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Tkalcec A, Bierlein M, Seeger-Schneider G, Walitza S, Jenny B, Menks WM, Felhbaum LV, Borbas R, Cole DM, Raschle N, Herbrecht E, Stadler C, Cubillo A. Empathy deficits, callous-unemotional traits and structural underpinnings in autism spectrum disorder and conduct disorder youth. Autism Res 2023; 16:1946-1962. [PMID: 37548142 DOI: 10.1002/aur.2993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023]
Abstract
Distinct empathy deficits are often described in patients with conduct disorder (CD) and autism spectrum disorder (ASD) yet their neural underpinnings and the influence of comorbid Callous-Unemotional (CU) traits are unclear. This study compares the cognitive (CE) and affective empathy (AE) abilities of youth with CD and ASD, their potential neuroanatomical correlates, and the influence of CU traits on empathy. Adolescents and parents/caregivers completed empathy questionnaires (N = 148 adolescents, mean age = 15.16 years) and T1 weighted images were obtained from a subsample (N = 130). Group differences in empathy and the influence of CU traits were investigated using Bayesian analyses and Voxel-Based Morphometry with Threshold-Free Cluster Enhancement focusing on regions involved in AE (insula, amygdala, inferior frontal gyrus and cingulate cortex) and CE processes (ventromedial prefrontal cortex, temporoparietal junction, superior temporal gyrus, and precuneus). The ASD group showed lower parent-reported AE and CE scores and lower self-reported CE scores while the CD group showed lower parent-reported CE scores than controls. When accounting for the influence of CU traits no AE deficits in ASD and CE deficits in CD were found, but CE deficits in ASD remained. Across all participants, CU traits were negatively associated with gray matter volumes in anterior cingulate which extends into the mid cingulate, ventromedial prefrontal cortex, and precuneus. Thus, although co-occurring CU traits have been linked to global empathy deficits in reports and underlying brain structures, its influence on empathy aspects might be disorder-specific. Investigating the subdimensions of empathy may therefore help to identify disorder-specific empathy deficits.
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Affiliation(s)
- Antonia Tkalcec
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Maria Bierlein
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Gudrun Seeger-Schneider
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Bettina Jenny
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Willeke M Menks
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, and Radboud University Medical Centre, Nijmegen, the Netherlands
- Psychology of Language Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Lynn V Felhbaum
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Reka Borbas
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - David M Cole
- Translational Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Nora Raschle
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Evelyn Herbrecht
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Christina Stadler
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Ana Cubillo
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
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Cubillo A, Tkalcec A, Oldenhof H, Unternaehrer E, Raschle N, Kohls G, Nauta-Jansen L, Hervas A, Fernandez-Rivas A, Konrad K, Popma A, Freitag C, de Brito S, Fairchild G, Stadler C. Linking heart rate variability to psychological health and brain structure in adolescents with and without conduct disorder. Front Psychiatry 2023; 14:1101064. [PMID: 37441149 PMCID: PMC10333527 DOI: 10.3389/fpsyt.2023.1101064] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/29/2023] [Indexed: 07/15/2023] Open
Abstract
Aims Heart rate variability (HRV) measures have been suggested in healthy individuals as a potential index of self-regulation skills, which include both cognitive and emotion regulation aspects. Studies in patients with a range of psychiatric disorders have however mostly focused on the potential association between abnormally low HRV at rest and specifically emotion regulation difficulties. Emotion regulation deficits have been reported in patients with Conduct Disorder (CD) however, the association between these emotion regulation deficits and HRV measures has yet to be fully understood. This study investigates (i) the specificity of the association between HRV and emotion regulation skills in adolescents with and without CD and (ii) the association between HRV and grey matter brain volumes in key areas of the central autonomic network which are involved in self-regulation processes, such as insula, lateral/medial prefrontal cortices or amygdala. Methods Respiratory sinus arrhythmia (RSA) measures of HRV were collected from adolescents aged between 9-18 years (693 CD (427F)/753 typically developing youth (TD) (500F)), as part of a European multi-site project (FemNAT-CD). The Inverse Efficiency Score, a speed-accuracy trade-off measure, was calculated to assess emotion and cognitive regulation abilities during an Emotional Go/NoGo task. The association between RSA and task performance was tested using multilevel regression models. T1-weighted structural MRI data were included for a subset of 577 participants (257 CD (125F); 320 TD (186F)). The CerebroMatic toolbox was used to create customised Tissue Probability Maps and DARTEL templates, and CAT12 to segment brain images, followed by a 2 × 2 (sex × group) full factorial ANOVA with RSA as regressor of interest. Results There were no significant associations between RSA and task performance, neither during emotion regulation nor during cognitive regulation trials. RSA was however positively correlated with regional grey matter volume in the left insula (pFWE = 0.011) across all subjects. Conclusion RSA was related to increased grey matter volume in the left insula across all subjects. Our results thus suggest that low RSA at rest might be a contributing or predisposing factor for potential self-regulation difficulties. Given the insula's role in both emotional and cognitive regulation processes, these brain structural differences might impact either of those.
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Affiliation(s)
- Ana Cubillo
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Antonia Tkalcec
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
| | - Helena Oldenhof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Child and Adolescent Psychiatry, Amsterdam Public Health, Amsterdam, Netherlands
| | - Eva Unternaehrer
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
| | - Nora Raschle
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Gregor Kohls
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Lucres Nauta-Jansen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Child and Adolescent Psychiatry, Amsterdam Public Health, Amsterdam, Netherlands
| | - Amaia Hervas
- Hospital Universitario Mutua Terrassa, IGAIN, Barcelona, Spain
| | - Aranzazu Fernandez-Rivas
- Biocruces Bizkaia Health Research Institute, Basurto University Hospital, University of the Basque Country, Bilbao, Spain
| | - Kerstin Konrad
- RWTH Aachen University & JARA-Brain Institute, Aachen, Germany
| | - Arne Popma
- Child and Adolescent Psychiatry Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Christine Freitag
- Child and Adolescent Psychiatry, Goethe University, Frankfurt, Germany
| | | | - Graeme Fairchild
- Developmental Psychopathology, University of Bath, Bath, United Kingdom
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
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Capdevila J, Hernando J, Teule A, Lopez C, Garcia-Carbonero R, Benavent M, Custodio A, Garcia-Alvarez A, Cubillo A, Alonso V, Carmona-Bayonas A, Alonso-Gordoa T, Crespo G, Jimenez-Fonseca P, Blanco M, Viudez A, La Casta A, Sevilla I, Segura A, Llanos M, Landolfi S, Nuciforo P, Manzano JL. Durvalumab plus tremelimumab for the treatment of advanced neuroendocrine neoplasms of gastroenteropancreatic and lung origin. Nat Commun 2023; 14:2973. [PMID: 37221181 DOI: 10.1038/s41467-023-38611-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
Single immune checkpoint blockade in advanced neuroendocrine neoplasms (NENs) shows limited efficacy; dual checkpoint blockade may improve treatment activity. Dune (NCT03095274) is a non-randomized controlled multicohort phase II clinical trial evaluating durvalumab plus tremelimumab activity and safety in advanced NENs. This study included 123 patients presenting between 2017 and 2019 with typical/atypical lung carcinoids (Cohort 1), G1/2 gastrointestinal (Cohort 2), G1/2 pancreatic (Cohort 3) and G3 gastroenteropancreatic (GEP) (Cohort 4) NENs; who progressed to standard therapies. Patients received 1500 mg durvalumab and 75 mg tremelimumab for up to 13 and 4 cycles (every 4 weeks), respectively. The primary objective was the 9-month clinical benefit rate (CBR) for cohorts 1-3 and 9-month overall survival (OS) rate for Cohort 4. Secondary endpoints included objective response rate, duration of response, progression-free survival according to irRECIST, overall survival, and safety. Correlation of PD-L1 expression with efficacy was exploratory. The 9-month CBR was 25.9%/35.5%/25% for Cohorts 1, 2, and 3 respectively. The 9-month OS rate for Cohort 4 was 36.1%, surpassing the futility threshold. Benefit in Cohort 4 was observed regardless of differentiation and Ki67 levels. PD-L1 combined scores did not correlate with treatment activity. Safety profile was consistent with that of prior studies. In conclusion, durvalumab plus tremelimumab is safe in NENs and shows modest survival benefit in G3 GEP-NENs; with one-third of these patients experiencing a prolonged OS.
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Affiliation(s)
- J Capdevila
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain.
