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Russell B, Hadi H, Moss CL, Green S, Haire A, Wylie H, Handford J, Monroy-Iglesias M, Dickinson H, Haire K, Van Hemelrijck M. The experience of surgical cancer patients during the COVID-19 pandemic at a large cancer centre in London. Support Care Cancer 2024; 32:321. [PMID: 38691178 PMCID: PMC11062958 DOI: 10.1007/s00520-024-08528-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/27/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND The COVID-19 pandemic has had an enormous impact on the experiences of patients across all health disciplines, especially those of cancer patients. The study aimed to understand the experiences of cancer patients who underwent surgery during the first two waves of the pandemic at Guy's Cancer Centre, which is a large tertiary cancer centre in London. METHODS A mixed-methods approach was adopted for this study. Firstly, a survey was co-designed by the research team and a patient study group. Patients who underwent surgery during the COVID-19 pandemic were invited to take part in this survey. Results were analysed descriptively. Three discussion groups were then conducted to focus on the main themes from the survey findings: communication, COVID-19 risk management and overall experience. These discussion groups were transcribed verbatim and underwent a thematic analysis using the NVivo software package. RESULTS Out of 1657 patients invited, a total of 250 (15%) participants took part in the survey with a mean age of 66 (SD 12.8) and 52% females. The sample was representative of a wide range of tumour sites and was reflective of those invited to take part. Overall, the experience of the cancer patients was positive. They felt that the safety protocols implemented at the hospital were effective. Communication was considered key, and patients were receptive to a change in the mode of communication from in-person to virtual. CONCLUSIONS Despite the immense challenges faced by our Cancer Centre, patients undergoing surgery during the first two waves of the COVID-19 pandemic had a generally positive experience with minimal disruptions to their planned surgery and ongoing care. Together with the COVID-19 safety precautions, effective communication between the clinical teams and the patients helped the overall patient experience during their surgical treatment.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK.
| | - Hajer Hadi
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Charlotte L Moss
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Saran Green
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Anna Haire
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Harriet Wylie
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Jasmine Handford
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | - Maria Monroy-Iglesias
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
| | | | - Kate Haire
- South-East London Cancer Alliance, London, UK
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Science, King's College London, London, UK
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Monroy-Iglesias MJ, Martin S, Cargaleiro C, Jones G, Steward L, Murtagh C, Bruno F, Millwaters J, Schizas A, Watson H, Haire A, Haire K, Moss CL, Russell B, Srirajaskanthan R, Van Hemelrijck M, Dolly S. Real-world data evaluating Guy's rapid diagnostic clinic as an alternate pathway for patients with FIT levels below 10. BMJ Open 2024; 14:e080285. [PMID: 38626962 PMCID: PMC11029265 DOI: 10.1136/bmjopen-2023-080285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To analyse the effectiveness of rapid diagnostic clinics (RDCs) as an alternative pathway for patients with concerning symptoms and a faecal immunochemical test (FIT) result <10. Our primary endpoint was rate of colorectal cancer (CRC) detection. Second endpoints were rates of other cancers and gastrointestinal (GI) serious benign conditions. Finally, we analysed the specific pathway followed by FIT <10 patients with cancer at Guy's and St Thomas NHS Foundation Trust (GSTT) RDC. DESIGN A retrospective and prospective cohort study. SETTING GSTT RDC, one of England's largest single-centre RDCs. Sociodemographic and clinical characteristics of FIT <10 patients were analysed descriptively. PARTICIPANTS Patients with an FIT result <10, seen at GSTT RDC between 1 January 2020 and 5 May 2023. RESULTS A total of 1299 patients with an FIT<10 were seen at GSTT RDC between January 2020 and May 2023. Of these, 66% (n=861) reported weight loss, 62% (n=805) pain, 37% (n=481) fatigue, 34% (n=444) were anaemic and 23% (n=301) had nausea and vomiting. Among these patients, 7% (n=88) received a cancer diagnosis, 36% (n=462) were identified as having a serious benign condition. Within the patients with cancer, 9% (n=8) were diagnosed with CRC. Among patients with serious benign conditions, 7% (n=31) were referred to colorectal, hepatopancreatobiliary, or upper GI specialists. CONCLUSION This study demonstrates the effectiveness of RDCs as an alternate pathway for FIT <10 patients with ongoing clinical concerns. These results contribute to enhancing patient care and optimising resource allocation within the healthcare system.
