II dose was guadecitabine 30 mg/m2, days 1–4, and pembrolizumab 200 mg on day 1 every 3 weeks. Two dose-limiting toxicities (neutropenia, febrile neutropenia) were reported at guadecitabine 45 mg/m2 with none reported at guadecitabine 30 mg/m2. The most common treatment-related adverse events (TRAEs) were neutropenia (58.8%), fatigue (17.6%), febrile neutropenia (11.8%) and nausea (11.8%). Common, grade 3+ TRAEs were neutropaenia (38.2%) and febrile neutropaenia (11.8%). There were no treatment-related deaths. Overall, 30 patients were evaluable for antitumor activity; ORR was 7% with 37% achieving disease control (progression-free survival) for ≥24 weeks. Of 12 evaluable patients with non-small cell lung cancer, 10 had been previously treated with immune checkpoint inhibitors with 5 (42%) having disease control ≥24 weeks (clinical benefit). Reduction in LINE-1 DNA methylation following treatment in blood (peripheral blood mononuclear cells) and tissue samples was demonstrated and methylation at transcriptional start site and 5’ untranslated region gene regions showed enriched negative correlation with gene expression. Increases in intra-tumoural effector T-cells were seen in some responding patients. Patients having clinical benefit had high baseline inflammatory signature on RNAseq analyses. Conclusions Guadecitabine in combination with pembrolizumab is tolerable with biological and anticancer activity. Reversal of previous resistance to immune checkpoint inhibitors is demonstrated.
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Affiliation(s)
| | - Wei Yuan
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Abhijit Pal
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | - Mateus Crespo
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Ana Ferreira
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Bora Gurel
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Toby Prout
- Drug Development Unit - Investigator Initiated Trials Team, Institute of Cancer Research, Sutton, UK
| | - Malaka Ameratunga
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | | | - Andra Curcean
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | - Claudia Bertan
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Chloe Baker
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Susana Miranda
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Nahal Masrour
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Wentin Chen
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Rita Pereira
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Ines Figueiredo
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Ricardo Morilla
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | - Ben Jenkins
- Clinical Trials and Statistics Unit, Institute of Cancer Research, Sutton, UK
| | - Anna Zachariou
- Drug Development Unit - Investigator Initiated Trials Team, Institute of Cancer Research, Sutton, UK
| | - Ruth Riisnaes
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Mona Parmar
- Drug Development Unit - Investigator Initiated Trials Team, Institute of Cancer Research, Sutton, UK
| | - Alison Turner
- Drug Development Unit - Investigator Initiated Trials Team, Institute of Cancer Research, Sutton, UK
| | - Suzanne Carreira
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK
| | - Christina Yap
- Clinical Trials and Statistics Unit, Institute of Cancer Research, Sutton, UK
| | - Robert Brown
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nina Tunariu
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | - Udai Banerji
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | - Juanita Lopez
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | - Johann de Bono
- Cancer Biomarkers Team, Institute of Cancer Research, Sutton, UK.,Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
| | - Anna Minchom
- Drug Development Unit, Royal Marsden Hospital/Institute of Cancer Research, Sutton, UK
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19
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Ramasamy K, Sadler R, Jeans S, Weeden P, Varghese S, Turner A, Larham J, Gray N, Carty O, Barrett J, Bowcock S, Oppermann U, Cook G, Kyriakou C, Drayson M, Basu S, Moore S, McDonald S, Gooding S, Javaid MK. Immune response to COVID‐19 vaccination is attenuated by poor disease control and antimyeloma therapy with vaccine driven divergent T cell response. Br J Haematol 2022; 197:293-301. [PMID: 35064676 PMCID: PMC9306522 DOI: 10.1111/bjh.18066] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 11/28/2022]
Abstract
Myeloma patients frequently respond poorly to bacterial and viral vaccination. A few studies have reported poor humoral immune responses in myeloma patients to COVID‐19 vaccination. Using a prospective study of myeloma patients in the UK Rudy study cohort, we assessed humoral and interferon gamma release assay (IGRA) cellular immune responses to COVID‐19 vaccination post second COVID‐19 vaccine administration. We report data from 214 adults with myeloma (n = 204) or smouldering myeloma (n = 10) who provided blood samples at least three weeks after second vaccine dose. Positive Anti‐spike antibody levels (> 50 iu/ml) were detected in 189/203 (92.7%), positive IGRA responses were seen in 97/158 (61.4%) myeloma patients. Only 10/158 (6.3%) patients were identified to have both a negative IGRA and negative anti‐spike protein antibody response. In all, 95/158 (60.1%) patients produced positive results for both anti‐spike protein serology and IGRA. After adjusting for disease severity and myeloma therapy, poor humoral immune response was predicted by male gender. Predictors of poor IGRA included anti‐CD38/anti‐BCMA (B‐cell maturation antigen) therapy and Pfizer‐BioNTech vaccination. Further work is required to understand the clinical significance of divergent cellular response to vaccination.
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Affiliation(s)
- Karthik Ramasamy
- Oxford University Hospitals NHS Trust Radcliffe department of Medicine Oxford University Oxford UK
| | - Ross Sadler
- Department of Immunology Churchill Hospital Oxford University Hospitals NHS Foundation Trust Oxford UK
| | - Sally Jeans
- The Botnar Research Centre Windmill Road Headington UK
| | - Paul Weeden
- The Botnar Research Centre Windmill Road Headington UK
| | - Sherin Varghese
- Late Phase Haematology Oxford University Hospital NHS Foundation Trust Churchill Hospital Churchill Drive Oxford UK
| | - Alison Turner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
| | | | - Nathanael Gray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
| | - Oluremi Carty
- Department of Immunology Churchill Hospital Oxford University Hospitals NHS Foundation Trust Oxford UK
| | - Joe Barrett
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
| | - Stella Bowcock
- Princess Royal University Hospital King’s College Hospital Foundation NHS Trust Farnborough Common Orpington Kent UK
| | - Udo Oppermann
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
| | - Gordon Cook
- NIHR Leeds Medtech & In vitro Diagnostics Cooperative Leeds Teaching Hospitals Trust UK
| | - Chara Kyriakou
- Department of Haematology University College London Hospitals NHS Trust London UK
| | - Mark Drayson
- College of Medical and Dental Sciences Medical School University of Birmingham Edgbaston Birmingham UK
| | - Supratik Basu
- University of Wolverhampton The Royal Wolverhampton NHS Trust UK
| | - Sally Moore
- Oxford University Hospitals NHS Trust NHS Foundation Trust, Oxford and Bath Royal United Hospitals Bath UK
| | | | - Sarah Gooding
- MRC Molecular Haematology Unit Weatherall Institute of Molecular Medicine University of Oxford Oxford UK
- Department of Haematology Oxford University Hospitals NHS Trust Oxford UK
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
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20
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Kwok A, Camacho IS, Winter S, Knight M, Meade RM, Van der Kamp MW, Turner A, O'Hara J, Mason JM, Jones AR, Arcus VL, Pudney CR. A Thermodynamic Model for Interpreting Tryptophan Excitation-Energy-Dependent Fluorescence Spectra Provides Insight Into Protein Conformational Sampling and Stability. Front Mol Biosci 2021; 8:778244. [PMID: 34926581 PMCID: PMC8681860 DOI: 10.3389/fmolb.2021.778244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
It is now over 30 years since Demchenko and Ladokhin first posited the potential of the tryptophan red edge excitation shift (REES) effect to capture information on protein molecular dynamics. While there have been many key efforts in the intervening years, a biophysical thermodynamic model to quantify the relationship between the REES effect and protein flexibility has been lacking. Without such a model the full potential of the REES effect cannot be realized. Here, we present a thermodynamic model of the tryptophan REES effect that captures information on protein conformational flexibility, even with proteins containing multiple tryptophan residues. Our study incorporates exemplars at every scale, from tryptophan in solution, single tryptophan peptides, to multitryptophan proteins, with examples including a structurally disordered peptide, de novo designed enzyme, human regulatory protein, therapeutic monoclonal antibodies in active commercial development, and a mesophilic and hyperthermophilic enzyme. Combined, our model and data suggest a route forward for the experimental measurement of the protein REES effect and point to the potential for integrating biomolecular simulation with experimental data to yield novel insights.
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Affiliation(s)
- A Kwok
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - I S Camacho
- Biometrology, Chemical and Biological Sciences Department, National Physical Laboratory, London, United Kingdom
| | - S Winter
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | | | - R M Meade
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - M W Van der Kamp
- School of Biochemistry, University of Bristol, Bristol, United Kingdom
| | | | | | - J M Mason
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - A R Jones
- Biometrology, Chemical and Biological Sciences Department, National Physical Laboratory, London, United Kingdom
| | - V L Arcus
- School of Science, Faculty of Science and Engineering, University of Waikato, Hamilton, New Zealand
| | - C R Pudney
- Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom.,BLOC Laboratories Limited, Bath, United Kingdom
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21
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Schepens B, van Schie L, Nerinckx W, Roose K, Van Breedam W, Fijalkowska D, Devos S, Weyts W, De Cae S, Vanmarcke S, Lonigro C, Eeckhaut H, Van Herpe D, Borloo J, Oliveira AF, Catani JPP, Creytens S, De Vlieger D, Michielsen G, Marchan JCZ, Moschonas GD, Rossey I, Sedeyn K, Van Hecke A, Zhang X, Langendries L, Jacobs S, Ter Horst S, Seldeslachts L, Liesenborghs L, Boudewijns R, Thibaut HJ, Dallmeier K, Velde GV, Weynand B, Beer J, Schnepf D, Ohnemus A, Remory I, Foo CS, Abdelnabi R, Maes P, Kaptein SJF, Rocha-Pereira J, Jochmans D, Delang L, Peelman F, Staeheli P, Schwemmle M, Devoogdt N, Tersago D, Germani M, Heads J, Henry A, Popplewell A, Ellis M, Brady K, Turner A, Dombrecht B, Stortelers C, Neyts J, Callewaert N, Saelens X. An affinity-enhanced, broadly neutralizing heavy chain-only antibody protects against SARS-CoV-2 infection in animal models. Sci Transl Med 2021; 13:eabi7826. [PMID: 34609205 PMCID: PMC9924070 DOI: 10.1126/scitranslmed.abi7826] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Broadly neutralizing antibodies are an important treatment for individuals with coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Antibody-based therapeutics are also essential for pandemic preparedness against future Sarbecovirus outbreaks. Camelid-derived single domain antibodies (VHHs) exhibit potent antimicrobial activity and are being developed as SARS-CoV-2–neutralizing antibody-like therapeutics. Here, we identified VHHs that neutralize both SARS-CoV-1 and SARS-CoV-2, including now circulating variants. We observed that the VHHs bound to a highly conserved epitope in the receptor binding domain of the viral spike protein that is difficult to access for human antibodies. Structure-guided molecular modeling, combined with rapid yeast-based prototyping, resulted in an affinity enhanced VHH-human immunoglobulin G1 Fc fusion molecule with subnanomolar neutralizing activity. This VHH-Fc fusion protein, produced in and purified from cultured Chinese hamster ovary cells, controlled SARS-CoV-2 replication in prophylactic and therapeutic settings in mice expressing human angiotensin converting enzyme 2 and in hamsters infected with SARS-CoV-2. These data led to affinity-enhanced selection of the VHH, XVR011, a stable anti–COVID-19 biologic that is now being evaluated in the clinic.