- Medical Oncology Department, IOB-Quiron-Teknon, Barcelona, Spain.
| | - J Hernando
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Teule
- Medical Oncology Department, Institut Català d'Oncologia (ICO) - IDIBELL L'Hospitalet del Llobregat, L'Hospitalet de Llobregat, Spain
| | - C Lopez
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - R Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Imas12, UCM, CNIO, Madrid, Spain
| | - M Benavent
- Medical Oncology Department, University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Garcia-Alvarez
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Cubillo
- Medical Oncology Department, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - V Alonso
- Medical Oncology Department, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - T Alonso-Gordoa
- Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - G Crespo
- Medical Oncology Department, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - P Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - M Blanco
- Medical Oncology Department, Hospital Universitario Gregorio Marañon, Madrid, Spain
| | - A Viudez
- Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - A La Casta
- Medical Oncology Department, Hospital Universitario Donostia, San Sebastián, Spain
| | - I Sevilla
- Medical Oncology Department, Investigación Clínica y Traslacional en Cáncer/Instituto de Investigaciones Biomédicas de Málaga (IBIMA)/Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Málaga, Spain
| | - A Segura
- Medical Oncology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M Llanos
- Medical Oncology Department, Hospital Universitario de Canarias, San Cristobal de la Laguna, Spain
| | - S Landolfi
- Pathology Department, Vall Hebron University Hospital, CIBERONC, Barcelona, Spain
| | - P Nuciforo
- Molecular Oncology Group. Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J L Manzano
- Medical Oncology Department, Institut Català d'Oncologia (ICO) - Badalona, Hospital Germans Trias i Pujol, Badalona, Spain
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Cubillo A, Hermes H, Berger E, Winkel K, Schunk D, Fehr E, Hare TA. Intra-individual variability in task performance after cognitive training is associated with long-term outcomes in children. Dev Sci 2023; 26:e13252. [PMID: 35184350 PMCID: PMC10078259 DOI: 10.1111/desc.13252] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/05/2021] [Revised: 11/22/2021] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
The potential benefits and mechanistic effects of working memory training (WMT) in children are the subject of much research and debate. We show that after five weeks of school-based, adaptive WMT 6-9 year-old primary school children had greater activity in prefrontal and striatal brain regions, higher task accuracy, and reduced intra-individual variability in response times compared to controls. Using a sequential sampling decision model, we demonstrate that this reduction in intra-individual variability can be explained by changes to the evidence accumulation rates and thresholds. Critically, intra-individual variability is useful in quantifying the immediate impact of cognitive training interventions, being a better predictor of academic skills and well-being 6-12 months after the end of training than task accuracy. Taken together, our results suggest that attention control is the initial mechanism that leads to the long-run benefits from adaptive WMT. Selective and sustained attention abilities may serve as a scaffold for subsequent changes in higher cognitive processes, academic skills, and general well-being. Furthermore, these results highlight that the selection of outcome measures and the timing of the assessments play a crucial role in detecting training efficacy. Thus, evaluating intra-individual variability, during or directly after training could allow for the early tailoring of training interventions in terms of duration or content to maximise their impact.
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Affiliation(s)
- Ana Cubillo
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland.,Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Henning Hermes
- DICE, Heinrich Heine University of Dusseldorf, Dusseldorf, Germany
| | - Eva Berger
- Chair of Public and Behavioral Economics, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Kirsten Winkel
- Chair of Statistics and Econometrics, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Daniel Schunk
- Chair of Public and Behavioral Economics, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Ernst Fehr
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Todd A Hare
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
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Abstract
Peer victimization is very common during late childhood and adolescence. Despite the relatively reduced number of studies, the neurobiological underpinnings of the negative impact of peer victimization experiences have received increasing attention in recent years. The present selective review summarizes the most recent available evidence and provides a general overview of the impact of peer victimization experiences on social processing and decision-making at the neurobiological level, highlighting the most pressing areas requiring further research. Three key cognitive areas show a clear negative impact of peer victimization and bullying experiences: social valuation processing, reward and reinforcement learning and self-regulation processes. Victims show enhanced activation in key regions of the limbic system including the amygdala, rostral and dorsal anterior cingulate cortices, suggestive of enhanced sensitivity to social stimuli. They also show enhanced recruitment of lateral prefrontal regions crucially involved in cognitive and emotional regulation processes, and abnormal reward-related striatal function. The presence of psychopathology is a complex factor, increased as a consequence of peer victimization, but that also constitutes vulnerability to such experiences.
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Affiliation(s)
- Ana Cubillo
- Jacobs Center for Productive Youth Development, Zurich Center for Neuroeconomics, University of Zürich, Zurich, Switzerland.,Department of Child and Adolescent Psychiatry, University Psychiatric Clinic Basel, Basel, Switzerland
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Bordonaro R, Calvo A, Auriemma A, Hollebecque A, Rubovszky G, Saunders MP, Pápai Z, Prager G, Stein A, André T, Argilés G, Cubillo A, Dahan L, Edeline J, Leger C, Cattan V, Fougeray R, Amellal N, Tabernero J. Trifluridine/tipiracil in combination with oxaliplatin and either bevacizumab or nivolumab in metastatic colorectal cancer: a dose-expansion, phase I study. ESMO Open 2021; 6:100270. [PMID: 34547581 PMCID: PMC8453191 DOI: 10.1016/j.esmoop.2021.100270] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 02/07/2023] Open
Abstract
Background In preclinical studies trifluridine/tipiracil (FTD/TPI) plus oxaliplatin (Industriestrasse, Holzkirchen, Germany) sensitised microsatellite stable (MSS) metastatic colorectal cancer (mCRC) to anti-programmed cell death protein-1; the addition of oxaliplatin or bevacizumab (F Hoffmann- la ROCHE AG, Kaiseraugst, Switzerland) enhanced the antitumour effects of FTD/TPI. This study aimed to investigate the safety and efficacy of FTD/TPI plus oxaliplatin and either bevacizumab or nivolumab (Uxbridge business Park, Uxbridge, United Kingdom) in patients with mCRC who had progressed after at least one prior line of treatment. Patients and methods In 14-day cycles, patients received FTD/TPI 35 mg/m2 (twice daily, days 1-5) plus oxaliplatin 85 mg/m2 (day 1), and, on day 1, either bevacizumab 5 mg/kg (cohort A) or nivolumab 3 mg/kg (cohort B). Patients in Cohort B had confirmed MSS status. Results In total, 54 patients were enrolled: 37 in cohort A and 17 in cohort B. Recruitment in cohort B was stopped early due to the low response rate (RR) observed at interim analyses of efficacy. The most common adverse events (AEs) in cohort A were neutropenia/decreased neutrophils (75.7%), nausea (59.5%), vomiting (40.5%), diarrhoea (37.8%), peripheral sensory neuropathy (37.8%), fatigue (35.1%) and decreased appetite (35.1%). In cohort B, the most common AEs were neutropenia/decreased neutrophils (70.6%), diarrhoea (58.8%), nausea (47.1%), vomiting (47.1%), fatigue (47.1%), asthenia (41.2%), paraesthesia (41.2%), thrombocytopenia/decreased platelets (35.3%) and decreased appetite (35.3%). Confirmed objective RR was 17.1% in cohort A and 7.1% in cohort B; the corresponding values for median progression-free survival in the two cohorts were 6.3 and 6.0 months. Conclusion FTD/TPI plus oxaliplatin and bevacizumab or nivolumab had an acceptable safety profile and demonstrated antitumour activity in previously treated patients with mCRC. This study evaluated the safety and efficacy of FTD/TPI plus oxaliplatin and either bevacizumab or nivolumab in mCRC patients. FTD/TPI plus oxaliplatin in combination with bevacizumab or nivolumab had an acceptable and manageable safety profile. Antitumour activity was observed following treatment with FTD/TPI plus oxaliplatin and bevacizumab. Despite a modest RR with the addition of nivolumab, survival data were promising in these poor-prognosis patients.