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Affiliation(s)
| | - Sabine Martin
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Carlos Cargaleiro
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Geraint Jones
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
- Southeast London Cancer Alliance, London, UK
| | - Lindsay Steward
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Colette Murtagh
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Flaminia Bruno
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Juliet Millwaters
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Alexis Schizas
- Department of Colorectal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Harriet Watson
- Department of Colorectal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Anna Haire
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Kate Haire
- Southeast London Cancer Alliance, London, UK
| | | | - Beth Russell
- Translational Oncology and Urology Research, King's College London, London, UK
| | | | | | - Saoirse Dolly
- Medical Oncology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
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3
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Russell B, Leech P, Wylie H, Moss CL, Haire A, Enting D, Amery S, Chatterton K, Khan MS, Thurairaja R, Nair R, Malde S, Smith K, Gillett C, Josephs D, Pintus E, Rudman S, Hughes S, Relton C, Van Hemelrijck M. A cohort profile of the Graham Roberts study cohort. Front Oncol 2024; 13:1334183. [PMID: 38264755 PMCID: PMC10803459 DOI: 10.3389/fonc.2023.1334183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/11/2023] [Indexed: 01/25/2024] Open
Abstract
Purpose The Graham Roberts Study was initiated in 2018 and is the first Trials Within Cohorts (TwiCs) study for bladder cancer. Its purpose is to provide an infrastructure for answering a breadth of research questions, including clinical, mechanistic, and supportive care centred questions for bladder cancer patients. Participants All consented patients are those aged 18 or older, able to provide signed informedconsent and have a diagnosis of new or recurrent bladder cancer. All patients are required to have completed a series of baseline questionnaires. The questionnaires are then sent out every 12 months and include information on demographics and medical history as well as questionnaires to collect information on quality of life, fatigue, depression, overall health, physical activity, and dietary habits. Clinical information such as tumor stage, grade and treatment has also been extracted for each patient. Findings to date To date, a total of 125 bladder cancer patients have been consented onto the study with 106 filling in the baseline questionnaire. The cohort is made up of 75% newly diagnosed bladder cancer patients and 66% non-muscle invasive bladder cancer cases. At present, there is 1-year follow-up information for 70 patients, 2-year follow-up for 57 patients, 3-year follow-up for 47 patients and 4-year follow-up for 19 patients. Future plans We plan to continue recruiting further patients into the cohort study. Using the data collected within the study, we hope to carry out independent research studies with a focus on quality of life. We are also committed to utilizing the Roberts Study Cohort to set up and commence an intervention. The future studies and trials carried out using the Roberts Cohort have the potential to identify and develop interventions that could improve the prevention, diagnosis, and treatment of bladder cancer.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Poppy Leech
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Harriet Wylie
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Charlotte Louise Moss
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Anna Haire
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Deborah Enting
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Suzanne Amery
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Kathryn Chatterton
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | | | - Ramesh Thurairaja
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Rajesh Nair
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Sachin Malde
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Kate Smith
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Cheryl Gillett
- King’s Health Partners Cancer Biobank, King’s College London, London, United Kingdom
| | - Debra Josephs
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Elias Pintus
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Sarah Rudman
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Simon Hughes
- Urology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Clare Relton
- Wolfson Institute of Population Health, Queen Mary University of London, London Sheffield, United Kingdom
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
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4
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Van Hemelrijck M, Fox L, Beyer K, Fedaraviciute E, George G, Hadi H, Haire A, Handford J, Mera A, Monroy-Iglesias MJ, Moss CL, Perdek N, Russell B, Santaolalla A, Sztankay M, Wylie H, Jassem J, Zubaryev M, Anderson BO, Ortiz R, Ilbawi A, Camacho R, Ferreira-Borges C, Roitberg F, Dvaladze AE, Lasierra Losada M, Alves da Costa F, Aggarwal A, Lawler M, Kopetskiy S, Sullivan R. Cancer care for Ukrainian refugees: Strategic impact assessments in the early days of the conflict. J Cancer Policy 2022; 34:100370. [PMID: 36375808 DOI: 10.1016/j.jcpo.2022.100370] [Citation(s) in RCA: 4] [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: 06/30/2022] [Revised: 10/25/2022] [Accepted: 11/10/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The invasion of Ukraine by Russia in February 2022 has resulted in destruction of healthcare infrastructure and triggered the largest wave of internally displaced populations and refugees since World War Two. Conflicts in transitioned countries such as Ukraine create new non-communicable disease (NCD) challenges, especially for cancer care for refugees and humanitarian assistance in host countries. In the early days, rapid attempts were made to model possible impacts. METHODS By evaluating open source intelligence used in the first three months of the conflict through snowball search methods, we aimed to address: (i) burden of cancer in Ukrainian population, specifically considering translating to the refugees population, and its cancer care capacity; ii) baseline capacity/strengths of cancer systems in initial host countries. Moreover, using a baseline scenario based on crude cancer incidence in Ukraine, and considering data from UNHCR, we estimated how cancer cases would be distributed across host countries. Finally, a surveillance assessment instrument was created, intersecting health system's capacity and influx of internally displaced populations and refugees. FINDINGS AND CONCLUSIONS The total new cancer patients per month in pre-conflict Ukraine was estimated as 13,106, of which < 1 % are paediatric cases. The estimated cancer cases in the refugee population (combining prevalent and incident), assuming 7.5 million refugees by July 2022 and a female:male ratio of 9:1, was 33,121 individuals (Poland: 19284; Hungary: 3484; Moldova: 2651; Slovakia: 2421; Romania: 5281). According to our assessments, Poland is the only neighbouring country classified as green/yellow for cancer capacity, i.e. sufficient ablility to absorb additional burden into national health system; Slovakia we graded as yellow, Hungary and Romania as yellow/red and Moldova as red.