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Affiliation(s)
- Bert Schepens
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Loes van Schie
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Wim Nerinckx
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Kenny Roose
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Wander Van Breedam
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Daria Fijalkowska
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Simon Devos
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Wannes Weyts
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Sieglinde De Cae
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Sandrine Vanmarcke
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Chiara Lonigro
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Hannah Eeckhaut
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Dries Van Herpe
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Jimmy Borloo
- VIB Discovery Sciences, Technologiepark-Zwijnaarde 104B, 9052 Ghent, Belgium
| | - Ana Filipa Oliveira
- VIB Discovery Sciences, Technologiepark-Zwijnaarde 104B, 9052 Ghent, Belgium
| | - João Paulo Portela Catani
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Sarah Creytens
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Dorien De Vlieger
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Gitte Michielsen
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Jackeline Cecilia Zavala Marchan
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - George D Moschonas
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Iebe Rossey
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Koen Sedeyn
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Annelies Van Hecke
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Xin Zhang
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Lana Langendries
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Sofie Jacobs
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Sebastiaan Ter Horst
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Laura Seldeslachts
- KU Leuven Department of Imaging and Pathology, Biomedical MRI and MoSAIC, 3000 Leuven, Belgium
| | - Laurens Liesenborghs
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Robbert Boudewijns
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA.,KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Group, 3000 Leuven, Belgium
| | - Hendrik Jan Thibaut
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Group, 3000 Leuven, Belgium.,KU Leuven Department of Microbiology, Immunology and Transplantation, Translational Platform Virology and Chemotherapy (TPVC), Rega Institute, 3000 Leuven, Belgium
| | - Kai Dallmeier
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA.,KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Group, 3000 Leuven, Belgium
| | - Greetje Vande Velde
- KU Leuven Department of Imaging and Pathology, Biomedical MRI and MoSAIC, 3000 Leuven, Belgium
| | - Birgit Weynand
- KU Leuven Department of Imaging and Pathology, Division of Translational Cell and Tissue Research, Translational Cell and Tissue Research, 3000 Leuven, Belgium
| | - Julius Beer
- Institute of Virology, Medical Center University Freiburg, 79104 Freiburg, Germany
| | - Daniel Schnepf
- Institute of Virology, Medical Center University Freiburg, 79104 Freiburg, Germany
| | - Annette Ohnemus
- Institute of Virology, Medical Center University Freiburg, 79104 Freiburg, Germany
| | - Isabel Remory
- Department of Medical Imaging, In vivo Cellular and Molecular Imaging Laboratory, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Caroline S Foo
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium
| | - Rana Abdelnabi
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Piet Maes
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, 3000 Leuven, Belgium
| | - Suzanne J F Kaptein
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Joana Rocha-Pereira
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Dirk Jochmans
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Leen Delang
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA
| | - Frank Peelman
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biomolecular Medicine, Ghent University, 9000 Ghent, Belgium
| | - Peter Staeheli
- Institute of Virology, Medical Center University Freiburg, 79104 Freiburg, Germany.,Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Martin Schwemmle
- Institute of Virology, Medical Center University Freiburg, 79104 Freiburg, Germany.,Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Nick Devoogdt
- Department of Medical Imaging, In vivo Cellular and Molecular Imaging Laboratory, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | | | | | | | | | | | | | | | | | - Bruno Dombrecht
- VIB Discovery Sciences, Technologiepark-Zwijnaarde 104B, 9052 Ghent, Belgium
| | | | - Johan Neyts
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute, 3000 Leuven, Belgium.,GVN, Global Virus Network, Baltimore, MD 21201, USA.,KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Group, 3000 Leuven, Belgium
| | - Nico Callewaert
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
| | - Xavier Saelens
- VIB-UGent Center for Medical Biotechnology, VIB, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Technologiepark-Zwijnaarde 75, 9052 Ghent, Belgium
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Tiu C, Welsh L, Jones T, Zachariou A, Prout T, Turner A, Daly R, Tunariu N, Riisnaes R, Gurel B, Crespo M, Carreira S, Vivanco I, Jenkins B, Yap C, Minchom A, Banerji U, deBono J, Lopez J. Preliminary evidence of antitumour activity of Ipatasertib (Ipat) and Atezolizumab (ATZ) in glioblastoma patients (pts) with PTEN loss from the Phase 1 Ice-CAP trial (NCT03673787). Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab195.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Despite improved understanding of effector T-cell trafficking into the central nervous system, initial trials with anti-PD1/PD-L1 immune checkpoint inhibitors (ICIs) have failed to meet their primary endpoints. PTEN loss of function is frequent in GBM and has been correlated with not only poor overall prognosis, but also impaired antitumour responses, including reduced T cell infiltration into tumour and reduced efficacy of ICIs.
Ipatasertib is a novel, potent, selective, small-molecule inhibitor of Akt. We have shown that Ipatasertib efficiently depletes FOXP3+ regulatory T cells from the tumour microenvironment (TME) resulting in increased infiltration of effector T cells in solid tumours (Lopez 2020, AACR).
We hypothesize that the use of AKT inhibition in PTEN glioblastomas may deplete the TME of suppressive immune cells, and render malignant brain tumours more responsive to ICIs. We present updated data for the combination of Ipat+ATZ in patients with glioblastoma.
Method
Patients with relapsed WHO grade IV GBM with stable neurological symptoms ≥5 days prior to enrolment, requiring <3mg Dexamethasone were recruited into two cohorts of this early phase, open-label, single-centre trial studying the combination of Ipatasertib (Ipat) and Atezolizumab (ATZ): a dose finding cohort (A2; n=9) and an expansion cohort (B3; n=7, recruitment ongoing).
The Ice-CAP A2 cohort assessed safety, pharmacodynamic, and preliminary clinical activity of Ipat (200mg or 400mg OD) + ATZ (1200mg Q3W) in pts with potentially resectable relapsed WHO Grade IV GBM. Pts had a 14-21-day run-in phase of Ipat then surgical tumour resection. Combination Ipat+ATZ commenced post surgery. Patients who declined surgery or who were deemed high risk for surgery proceeded directly to combination.
Patients in the expansion cohort B3 commenced directly on Ipat+ATZ at the RP2D of 400mg Ipat with ATZ.
Results
16 evaluable recurrent GBM pts were enrolled across two cohorts. Median age 56 yrs (25-71 yrs). Median ECOG PS 1. Median lines of prior therapy 1 (range 1-4). 10 pts had PTEN loss by IHC (H<30) and/or PTEN mutations on next generation sequencing.
No DLTs, treatment-related (TR) serious adverse events (AEs), or immune-related AEs were observed. Most common TR AEs were G1 diarrhoea (44%), mucositis (17%), rash (28%).
Clinical benefit rate (CR, PR and SD> 6 cycles) at clinical cutoff date (23/02/21) in patients with PTEN aberration was 30% (3/10). A 58-year-old man with PTEN loss had MRI at Cycle 5 showing worsening enhancement suggestive of disease progression. Resection of the lesion showed intense lymphocyte infiltration and pathological CR. He is currently on Cycle 22 with no evidence of disease. Two other patients with PTEN loss with radiological stable disease per RANO criteria remain well on study for >6 cycles.
Conclusion
Combination Ipat+ATZ appears safe and tolerable in GBM pts, with 400mg Ipatasertib OD + 1200mg ATZ Q3W declared as RP2D. Early efficacy signals were detected with PTEN loss being a promising predictive biomarker for response to combination. An expansion cohort enriched with pts with PTEN loss is ongoing.
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Affiliation(s)
- Crescens Tiu
- Royal Marsden Hospital
- Institute of Cancer Research, Royal Marsden Hospital
| | | | - Timothy Jones
- St George’s University Hospital NHS Foundation Trust
| | | | - Toby Prout
- Institute of Cancer Research, Royal Marsden Hospital
| | - Alison Turner
- Institute of Cancer Research, Royal Marsden Hospital
| | - Rob Daly
- Institute of Cancer Research, Royal Marsden Hospital
| | - Nina Tunariu
- Royal Marsden Hospital
- Institute of Cancer Research, Royal Marsden Hospital
| | - Ruth Riisnaes
- Institute of Cancer Research, Royal Marsden Hospital
| | - Bora Gurel
- Institute of Cancer Research, Royal Marsden Hospital
| | - Mateus Crespo
- Institute of Cancer Research, Royal Marsden Hospital
| | | | - Igor Vivanco
- Institute of Cancer Research, Royal Marsden Hospital
| | - Ben Jenkins
- Institute of Cancer Research, Royal Marsden Hospital
| | - Christina Yap
- Institute of Cancer Research, Royal Marsden Hospital
| | - Anna Minchom
- Royal Marsden Hospital
- Institute of Cancer Research, Royal Marsden Hospital
| | - Udai Banerji
- Royal Marsden Hospital
- Institute of Cancer Research, Royal Marsden Hospital
| | - Johann deBono
- Royal Marsden Hospital
- Institute of Cancer Research, Royal Marsden Hospital
| | - Juanita Lopez
- Royal Marsden Hospital
- Institute of Cancer Research, Royal Marsden Hospital
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Wang L, Jia S, Wang G, Turner A, Ratchev S. Enhancing learning capabilities of movement primitives under distributed probabilistic framework for flexible assembly tasks. Neural Comput Appl 2021. [DOI: 10.1007/s00521-021-06543-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractThis paper presents a novel probabilistic distributed framework based on movement primitives for flexible robot assembly. Since the modern advanced industrial cell usually deals with various scenarios that are not fixed via-point trajectories but highly reconfigurable tasks, the industrial robots used in these applications must be capable of adapting and learning new in-demand skills without programming experts. Therefore, we propose a probabilistic framework that could accommodate various learning abilities trained with different movement-primitive datasets, separately. Derived from the Bayesian Committee Machine, this framework could infer new adapting trajectories with weighted contributions of each training dataset. To verify the feasibility of our proposed imitation learning framework, the simulation comparison with the state-of-the-art movement learning framework task-parametrised GMM is conducted. Several key aspects, such as generalisation capability, learning accuracy and computation expense, are discussed and compared. Moreover, two real-world experiments, i.e. riveting picking and nutplate picking, are further tested with the YuMi collaborative robot to verify the application feasibility in industrial assembly manufacturing.