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Affiliation(s)
- R Bordonaro
- Azienda Ospedaliera ARNAS Garibaldi, Catania, Italy.
| | - A Calvo
- Gregorio Marañon University General Hospital, Madrid, Spain
| | - A Auriemma
- Azienda Ospedaliera Universitaria Integrat, University of Verona, Verona, Italy
| | - A Hollebecque
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - G Rubovszky
- Department of Medical Oncology and Clinical Pharmacology, National Institute of Oncology Hungary, Budapest, Hungary
| | | | - Z Pápai
- Department of Medical Oncology, Duna Medical Centre, Budapest, Hungary
| | - G Prager
- Comprehensive Cancer Centre Vienna, Medical University Vienna, Austria
| | - A Stein
- UKE Universitätsklinikum Hamburg-Eppendorf KMTZ, Hamburg, Germany
| | - T André
- Sorbonne Université et Hôpital Saint-Antoine, Service d'Oncologie Médicale, Paris, France
| | - G Argilés
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - A Cubillo
- Medical Oncology, Hospital Universitario Madrid Sanchinarro Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - L Dahan
- Aix Marseille University; Assistance Publique Hôpitaux de Marseille, Centre d'Essais Précoces en Cancérologie de Marseille CLIP, Marseille, France
| | - J Edeline
- Department of Medical Oncology, Centre Eugene Marquis, ARPEGO network, Rennes, France
| | - C Leger
- Institut de Recherches Internationales Servier, Suresnes, France
| | - V Cattan
- Institut de Recherches Internationales Servier, Suresnes, France
| | - R Fougeray
- Institut de Recherches Internationales Servier, Suresnes, France
| | - N Amellal
- Institut de Recherches Internationales Servier, Suresnes, France
| | - J Tabernero
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; UVic-UCC, IOB-Quiron, Barcelona, Spain
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Capdevila J, Landolfi S, Hernando J, Teule A, Garcia-Carbonero R, Custodio A, Cubillo A, Alonso-Gordoa T, Carmona-Bayonas A, Crespo G, Blanco M, Viudez A, La Casta A, Sevilla I, Segura Á, López C, Benavent Viñuales M, Nuciforo P, Manzano J. 1107P Durvalumab plus tremelimumab in patients with grade 3 neuroendocrine neoplasms of gastroenteropancreatic origin: Updated results from the multicenter phase II DUNE trial (GETNE 1601). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.189] [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] Open
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Hernando J, Manzano J, Teule A, López C, Garcia-Carbonero R, Benavent Viñuales M, Custodio A, Cubillo A, Alonso V, Alonso-Gordoa T, Carmona-Bayonas A, Crespo G, Blanco M, Jimenez-Fonseca P, Viudez A, La Casta A, Sevilla I, Llanos M, Segura Á, Capdevila J. 1099MO Durvalumab plus tremelimumab influence on response to subsequent treatments in patients with neuroendocrine neoplasms (NENs) of gastroenteropancreatic and lung origins: Results from the phase II DUNE trial (GETNE 1601). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.181] [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: 11/24/2022] Open
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Gkika E, Grosu A, Macarulla T, Cubillo A, Pazgan-Simon M, Seufferlein T, Touchefeu Y. O-16 HEPANOVA: Final efficacy and safety results from a phase 2 study of Tumor Treating Fields (TTFields, 150 kHz) concomitant with sorafenib in advanced hepatocellular carcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Tabernero J, Bekaii-Saab T, Safont Aguilera M, Cubillo A, Garcia-Carbonero R, Limon L, Rodríguez-Salas N, Tournigand C, Borg C, Raghav K, Finley G, Strickler J, Beier F, Salim S, Esser R, Liu E, Adrian S, López-López C. P-111 PERSPECTIVE: Tepotinib plus cetuximab in patients with RAS/BRAF wild-type left-sided metastatic colorectal cancer and acquired resistance to anti-EGFR antibody therapy due to MET amplification. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.166] [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] Open
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Taieb J, Hammel P, Reni M, Palmer D, Bridgewater J, Cubillo A, Prager G, Bayle S, Hédouin-Biville F, Teng Z, Seufferlein T, Macarulla T. SO-3 Treatment sequences and prognostic factors in metastatic pancreatic ductal adenocarcinoma: Univariate and multivariate analyses of a real-world study in Europe. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.027] [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: 11/26/2022] Open
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Peinado P, Sanz Garcia E, Moreno I, Dorta M, Alvarez B, Alvarez Gallego R, Madurga R, Ugidos L, Rodriguez Pascual J, Muñoz C, Garcia-Rico E, Cubillo A. 1760P COVID-19 severe pneumonia in cancer patients: Impact and predictive factors. Ann Oncol 2020. [PMCID: PMC7506389 DOI: 10.1016/j.annonc.2020.08.1824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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13
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Capdevila J, Teule A, López C, García-Carbonero R, Benavent M, Custodio A, Cubillo A, Alonso V, Gordoa TA, Carmona-Bayonas A, Crespo G, Blanco-Codesido M, Jimenez-Fonseca P, Viúdez A, La Casta Muñoa A, Sevilla I, Llanos M, Segura A, Hernando-Cubero J, Manzano J. 1157O A multi-cohort phase II study of durvalumab plus tremelimumab for the treatment of patients (pts) with advanced neuroendocrine neoplasms (NENs) of gastroenteropancreatic or lung origin: The DUNE trial (GETNE 1601). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1370] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Liu R, Gomes A, Ao G, de Miguel M, Moreno I, Boni V, Cubillo A, Cárdenas J, Ugidos L, Calvo E. 592P A predictive score of antitumour activity of novel agents in cancer patients treated in early phase studies. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.706] [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] Open
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15
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Ao G, Gomes A, Liu R, de Miguel M, Moreno I, Boni V, Cubillo A, Cárdenas J, Ugidos L, Calvo E. 587P Toxicity and antitumor activity of novel agents in elderly cancer patients in phase I studies. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.701] [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: 11/24/2022] Open
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16
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Hammel P, Berardi R, Creemers G, Cutsem EV, Cubillo A, Greil R, Wasan H, Metges J, Noel M, Nygren P, Osterlund P, Seufferlein T, Macarulla T, Fountzilas C, Gupta A, Grummer L, Kacel S, Biswas-Baldwin N, Kay R, Youssoufian H, El-Hariry I, Hidalgo M. P-80 TRYbeCA-1: A randomized, phase 3 study of eryaspase in combination with chemotherapy versus chemotherapy alone as second-line treatment in patients with pancreatic adenocarcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.162] [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] Open
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17
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Grosu A, Touchefeu Y, Brunner T, Gkika E, Thimme R, Cubillo A. P-215 phase 2 HEPANOVA study of tumor treating fields (TTFields, 150 kHz) concomitant with sorafenib in advanced hepatocellular carcinoma (HCC): Interim safety analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.297] [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] Open
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18
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Cubillo A, Halari R, Taylor E, Rubia K, Giampietro V. Fronto-striatal Brain Dysfunction in Adults with Hyperactive/inattentive Behaviours Followed up from Childhood During Interference Inhibition and Attention Allocation. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)70626-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Functional magnetic resonance imaging studies (fMRI) in children with Attention Deficit Hyperactivity Disorder (ADHD) have observed functional abnormalities in fronto-striatal and temporo-parietal brain regions during tasks of inhibitory and attention control. However, hardly any modern functional imaging studies have investigated functions of interference inhibition or attention control in adult ADHD.We used fMRI combined with a variant of the Simon task that measures interference inhibition as well as attention allocation to compare 11 medication-naïve adults (26-30 yrs) with inattentive/hyperactive behaviours and 15 age-matched healthy controls. Patients were followed up from childhood ADHD, recruited from a 20-year prospective longitudinal epidemiological study. All met criteria for inattentive/hyperactive behaviours on an Adult Hyperactive Interview, but only 8 met clinical diagnostic criteria for ADHD. Correlation analyses were furthermore conducted within patients to correlate symptoms with brain activation. Functional connectivity analyses for group differences in fronto-striatal connectivity will be presented at the conference.No differences were observed in task performance. During interference inhibition, adults with persistent inattentive/hyperactive compared to controls showed reduced activation in predominantly left orbitofrontal and medial cortex, caudate and putamen. During attention allocation adults with hyperactive behaviours showed dysfunction in left inferior/dorsolateral prefrontal cortex and in right inferior and superior parietal areas. Correlation analysis showed a significant negative correlation between inattentive/hyperactive behaviours and the parietal activation cluster during interference inhibition. The study demonstrates the continuity of the pattern of fronto-striatal and parietal neurofunctional abnormalities during tasks of interference inhibition and attention allocation from childhood to adult ADHD even with symptomatic improvement.