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Affiliation(s)
- M Van Hemelrijck
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - L Fox
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - K Beyer
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - E Fedaraviciute
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - G George
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - H Hadi
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - A Haire
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - J Handford
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - A Mera
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - M J Monroy-Iglesias
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - C L Moss
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - N Perdek
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - B Russell
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - A Santaolalla
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - M Sztankay
- University Hospital of Psychiatry, Medical University of Innsbruck, Austria.
| | - H Wylie
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - J Jassem
- Department of Oncology & Radiotherapy, Medical University of Gdańsk Mariana Smoluchowskiego, Gdańsk, Poland.
| | - M Zubaryev
- National Cancer Institute, Kyiv, Ukraine.
| | | | - R Ortiz
- World Health Organization, Geneva, Switzerland.
| | - A Ilbawi
- World Health Organization, Geneva, Switzerland.
| | - R Camacho
- World Health Organization, Geneva, Switzerland.
| | | | - F Roitberg
- World Health Organization, Geneva, Switzerland.
| | | | | | | | - A Aggarwal
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
| | - M Lawler
- Queen's University, Belfast, UK.
| | | | - R Sullivan
- Centre for Cancer, Society and Public Health, King's College London & Global Oncology Group, London, UK.
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5
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George G, Rudman S, Fleure L, Moon Z, Garmo H, Cahill F, Fox L, Moss C, Wylie H, Haire A, Van Hemelrijck M. Qualitative Analysis of Interviews and Focus Groups Exploring Factors Contributing to Adherence to GnRH Agonists in Men with Prostate Cancer. Semin Oncol Nurs 2022; 38:151236. [PMID: 34920915 DOI: 10.1016/j.soncn.2021.151236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/22/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Side effects from the prolonged use of gonadotropin-releasing hormone (GnRH) agonists may lead to nonadherence to the treatment in men with advanced prostate cancer (PCa). We investigated the reasons contributing to nonadherence to GnRH agonists through interviews with men with PCa and focus groups with their health care professionals. DATA SOURCES The three stages of the study were validation of themes, interviews with men on GnRH agonists, and focus groups with oncology specialists and clinical nurse specialists. An experienced oncologist validated factors contributing to nonadherence identified from the literature. A total of 10 men with PCa were recruited from a large teaching hospital and were interviewed on a one-to-one basis using a topic guide. In stage three, two separate focus groups were held with oncology specialists and clinical nurse specialists treating men with PCa. The interviews and focus groups were audio recorded and transcribed verbatim. Initial codes identified from stage three were grouped into themes and thematically analyzed. CONCLUSION Themes identified from the interviews and focus groups influencing adherence to treatment were side effects of treatment, patient belief system, benefits outweigh harm, quality of life over quantity of life, social support, and patient-clinician relationship. Although side effects such as hot flushes and loss of libido were sometimes overwhelming for many, these men felt that treatment benefits outweighed harm. IMPLICATIONS FOR NURSING PRACTICE Reasons leading to nonadherence can be multifactorial and unique to each patient. Employing different strategies by health care professionals may lead to the eventual acceptance of treatment, while also acknowledging their reasons for nonadherence.
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Affiliation(s)
- Gincy George
- Translational Oncology and Urology Research, King's College London, London, UK.