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Turner A. 313 A Team-Based Learning Approach to Reimbursement and Billing Education for Emergency Medicine Residents. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sopp JM, Peters SJ, Rowley TF, Oldham RJ, James S, Mockridge I, French RR, Turner A, Beers SA, Humphreys DP, Cragg MS. On-target IgG hexamerisation driven by a C-terminal IgM tail-piece fusion variant confers augmented complement activation. Commun Biol 2021; 4:1031. [PMID: 34475514 PMCID: PMC8413284 DOI: 10.1038/s42003-021-02513-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 08/02/2021] [Indexed: 12/20/2022] Open
Abstract
The majority of depleting monoclonal antibody (mAb) drugs elicit responses via Fc-FcγR and Fc-C1q interactions. Optimal C1q interaction is achieved through hexameric Fc:Fc interactions at the target cell surface. Herein is described an approach to exploit the tailpiece of the naturally multimeric IgM to augment hexamerisation of IgG. Fusion of the C-terminal tailpiece of IgM promoted spontaneous hIgG hexamer formation, resulting in enhanced C1q recruitment and complement-dependent cytotoxicity (CDC) but with off-target complement activation and reduced in-vivo efficacy. Mutation of the penultimate tailpiece cysteine to serine (C575S) ablated spontaneous hexamer formation, but facilitated reversible hexamer formation after concentration in solution. C575S mutant tailpiece antibodies displayed increased complement activity only after target binding, in-line with the concept of 'on-target hexamerisation', whilst retaining efficient in-vivo efficacy and augmented target cell killing in the lymph node. Hence, C575S-tailpiece technology represents an alternative format for promoting on-target hexamerisation and enhanced CDC.
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Affiliation(s)
- Joshua M Sopp
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | | | - Robert J Oldham
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sonya James
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ian Mockridge
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ruth R French
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Stephen A Beers
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Mark S Cragg
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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Banerjee S, Grochot R, Shinde R, Lima J, Krebs M, Rahman R, Little M, Tunariu N, Curcean A, Badham H, Mahmud M, Turner A, Parmar M, Yap C, Minchom A, Lopez J, de Bono J, Banerji U. 725MO Phase I study of the combination of the dual RAF/MEK inhibitor VS-6766 and the FAK inhibitor defactinib: Results of efficacy in low grade serous ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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27
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Davies M, Jackson KA, Mackinnon AL, Turner A, Kuznik K, Hill J, Newton JL, Sanchez Santos M. Epidemiology of race day injury in young professional jockeys in Great Britain from 2007 to 2018: a retrospective cohort study. BMJ Open 2021; 11:e044075. [PMID: 34380713 PMCID: PMC8359493 DOI: 10.1136/bmjopen-2020-044075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION There are limited injury data in professional horse racing, particularly by sex. OBJECTIVES To describe injury incidence, characteristics and falls in male and female, flat and jump jockeys in Great Britain. DESIGN AND SETTING Retrospective cohort study of professional jockeys in Britain. PARTICIPANTS 245 jockeys licensed between 2007 and 2017. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was injury on a race day. Injury incidence (per 1000 rides; per 1000 falls) was derived. Incidence-rate ratios (IRR) were calculated to compare incidence between flat and jump racing, male and female jockeys, and male flat and male jump jockeys for: (i) injury incidence, (ii) fall incidence and (iii) injuries per fall. RESULTS 234 British professional jockeys were included. Jockeys were on average 19.5±2.0 years old at licence date, 79.9% male and 58.1% flat. The time of follow-up (racing in the study) was 3.7 (SD=2.3) years. There were 278 injuries, occurring in-race (81.7%), in the stalls (10.8%) or parade ring (6.1%). After one injury was removed to preserve anonymity, 57.2% were soft tissue injuries, 25.3% fractures and 10.5% concussion. There were 1634 falls, with 92% in male jump racing. The injury incidence was higher in jump racing (5.1 vs 1.0/1000 jockey rides). The falls incidence was 1.8/1000 rides in flat and 46.2/1000 rides in jump racing (IRR 0.04, 95% CI 0.03 to 0.04). There were over five times higher injuries/1000 falls in flat than jump racing (IRR 5.56, 95% CI 4.05 to 7.53). Male flat jockeys fell less than female flat (IRR 0.57, 95% CI 0.35 to 0.97). CONCLUSION Most injuries occurred in-race and were soft tissue injuries. Jump jockeys fell more often than flat, and female flat jockeys fell more often than male flat. Flat jockeys injured more frequently when falling. No sex differences were seen for injuries per fall.
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Affiliation(s)
- Madeleine Davies
- Institute for Sport, Exercise and Health, University College London, London, UK
- Department of Health, University of Bath, Bath, UK
| | - Kate A Jackson
- Centre for Sport, Exercise and Osteoarthritis Research Verses Arthritis, University of Oxford, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford, Oxfordshire, UK
- Sporting Knee Injury Prevention Programme (SKIPP), Headington, Oxfordshire, UK
| | - Anna Louise Mackinnon
- Centre for Sport, Exercise and Osteoarthritis Research Verses Arthritis, University of Oxford, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford, Oxfordshire, UK
- Injured Jockeys Fund, Newmarket, UK
| | - Alison Turner
- NIHR Oxford Biomedical Research Centre, Oxford, Oxfordshire, UK
| | - Kerry Kuznik
- Centre for Sport, Exercise and Osteoarthritis Research Verses Arthritis, University of Oxford, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford, Oxfordshire, UK
- British Horseracing Authority Ltd, London, UK
| | - Jerry Hill
- British Horseracing Authority Ltd, London, UK
| | - Julia L Newton
- Centre for Sport, Exercise and Osteoarthritis Research Verses Arthritis, University of Oxford, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford, Oxfordshire, UK
- NIHR Oxford Biomedical Research Centre, Oxford, Oxfordshire, UK
| | - Maria Sanchez Santos
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK
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Ramasamy K, Sadler R, Jeans S, Varghese S, Turner A, Larham J, Gray N, Barrett J, Bowcock S, Cook G, Kyriakou C, Smith D, Drayson M, Basu S, Moore S, McDonald S, Gooding S, Javaid MK. COVID symptoms, testing, shielding impact on patient-reported outcomes and early vaccine responses in individuals with multiple myeloma. Br J Haematol 2021; 196:95-98. [PMID: 34341984 PMCID: PMC8444854 DOI: 10.1111/bjh.17764] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Karthik Ramasamy
- Oxford University Hospitals NHS Trust, Oxford, UK.,Oxford University, Oxford, UK
| | - Ross Sadler
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - Sally Jeans
- RUDY Study Participant Forum Member, Oxford, UK
| | | | | | - Jemma Larham
- Oxford University Hospitals NHS Trust, Oxford, UK
| | | | | | | | - Gordon Cook
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Chara Kyriakou
- University College London Hospitals NHS Trust, London, UK
| | - Dean Smith
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Supratik Basu
- University of Wolverhampton, Wolverhampton, UK.,Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Sally Moore
- Oxford University Hospitals NHS Trust, Oxford, UK.,Bath Royal United Hospitals, Bath, UK
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Hodonsky C, Turner A, Khan M, López N, Wong D, Barrientos N, Kovacic J, Leeper N, Björkegren J, Miller C. Ancestrally diverse study populations benefit eQTL discovery and characterization in coronary artery tissue. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Krebs MG, Shinde R, Rahman RA, Grochot R, Little M, King J, Kitchin J, Parmar M, Turner A, Mahmud M, Yap C, Tunariu N, Lopez J, De Bono JS, Banerji U, Minchom A. Abstract CT019: A phase I trial of the combination of the dual RAF-MEK inhibitor VS-6766 and the FAK inhibitor defactinib: Evaluation of efficacy in KRAS mutated NSCLC. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-ct019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
KRAS is a known oncogenic driver in non-small cell lung cancer (NSCLC), with KRAS G12C and G12V mutations occurring in ~13% and ~7% of the of NSCLC ( adenocarcinoma subtype). The dual RAF-MEK inhibitor VS-6766 has shown single agent activity against G12V KRAS mutated NSCLC (Guo C et al Lancet Oncology 2020, 21:1478-88). Based on pre-clinical data, we hypothesised that augmented focal adhesion kinase (FAK) signalling is a mechanism of resistance to MEK inhibition and devised the current clinical trial. We have previously reported the safety of an intermittent schedule of the combination of VS-6766 and the FAK inhibitor defactinib and its efficacy in low grade serous ovarian cancer (Shinde et al., AACR 2020). We now report the activity of the combination in KRAS mutated NSCLC.
Methods
Patients were treated with an intermittent dose of drugs VS-6766 at 3.2 - 4 mg twice a week and defactinib 200 mg twice daily in the dose escalation and expansion cohorts of the study. Both drugs were administered three weeks on/one week off in 28-day cycles. We aim to recruit 20 patients with KRAS mutated NSCLC in an expansion cohort.
Results
To date, 19 patients with KRAS mutated NSCLC have been treated in the dose escalation and expansion cohorts. All patients had been previously treatment with a PD-1 or PDL-1 targeting immune checkpoint inhibitor. The median age was 64 years (22 - 73), M/F ratio was 7/12, and the median prior lines of treatment was 3. Currently, 17 of 19 patients have had at least one re-staging assessment, 2/17 (12%) patients had a partial response and 10/17 (59%) had stable disease as their best response. Of note, 11/17 (65%) patients had a degree of reduction in size of their tumours and 5/17 (29%) have been treated for 6 months or more with 3 patients still on treatment. Interestingly, 2/2 (100%) of the KRAS G12V NSCLC patients showed a partial response.
Conclusions
Developing new treatments for non-G12C KRAS mutated NSCLC is an area of unmet need. The combination of VS-6766 and defactinib treatment in cohorts of patients with NSCLC pre-treated with chemotherapy and immunotherapy has shown anti-tumour activity in subsets of patients with KRAS mutated NSCLC, in particular those with tumours harbouring KRAS G12V mutations. A registration-directed study evaluating VS-6766 ± defactinib for treatment of recurrent NSCLC with KRAS G12V mutation (NCT04620330) has been initiated
Citation Format: Matthew G. Krebs, Rajiv Shinde, Rozana Abdul Rahman, Rafael Grochot, Martin Little, Jenny King, Joseph Kitchin, Mona Parmar, Alison Turner, Muneeb Mahmud, Christina Yap, Nina Tunariu, Juanita Lopez, Johann S. De Bono, Udai Banerji, Anna Minchom. A phase I trial of the combination of the dual RAF-MEK inhibitor VS-6766 and the FAK inhibitor defactinib: Evaluation of efficacy in KRAS mutated NSCLC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT019.