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Chen-Zhao X, Hernando O, López M, Sánchez E, Montero A, García-Aranda M, Ciérvide R, Valero J, Alonso R, Cárdenas-Rebollo JM, Vicente E, Quijano Y, Cubillo A, Álvarez R, Prados S, Plaza C, García J, Zucca D, Fernández-Letón P, Rubio C. A prospective observational study of the clinical and pathological impact of stereotactic body radiotherapy (SBRT) as a neoadjuvant strategy of chemoradiation in pancreatic cancer. Clin Transl Oncol 2020; 22:1499-1505. [PMID: 31974820 DOI: 10.1007/s12094-020-02287-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/04/2019] [Accepted: 01/01/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE/OBJECTIVE(S) To improve the curative resection rates and prognoses, a variety of neoadjuvant (NA) strategies have been explored in PDAC. In our institution, non-metastatic PDACs have been treated with a NA intent with induction multiagent chemotherapy and SBRT. The primary endpoint was to increase R0 resection rate. The secondary endpoints were the analysis of the clinical tolerance, the pathological response, the local control (LC) and the OS. MATERIALS/METHODS All consecutive patients with non-metastatic PDAC underwent SBRT as part of the NA strategy were included. A total dose of 40-62 Gy were delivered in 5-10 fractions. Surgery was performed after SBRT and restaging. RESULTS Since February 2014 to December 2018, 45 patients were enrolled. Thirty-two patients underwent surgery (71.1%), 10 out of 15 were initially unresectable disease patients (66.75%). R0 resection rate was 93% (30 patients) and pN0 status was achieved in 20 patients (60.6%). Tumour regression grade (TRG): 12 patients with complete response or marked response (TRG 0-1: 37.5%), 16 patients with moderate response (TRG 2: 50%) and four patients with poor response (TRG 3: 12.5%). The median follow-up was 16.2 m (range 6.6-59.6 m) since diagnosis. The LC rate achieved was very high (95.5%). Actuarial 12 and 24 m OS was 67.4% and 35.9% respectively. No grade 3 or higher toxicity related to SBRT was observed. CONCLUSION The results are encouraging, suggesting that SBRT has a significant role in the management of these patients and further studies will be necessary to prove these findings.
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Affiliation(s)
- X Chen-Zhao
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain.
| | - O Hernando
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - E Sánchez
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M García-Aranda
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Ciérvide
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J Valero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J M Cárdenas-Rebollo
- Department of Applied Mathematics and Statistics, CEU San Pablo University, Madrid, Spain
| | - E Vicente
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - Y Quijano
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - A Cubillo
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Álvarez
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - S Prados
- Gastroenterology, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Plaza
- Anatomical Pathology, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - D Zucca
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - P Fernández-Letón
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - C Rubio
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
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Cubillo A, Makwana AB, Hare TA. Differential modulation of cognitive control networks by monetary reward and punishment. Soc Cogn Affect Neurosci 2020; 14:305-317. [PMID: 30690563 PMCID: PMC6399610 DOI: 10.1093/scan/nsz006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 03/08/2018] [Revised: 12/01/2018] [Accepted: 01/21/2019] [Indexed: 12/21/2022] Open
Abstract
Incentives are primary determinants of if and how well an organism will perform a given behavior. Here, we examined how incentive valence and magnitude influence task switching, a critical cognitive control process, and test the predictions that the anterior cingulate cortex (ACC) and the ventral striatum (vStr) function as key nodes linking motivation and control systems in the brain. Our results indicate that reward and punishment incentives have both common and distinct effects on cognitive control at the behavioral and neurobiological levels. For example, reward incentives led to greater activity in the ACC during the engagement of control relative to punishments. Furthermore, the neural responses to reward and punishment differed as a function of individual sensitivity to each incentive valence. Functional connectivity analyses suggest a role for vStr in signaling motivational value during cognitive control and as a potential link between motivation and control networks. Overall, our findings suggest that similar changes in observed behavior (e.g. response accuracy) under reward and punishment incentives are mediated by, at least partially, distinct neurobiological substrates.
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Affiliation(s)
- Ana Cubillo
- Department of Economics, University of Zurich, Zürich, Switzerland
| | - Aidan B Makwana
- Department of Economics, University of Zurich, Zürich, Switzerland
| | - Todd A Hare
- Department of Economics, University of Zurich, Zürich, Switzerland
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21
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Bendell J, Lieu C, Raghav K, Argilés G, Cubillo A, Qu X, Yan Y, Merchant M, Zeuner H, Gallo J, Segal N. A phase Ib study of the safety and efficacy of atezolizumab (atezo) + bevacizumab (bev) + cobimetinib (cobi) in patients (pts) with metastatic colorectal cancer (mCRC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Rubio C, Chen X, Lopez M, Hernando O, Sanchez E, Montero A, Aranda MG, Ciervide R, Valero J, Alonso R, Vicente E, Quijano Y, Cubillo A, Gallego RA, Prados S, Plaza C, Pérez J, Garcia J, Zucca D, Leton PF. A Prospective Observational Study of the Impact of Stereotactic Body Radiotherapy (SBRT) As a Neoadjuvant Strategy of Chemoradiation in Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1925] [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: 10/26/2022]
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23
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Ceniceros L, Álvarez R, Muñoz C, Sanz-García E, Ugidos L, Rodriguez-Pascual J, Hernandez S, Gomez P, Garcia-Rico E, Cubillo A. Clinical and molecular characteristics of biliary tract carcinoma using next-generation sequencing. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.206] [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: 11/14/2022] Open
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24
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Cheng A, Abou-Alfa G, Ren Z, Assenat E, Cubillo A, Pluntke S, Rimassa L, Ross P, Wyrwicz L, Hou J, Li C, Wu J, Ducreux M. Efficacy, safety, and pharmacokinetics of the anti-programmed cell death receptor-1 (PD-1) monoclonal antibody, tislelizumab (BGB-A317) in a phase 2, open-label, multicenter study to investigate in patients with unresectable hepatocellular carcinoma - Trial in progress. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.099] [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: 11/12/2022] Open
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25
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Raman S, Pless M, Cubillo A, Calvo A, Hecht R, Liu C, Chan E, Chesney J, Prat A. 3:36 PM Abstract No. 375 Early safety from a phase 1, multicenter, open-label clinical trial of talimogene laherparepvec (T-VEC) injected into liver tumors. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.416] [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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26
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Rubio C, Hernando O, Sanchez E, Chen X, Valero J, Ciervide R, Aranda MG, Zucca D, Ruiz Zorrilla JG, Lopez M, Moreno JMP, Vicente E, Quijano Y, Cubillo A, Alvarez B, Madrigal L, Leton PF, Allona M, Torres M, Velilla MF. Clinical Experience and Long Follow-Up of Patients With Liver and Lung Metastasis Treated with Stereotactic Body Radiation Therapy with Intrafraction Control of Tumor Motion Guided By Internal Fiducials and a Gating Technique. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1041] [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: 10/18/2022]
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27
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Tabernero J, Ciardiello F, Montagut C, Ding C, Kopetz S, Tuxen Poulsen T, Bardelli A, Wyrwicz L, Cubillo A, Santos C, Fumi G, Zagonel V, Bennouna J, Siena S, Falcone A, Benavent M, Argiles G, Kragh M, Horak I, Dvorkin M. Efficacy and safety of Sym004 in refractory metastatic colorectal cancer with acquired resistance to anti-EGFR therapy: Results of a randomized phase II study (RP2S). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Toledo R, Garralda E, Pons T, Monsech J, Vega E, Alvarez R, Cubillo A, Blanco-Aparicio C, Dominguez O, Martinez J, Hidalgo M. Whole-exome sequencing of matched germline and plasma cell-free DNA portrays the somatic mutation landscape of refractory metastatic colorectal cancer and identifies mutated KDR/VEGFR2 as new cause of therapy resistance. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.091] [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: 11/14/2022] Open
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29
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Hidalgo M, Pazo-Cid R, Guillen-Ponce C, López R, Vera R, Reboredo M, Muñoz A, Martinez de Castro E, Díaz Beveridge R, La Casta A, Martin-Valades J, Cubillo A, Martínez-Galán J, Ales I, Sastre J, Macarulla Mercade T. A phase I and randomized phase II trial to evaluate the efficacy and safety of nab-paclitaxel (nab-P) in combination with gemcitabine (G) for the treatment of patients with ECOG 2 advanced pancreatic cancer (PDAC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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Adiwijaya BS, Kim J, Lang I, Csõszi T, Cubillo A, Chen JS, Wong M, Park JO, Kim JS, Rau KM, Melichar B, Gallego JB, Fitzgerald J, Belanger B, Molnar I, Ma WW. Population Pharmacokinetics of Liposomal Irinotecan in Patients With Cancer. Clin Pharmacol Ther 2017; 102:997-1005. [PMID: 28445610 PMCID: PMC5697569 DOI: 10.1002/cpt.720] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 07/25/2016] [Revised: 03/29/2017] [Accepted: 04/19/2017] [Indexed: 12/18/2022]
Abstract
Nanoliposomal irinotecan (nal‐IRI) is a liposomal formulation of irinotecan with a longer half‐life (t1/2), higher plasma total irinotecan (tIRI), and lower SN‐38 maximum concentration (Cmax) compared with nonliposomal irinotecan. Population pharmacokinetic (PK) analysis of nal‐IRI was performed for tIRI and total SN‐38 (tSN38) using patient samples from six studies. PK‐safety association was evaluated for neutropenia and diarrhea in 353 patients. PK‐efficacy association was evaluated from a phase III study in pancreatic cancer NAPOLI1. Efficacy was associated with longer duration of unencapsulated SN‐38 (uSN38) above a threshold and higher Cavg of tIRI, tSN38, and uSN38. Neutropenia was associated with uSN38 Cmax and diarrhea with tIRI Cmax. Baseline predictive factors were race, body surface area, and bilirubin. Analysis identified PK factors associated with efficacy, safety, and predictive baseline factors. The results support the benefit of nal‐IRI dose of 70 mg/m2 (free‐base; equivalent to 80 mg/m2 salt base) Q2W over 100 mg/m2 Q3W.