| | - Sarah Rudman
- Medical Oncology, Guy's and St Thomas' Foundation Trust, London, UK
| | - Louisa Fleure
- Medical Oncology, Guy's and St Thomas' Foundation Trust, London, UK
| | - Zoe Moon
- Institute of Psychiatry, Psychology & Neuroscience, Health Psychology Section, King's College London, London, UK
| | - Hans Garmo
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Fidelma Cahill
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Louis Fox
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Charlotte Moss
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Harriet Wylie
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Anna Haire
- Translational Oncology and Urology Research, King's College London, London, UK
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Manuelli V, Cahill F, Wylie H, Gillett C, Correa I, Heck S, Rimmer A, Haire A, Van Hemelrijck M, Rudman S, Wells CM. Invadopodia play a role in prostate cancer progression. BMC Cancer 2022; 22:386. [PMID: 35397545 PMCID: PMC8994910 DOI: 10.1186/s12885-022-09424-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/16/2022] [Indexed: 01/06/2023] Open
Abstract
Background Invadopodia, actin-rich structures that release metallo-proteases at the interface with extra-cellular matrix, in a punctate manner are thought to be important drivers of tumour invasion. Invadopodia formation has been observed in-vitro and in-vivo in numerous metastatic cell lines derived from multiple tumour types. However, prostate cancer cell lines have not been routinely reported to generate invadopodia and the few instances have always required external stimulation. Methods In this study, the invasive potential of primary prostate adenocarcinoma cell lines, which have never been fully characterised before, was investigated both in-vitro invadopodia assays and in-vivo zebrafish dissemination assay. Subsequently, circulating tumour cells from prostate cancer patients were isolated and tested in the invadopodia assay. Results Retention of E-cadherin and N-cadherin expression indicated a transitional state of EMT progression, consistent with the idea of partial EMT that has been frequently observed in aggressive prostate cancer. All cell lines tested were capable of spontaneous invadopodia formation and possess a significant degradative ability in-vitro under basal conditions. These cell lines were invasive in-vivo and produced visible metastasis in the zebrafish dissemination assay. Importantly we have proceeded to demonstrate that circulating tumour cells isolated from prostate cancer patients exhibit invadopodia-like structures and degrade matrix with visible puncta. This work supports a role for invadopodia activity as one of the mechanisms of dissemination employed by prostate cancer cells. Conclusion The combination of studies presented here provide clear evidence that invadopodia activity can play a role in prostate cancer progression. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09424-4.
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Beyer K, Moris L, Lardas M, Haire A, Barletta F, Scuderi S, Molnar M, Herrera R, Rauf A, Campi R, Greco I, Shiranov K, Dabestani S, van den Broeck T, Arun S, Gacci M, Gandaglia G, Omar MI, MacLennan S, Roobol MJ, Farahmand B, Vradi E, Devecseri Z, Asiimwe A, Zong J, Maclennan SJ, Collette L, NDow J, Briganti A, Bjartell A, Van Hemelrijck M. Diagnostic and prognostic factors in patients with prostate cancer: a systematic review. BMJ Open 2022; 12:e058267. [PMID: 35379637 PMCID: PMC8981333 DOI: 10.1136/bmjopen-2021-058267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES As part of the PIONEER Consortium objectives, we have explored which diagnostic and prognostic factors (DPFs) are available in relation to our previously defined clinician and patient-reported outcomes for prostate cancer (PCa). DESIGN We performed a systematic review to identify validated and non-validated studies. DATA SOURCES MEDLINE, Embase and the Cochrane Library were searched on 21 January 2020. ELIGIBILITY CRITERIA Only quantitative studies were included. Single studies with fewer than 50 participants, published before 2014 and looking at outcomes which are not prioritised in the PIONEER core outcome set were excluded. DATA EXTRACTION AND SYNTHESIS After initial screening, we extracted data following the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of prognostic factor studies (CHARMS-PF) criteria and discussed the identified factors with a multidisciplinary expert group. The quality of the included papers was scored for applicability and risk of bias using validated tools such as PROBAST, Quality in Prognostic Studies and Quality Assessment of Diagnostic Accuracy Studies 2. RESULTS The search identified 6604 studies, from which 489 DPFs were included. Sixty-four of those were internally or externally validated. However, only three studies on diagnostic and seven studies on prognostic factors had a low risk of bias and a low risk concerning applicability. CONCLUSION Most of the DPFs identified require additional evaluation and validation in properly designed studies before they can be recommended for use in clinical practice. The PIONEER online search tool for DPFs for PCa will enable researchers to understand the quality of the current research and help them design future studies. ETHICS AND DISSEMINATION There are no ethical implications.