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Affiliation(s)
- Matthew G. Krebs
- 1The Christie NHS Foundation Trust and The University of Manchester, Manchester, United Kingdom
| | - Rajiv Shinde
- 2The Royal Marsden Hospital, Sutton, United Kingdom
| | - Rozana Abdul Rahman
- 1The Christie NHS Foundation Trust and The University of Manchester, Manchester, United Kingdom
| | | | - Martin Little
- 1The Christie NHS Foundation Trust and The University of Manchester, Manchester, United Kingdom
| | - Jenny King
- 3The Institute of Cancer Research, Sutton, United Kingdom
| | - Joseph Kitchin
- 3The Institute of Cancer Research, Sutton, United Kingdom
| | - Mona Parmar
- 4The Institute of Cancer Research, London, United Kingdom
| | - Alison Turner
- 4The Institute of Cancer Research, London, United Kingdom
| | - Muneeb Mahmud
- 4The Institute of Cancer Research, London, United Kingdom
| | - Christina Yap
- 4The Institute of Cancer Research, London, United Kingdom
| | - Nina Tunariu
- 5Royal Marsden Hospital/The Institute of Cancer Research, London, United Kingdom
| | - Juanita Lopez
- 3The Institute of Cancer Research, Sutton, United Kingdom
| | | | - Udai Banerji
- 3The Institute of Cancer Research, Sutton, United Kingdom
| | - Anna Minchom
- 3The Institute of Cancer Research, Sutton, United Kingdom
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Valerio V, Shen HC, Field E, Mcdonald EG, Turner A, Bernatsky S, Hudson M, Colmegna I. POS1268 COVID-19 VACCINE HESITANCY AMONG RHEUMATOLOGY PATIENTS RECEIVING INFLUENZA VACCINE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Adults with rheumatic diseases are a COVID-19 vulnerable population with potential increased risk for severe infection. COVID-19 vaccines are a key strategy to ending the pandemic. Unfortunately, fears about vaccines, some of which are propagated by misinformation, are common and may prevent or inappropriately delay vaccination. Refusal or uncertainty to get a vaccine despite its availability is known as vaccine hesitancy.Objectives:This study aims at defining causes of COVID-19 vaccine hesitancy among rheumatology patients.Methods:Between November and December 2020, a cross-sectional survey was completed by rheumatology patients presenting to a large Canadian tertiary-care center for influenza immunization. COVID-19 risk factors, previous COVID-19 infection, the likelihood of getting a future COVID-19 vaccine (scale 0-10), and contextual, individual, and vaccine-specific potential determinants of vaccine hesitancy were assessed. Patients were classified into 5 groups based on how likely they were to get a future COVID-19 vaccine (0= not likely at all; 2.5= unlikely; 5= intermediate; 7.5= likely; 10= highly likely). A machine learning approach (XgBoost) was used to fit univariate models for a multi-class correlation.Results:157 rheumatology patients completed the survey. Most were females (n=112, 71%) with a mean age of 54.6 (standard deviation 17.9). The majority (73%) had tertiary-education, and 46% were employed at the time of the survey. The most common rheumatology diagnoses were rheumatoid arthritis (n=90, 58%), systemic lupus erythematosus/vasculitis (n=41, 26%) and spondyloarthropathies (n=39, 25%). Most patients were on immunosuppressors (n=93, 59%). Only half (n=85, 54%) were highly likely to accept a future COVID vaccine, 17% (n=26) likely, 19% (n=30) intermediate, 6% (n=10) unlikely, and 4% (n=6) not likely at all. One hundred thirty-five patients (86%) previously received the flu vaccine, whereas 6% (n=10) previously rejected it. Only three patients were previously diagnosed with COVID-19 (2%) one of whom was hospitalized. Eighty-seven patients (56%) considered that the COVID-19 vaccine should be mandatory, and 101 (65%) that they should receive it. Most respondents were somewhat concerned about receiving a future COVID-19 vaccine (n=116, 76%) despite that 65% believed that vaccines benefits outweighed their risks. Almost all, (n=145, 96%) believed that governmental decisions about vaccines are in the best interest of the population, while less than half (n=70, 45%) were confident that pharmaceutical companies would provide safe and effective vaccines. One hundred participants (65%) denied feeling social pressure to get the vaccine, and 55% (n=81) were willing to pay for the vaccine. Feeling social pressure about getting a COVID-19 vaccine, having severe concerns about receiving a future COVID-19 vaccine, distrust in pharmaceutical companies, lower education, and doubts of whether vaccines benefits outweigh their risks, were negatively associated with COVID vaccine acceptance.Conclusion:Forty six percent of rheumatology patients being immunized against influenza showed at least some hesitancy towards COVID-19 vaccination. Multiple contextual, individual, and vaccine-related factors may contribute. Targeted educational strategies, including producing and communicating data on vaccine safety, may help promote vaccine uptake in this potentially vulnerable population.Disclosure of Interests:None declared
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Gimeno IM, Shaw WN, Turner A, Bremen J, Cortes AL, Faiz NM, Gonder E, Robbins K. Replication of Marek's disease vaccines in turkey embryos and their effect on TLR-3 and IFN-γ transcripts. Avian Pathol 2021; 50:1-7. [PMID: 33533643 DOI: 10.1080/03079457.2021.1882937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Abstract
Understanding the pathogenesis of herpesvirus of turkeys (HVT) in its natural host is necessary before recombinant HVT (rHVT) can be used efficiently in turkey flocks. The objectives of this study were to evaluate when commercial turkey flocks get infected with wild type HVT, to study replication of HVT (conventional and recombinant rHVT-Newcastle disease, rHVT-ND) and other Marek's disease (MD) vaccines (SB-1 and CVI988) in turkey embryonic tissues, and to evaluate the expression of TLR-3 and IFN-γ in the lung and spleen of one-day-old turkeys after in ovo vaccination with MD vaccines. Our results demonstrated that commercial turkeys got exposed to wild type HVT within the first days of life; therefore, there is a potential of interaction between wild type HVT and rHVT when administered at day of age. On the other hand, all evaluated vaccines (especially HVT and rHVT-ND) replicated very well in turkey embryonic tissues. In ovo vaccination with HVT and CVI988 increased transcription of TLR-3 in the spleen of one-day-old turkeys. However, no effect on the transcription of TLR-3 or IFN-γ in the lungs and IFN-γ in the spleen in newly hatched turkeys was detected in the present study. Because of the limitations of evaluated genes, timepoints, and studied tissues, future studies are warranted to better understand the effect of MD vaccines on the turkey embryo immune responses.RESEARCH HIGHLIGHTS Commercial turkey flocks get infected with wild type HVT within the first days of life.HVT and rHVT replicates readily in turkey embryonic tissues.SB-1 and CVI988 also replicate in turkey embryonic tissues, but at lower rates than HVT and rHVT.HVT and CVI988 increase transcription of TLR-3 in the spleen.
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Affiliation(s)
- I M Gimeno
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University, Raleigh, NC, USA
| | - W N Shaw
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University, Raleigh, NC, USA
| | - A Turner
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University, Raleigh, NC, USA
| | - J Bremen
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University, Raleigh, NC, USA
| | - A L Cortes
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University, Raleigh, NC, USA
| | - N M Faiz
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University, Raleigh, NC, USA
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - E Gonder
- Butterball, LLC, Garner, NC, USA
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33
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Hamakawa N, Kogetsu A, Isono M, Yamasaki C, Manabe S, Takeda T, Iwamoto K, Kubota T, Barrett J, Gray N, Turner A, Teare H, Imamura Y, Yamamoto BA, Kaye J, Hide M, Takahashi MP, Matsumura Y, Javaid MK, Kato K. The practice of active patient involvement in rare disease research using ICT: experiences and lessons from the RUDY JAPAN project. Res Involv Engagem 2021; 7:9. [PMID: 33526087 PMCID: PMC7852111 DOI: 10.1186/s40900-021-00253-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/15/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND The role of patients in medical research is changing, as more emphasis is being placed on patient involvement, and patient reported outcomes are increasingly contributing to clinical decision-making. Information and communication technology provides new opportunities for patients to actively become involved in research. These trends are particularly noticeable in Europe and the US, but less obvious in Japan. The aim of this study was to investigate the practice of active involvement of patients in medical research in Japan by utilizing a digital platform, and to analyze the outcomes to clarify what specific approaches could be put into practice. METHODS We developed the RUDY JAPAN system, an ongoing rare disease medical research platform, in collaboration with the Rare and Undiagnosed Diseases Study (RUDY) project in the UK. After 2 years of preparation, RUDY JAPAN was launched in December 2017. Skeletal muscle channelopathies were initially selected as target diseases, and hereditary angioedema was subsequently added. Several approaches for active patient involvement were designed through patient-researcher collaboration, namely the Steering Committee, questionnaire development, dynamic consent, and other communication strategies. We analyzed our practices and experiences focusing on how each approach affected and contributed to the research project. RESULTS RUDY JAPAN has successfully involved patients in this research project in various ways. While not a part of the initial decision-making phase to launch the project, patients have increasingly been involved since then. A high level of patient involvement was achieved through the Steering Committee, a governance body that has made a major contribution to RUDY JAPAN, and the process of the questionnaire development. The creation of the Patient Network Forum, website and newsletter cultivated dialogue between patients and researchers. The registry itself allowed patient participation through data input and control of data usage through dynamic consent. CONCLUSIONS We believe the initial outcomes demonstrate the feasibility and utility of active patient involvement in Japan. The collaboration realized through RUDY JAPAN was enabled by digital technologies. It allowed busy patients and researchers to find the space to meet and work together for the Steering Committee, questionnaire development and various communication activities. While the practice of active patient involvement in Japan is still in its early stages, this research confirms its viability if the right conditions are in place. (331 words).
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Affiliation(s)
- Nao Hamakawa
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Atsushi Kogetsu
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Moeko Isono
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Chisato Yamasaki
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Shirou Manabe
- Department of Medical Informatics, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Toshihiro Takeda
- Department of Medical Informatics, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kazumasa Iwamoto
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoya Kubota
- Department of Functional Diagnostic Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Joe Barrett
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Nathanael Gray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Alison Turner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Yukie Imamura
- HAEJ, Non-profit Patient Organization for Hereditary Angioedema in Japan, Kakogawa, Hyogo, Japan
| | - Beverley Anne Yamamoto
- HAEJ, Non-profit Patient Organization for Hereditary Angioedema in Japan, Kakogawa, Hyogo, Japan
- HAEi, Non-profit International Patient Organization for Hereditary Angioedema registered in the US, Fairfax City, Virginia, USA
- Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Jane Kaye
- HeLEX Centre, University of Oxford, Oxford, UK
| | - Michihiro Hide
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masanori P Takahashi
- Department of Functional Diagnostic Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yasushi Matsumura
- Department of Medical Informatics, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Muhammad Kassim Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kazuto Kato
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
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Lightwood DJ, Munro RJ, Porter J, McMillan D, Carrington B, Turner A, Scott-Tucker A, Hickford ES, Schmidt A, Fox D, Maloney A, Ceska T, Bourne T, O'Connell J, Lawson ADG. A conformation-selective monoclonal antibody against a small molecule-stabilised signalling-deficient form of TNF. Nat Commun 2021; 12:583. [PMID: 33495445 PMCID: PMC7835358 DOI: 10.1038/s41467-020-20825-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 12/04/2020] [Indexed: 02/08/2023] Open
Abstract
We have recently described the development of a series of small-molecule inhibitors of human tumour necrosis factor (TNF) that stabilise an open, asymmetric, signalling-deficient form of the soluble TNF trimer. Here, we describe the generation, characterisation, and utility of a monoclonal antibody that selectively binds with high affinity to the asymmetric TNF trimer-small molecule complex. The antibody helps to define the molecular dynamics of the apo TNF trimer, reveals the mode of action and specificity of the small molecule inhibitors, acts as a chaperone in solving the human TNF-TNFR1 complex crystal structure, and facilitates the measurement of small molecule target occupancy in complex biological samples. We believe this work defines a role for monoclonal antibodies as tools to facilitate the discovery and development of small-molecule inhibitors of protein-protein interactions.