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Affiliation(s)
- B S Adiwijaya
- Merrimack Pharmaceuticals, Inc., Cambridge, Massachusetts, USA
| | - J Kim
- Merrimack Pharmaceuticals, Inc., Cambridge, Massachusetts, USA
| | - I Lang
- National Institute of Oncology, Budapest, Hungary
| | - T Csõszi
- JNSZ Megyei Hetényi Géza Kórház Rendelöintézet, Szolnok, Hungary
| | - A Cubillo
- Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - J-S Chen
- Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - M Wong
- Westmead Hospital, Westmead, Australia
| | - J O Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J S Kim
- Korea University Guro Hospital, Seoul, South Korea
| | - K M Rau
- Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
| | - B Melichar
- Onkologicka Klinika, Lekarska Fakulta Univerzity Palackeho a Fakultni Nemocnice, Olomouc, Czech Republic
| | | | - J Fitzgerald
- Merrimack Pharmaceuticals, Inc., Cambridge, Massachusetts, USA
| | - B Belanger
- Merrimack Pharmaceuticals, Inc., Cambridge, Massachusetts, USA
| | - I Molnar
- Merrimack Pharmaceuticals, Inc., Cambridge, Massachusetts, USA
| | - W W Ma
- Mayo Clinic, Rochester, Minnesota, USA
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31
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Norman LJ, Carlisi CO, Christakou A, Cubillo A, Murphy CM, Chantiluke K, Simmons A, Giampietro V, Brammer M, Mataix-Cols D, Rubia K. Shared and disorder-specific task-positive and default mode network dysfunctions during sustained attention in paediatric Attention-Deficit/Hyperactivity Disorder and obsessive/compulsive disorder. Neuroimage Clin 2017; 15:181-193. [PMID: 28529874 PMCID: PMC5429245 DOI: 10.1016/j.nicl.2017.04.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 01/30/2017] [Revised: 03/29/2017] [Accepted: 04/15/2017] [Indexed: 12/24/2022]
Abstract
Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) and obsessive/compulsive disorder (OCD) share problems with sustained attention, and are proposed to share deficits in switching between default mode and task positive networks. The aim of this study was to investigate shared and disorder-specific brain activation abnormalities during sustained attention in the two disorders. Twenty boys with ADHD, 20 boys with OCD and 20 age-matched healthy controls aged between 12 and 18 years completed a functional magnetic resonance imaging (fMRI) version of a parametrically modulated sustained attention task with a progressively increasing sustained attention load. Performance and brain activation were compared between groups. Only ADHD patients were impaired in performance. Group by sustained attention load interaction effects showed that OCD patients had disorder-specific middle anterior cingulate underactivation relative to controls and ADHD patients, while ADHD patients showed disorder-specific underactivation in left dorsolateral prefrontal cortex/dorsal inferior frontal gyrus (IFG). ADHD and OCD patients shared left insula/ventral IFG underactivation and increased activation in posterior default mode network relative to controls, but had disorder-specific overactivation in anterior default mode regions, in dorsal anterior cingulate for ADHD and in anterior ventromedial prefrontal cortex for OCD. In sum, ADHD and OCD patients showed mostly disorder-specific patterns of brain abnormalities in both task positive salience/ventral attention networks with lateral frontal deficits in ADHD and middle ACC deficits in OCD, as well as in their deactivation patterns in medial frontal DMN regions. The findings suggest that attention performance in the two disorders is underpinned by disorder-specific activation patterns.
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Affiliation(s)
- Luke J Norman
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Christina O Carlisi
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Anastasia Christakou
- Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Ana Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Clodagh M Murphy
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kaylita Chantiluke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Andrew Simmons
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Michael Brammer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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32
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Hoogman M, Bralten J, Hibar DP, Mennes M, Zwiers MP, Schweren LSJ, van Hulzen KJE, Medland SE, Shumskaya E, Jahanshad N, Zeeuw PD, Szekely E, Sudre G, Wolfers T, Onnink AMH, Dammers JT, Mostert JC, Vives-Gilabert Y, Kohls G, Oberwelland E, Seitz J, Schulte-Rüther M, Ambrosino S, Doyle AE, Høvik MF, Dramsdahl M, Tamm L, van Erp TGM, Dale A, Schork A, Conzelmann A, Zierhut K, Baur R, McCarthy H, Yoncheva YN, Cubillo A, Chantiluke K, Mehta MA, Paloyelis Y, Hohmann S, Baumeister S, Bramati I, Mattos P, Tovar-Moll F, Douglas P, Banaschewski T, Brandeis D, Kuntsi J, Asherson P, Rubia K, Kelly C, Martino AD, Milham MP, Castellanos FX, Frodl T, Zentis M, Lesch KP, Reif A, Pauli P, Jernigan TL, Haavik J, Plessen KJ, Lundervold AJ, Hugdahl K, Seidman LJ, Biederman J, Rommelse N, Heslenfeld DJ, Hartman CA, Hoekstra PJ, Oosterlaan J, Polier GV, Konrad K, Vilarroya O, Ramos-Quiroga JA, Soliva JC, Durston S, Buitelaar JK, Faraone SV, Shaw P, Thompson PM, Franke B. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. Lancet Psychiatry 2017; 4:310-319. [PMID: 28219628 PMCID: PMC5933934 DOI: 10.1016/s2215-0366(17)30049-4] [Citation(s) in RCA: 423] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/04/2017] [Accepted: 01/09/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Neuroimaging studies have shown structural alterations in several brain regions in children and adults with attention deficit hyperactivity disorder (ADHD). Through the formation of the international ENIGMA ADHD Working Group, we aimed to address weaknesses of previous imaging studies and meta-analyses, namely inadequate sample size and methodological heterogeneity. We aimed to investigate whether there are structural differences in children and adults with ADHD compared with those without this diagnosis. METHODS In this cross-sectional mega-analysis, we used the data from the international ENIGMA Working Group collaboration, which in the present analysis was frozen at Feb 8, 2015. Individual sites analysed structural T1-weighted MRI brain scans with harmonised protocols of individuals with ADHD compared with those who do not have this diagnosis. Our primary outcome was to assess case-control differences in subcortical structures and intracranial volume through pooling of all individual data from all cohorts in this collaboration. For this analysis, p values were significant at the false discovery rate corrected threshold of p=0·0156. FINDINGS Our sample comprised 1713 participants with ADHD and 1529 controls from 23 sites with a median age of 14 years (range 4-63 years). The volumes of the accumbens (Cohen's d=-0·15), amygdala (d=-0·19), caudate (d=-0·11), hippocampus (d=-0·11), putamen (d=-0·14), and intracranial volume (d=-0·10) were smaller in individuals with ADHD compared with controls in the mega-analysis. There was no difference in volume size in the pallidum (p=0·95) and thalamus (p=0·39) between people with ADHD and controls. Exploratory lifespan modelling suggested a delay of maturation and a delay of degeneration, as effect sizes were highest in most subgroups of children (<15 years) versus adults (>21 years): in the accumbens (Cohen's d=-0·19 vs -0·10), amygdala (d=-0·18 vs -0·14), caudate (d=-0·13 vs -0·07), hippocampus (d=-0·12 vs -0·06), putamen (d=-0·18 vs -0·08), and intracranial volume (d=-0·14 vs 0·01). There was no difference between children and adults for the pallidum (p=0·79) or thalamus (p=0·89). Case-control differences in adults were non-significant (all p>0·03). Psychostimulant medication use (all p>0·15) or symptom scores (all p>0·02) did not influence results, nor did the presence of comorbid psychiatric disorders (all p>0·5). INTERPRETATION With the largest dataset to date, we add new knowledge about bilateral amygdala, accumbens, and hippocampus reductions in ADHD. We extend the brain maturation delay theory for ADHD to include subcortical structures and refute medication effects on brain volume suggested by earlier meta-analyses. Lifespan analyses suggest that, in the absence of well powered longitudinal studies, the ENIGMA cross-sectional sample across six decades of ages provides a means to generate hypotheses about lifespan trajectories in brain phenotypes. FUNDING National Institutes of Health.