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Affiliation(s)
- Katharina Beyer
- Translational and Oncology Research (TOUR), King's College London, Faculty of Life Sciences and Medicine, London, UK
| | - Lisa Moris
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Michael Lardas
- Department of Urology, Metropolitan Hospital, Athens, Greece
| | - Anna Haire
- Translational and Oncology Research (TOUR), King's College London, Faculty of Life Sciences and Medicine, London, UK
| | - Francesco Barletta
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Simone Scuderi
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | | | - Abdul Rauf
- Department of Urology, Mid Cheshire Hospitals, NHS Foundation Trust, Crewe, UK
| | - Riccardo Campi
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Isabella Greco
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | | | - Saeed Dabestani
- Dept. of Translational Medicine, Division of Urological Cancers, Lund University, Kristianstad Central Hospital, Malmo, Sweden
| | | | | | - Mauro Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Giorgio Gandaglia
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | | | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | | | | | - Jihong Zong
- Global Medical Affairs Oncology, Real World Evidence, Bayer HealthCare Pharmaceuticals Inc, Whippany, New Jersey, USA
| | | | | | - James NDow
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology, University Vita e Salute-San Raffaele, Milan, Italy
| | - Anders Bjartell
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Mieke Van Hemelrijck
- Translational and Oncology Research (TOUR), King's College London, Faculty of Life Sciences and Medicine, London, UK
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Russell B, Moss C, Tsotra E, Gousis C, Josephs D, Enting D, Karampera C, Khan M, Roca J, Sita-Lumsden A, Owczarczyk K, Wylie H, Haire A, Smith D, Zaki K, Swampillai A, Lei M, Manik V, Michalarea V, Kristeleit R, Mera A, Sawyer E, Flanders L, De Francesco I, Papa S, Ross P, Spicer J, Dann B, Jogia V, Shaunak N, Kristeleit H, Rigg A, Montes A, Van Hemelrijck M, Dolly S. The Impact of COVID-19 on the Delivery of Systemic Anti-Cancer Treatment at Guy's Cancer Centre. Cancers (Basel) 2022; 14:cancers14020266. [PMID: 35053432 PMCID: PMC8773464 DOI: 10.3390/cancers14020266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/07/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to assess the outcome of cancer patients undergoing systemic anti-cancer treatment (SACT) at our centre to help inform future clinical decision-making around SACT during the COVID-19 pandemic. METHODS Patients receiving at least one episode of SACT for solid tumours at Guy's Cancer Centre between 1 March and 31 May 2020 and the same period in 2019 were included in the study. Data were collected on demographics, tumour type/stage, treatment type (chemotherapy, immunotherapy, biological-targeted) and SARS-CoV2 infection. RESULTS A total of 2120 patients received SACT in 2020, compared to 2449 in 2019 (13% decrease). From 2019 to 2020, there was an increase in stage IV disease (62% vs. 72%), decrease in chemotherapy (42% vs. 34%), increase in immunotherapy (6% vs. 10%), but similar rates of biologically targeted treatments (37% vs. 38%). There was a significant increase in 1st and 2nd line treatments in 2020 (68% vs. 81%; p < 0.0001) and reduction in 3rd and subsequent lines (26% vs. 15%; p = 0.004) compared to 2019. Of the 2020 cohort, 2% patients developed SARS-CoV2 infections. CONCLUSIONS These real-world data from a tertiary Cancer Centre suggest that despite the challenges faced due to the COVID-19 pandemic, SACT was able to be continued without any significant effects on the mortality of solid-tumour patients. There was a low rate (2%) of SARS-CoV-2 infection which is comparable to the 1.4%-point prevalence in our total cancer population.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.M.); (H.W.); (A.H.); (M.V.H.)
- Correspondence:
| | - Charlotte Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.M.); (H.W.); (A.H.); (M.V.H.)
| | - Eirini Tsotra
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Charalampos Gousis
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Debra Josephs
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Deborah Enting
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Christina Karampera
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Muhammad Khan
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Jose Roca
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Kasia Owczarczyk
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (K.O.); (D.S.); (A.S.); (M.L.); (V.M.); (E.S.); (I.D.F.)
| | - Harriet Wylie
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.M.); (H.W.); (A.H.); (M.V.H.)
| | - Anna Haire
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.M.); (H.W.); (A.H.); (M.V.H.)
| | - Daniel Smith
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (K.O.); (D.S.); (A.S.); (M.L.); (V.M.); (E.S.); (I.D.F.)
| | - Kamarul Zaki
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Angela Swampillai
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (K.O.); (D.S.); (A.S.); (M.L.); (V.M.); (E.S.); (I.D.F.)
| | - Mary Lei
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (K.O.); (D.S.); (A.S.); (M.L.); (V.M.); (E.S.); (I.D.F.)
| | - Vishal Manik
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (K.O.); (D.S.); (A.S.); (M.L.); (V.M.); (E.S.); (I.D.F.)
| | - Vasiliki Michalarea
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Rebecca Kristeleit
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Anca Mera
- Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.M.); (B.D.); (V.J.)
| | - Elinor Sawyer
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (K.O.); (D.S.); (A.S.); (M.L.); (V.M.); (E.S.); (I.D.F.)
| | - Lucy Flanders
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Irene De Francesco
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (K.O.); (D.S.); (A.S.); (M.L.); (V.M.); (E.S.); (I.D.F.)
| | - Sophie Papa
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
- Immunoengineering Group, King’s College London, London SE1 9RT, UK
| | - Paul Ross
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - James Spicer
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
- Pharmacy, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK;
| | - Bill Dann
- Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.M.); (B.D.); (V.J.)
| | - Vikash Jogia
- Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.M.); (B.D.); (V.J.)
| | - Nisha Shaunak
- Pharmacy, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK;
| | - Hartmut Kristeleit
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Anne Rigg
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Ana Montes
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.M.); (H.W.); (A.H.); (M.V.H.)
| | - Saoirse Dolly
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (E.T.); (C.G.); (D.J.); (D.E.); (C.K.); (M.K.); (J.R.); (A.S.-L.); (K.Z.); (V.M.); (R.K.); (L.F.); (S.P.); (P.R.); (J.S.); (H.K.); (A.R.); (A.M.); (S.D.)