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Affiliation(s)
| | | | - John Porter
- UCB Pharma, 208 Bath Road, Slough, SL1 3WE, UK
| | | | | | | | | | | | | | - David Fox
- UCB Pharma, 7869 NE Day Road W, Bainbridge Island, WA, 98110, USA
| | | | - Tom Ceska
- UCB Pharma, 208 Bath Road, Slough, SL1 3WE, UK
| | - Tim Bourne
- UCB Pharma, 208 Bath Road, Slough, SL1 3WE, UK
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Pascual J, Lim JSJ, Macpherson IR, Armstrong AC, Ring A, Okines AFC, Cutts RJ, Herrera-Abreu MT, Garcia-Murillas I, Pearson A, Hrebien S, Gevensleben H, Proszek PZ, Hubank M, Hills M, King J, Parmar M, Prout T, Finneran L, Malia J, Swales KE, Ruddle R, Raynaud FI, Turner A, Hall E, Yap TA, Lopez JS, Turner NC. Triplet Therapy with Palbociclib, Taselisib, and Fulvestrant in PIK3CA-Mutant Breast Cancer and Doublet Palbociclib and Taselisib in Pathway-Mutant Solid Cancers. Cancer Discov 2021. [PMID: 32958578 DOI: 10.1158/2159-8290.cd-20-0553/333474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Cyclin-dependent kinase 4/6 (CDK4/6) and PI3K inhibitors synergize in PIK3CA-mutant ER-positive HER2-negative breast cancer models. We conducted a phase Ib trial investigating the safety and efficacy of doublet CDK4/6 inhibitor palbociclib plus selective PI3K inhibitor taselisib in advanced solid tumors, and triplet palbociclib plus taselisib plus fulvestrant in 25 patients with PIK3CA-mutant, ER-positive HER2-negative advanced breast cancer. The triplet therapy response rate in PIK3CA-mutant, ER-positive HER2-negative cancer was 37.5% [95% confidence interval (CI), 18.8-59.4]. Durable disease control was observed in PIK3CA-mutant ER-negative breast cancer and other solid tumors with doublet therapy. Both combinations were well tolerated at pharmacodynamically active doses. In the triplet group, high baseline cyclin E1 expression associated with shorter progression-free survival (PFS; HR = 4.2; 95% CI, 1.3-13.1; P = 0.02). Early circulating tumor DNA (ctDNA) dynamics demonstrated high on-treatment ctDNA association with shorter PFS (HR = 5.2; 95% CI, 1.4-19.4; P = 0.04). Longitudinal plasma ctDNA sequencing provided genomic evolution evidence during triplet therapy. SIGNIFICANCE: The triplet of palbociclib, taselisib, and fulvestrant has promising efficacy in patients with heavily pretreated PIK3CA-mutant ER-positive HER2-negative advanced breast cancer. A subset of patients with PIK3CA-mutant triple-negative breast cancer derived clinical benefit from palbociclib and taselisib doublet, suggesting a potential nonchemotherapy targeted approach for this population.This article is highlighted in the In This Issue feature, p. 1.
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Affiliation(s)
- Javier Pascual
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.,The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Joline S J Lim
- National University Cancer Institute, Singapore (NCIS), National University Hospital, Singapore
| | - Iain R Macpherson
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Anne C Armstrong
- Department of Medical Oncology, Christie Hospital NHS Foundation Trust and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Alistair Ring
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Alicia F C Okines
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Rosalind J Cutts
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Maria Teresa Herrera-Abreu
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Isaac Garcia-Murillas
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Alex Pearson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Sarah Hrebien
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | | | - Paula Z Proszek
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Michael Hubank
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Margaret Hills
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Jenny King
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mona Parmar
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Toby Prout
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Laura Finneran
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Jason Malia
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Karen E Swales
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Ruddle
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Florence I Raynaud
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Alison Turner
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Emma Hall
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Timothy A Yap
- Department of Investigational Cancer Therapeutics (Phase I Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Juanita S Lopez
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Nicholas C Turner
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom. .,The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom.,Ralph Lauren Centre for Breast Cancer Research, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
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36
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Pascual J, Lim JSJ, Macpherson IR, Armstrong AC, Ring A, Okines AFC, Cutts RJ, Herrera-Abreu MT, Garcia-Murillas I, Pearson A, Hrebien S, Gevensleben H, Proszek PZ, Hubank M, Hills M, King J, Parmar M, Prout T, Finneran L, Malia J, Swales KE, Ruddle R, Raynaud FI, Turner A, Hall E, Yap TA, Lopez JS, Turner NC. Triplet Therapy with Palbociclib, Taselisib, and Fulvestrant in PIK3CA-Mutant Breast Cancer and Doublet Palbociclib and Taselisib in Pathway-Mutant Solid Cancers. Cancer Discov 2021; 11:92-107. [PMID: 32958578 DOI: 10.1158/2159-8290.cd-20-0553] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/11/2020] [Accepted: 09/16/2020] [Indexed: 11/16/2022]
Abstract
Cyclin-dependent kinase 4/6 (CDK4/6) and PI3K inhibitors synergize in PIK3CA-mutant ER-positive HER2-negative breast cancer models. We conducted a phase Ib trial investigating the safety and efficacy of doublet CDK4/6 inhibitor palbociclib plus selective PI3K inhibitor taselisib in advanced solid tumors, and triplet palbociclib plus taselisib plus fulvestrant in 25 patients with PIK3CA-mutant, ER-positive HER2-negative advanced breast cancer. The triplet therapy response rate in PIK3CA-mutant, ER-positive HER2-negative cancer was 37.5% [95% confidence interval (CI), 18.8-59.4]. Durable disease control was observed in PIK3CA-mutant ER-negative breast cancer and other solid tumors with doublet therapy. Both combinations were well tolerated at pharmacodynamically active doses. In the triplet group, high baseline cyclin E1 expression associated with shorter progression-free survival (PFS; HR = 4.2; 95% CI, 1.3-13.1; P = 0.02). Early circulating tumor DNA (ctDNA) dynamics demonstrated high on-treatment ctDNA association with shorter PFS (HR = 5.2; 95% CI, 1.4-19.4; P = 0.04). Longitudinal plasma ctDNA sequencing provided genomic evolution evidence during triplet therapy. SIGNIFICANCE: The triplet of palbociclib, taselisib, and fulvestrant has promising efficacy in patients with heavily pretreated PIK3CA-mutant ER-positive HER2-negative advanced breast cancer. A subset of patients with PIK3CA-mutant triple-negative breast cancer derived clinical benefit from palbociclib and taselisib doublet, suggesting a potential nonchemotherapy targeted approach for this population.This article is highlighted in the In This Issue feature, p. 1.
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Affiliation(s)
- Javier Pascual
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Joline S J Lim
- National University Cancer Institute, Singapore (NCIS), National University Hospital, Singapore
| | - Iain R Macpherson
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Anne C Armstrong
- Department of Medical Oncology, Christie Hospital NHS Foundation Trust and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Alistair Ring
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Alicia F C Okines
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Rosalind J Cutts
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Maria Teresa Herrera-Abreu
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Isaac Garcia-Murillas
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Alex Pearson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Sarah Hrebien
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | | | - Paula Z Proszek
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Michael Hubank
- Centre for Molecular Pathology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Margaret Hills
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Jenny King
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mona Parmar
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Toby Prout
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Laura Finneran
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Jason Malia
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Karen E Swales
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Ruddle
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Florence I Raynaud
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Alison Turner
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Emma Hall
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Timothy A Yap
- Department of Investigational Cancer Therapeutics (Phase I Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Juanita S Lopez
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Nicholas C Turner
- Breast Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
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Beningfield J, Edwards P, Turner A, Kotze V. Intent and perceived barriers to implementing a fully plant based vegan diet in South Africa. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yap TA, Kristeleit R, Michalarea V, Pettitt SJ, Lim JSJ, Carreira S, Roda D, Miller R, Riisnaes R, Miranda S, Figueiredo I, Rodrigues DN, Ward S, Matthews R, Parmar M, Turner A, Tunariu N, Chopra N, Gevensleben H, Turner NC, Ruddle R, Raynaud FI, Decordova S, Swales KE, Finneran L, Hall E, Rugman P, Lindemann JPO, Foxley A, Lord CJ, Banerji U, Plummer R, Basu B, Lopez JS, Drew Y, de Bono JS. Phase I Trial of the PARP Inhibitor Olaparib and AKT Inhibitor Capivasertib in Patients with BRCA1/2- and Non- BRCA1/2-Mutant Cancers. Cancer Discov 2020; 10:1528-1543. [PMID: 32532747 PMCID: PMC7611385 DOI: 10.1158/2159-8290.cd-20-0163] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/20/2020] [Accepted: 06/09/2020] [Indexed: 11/16/2022]
Abstract
Preclinical studies have demonstrated synergy between PARP and PI3K/AKT pathway inhibitors in BRCA1 and BRCA2 (BRCA1/2)-deficient and BRCA1/2-proficient tumors. We conducted an investigator-initiated phase I trial utilizing a prospective intrapatient dose- escalation design to assess two schedules of capivasertib (AKT inhibitor) with olaparib (PARP inhibitor) in 64 patients with advanced solid tumors. Dose expansions enrolled germline BRCA1/2-mutant tumors, or BRCA1/2 wild-type cancers harboring somatic DNA damage response (DDR) or PI3K-AKT pathway alterations. The combination was well tolerated. Recommended phase II doses for the two schedules were: olaparib 300 mg twice a day with either capivasertib 400 mg twice a day 4 days on, 3 days off, or capivasertib 640 mg twice a day 2 days on, 5 days off. Pharmacokinetics were dose proportional. Pharmacodynamic studies confirmed phosphorylated (p) GSK3β suppression, increased pERK, and decreased BRCA1 expression. Twenty-five (44.6%) of 56 evaluable patients achieved clinical benefit (RECIST complete response/partial response or stable disease ≥ 4 months), including patients with tumors harboring germline BRCA1/2 mutations and BRCA1/2 wild-type cancers with or without DDR and PI3K-AKT pathway alterations. SIGNIFICANCE: In the first trial to combine PARP and AKT inhibitors, a prospective intrapatient dose- escalation design demonstrated safety, tolerability, and pharmacokinetic-pharmacodynamic activity and assessed predictive biomarkers of response/resistance. Antitumor activity was observed in patients harboring tumors with germline BRCA1/2 mutations and BRCA1/2 wild-type cancers with or without somatic DDR and/or PI3K-AKT pathway alterations.This article is highlighted in the In This Issue feature, p. 1426.
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Affiliation(s)
- Timothy A Yap
- Royal Marsden Hospital, London, United Kingdom.