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Affiliation(s)
- Martine Hoogman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands.
| | - Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Derrek P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, USA
| | - Maarten Mennes
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Marcel P Zwiers
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Lizanne S J Schweren
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Kimm J E van Hulzen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Elena Shumskaya
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, USA
| | - Patrick de Zeeuw
- NICHE-lab, Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eszter Szekely
- Neurobehavioral Clinical Research Section, National Human Genome Research Institute, Bethesda, MD, USA
| | - Gustavo Sudre
- Neurobehavioral Clinical Research Section, National Human Genome Research Institute, Bethesda, MD, USA
| | - Thomas Wolfers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Alberdingk M H Onnink
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Janneke T Dammers
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Jeanette C Mostert
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Yolanda Vives-Gilabert
- Asociación para la Innovación en Análisis, Gestión y Procesamiento de Datos Científicos y Tecnológicos, Barcelona, Spain
| | - Gregor Kohls
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany
| | - Eileen Oberwelland
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany; JARA Translational Brain Medicine, Research Center Juelich, Aachen, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany
| | - Martin Schulte-Rüther
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany; JARA Translational Brain Medicine, Research Center Juelich, Aachen, Germany
| | - Sara Ambrosino
- NICHE-lab, Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Alysa E Doyle
- Department of Psychiatry and Center for Human Genetics Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Stanley Center for Psychiatric Research at the Broad Institute, Cambridge, MA, USA
| | - Marie F Høvik
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Leanne Tamm
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Theo G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Anders Dale
- Departments of Neurosciences and Radiology, University of California, San Diego, San Diego, CA, USA; UCSD Center for Translational Imaging and Precision Medicine, San Diego, CA, USA
| | - Andrew Schork
- Department of Cognitive Science, UC San Diego, La Jolla, CA, USA
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany; Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Kathrin Zierhut
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany; Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Ramona Baur
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Hazel McCarthy
- Department of Psychiatry, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Yuliya N Yoncheva
- The Child Study Center at NYU Langone Medical Center, New York, NY, USA
| | - Ana Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kaylita Chantiluke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ivanei Bramati
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Paulo Mattos
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Tovar-Moll
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Morphological Sciences Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pamela Douglas
- Department of Psychiatry, University of California, Los Angeles, CA, USA
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Centre Zurich, University of Zurich, Zurich, Switzerland; ETH Zurich, Zurich, Switzerland
| | - Jonna Kuntsi
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip Asherson
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Clare Kelly
- Department of Psychiatry, University of Dublin, Trinity College Dublin, Dublin, Ireland; The Child Study Center at NYU Langone Medical Center, New York, NY, USA; Trinity College Institute of Neuroscience, Dublin, Ireland
| | | | - Michael P Milham
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA; Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Francisco X Castellanos
- The Child Study Center at NYU Langone Medical Center, New York, NY, USA; Division of Child and Adolescent Psychiatric Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Thomas Frodl
- Department of Psychiatry, University of Dublin, Trinity College Dublin, Dublin, Ireland; Department of Psychiatry and Psychotherapy, University Hospital, Otto-von-Guericke-University, Magdeburg, Germany
| | - Mariam Zentis
- Department of Psychiatry and Psychotherapy, University Hospital, Otto-von-Guericke-University, Magdeburg, Germany
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany; Department of Translational Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Paul Pauli
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Terry L Jernigan
- Departments of Cognitive Science, Psychiatry, Radiology, and Center for Human Development, University of California, San Diego, CA, USA
| | - Jan Haavik
- KG Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Department of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Kenneth Hugdahl
- Department of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joseph Biederman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Nanda Rommelse
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands; Karakter Child and Adolescent Psychiatry, Nijmegen, Netherlands
| | - Dirk J Heslenfeld
- Department of Cognitive Psychology, VU University Amsterdam, Amsterdam, Netherlands; Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Pieter J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jaap Oosterlaan
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Georg von Polier
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany
| | - Oscar Vilarroya
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Fundació IMIM, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain
| | - Joan Carles Soliva
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sarah Durston
- NICHE-lab, Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands; Karakter Child and Adolescent Psychiatry, Nijmegen, Netherlands
| | - Stephen V Faraone
- KG Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Philip Shaw
- Neurobehavioral Clinical Research Section, National Human Genome Research Institute, Bethesda, MD, USA; National Institute of Mental Health, Bethesda, MD, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, USA
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
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Hubner R, Cubillo A, Blanc JF, Melisi D, von Hoff D, Wang-Gillam A, Chen LT, Becker C, Mamlouk K, Belanger B, Yang Y, de Jong F, Siveke J. 242P Effects of nal-IRI (MM-398) ± 5-fluorouracil on quality of life (QoL) of patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) previously treated with gemcitabine based therapy: Results from NAPOLI-1. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw582.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hubner R, Cubillo A, Blanc JF, Melisi D, von Hoff D, Wang-Gillam A, Chen LT, Becker C, Mamlouk K, Belanger B, Yang Y, de Jong F, Siveke J. 242P Effects of nal-IRI (MM-398) 6 5-fluorouracil on quality of life (QoL) of patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) previously treated with gemcitabine based therapy: Results from NAPOLI-1. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00399-9] [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: 10/22/2022] Open
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Garcia-Carbonero R, Boni V, Duran I, Gil M, Espinosa M, Salazar R, Cubillo A, Jurado M, Champion B, Alvis S, Fisher K, Beadle J, Pover G, McElwaine-Johnn H, Ellis C, Blanc C, Calvo E. A mechanism of action study of intra-tumoral or intravenous dosing of enadenotucirev, an oncolytic adenovirus in patients with colon, lung, bladder and renal carcinoma undergoing resection of primary tumor. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.41] [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: 11/12/2022] Open
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Hubner R, Cubillo A, Blanc JF, Melisi D, Von Hoff D, Wang-Gillam A, Chen LT, Becker C, Mamlouk K, Belanger B, Yang Y, de Jong F, Siveke J. O-004 Effects of nal-IRI (MM-398) ± 5-fluorouracil on quality of life (QoL) in NAPOLI-1: a phase 3 study in patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) previously treated with gemcitabine. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ma W, Chung I, Lang I, Csõszi T, Wenczl M, Cubillo A, Chen J, Wong M, Park J, Kim J, Rau K, Melichar B, Gallego J, Smakal M, Kim J, Belanger B, Bayever E, Adiwijaya B. 2365 Nanoliposomal irinotecan (MM-398, nal-IRI) population pharmacokinetics (PK) and its association with efficacy and safety in patients with solid tumors based on the phase 3 study NAPOLI-1 and five phase 1 and 2 studies. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31281-3] [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: 11/25/2022]
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Hidalgo M, Cubillo A, Stagg R, Dupont J, Wan-Ching Y, Hoey T. 166 Pre-clinical and clinical activity of Anti-DLL4 (demcizumab) in combination with gemcitabine plus nab-paclitaxel in pancreatic cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70292-8] [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: 10/24/2022]
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Guillen-Ponce C, Lopez R, Macarulla T, Rivera F, Cubillo A, Carrato A, Brozos E, Sauri Nadal T, López C, Hidalgo M. A Phase (Ph) I/II Trial to Evaluate the Efficacy (E) and Safety (S) of Nab-Paclitaxel (Nab-P) in Combination (Co) with Gemcitabine (G) for the Treatment (Tr) of Frail (Fr) Patients (P) with Advanced or Metastatic Pancreatic Cancer (Apc): Safety Results of the Phase I Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.85] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Boni V, De La Portilla F, Cubillo A, Gil-Martin M, Calvo E, Salazar R, Santos C, Sanchez-Gastaldo A, Prados S, Sanjuan X, Bozada J, Duran H, Jurado M, Ellis C, Alvis S, Beadle J, Fisher K, Blanc C, Garcia-Carbonero R. A Phase 1 Mechanism of Action Study of Intra-Tumoural (It) or Intravenous (Iv) Administration of Enadenotucirev, an Oncolytic Ad11/Ad3 Chimeric Group B Adenovirus in Colon Cancer Patients Undergoing Resection of Primary Tumour. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu342.21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Calvo E, Gil Martín M, Cubillo A, Machiels J, Rottey S, Mardjuadi F, Geboes K, Salazar R, Beadle J, Ellis C, Fisher K, Blanc C. A Phase 1 Study of Enadenotucirev, an Oncolytic Ad11/Ad3 Chimeric Group B Adenovirus, Administered Intravenously - Analysis of Dose Expansion and Repeat Cycle Cohorts in Patients with Metastatic Colorectal Cancer (Mcrc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu342.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cubillo A, Álvarez R, Rodriguez-Pascual J, Muñoz M, Pond G, Perea S, Sanchez G, Martin M, Garralda E, De Vicente E, Quijano Y, Hidalgo M. Angiogenic Switch As Predictor of Response to Chemotherapy+ Bevacizumab in Patients with Metastatic Colorectal Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.33] [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: 11/13/2022] Open