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9
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Green S, Tuck S, Long J, Green T, Green A, Ellis P, Haire A, Moss C, Cahill F, McCartan N, Brown L, Santaolalla A, Marsden T, Justo MR, Hadley J, Punwani S, Attard G, Ahmed H, Moore CM, Emberton M, Van Hemelrijck M. ReIMAGINE: a prostate cancer research consortium with added value through its patient and public involvement and engagement. Res Involv Engagem 2021; 7:81. [PMID: 34789334 PMCID: PMC8596340 DOI: 10.1186/s40900-021-00322-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND ReIMAGINE aims to improve the current prostate specific antigen (PSA)/biopsy risk stratification for prostate cancer (PCa) and develop a new image-based method (with biomarkers) for diagnosing high/low risk PCa in men. ReIMAGINE's varied patient and public involvement (PPI) and engagement (PE) strategy maximises the impact of its scientific output by informing and shaping the different stages of research. AIMS Through including the voice of patients and the public, the ReIMAGINE Consortium aims to translate these different perspectives into the design and implementation process. This will improve the overall quality of the research by: reflecting the needs and priorities of patients and the public, ensuring methods and procedures are feasible and appropriate ensuring information is relevant and accessible to those being recruited to the study identifying dissemination channels relevant to patients/the public and developing outputs that are accessible to a lay audience With support from our patient/user groups, the ReIMAGINE Consortium aims to improve our ability to derive prognostic information and allocate men to the most appropriate and effective therapies, using a novel image-based risk stratification with investigation of non-imaging biomarkers. FINDINGS We have been working with patients and the public from initiation of the project to ensure that the research is relevant to men and their families. Our PPI Sub-Committee, led by a PCa patient, has been involved in our dissemination strategy, outreach activities, and study design recommendations. For example, the sub-committee have developed a variety of informative videos relevant and accessible to those being recruited, and organised multiple online research engagement events that are accessible to a lay audience. As quoted by one of the study participants, "the more we present the benefits and opportunities to patients and the public, the more research commitment we obtain, and the sooner critical clinical questions such as PCa diagnostics will be addressed".
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Affiliation(s)
- S Green
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - S Tuck
- ReIMAGINE Consortium Patient Representative, London, UK
| | - J Long
- ReIMAGINE Consortium Patient Representative, London, UK
| | - T Green
- ReIMAGINE Consortium Patient Representative, London, UK
| | - A Green
- ReIMAGINE Consortium Patient Representative, London, UK
| | - P Ellis
- ReIMAGINE Consortium Patient Representative, London, UK
| | - A Haire
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - C Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - F Cahill
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - N McCartan
- UCL Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - L Brown
- MRC Clinical Trials Unit, University College London, London, UK
| | - A Santaolalla
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - T Marsden
- UCL Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - M Rodriquez Justo
- UCL Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - J Hadley
- UCL Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - S Punwani
- Centre for Medical Imaging, University College London, London, UK
| | - G Attard
- UCL Division of Surgical and Interventional Sciences, University College London, London, UK
| | - H Ahmed
- Imperial College, London, UK
| | - C M Moore
- UCL Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - M Emberton
- UCL Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - M Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
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10
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Fox L, Wylie H, Haire A, Green S, Kibaru J, Van Hemelrijck M. "Something Good Has to Come Out of the Horror": A Qualitative Examination of Cancer Survivors' Attitudes Towards Participation in Research During the First Year of the COVID-19 Pandemic. Front Public Health 2021; 9:741188. [PMID: 34778175 PMCID: PMC8585927 DOI: 10.3389/fpubh.2021.741188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The first year of the COVID-19 pandemic has been highly disruptive for people with cancer. Furthermore, it has been shown that accrual to cancer trials dropped substantially in 2020. Building on findings from a previous pilot survey, the present study used qualitative methods to gain insights into attitudes towards participation in research studies amongst people who have experienced cancer, in the context of the first year of the COVID-19 pandemic. Materials and Methods: We interviewed 13 participants from the UK, who were purposively sampled, including a broad sample of cancer types, and a mixture of individuals who have and have not taken part in research previously. Participants underwent semi-structured interviews (median interview duration: 47 min) and were asked open-ended questions about their attitude towards and experiences with COVID-19, and their attitude towards research participation. In addition to this, prompts were used to ask participants about concerns that were highlighted by our previous quantitative work on this topic, such as concerns about being older or having to travel to participate. Interview transcripts were analysed using a framework analysis approach. Results: Our findings suggest that cancer patient decision-making about research participation during an infectious disease pandemic may be a function of a basic cost-benefit analysis, which considers the benefit of taking part, either personally to themselves or to wider society. The benefit may then be weighed by the patient against the risk of being infected, which may be influenced by trust in the relevant clinicians/researchers; familiarity with the study location; provision of detailed information on safety protocols for infectious disease; and, in particular, the availability of safe transport to and from the study location. Discussion: Some cancer patients say that they would be less likely to participate in a research study in the middle of an infectious disease pandemic due to an increased risk to themselves. Patients' perceived risk to themselves from participating may be ameliorated via the provision of certain practical solutions that can be considered at the study protocol design stage, such as safe travel, information, and the use of staff and study sites familiar to the patient.