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Stephen J Pettitt
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | | | | | - Desamparados Roda
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Rowan Miller
- University College London, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Sarah Ward
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Matthews
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Mona Parmar
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Alison Turner
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | | | - Neha Chopra
- Royal Marsden Hospital, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | | | - Nicholas C Turner
- Royal Marsden Hospital, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Ruddle
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Karen E Swales
- The Institute of Cancer Research, London, United Kingdom
| | - Laura Finneran
- The Institute of Cancer Research, London, United Kingdom
| | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
| | - Paul Rugman
- Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | | | - Andrew Foxley
- Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Christopher J Lord
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | - Udai Banerji
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Plummer
- Clinical and Translational Research Institute, Newcastle University, Newcastle, United Kingdom
| | - Bristi Basu
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Juanita S Lopez
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Yvette Drew
- Clinical and Translational Research Institute, Newcastle University, Newcastle, United Kingdom
| | - Johann S de Bono
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
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Papadatos-Pastos D, Pal A, Akay M, Ameratunga M, Mithra S, Ang JE, Levva S, Caldwell R, Riisnaes R, Crespo M, Yuan W, Seed G, Gurel B, Figueiredo I, Pereira R, Miranda S, Ferreira A, Carreira S, Bertan C, Baker C, Morilla R, Brown R, Masrour N, Prout T, Zachariou A, Turner A, Parmar M, Van de Velde M, Jenkins B, Yap C, Tunariu N, Banerji U, Lopez J, Minchom A, De Bono J. Abstract CT129: HyPeR: A phase 1, dose escalation and expansion trial of guadecitabine (SGI-110), a second-generation hypomethylating agent in combination with pembrolizumab (MK3475) in patients with refractory solid tumors. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-ct129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Methylation is reported to support cancer immune tolerance. We conducted a phase 1 dose-escalation trial [NCT02998567] of combination guadecitabine (G; DNA hypomethylating agent) and pembrolizumab (P) in patients (pts) with advanced cancers. We hypothesized that G can normalize the expression of epigenetically suppressed immune genes, increase interferon producing tumor-infiltrating lymphocytes (TILs), and enhance the anticancer activity of P. Methods: In dose escalation (Es), pts received G (45 mg/m2 or 30 mg/m2, administered SC on days 1-4) with P (200 mg, administered IV starting from cycle 2 onwards) as outpatient Q3W; in expansion (Ex), the RP2D of G (30 mg/m2) with P (200 mg) Q3W was administered. Pre-treatment and on-treatment tumor biopsies were evaluated for PD-L1 expression, tumor infiltrating lymphocytes, gene expression by RNAseq and methylome studies. Longitudinal analyses of peripheral blood CD3, CD4 and CD8 lymphocytes by flow cytometry were performed. Results: Overall, 34 pts (Es, n = 14; Ex, n = 20) were evaluable for safety. The most common treatment-related adverse events (TRAEs) were neutropenia (n = 21), fatigue (n = 6) and thrombocytopenia (n = 3), diarrhea (n = 2). G3+ TRAEs were neutropenia (n = 14), febrile neutropenia (n = 4), raised ALP (n = 1), raised AST (n=1), colitis (n = 1), diarrhoea (n = 1) and lung infection (n = 1). Two DLTs (neutropenia, febrile neutropenia) were reported at G 45mg/m2 with none reported at G 30mg/m2. There were no treatment-related deaths. In total, 28 pts (Es, n = 12; Ex, n = 16) were evaluable for antitumor activity studies (≥2 scans); ORR (CR+PR) and DCR (CR+PR+SD) were 3% and 57%; 10/15 pts with non-small cell lung cancer (13 pts resistant/refractory to PD-1/PD-L1 targeting agents) were evaluable, with a DCR of 80% and 5 pts having DCR > 6 months with 8 pts remaining on study treatment. Overall, 25 paired biopsies were obtained. Using LINE1 sequences to study global methylation, both tumor biopsies and peripheral blood showed reduced methylation post-G treatment. Preliminary data on tumor-infiltrating lymphocytes assessed by multicolor immunofluorescence in 9 paired biopsies showed a numerical increase in median values of T-helper (CD4+FOXP3-) (10.20 to 19.70, p = 0.5469), T-regulatory (CD4+FOXP3+) (5.1 to 6.7, p=0.8438), and T-cytotoxic (CD8+) cell densities (2.7 to 7.4, p=0.6523) . Comparing with matched pre-treatment, on treatment tumor had numerical increases in interferon alpha and gamma response pathway activation in serial biopsy RNAseq analyses but did not reach significance. Conclusions: G plus P resulted in no unexpected toxicities with evidence suggestive of biological and anti-cancer activity.
Citation Format: Dionysis Papadatos-Pastos, Abhijit Pal, Melek Akay, Malaka Ameratunga, Sanjena Mithra, Joo-Ern Ang, Sofia Levva, Reece Caldwell, Ruth Riisnaes, Mateus Crespo, Wei Yuan, George Seed, Bora Gurel, Ines Figueiredo, Rita Pereira, Susana Miranda, Anna Ferreira, Suzanne Carreira, Claudia Bertan, Chloe Baker, Ricardo Morilla, Robert Brown, Nahal Masrour, Toby Prout, Anna Zachariou, Alison Turner, Mona Parmar, Mark Van de Velde, Ben Jenkins, Christina Yap, Nina Tunariu, Udai Banerji, Juanita Lopez, Anna Minchom, Johann De Bono. HyPeR: A phase 1, dose escalation and expansion trial of guadecitabine (SGI-110), a second-generation hypomethylating agent in combination with pembrolizumab (MK3475) in patients with refractory solid tumors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT129.
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Affiliation(s)
| | | | - Melek Akay
- 1University College London Hospitals, London, United Kingdom
| | - Malaka Ameratunga
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
| | - Sanjena Mithra
- 1University College London Hospitals, London, United Kingdom
| | - Joo-Ern Ang
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
| | - Sofia Levva
- 1University College London Hospitals, London, United Kingdom
| | - Reece Caldwell
- 4The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- 4The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- 4The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- 4The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- 4The Institute of Cancer Research, London, United Kingdom
| | - Bora Gurel
- 4The Institute of Cancer Research, London, United Kingdom
| | | | - Rita Pereira
- 4The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- 4The Institute of Cancer Research, London, United Kingdom
| | - Anna Ferreira
- 4The Institute of Cancer Research, London, United Kingdom
| | | | - Claudia Bertan
- 4The Institute of Cancer Research, London, United Kingdom
| | - Chloe Baker
- 4The Institute of Cancer Research, London, United Kingdom
| | - Ricardo Morilla
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
| | - Robert Brown
- 5Imperial College London, London, United Kingdom
| | | | - Toby Prout
- 4The Institute of Cancer Research, London, United Kingdom
| | - Anna Zachariou
- 4The Institute of Cancer Research, London, United Kingdom
| | - Alison Turner
- 4The Institute of Cancer Research, London, United Kingdom
| | - Mona Parmar
- 4The Institute of Cancer Research, London, United Kingdom
| | | | - Ben Jenkins
- 4The Institute of Cancer Research, London, United Kingdom
| | - Christina Yap
- 4The Institute of Cancer Research, London, United Kingdom
| | - Nina Tunariu
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
| | - Udai Banerji
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
| | - Juanita Lopez
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
| | - Anna Minchom
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
| | - Johann De Bono
- 3The Royal Marsden and Institute of Cancer Research, London, United Kingdom
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Lopez JS, Biondo A, Tiu C, Scaranti M, Ameratunga M, Zachariou A, Turner A, Tunariu N, Prout T, Parmar M, Badham H, Swales K, Yuan W, Morilla R, Crespo M, Daly R, Figueiredo I, Gurel B, Pereira R, Riisnaes R, Vivanco I, Minchom A, Jenkins B, Yap C, Banerji U, De Bono J. Abstract CT140: Proof-of-concept evidence of immune modulation by blockade of the phosphatidylinositol 3-kinase (PI3K)-AKT signaling pathway in the phase I dose escalation study of Ipatasertib (Ipa) in combination with atezolizumab (A) in patients (pts) with advanced solid tumors (Ice-CAP). Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-ct140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Hyperactivation of the PI3K/AKT pathway correlates with impaired anti-tumor responses, including reduced T cell infiltration into tumor, and reduced efficacy of immune checkpoint inhibitors. Blockade of this pathway synergizes with PD-L1/PD-1 axis blockade preclinically.
Methods: This Phase I clinical trial (NCT03673787) assessed the safety, pharmacodynamic, and preliminary clinical activity of Ipa (200mg or 400mg OD) given in combination with A 1200mg q3 wk in refractory pts. Serial paired blood and tumor samples were analysed to interrogate the effect of Ipa on the tumor micro-environment and host immune system prior to the addition of the immune check point inhibitor, A.
Results: 18 adult pts were treated in dose escalation. Median age 49 yrs. All pts had ECOG PS 0-1 and median 7 prior therapies. Most common TRAEs (>15%) were mild Gr1-2 diarrhea (56%), rash (50%), fatigue (33%), nausea (33%), raised ALT/AST (33%), headache (28%) and arthralgia (22%). 1 pt had G2 systemic immune activation; 2 pts had G3 rash, both rapidly reversible. 1 DLT of G3 raised ALT seen at 200mg (1 DLT/9 evaluable pts) but none at 400mg (0 DLT/6). Of 14 RECIST evaluable patients, there were 2 confirmed PRs, and 5 SD (clinical benefit rate 50%). Reductions of CD4+FOXP3+ Tregs in tumor microenvironment were seen after 2wks of single agent Ipa, regardless of PIK3/AKT somatic mutation status (Table 1). Responding pts had a >400% median increase in intra-tumoral CD8+ Teff cell infiltration, effectively switching from a desert phenotype to an inflamed phenotype. Paired changes in FACS, transcriptome and cytokine will also be presented.Conclusions: The RP2D of Ipa 400mg OD combination with A was well tolerated with early efficacy signals. Further biomarker work is ongoing and will be evaluated in expansion cohorts.