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Hart H, Marquand AF, Smith A, Cubillo A, Simmons A, Brammer M, Rubia K. Predictive neurofunctional markers of attention-deficit/hyperactivity disorder based on pattern classification of temporal processing. J Am Acad Child Adolesc Psychiatry 2014; 53:569-78.e1. [PMID: 24745956 DOI: 10.1016/j.jaac.2013.12.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 10/29/2013] [Accepted: 01/14/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) is currently diagnosed on the basis of subjective measures, despite evidence for multi-systemic structural and neurofunctional deficits. A consistently observed neurofunctional deficit is in fine-temporal discrimination (TD). The aim of this proof-of-concept study was to examine the feasibility of distinguishing patients with ADHD from controls using multivariate pattern recognition analyses of functional magnetic resonance imaging (fMRI) data of TD. METHOD A total of 20 medication-naive adolescent male patients with ADHD and 20 age-matched healthy controls underwent fMRI while performing a TD task. The fMRI data were analyzed with Gaussian process classifiers to predict individual ADHD diagnosis based on brain activation patterns. RESULTS The pattern of brain activation correctly classified up to 80% of patients and 70% of controls, achieving an overall classification accuracy of 75%. The distributed activation networks with the highest delineation between patients and controls corresponded to a distributed network of brain regions involved in TD and typically compromised in ADHD, including inferior and dorsolateral prefrontal, insula, and parietal cortices, and the basal ganglia, anterior cingulate, and cerebellum. These regions overlapped with areas of reduced activation in patients with ADHD relative to controls in a univariate analysis, suggesting that these are dysfunctional regions. CONCLUSIONS We show evidence that pattern recognition analyses combined with fMRI using a disorder-sensitive task such as timing have potential in providing objective diagnostic neuroimaging biomarkers of ADHD.
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Cubillo A, Smith AB, Barrett N, Giampietro V, Brammer M, Simmons A, Rubia K. Drug-specific laterality effects on frontal lobe activation of atomoxetine and methylphenidate in attention deficit hyperactivity disorder boys during working memory. Psychol Med 2014; 44:633-646. [PMID: 23597077 DOI: 10.1017/s0033291713000676] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The catecholamine reuptake inhibitors methylphenidate (MPH) and atomoxetine (ATX) are the most common treatments for attention deficit hyperactivity disorder (ADHD). This study compares the neurofunctional modulation and normalization effects of acute doses of MPH and ATX within medication-naive ADHD boys during working memory (WM). METHOD A total of 20 medication-naive ADHD boys underwent functional magnetic resonance imaging during a parametric WM n-back task three times, under a single clinical dose of either MPH, ATX or placebo in a randomized, double-blind, placebo-controlled, cross-over design. To test for normalization effects, brain activations in ADHD under each drug condition were compared with that of 20 age-matched healthy control boys. RESULTS Relative to healthy boys, ADHD boys under placebo showed impaired performance only under high WM load together with significant underactivation in the bilateral dorsolateral prefrontal cortex (DLPFC). Both drugs normalized the performance deficits relative to controls. ATX significantly enhanced right DLPFC activation relative to MPH within patients, and significantly normalized its underactivation relative to controls. MPH, by contrast, both relative to placebo and ATX, as well as relative to controls, upregulated the left inferior frontal cortex (IFC), but only during 2-back. Both drugs enhanced fronto-temporo-striatal activation in ADHD relative to control boys and deactivated the default-mode network, which were negatively associated with the reduced DLPFC activation and performance deficits, suggesting compensation effects. CONCLUSIONS The study shows both shared and drug-specific effects. ATX upregulated and normalized right DLPFC underactivation, while MPH upregulated left IFC activation, suggesting drug-specific laterality effects on prefrontal regions mediating WM.
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Affiliation(s)
- A Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - A B Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - N Barrett
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - V Giampietro
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - M Brammer
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - A Simmons
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - K Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
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Smith A, Cubillo A, Barrett N, Giampietro V, Simmons A, Brammer M, Rubia K. Neurofunctional effects of methylphenidate and atomoxetine in boys with attention-deficit/hyperactivity disorder during time discrimination. Biol Psychiatry 2013; 74:615-22. [PMID: 23731741 DOI: 10.1016/j.biopsych.2013.03.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 03/04/2013] [Accepted: 03/11/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The catecholamine agonists methylphenidate and atomoxetine effectively treat attention-deficit/hyperactivity disorder (ADHD). Furthermore, dopamine agonists have shown to improve time estimation in ADHD, a core cognitive deficit. However, few have compared the effects of methylphenidate and atomoxetine on brain function in ADHD, and none during time estimation. Using single dose challenges, we investigated shared and drug-specific effects in ADHD adolescents on the neural substrates of time discrimination (TD). METHODS Twenty ADHD adolescent male subjects were compared in a randomized double-blind cross-over design after single doses of methylphenidate, atomoxetine, and placebo in functional magnetic resonance imaging during TD. Normalization effects were assessed by comparing brain activation under each drug condition with that of 20 healthy age-matched control subjects. RESULTS Relative to control subjects, patients under placebo showed TD deficits and reduced activation of ventrolateral prefrontal cortex (VLPFC)/insula, inferior frontal cortex, and supplementary motor area. Performance differences were normalized only by methylphenidate, relative to both atomoxetine and placebo. Both medications, however, significantly upregulated right VLPFC/insula activation within patients and normalized its underactivation in ADHD boys under placebo relative to control subjects. The supplementary motor area and inferior frontal cortex activation differences that were observed under placebo were reduced by methylphenidate and atomoxetine, respectively, but neither survived rigorous testing for normalization. CONCLUSIONS While only methylphenidate had a drug-specific effect of improving TD performance deficits, both drugs significantly upregulated and normalized right VLPFC underactivation in ADHD boys under placebo relative to control subjects, suggesting shared effects of stimulants and nonstimulants on a key prefrontal dysfunction during timing.
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Affiliation(s)
- Anna Smith
- Department of Child Psychiatry, Institute of Psychiatry, King's College London, United Kingdom.
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46
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Alvarez R, Musteanu M, Garcia-Garcia E, Lopez-Casas PP, Megias D, Guerra C, Muñoz M, Quijano Y, Cubillo A, Rodriguez-Pascual J, Plaza C, de Vicente E, Prados S, Tabernero S, Barbacid M, Lopez-Rios F, Hidalgo M. Stromal disrupting effects of nab-paclitaxel in pancreatic cancer. Br J Cancer 2013; 109:926-33. [PMID: 23907428 PMCID: PMC3749580 DOI: 10.1038/bjc.2013.415] [Citation(s) in RCA: 252] [Impact Index Per Article: 22.9] [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: 02/25/2013] [Revised: 06/26/2013] [Accepted: 07/01/2013] [Indexed: 12/12/2022] Open
Abstract
Background: Nab-paclitaxel and gemcitabine have demonstrated a survival benefit over gemcitabine alone in advanced pancreatic cancer (PDA). This study aimed to investigate the clinical, biological, and imaging effects of the regimen in patients with operable PDA. Methods: Patients with operable PDA received two cycles of nab-paclitaxel and gemcitabine before surgical resection. FDG-PET and CA19.9 tumour marker levels were used to measure clinical activity. Effects on tumour stroma were determined by endoscopic ultrasound (EUS) elastography. The collagen content and architecture as well as density of cancer-associated fibroblasts (CAFs) were determined in the resected surgical specimen and compared with a group of untreated and treated with conventional chemoradiation therapy controls. A co-clinical study in a mouse model of PDA was conducted to differentiate between the effects of nab-paclitaxel and gemcitabine. Results: A total of 16 patients were enrolled. Treatment resulted in significant antitumour effects with 50% of patients achieving a >75% decrease in circulating CA19.9 tumour marker and a response by FDG-PET. There was also a significant decrement in tumour stiffness as measured by EUS elastography. Seven of 12 patients who completed treatment and were operated had major pathological regressions. Analysis of residual tumours showed a marked disorganised collagen with a very low density of CAF, which was not observed in the untreated or conventionally treated control groups. The preclinical co-clinical study showed that these effects were specific of nab-paclitaxel and not gemcitabine. Conclusion: These data suggest that nab-paclitaxel and gemcitabine decreases CAF content inducing a marked alteration in cancer stroma that results in tumour softening. This regimen should be studied in patients with operable PDA.