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Affiliation(s)
- Louis Fox
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
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Marsden T, Lomas DJ, McCartan N, Hadley J, Tuck S, Brown L, Haire A, Moss CL, Green S, Van Hemelrijck M, Coolen T, Santaolalla A, Isaac E, Brembilla G, Kopcke D, Giganti F, Sidhu H, Punwani S, Emberton M, Moore CM. ReIMAGINE Prostate Cancer Screening Study: protocol for a single-centre feasibility study inviting men for prostate cancer screening using MRI. BMJ Open 2021; 11:e048144. [PMID: 34593491 PMCID: PMC8487192 DOI: 10.1136/bmjopen-2020-048144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The primary objective of the ReIMAGINE Prostate Cancer Screening Study is to explore the uptake of an invitation to prostate cancer screening using MRI. METHODS AND ANALYSIS The ReIMAGINE Prostate Cancer Screening Study is a prospective single-centre feasibility study. Eligible men aged 50-75 years with no prior prostate cancer diagnosis or treatment will be identified through general practitioner practices and randomly selected for invitation. Those invited will be offered an MRI scan and a prostate-specific antigen (PSA) blood test. The screening MRI scan consists of T2-weighted, diffusion-weighted and research-specific sequences, without the use of intravenous contrast agents. Men who screen positive on either MRI or PSA density will be recommended to have standard of care (National Health Service) tests for prostate cancer assessment, which includes multiparametric MRI. The study will assess the acceptability of an MRI-based prostate screening assessment and the prevalence of cancer detected in MRI-screened men. Summary statistics will be used to explore baseline characteristics in relation to acceptance rates and prevalence of cancer. ETHICS AND DISSEMINATION ReIMAGINE Prostate Cancer Screening is a single-site screening study to assess the feasibility of MRI as a screening tool for prostate cancer. Ethical approval was granted by London-Stanmore Research Ethics Committee Heath Research Authority (reference 19/LO/1129). Study results will be published in peer-reviewed journals after completion of data analysis and used to inform the design of a multicentre screening study in the UK. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04063566).
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Affiliation(s)
- Teresa Marsden
- Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Derek J Lomas
- Department of Urology, Mayo Clinic, Rochester, New York, USA
| | - Neil McCartan
- Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Joanna Hadley
- Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Steve Tuck
- ReIMAGINE Consortium Patient Representative, University College London, London, UK
| | - Louise Brown
- MRC Clinical Trials Unit, University College London, London, UK
| | - Anna Haire
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Saran Green
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Ton Coolen
- London Institute for Mathematical Sciences, London, UK
| | - Aida Santaolalla
- Cancer Epidemiology Group, Division of Cancer Studies, King's College London, London, UK
| | - Elizabeth Isaac
- Centre for Medical Imaging, University College London, London, UK
| | | | - Douglas Kopcke
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Francesco Giganti
- Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Harbir Sidhu
- Centre for Medical Imaging, University College London, London, UK
| | - Shonit Punwani
- Centre for Medical Imaging, University College London, London, UK
| | - Mark Emberton
- Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Caroline M Moore
- Division of Surgical and Interventional Sciences, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
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12
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Russell B, Moss CL, Shah V, Ko TK, Palmer K, Sylva R, George G, Monroy-Iglesias MJ, Patten P, Ceesay MM, Benjamin R, Potter V, Pagliuca A, Papa S, Irshad S, Ross P, Spicer J, Kordasti S, Crawley D, Wylie H, Cahill F, Haire A, Zaki K, Sita-Lumsden A, Josephs D, Enting D, Swampillai A, Sawyer E, D'Souza A, Gomberg S, Harrison C, Fields P, Wrench D, Rigg A, Sullivan R, Kulasekararaj A, Dolly S, Van Hemelrijck M. Risk of COVID-19 death in cancer patients: an analysis from Guy's Cancer Centre and King's College Hospital in London. Br J Cancer 2021; 125:939-947. [PMID: 34400804 PMCID: PMC8366163 DOI: 10.1038/s41416-021-01500-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/26/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Using an updated dataset with more patients and extended follow-up, we further established cancer patient characteristics associated with COVID-19 death. METHODS Data on all cancer patients with a positive reverse transcription-polymerase chain reaction swab for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) at Guy's Cancer Centre and King's College Hospital between 29 February and 31 July 2020 was used. Cox proportional hazards regression was performed to identify which factors were associated with COVID-19 mortality. RESULTS Three hundred and six SARS-CoV-2-positive cancer patients were included. Seventy-one had mild/moderate and 29% had severe COVID-19. Seventy-two patients died of COVID-19 (24%), of whom 35 died <7 days. Male sex [hazard ratio (HR): 1.97 (95% confidence interval (CI): 1.15-3.38)], Asian ethnicity [3.42 (1. 59-7.35)], haematological cancer [2.03 (1.16-3.56)] and a cancer diagnosis for >2-5 years [2.81 (1.41-5.59)] or ≥5 years were associated with an increased mortality. Age >60 years and raised C-reactive protein (CRP) were also associated with COVID-19 death. Haematological cancer, a longer-established cancer diagnosis, dyspnoea at diagnosis and raised CRP were indicative of early COVID-19-related death in cancer patients (<7 days from diagnosis). CONCLUSIONS Findings further substantiate evidence for increased risk of COVID-19 mortality for male and Asian cancer patients, and those with haematological malignancies or a cancer diagnosis >2 years. These factors should be accounted for when making clinical decisions for cancer patients.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