Table 1:Changes in immune cell populations as assessed by multicolour Immunofluorescence in paired biopsies of breast/gynae patients, % change in cell number/mm2 from baseline (median [min,max$])&Post 2 weeks single agent Ipatasertib(n=9)Post 1 cycle of combination Ipatasertib and Atezolizumab(n=7)CD4+FOXP3+Tregs cellsCD 8+ Teff cellsCD4+FOXP3+Tregs cellsCD 8+ Teff cellsIntra-tumourstromaIntra-tumourstromaIntra-tumourstromaIntra-tumourstromaAll patients-23.9*[-89.7, BL0]-30.0*[-91.6, BL0]-37.7*[-84.4, -24.5]-28.4[-92.4, 259.8]335.9[-44.0,BL0]45.4[-51.0, BL0]59.6[-60.6,493.3]64.7[-51.7,293.3]Stratified by somatic PI3K/AKT/PTEN mutational statusPathogenic mutations (mt)11.1[-82.2, BL0]#-10.7[-91.6, BL0]Φnsnsnsns-30.5[-60.6,-0.5]11.3[-51.7,50.0]Wildtype (wt)-63.1[-89.7,19.0]#-47.5[-77.0,11.1]Φnsnsnsns426.5[59.6,493.3]126.7[79.4,293.3]Stratified by responseResponders (PR + SD>4 cycles). 1 ER+ HER2+ breast cancer (wt), 1 ER+ HER2- breast cancer (wt)459.9[426.5,493.3]@103.1[79.4,126.7]Non-responders (PD at 4 cycles) 1 cervical cancer, 4 ER+ breast cancer-0.5[-60.6, 59.6]@30.6[-51.7,293.3]*significant change (p≤0.05; Wilcoxon sign-rank test) from baseline, $maximum values denoted by BL0indicate that the baseline value was zero, and so percentage change from baseline is not defined. For the analysis, the baseline value has been replaced by a nominal value of 0.1 so that a large percentage increase is associated with these cases. Note that these large percentage increases do not affect the non-parametric statistical tests used.#no significant difference in distribution of reduction in intra-tumoural CD4+ FOXP3+Tregsbetween pts with pathogenic mutations in PI3K/AKT and those without (p=0.30; Wilcoxon rank-sum test)Φno significant difference in distribution of reduction in stromal CD4+FOXP3+Tregsbetween pts with pathogenic mutations in PI3K/AKT and those without (p=0.44; Wilcoxon rank-sum test) @ difference between responders and non-responders p=0.083; Wilcoxon rank-sum test)mt pathogenic mutations in PI3K/AKT and PTEN as per COSMIC database present in tumour or PTEN loss by IHC. wt no pathogenic mutations in PI3K/AKT and PTEN as per COSMIC database detected in tumour and intact PTEN expression by IHC. &exploratory analyses with no adjustment for multiple testing
Citation Format: Juanita S. Lopez, Andrea Biondo, Crescens Tiu, Mariana Scaranti, Malaka Ameratunga, Anna Zachariou, Alison Turner, Nina Tunariu, Toby Prout, Mona Parmar, Hannah Badham, Karen Swales, Wei Yuan, Ricardo Morilla, Mateus Crespo, Rob Daly, Ines Figueiredo, Bora Gurel, Rita Pereira, Ruth Riisnaes, Igor Vivanco, Anna Minchom, Ben Jenkins, Christina Yap, Udai Banerji, Johann De Bono. Proof-of-concept evidence of immune modulation by blockade of the phosphatidylinositol 3-kinase (PI3K)-AKT signaling pathway in the phase I dose escalation study of Ipatasertib (Ipa) in combination with atezolizumab (A) in patients (pts) with advanced solid tumors (Ice-CAP) [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT140.
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Affiliation(s)
- Juanita S. Lopez
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Andrea Biondo
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Crescens Tiu
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Mariana Scaranti
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Malaka Ameratunga
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Anna Zachariou
- 2The Institute of Cancer Research, London, United Kingdom
| | - Alison Turner
- 2The Institute of Cancer Research, London, United Kingdom
| | - Nina Tunariu
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Toby Prout
- 2The Institute of Cancer Research, London, United Kingdom
| | - Mona Parmar
- 2The Institute of Cancer Research, London, United Kingdom
| | - Hannah Badham
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Karen Swales
- 2The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- 2The Institute of Cancer Research, London, United Kingdom
| | - Ricardo Morilla
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- 2The Institute of Cancer Research, London, United Kingdom
| | - Rob Daly
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | | | - Bora Gurel
- 2The Institute of Cancer Research, London, United Kingdom
| | - Rita Pereira
- 2The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- 2The Institute of Cancer Research, London, United Kingdom
| | - Igor Vivanco
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Anna Minchom
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Ben Jenkins
- 2The Institute of Cancer Research, London, United Kingdom
| | - Christina Yap
- 2The Institute of Cancer Research, London, United Kingdom
| | - Udai Banerji
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
| | - Johann De Bono
- 1The Royal Marsden NHS Foundation Trust Hospital and the Institute of Cancer Research, London, United Kingdom
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Shinde R, Terbuch A, Little M, Caldwell R, Kurup R, Riisnaes R, Crespo M, Ruddle R, Gurel B, Stewart A, King J, Parmar M, Turner A, Raynaud F, Mahmud M, Yap C, Pachter JA, Mills GB, Minchom A, Lopez J, Banerjee SN, de Bono JS, Krebs M, Banerji U. Abstract CT143: Phase I study of the combination of a RAF-MEK inhibitor CH5126766 and FAK inhibitor defactinib in an intermittent dosing schedule with expansions inKRASmutant cancers. Tumour Biol 2020. [DOI: 10.1158/1538-7445.am2020-ct143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Heads JT, Lamb R, Kelm S, Adams R, Elliott P, Tyson K, Topia S, West S, Nan R, Turner A, Lawson ADG. Electrostatic interactions modulate the differential aggregation propensities of IgG1 and IgG4P antibodies and inform charged residue substitutions for improved developability. Protein Eng Des Sel 2020; 32:277-288. [PMID: 31868219 PMCID: PMC7036597 DOI: 10.1093/protein/gzz046] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/17/2019] [Accepted: 11/19/2019] [Indexed: 11/14/2022] Open
Abstract
Native state aggregation is an important concern in the development of therapeutic antibodies. Enhanced knowledge of mAb native state aggregation mechanisms would permit sequence-based selection and design of therapeutic mAbs with improved developability. We investigated how electrostatic interactions affect the native state aggregation of seven human IgG1 and IgG4P mAb isotype pairs, each pair having identical variable domains that are different for each set of IgG1 and IgG4P constructs. Relative aggregation propensities were determined at pH 7.4, representing physiological conditions, and pH 5.0, representing commonly used storage conditions. Our work indicates that the net charge state of variable domains relative to the net charge state of the constant domains is predominantly responsible for the different native state aggregation behavior of IgG1 and IgG4P mAbs. This observation suggests that the global net charge of a multi domain protein is not a reliable predictor of aggregation propensity. Furthermore, we demonstrate a design strategy in the frameworks of variable domains to reduce the native state aggregation propensity of mAbs identified as being aggregation-prone. Importantly, substitution of specifically identified residues with alternative, human germline residues, to optimize Fv charge, resulted in decreased aggregation potential at pH 5.0 and 7.4, thus increasing developability.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ruodan Nan
- UCB Pharma, Slough, Berkshire SL1 3WE, UK
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Stabel JR, Turner A, Walker M. An eco-friendly decontaminant to kill Mycobacterium avium subsp. paratuberculosis. J Microbiol Methods 2020; 176:106001. [PMID: 32653399 DOI: 10.1016/j.mimet.2020.106001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
Mycobacteria are difficult to kill due to the complexity of their cell wall. Further, Mycobacterium avium subsp. paratuberculosis (MAP) has one of the more elaborate cell wall compositions of all the mycobacteria. As a working pathogen within a research laboratory setting or as an environmental contaminant shed in the manure from infected animals, MAP is highly resistant to typical disinfectants. In the past, the most successful disinfectants to kill mycobacteria were based upon phenolics, harsh compounds that can break down the lipids within the cell wall. New disinfectants have been developed that are less toxic to the environment, however, it is unknown how well they perform compared to more traditional disinfectants. In the present study, we present comparative data on the utility of a commercial eco-friendly disinfectant, Benefect®, compared to Amphyl®, a phenolic-based disinfectant, and Lysol®, a quaternary ammonium-based disinfectant, to kill MAP in pure culture, tissues, and manure. Results demonstrated that Benefect was highly effective with up to 100% kill of MAP within 30 min in all experiments, paralleling results obtained with Amphyl. Lysol performed the most poorly, requiring longer contact times to kill MAP. These results suggest that natural, nontoxic ingredients can be used to disinfect even hearty pathogens such as MAP effectively, both within the laboratory and on-farm.
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Affiliation(s)
- J R Stabel
- USDA-ARS-National Animal Disease Center, Ames, IA 50010, United States of America.
| | - A Turner
- USDA-ARS-National Animal Disease Center, Ames, IA 50010, United States of America
| | - M Walker
- USDA-ARS-National Animal Disease Center, Ames, IA 50010, United States of America
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Eirene O, Bubu OM, Donley T, Blanc J, Madera C, Turner A, Mbah AK, Williams NJ, Youngstedt S, Shochat T, Seixas AA, Osorio RS, Jean-Louis G. 0864 Race/ethnicity And Sex-dependent Effects Of Metabolic Burden Across Different Age-categories On Trends In Self-reported Sleep Duration: Findings From The National Health Interview Survey, 2004-2013. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We examined race and sex-dependent effects of metabolic burden across different age-categories on trends in self-reported sleep duration for the U.S. non-institutionalized civilian population.
Methods
We analyzed data from the National Health Interview Survey (NHIS) adults aged 18-85 from 2004 to 2013 (N=258,158). Metabolic burden was characterized by obesity (BMI>30), dyslipidemia, diabetes, and hypertension morbidity burden levels. Racial/ethnic categories included non-Hispanic Whites (NHW), Blacks/African Americans (AAs) and Hispanics. Sleep duration within a 24-hour period on average was categorized as short sleep (≤ 6hrs), adequate sleep (7-8 hrs.), and long sleep (≥ 9hrs). Age was categorized as 18 - <26, 26 - <65 and 65 - 85. Adjusted multinomial logistic regression models stratified by race, sex and age-categories examined effects of metabolic burden on trends in self-reported sleep duration.
Results
The prevalence of short sleep duration was relatively stable from 2004-2012 for NHW and all females. However, AA and Hispanic males showed consistent increase in the rates of short sleepers beginning in 2007 through 2013 especially for ages 18 - <26, and 26 - <65 (P <.001 for trend). For all racial/ethnic categories, compared to individuals aged 18 - <26, individuals aged 26 - <65 were more likely to report short sleep (aOR: 1.55, 95% CI: 1.50-1.61) and individuals aged 65 - 85 were more likely to be long sleepers (aOR: 1.95, 95% CI: 1.86-2.05). Interestingly, the rate of short sleep increased as the metabolic burden increased (P <.001 for trend). This trend was more pronounced among AA and Hispanic males aged 65 - 85 with ≥ 2 metabolic conditions who were more likely to report short sleep (aOR: 1.77, 95% CI: 1.44-2.19 and aOR: 1.45, 95% CI: 1.17-1.93 respectively), compared to NHW males.
Conclusion
Increased metabolic burden among minority populations and especially in the elderly male, affect sleep and may have consequences for treating these populations.