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Affiliation(s)
- R Alvarez
- Centro Integral Oncológico Clara Campal, Oña 10, 28050 Madrid, Spain
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47
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Cubillo A, Smith AB, Barrett N, Giampietro V, Brammer MJ, Simmons A, Rubia K. Shared and drug-specific effects of atomoxetine and methylphenidate on inhibitory brain dysfunction in medication-naive ADHD boys. ACTA ACUST UNITED AC 2012; 24:174-85. [PMID: 23048018 PMCID: PMC3862268 DOI: 10.1093/cercor/bhs296] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [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] [Indexed: 11/17/2022]
Abstract
The stimulant methylphenidate (MPX) and the nonstimulant atomoxetine (ATX) are the most commonly prescribed medications for attention deficit hyperactivity disorder (ADHD). However, no functional magnetic resonance imaging (fMRI) study has as yet investigated the effects of ATX on inhibitory or any other brain function in ADHD patients or compared its effects with those of MPX. A randomized, double-blind, placebo-controlled, crossover pharmacological design was used to compare the neurofunctional effects of single doses of MPX, ATX, and placebo during a stop task, combined with fMRI within 19 medication-naive ADHD boys, and their potential normalization effects relative to 29 age-matched healthy boys. Compared with controls, ADHD boys under placebo showed bilateral ventrolateral prefrontal, middle temporal, and cerebellar underactivation. Within patients, MPX relative to ATX and placebo significantly upregulated right ventrolateral prefrontal activation, which correlated with enhanced inhibitory capacity. Relative to controls, both drugs significantly normalized the left ventrolateral prefrontal underactivation observed under placebo, while MPX had a drug-specific effect of normalizing right ventrolateral prefrontal and cerebellar underactivation observed under both placebo and ATX. The findings show shared and drug-specific effects of MPX and ATX on performance and brain activation during inhibitory control in ADHD patients with superior upregulation and normalization effects of MPX.
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48
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Rodríguez-Pascual J, Sha P, García-García E, Rajeshkumar NV, De Vicente E, Quijano Y, Cubillo A, Angulo B, Hernando O, Hidalgo M. A preclinical and clinical study of mycophenolate mofetil in pancreatic cancer. Invest New Drugs 2012; 31:14-9. [PMID: 22669334 DOI: 10.1007/s10637-012-9822-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 04/17/2012] [Indexed: 11/25/2022]
Abstract
A high throughput screening for anticancer activity of FDA approved drugs identified mycophenolic acid (MPA), an inhibitor of inositol monophosphate dehydrogenase (IMPDH) as an active agent with an antiangiogenesis mode of action. Exposure of pancreatic cancer cell lines to MPA resulted in growth inhibition and reduced the expression of VEGF that was reversed by supplementing the media with guanosine supporting and IMPDH-dependant mechanism. In preclinical in vivo study, MPA showed a moderate inhibition of tumor growth in a panel of 6 human derived pancreatic cancer xenografts but reduced the expression of VEGF. To investigate the effects of MPA in human pancreatic cancer, a total of 12 patients with resectable pancreatic cancer (PDA) received increasing doses of mycophenolate mofetil (MMF) in cohorts of 6 patients each from 5-15 days prior to surgical resection. Treatment was well tolerated with one episode of grade 1 muscle pain, one episode of grade 2 lymphopenia (2 gr/day dose) and one episode of grade 2 elevantion in LFT (all in the 2 gr./day dose). Patients recovered from surgery uneventfully with no increased post-operative complications. Assessment of CD31, VEGF, and TUNEL in resected specimens compared to a non treated control of 6 patients showed no significant variations in any of the study endpoints. In conclusion, this study shows the feasibility of translating a preclinical observation to the clinical setting and to explore a drug mechanism of action in patients. MPA, however, did not show any hints of antiangiogenesis of anticancer clinical activity questioning if this agent should be further developed in PDA.
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Cubillo A, Halari R, Giampietro V, Taylor E, Rubia K. Fronto-striatal underactivation during interference inhibition and attention allocation in grown up children with attention deficit/hyperactivity disorder and persistent symptoms. Psychiatry Res 2011; 193:17-27. [PMID: 21601434 DOI: 10.1016/j.pscychresns.2010.12.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 12/16/2010] [Accepted: 12/23/2010] [Indexed: 10/18/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) in medication-naïve children has been associated with reduced activation in inferior/medial prefrontal, striatal and parieto-temporal cortices during inhibitory control and attention allocation. Functional magnetic resonance imaging (fMRI) studies in adult ADHD, however, have been inconsistent and confounded by medication-history and the need for a retrospective diagnosis of childhood ADHD. We used fMRI combined with a Simon task that measured interference inhibition and controlled for and co-measured attention allocation to compare brain function in 11 medication-naïve adults with persistent inattentive/hyperactive behaviours, followed up from childhood ADHD, and 15 age-matched controls. Despite comparable task performance, patients showed reduced activation compared to controls in left orbital/medial frontal cortex and striatum during interference inhibition and in left lateral inferior/dorsolateral prefrontal cortex during attention allocation. Whole-brain regression analyses within patients showed a negative correlation between symptom severity and fronto-striatal, temporo-parietal and cerebellar brain activation. The findings demonstrate that the typical fronto-striatal dysfunction observed in children with ADHD during interference inhibition and attention allocation is also observed in adults grown up from childhood ADHD with persistent symptoms. Furthermore, they show that functional deficits in adult ADHD are not related to chronic stimulant medication given that this sample was medication-naive.
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Affiliation(s)
- Ana Cubillo
- Department of Child Psychiatry, Institute of Psychiatry, King's College London, London, SE5 8AF, UK
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50
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Cubillo A, Halari R, Smith A, Taylor E, Rubia K. A review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention. Cortex 2011; 48:194-215. [PMID: 21575934 DOI: 10.1016/j.cortex.2011.04.007] [Citation(s) in RCA: 304] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 02/03/2011] [Accepted: 04/11/2011] [Indexed: 12/18/2022]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) has long been associated with abnormalities in frontal brain regions. In this paper we review the current structural and functional imaging evidence for abnormalities in children and adults with ADHD in fronto-striatal, fronto-parieto-temporal, fronto-cerebellar and fronto-limbic regions and networks. While the imaging studies in children with ADHD are more numerous and consistent, an increasing number of studies suggests that these structural and functional abnormalities in fronto-cortical and fronto-subcortical networks persist into adulthood, despite a relative symptomatic improvement in the adult form of the disorder. We furthermore present new data that support the notion of a persistence of neurofunctional deficits in adults with ADHD during attention and motivation functions. We show that a group of medication-naïve young adults with ADHD behaviours who were followed up 20 years from a childhood ADHD diagnosis show dysfunctions in lateral fronto-striato-parietal regions relative to controls during sustained attention, as well as in ventromedial orbitofrontal regions during reward, suggesting dysfunctions in cognitive-attentional as well as motivational neural networks. The lateral fronto-striatal deficit findings, furthermore, were strikingly similar to those we have previously observed in children with ADHD during the same task, reinforcing the notion of persistence of fronto-striatal dysfunctions in adult ADHD. The ventromedial orbitofrontal deficits, however, were associated with comorbid conduct disorder (CD), highlighting the potential confound of comorbid antisocial conditions on paralimbic brain deficits in ADHD. Our review supported by the new data therefore suggest that both adult and childhood ADHD are associated with brain abnormalities in fronto-cortical and fronto-subcortical systems that mediate the control of cognition and motivation. The brain deficits in ADHD therefore appear to be multi-systemic and to persist throughout the lifespan.
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Affiliation(s)
- Ana Cubillo
- Department of Child Psychiatry, Institute of Psychiatry, King's College London, UK
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