Support
NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01AG056531, R25HL105444, R25NS094093, K07AG05268503, R01HL142066, K23HL125939)
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Affiliation(s)
- O Eirene
- NYU School of Medicine, New York, NY
| | - O M Bubu
- NYU School of Medicine, New York, NY
| | - T Donley
- NYU School of Medicine, New York, NY
| | - J Blanc
- NYU School of Medicine, New York, NY
| | - C Madera
- NYU School of Medicine, New York, NY
| | - A Turner
- NYU School of Medicine, New York, NY
| | - A K Mbah
- University of South Florida, Tampa, FL
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Lightwood D, Tservistas M, Zehentleitner M, Sarkar K, Turner A, Bracher M, Smith B, Lamour S, Bourne T, Shaw S, Gozzard N, Palframan RT. Efficacy of an Inhaled IL-13 Antibody Fragment in a Model of Chronic Asthma. Am J Respir Crit Care Med 2019; 198:610-619. [PMID: 29883204 DOI: 10.1164/rccm.201712-2382oc] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
RATIONALE IL-13 is an important cytokine implicated in the pathogenesis of allergic asthma and is an attractive target for an inhaled therapeutic. OBJECTIVE To investigate the efficacy of CDP7766, a nebulized inhaled anti-IL-13 monoclonal antibody Fab fragment, in a model of allergic asthma in cynomolgus macaques naturally sensitized to Ascaris suum. METHODS CDP7766 was nebulized using a vibrating-membrane nebulizer on the basis of eFlow technology. The aerosol generated was analyzed to determine the particle size profile and the biophysical and functional properties of CDP7766. Nebulized CDP7766 (0.1-60 mg/animal, once daily for 5 d) was delivered via the inhaled route. MEASUREMENTS AND MAIN RESULTS The investigational eFlow nebulizer used in this study generated a respirable aerosol of CDP7766 with no evidence of degradation, loss of potency, aggregation, or formation of particulates. Inhaled CDP7766 was well tolerated in the model (no adverse effects related to local irritation) and significantly inhibited BAL allergen-induced cytokine and chemokine upregulation (60 mg vs. vehicle: eotaxin-3, P < 0.0008; MIP [macrophage inflammatory protein]-1β, IL-8, IFN-γ, P ≤ 0.01). CDP7766 significantly inhibited the increase in pulmonary resistance stimulated by inhaled allergen, measured 15 minutes and 24 hours after allergen challenge. CONCLUSION Inhaled CDP7766 potently inhibited the function of IL-13 generated during the airway response to inhaled allergen in cynomolgus macaques, demonstrating the potential of inhaled anti-IL-13 therapeutics for the treatment of allergic asthma.
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Affiliation(s)
| | | | | | | | - Alison Turner
- 1 UCB Pharma, Slough, Berkshire, United Kingdom; and
| | | | - Bryan Smith
- 1 UCB Pharma, Slough, Berkshire, United Kingdom; and
| | | | - Tim Bourne
- 1 UCB Pharma, Slough, Berkshire, United Kingdom; and
| | - Stevan Shaw
- 1 UCB Pharma, Slough, Berkshire, United Kingdom; and
| | - Neil Gozzard
- 1 UCB Pharma, Slough, Berkshire, United Kingdom; and
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Mackinnon AL, Jackson K, Kuznik K, Turner A, Hill J, Davies MAM, Jones ME, Delmestri A, Sanchez-Santos MT, Newton J. Increased Risk of Musculoskeletal Disorders and Mental Health Problems in Retired Professional Jockeys: A Cross-Sectional Study. Int J Sports Med 2019; 40:e5-e5. [PMID: 31480087 PMCID: PMC10332912 DOI: 10.1055/a-1004-5495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Anna-Louise Mackinnon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Kate Jackson
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Kerry Kuznik
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
- British Horseracing Authority Ltd, Medical, London, United Kingdom of Great Britain and Northern Ireland
| | - Alison Turner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Jerry Hill
- British Horseracing Authority Ltd, Medical, London, United Kingdom of Great Britain and Northern Ireland
| | - Madeleine A M Davies
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
- Department of Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
| | - Mary Elizabeth Jones
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Antonella Delmestri
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Maria T Sanchez-Santos
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Julia Newton
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
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47
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Mackinnon AL, Jackson K, Kuznik K, Turner A, Hill J, Davies MAM, Jones ME, Delmestri A, Sanchez-Santos MT, Newton J. Increased Risk of Musculoskeletal Disorders and Mental Health Problems in Retired Professional Jockeys: A Cross-Sectional Study. Int J Sports Med 2019; 40:732-738. [PMID: 31390657 DOI: 10.1055/a-0902-8601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To examine the prevalence of chronic disease and mental health problems in retired professional, male jockeys compared to an age-matched reference population. A cross-sectional study comparing data from a cohort of retired professional jockeys with an age-matched general population sample. Male participants (age range: 50-89 years old) were used to compare health outcomes of self-reported physician-diagnosed conditions: heart disease, stroke, diabetes, hypertension, osteoporosis, osteoarthritis, depression and anxiety between study populations. Conditional logistic regression models were used to estimate associations between study groups and health outcome. In total, 810 participants (135 retired professional male jockeys and 675 participants from the reference population) were included, with an average age of 64.7±9.9 years old. Increased odds of having osteoporosis (OR=6.5, 95%CI 2.1-20.5), osteoarthritis (OR=7.5, 95%CI 4.6-12.2), anxiety (OR=2.8, 95%CI 1.3-5.9) and depression (OR=2.6, 95%CI 1.3-5.7) were seen in the retired professional jockeys. No differences were found for the remaining health outcomes. Retired professional jockeys had increased odds of musculoskeletal disease and mental health problems compared to the general population. Understanding the prevalence of chronic disease and mental health problems in retired professional jockeys will help inform screening and intervention strategies for jockeys.
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Affiliation(s)
- Anna-Louise Mackinnon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Kate Jackson
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Kerry Kuznik
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland.,British Horseracing Authority Ltd, Medical, London, United Kingdom of Great Britain and Northern Ireland
| | - Alison Turner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Jerry Hill
- British Horseracing Authority Ltd, Medical, London, United Kingdom of Great Britain and Northern Ireland
| | - Madeleine A M Davies
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland.,Department of Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
| | - Mary Elizabeth Jones
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Antonella Delmestri
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Maria T Sanchez-Santos
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Julia Newton
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Oxford, United Kingdom of Great Britain and Northern Ireland.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
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48
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Prasai K, Jiang J, Mishkin A, Shyam B, Angelova S, Birney R, Drabold DA, Fazio M, Gustafson EK, Harry G, Hoback S, Hough J, Lévesque C, MacLaren I, Markosyan A, Martin IW, Menoni CS, Murray PG, Penn S, Reid S, Robie R, Rowan S, Schiettekatte F, Shink R, Turner A, Vajente G, Cheng HP, Fejer MM, Mehta A, Bassiri R. High Precision Detection of Change in Intermediate Range Order of Amorphous Zirconia-Doped Tantala Thin Films Due to Annealing. Phys Rev Lett 2019; 123:045501. [PMID: 31491265 DOI: 10.1103/physrevlett.123.045501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Indexed: 06/10/2023]
Abstract
Understanding the local atomic order in amorphous thin film coatings and how it relates to macroscopic performance factors, such as mechanical loss, provides an important path towards enabling the accelerated discovery and development of improved coatings. High precision x-ray scattering measurements of thin films of amorphous zirconia-doped tantala (ZrO_{2}-Ta_{2}O_{5}) show systematic changes in intermediate range order (IRO) as a function of postdeposition heat treatment (annealing). Atomic modeling captures and explains these changes, and shows that the material has building blocks of metal-centered polyhedra and the effect of annealing is to alter the connections between the polyhedra. The observed changes in IRO are associated with a shift in the ratio of corner-sharing to edge-sharing polyhedra. These changes correlate with changes in mechanical loss upon annealing, and suggest that the mechanical loss can be reduced by developing a material with a designed ratio of corner-sharing to edge-sharing polyhedra.
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Affiliation(s)
- K Prasai
- E. L. Ginzton Laboratory, Stanford University, Stanford, California 94305, USA
| | - J Jiang
- Department of Physics and Quantum Theory Project, University of Florida, Gainesville, Florida 32611, USA
| | - A Mishkin
- Department of Physics and Quantum Theory Project, University of Florida, Gainesville, Florida 32611, USA
| | - B Shyam
- University of Dayton Research Institute, Dayton, Ohio 45469, USA
| | - S Angelova
- SUPA, Department of Biomedical Engineering, University of Strathclyde, Glasgow G1 1QE, United Kingdom
| | - R Birney
- SUPA, Department of Biomedical Engineering, University of Strathclyde, Glasgow G1 1QE, United Kingdom
| | - D A Drabold
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - M Fazio
- Department of Electrical and Computer Engineering, Colorado State University, Fort Collins, Colorado 80523, USA
| | - E K Gustafson
- LIGO Laboratory, California Institute of Technology, Pasadena, California 91125, USA
| | - G Harry
- Department of Physics, American University, Washington, DC 20016, USA
| | - S Hoback
- Department of Physics, American University, Washington, DC 20016, USA
| | - J Hough
- SUPA, School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - C Lévesque
- Department of Physics, Université de Montréal, Québec H3T 1J4, Canada
| | - I MacLaren
- SUPA, School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A Markosyan
- E. L. Ginzton Laboratory, Stanford University, Stanford, California 94305, USA
| | - I W Martin
- SUPA, School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - C S Menoni
- Department of Electrical and Computer Engineering, Colorado State University, Fort Collins, Colorado 80523, USA
| | - P G Murray
- SUPA, School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - S Penn
- Department of Physics, Hobart and William Smith Colleges, Geneva, New York 14456, USA
| | - S Reid
- SUPA, Department of Biomedical Engineering, University of Strathclyde, Glasgow G1 1QE, United Kingdom
| | - R Robie
- SUPA, School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - S Rowan
- SUPA, School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - F Schiettekatte
- Department of Physics, Université de Montréal, Québec H3T 1J4, Canada
| | - R Shink
- Department of Physics, Université de Montréal, Québec H3T 1J4, Canada
| | - A Turner
- SUPA, School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - G Vajente
- LIGO Laboratory, California Institute of Technology, Pasadena, California 91125, USA
| | - H-P Cheng
- Department of Physics and Quantum Theory Project, University of Florida, Gainesville, Florida 32611, USA
| | - M M Fejer
- E. L. Ginzton Laboratory, Stanford University, Stanford, California 94305, USA
| | - A Mehta
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - R Bassiri
- E. L. Ginzton Laboratory, Stanford University, Stanford, California 94305, USA
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Van Kampen C, Arnoczky S, Parks P, Hackett E, Ruehlman D, Turner A, Schlegel T. Tissue-engineered augmentation of a rotator cuff tendon using a reconstituted collagen scaffold: a histological evaluation in sheep. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2013.17] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - S. Arnoczky
- Laboratory for Comparative Orthopaedic Research, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - P. Parks
- Histopathometrics, LLC, Mendota Heights, Minnesota, USA
| | - E. Hackett
- Small Ruminant Comparative Orthopedic Laboratory, Department of Clinical Sciences, Colorado State University, Ft. Collins, Colorado, USA
| | - D. Ruehlman
- Small Ruminant Comparative Orthopedic Laboratory, Department of Clinical Sciences, Colorado State University, Ft. Collins, Colorado, USA
| | - A. Turner
- Small Ruminant Comparative Orthopedic Laboratory, Department of Clinical Sciences, Colorado State University, Ft. Collins, Colorado, USA
| | - T. Schlegel
- Steadman Hawkins Clinic Denver, Greenwood Village, Colorado, USA
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50
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Adizie J, Kadiri S, Ismail I, Woolhouse I, Turner A. A local qualitative study exploring facilitators and barriers to effective lung cancer decision making. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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