| | - Charlotte L Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Vallari Shah
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Thinzar Ko Ko
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Kieran Palmer
- King's College Hospital NHS Foundation Trust, London, UK
| | - Rushan Sylva
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Gincy George
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Maria J Monroy-Iglesias
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Piers Patten
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Reuben Benjamin
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Victoria Potter
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Antonio Pagliuca
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Sophie Papa
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Sheeba Irshad
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Paul Ross
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - James Spicer
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Shahram Kordasti
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Danielle Crawley
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Harriet Wylie
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Fidelma Cahill
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Anna Haire
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Kamarul Zaki
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Debra Josephs
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Deborah Enting
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Angela Swampillai
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Elinor Sawyer
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Clinical Oncology, Guy's and St Thomas NHS Foundation Trust (GSTT), London, UK
| | - Andrea D'Souza
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Simon Gomberg
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Claire Harrison
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Paul Fields
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - David Wrench
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Anne Rigg
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Richard Sullivan
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Austin Kulasekararaj
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Saoirse Dolly
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
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Van Hemelrijck M, Peters V, Loong JF, Russell B, Fox L, Wylie H, Santaolalla A, Beyer K, Rammant E, Lin E, Haire A, Moss C, Green S. The importance of patient and public involvement in cancer research: time to create a new job profile. Future Oncol 2021; 17:3667-3670. [PMID: 34213357 DOI: 10.2217/fon-2021-0489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Tweetable abstract Need to add #PPI coordinator to required job profiles in #research: improve research quality, enthuse research team and ensure #patients and their families are the center of our research activities.
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Affiliation(s)
- Mieke Van Hemelrijck
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | | | | | - Beth Russell
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Louis Fox
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Harriet Wylie
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Aida Santaolalla
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Katharina Beyer
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Elke Rammant
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - E Lin
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Anna Haire
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Charlotte Moss
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
| | - Saran Green
- Translational Oncology & Urology Research, Faculty of Life Sciences & Medicine, King's College London, London, SE1 9RT, UK
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14
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Timbres J, Moss C, Mera A, Haire A, Gillett C, Van Hemelrijck M, Sawyer E. Survival Outcomes in Invasive Lobular Carcinoma Compared to Oestrogen Receptor-Positive Invasive Ductal Carcinoma. Cancers (Basel) 2021; 13:cancers13123036. [PMID: 34207042 PMCID: PMC8234044 DOI: 10.3390/cancers13123036] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/19/2021] [Accepted: 06/07/2021] [Indexed: 01/19/2023] Open
Abstract
Invasive lobular breast cancer (ILC) accounts for 10-15% of breast cancers and has distinct characteristics compared with the more common invasive ductal carcinoma (IDC). Studies have shown that ILC may be less sensitive to chemotherapy than IDC, with lower rates of complete pathological response after neo-adjuvant chemotherapy, but it is not clear how this affects long-term survival. Patients at Guy's and St Thomas' NHS Foundation Trust between 1975 and 2016 diagnosed with ER+ IDC or ER+ ILC were eligible for inclusion. Kaplan-Meier plots and Cox proportional-hazards regression models were used for analysis. There was no difference in overall survival comparing ER+ ILC to ER+ IDC (OR: 0.94, 95% CI: 0.83, 1.04) with a median follow-up time of 8.3 years compared to 8.4 years in IDC. However, ER+HER2- ILC had worse survival compared to ER+HER2- IDC in those that received chemotherapy (OR: 1.46, 95% CI: 1.06, 2.01). Here, median follow-up time was 7.0 years in ILC compared to 8.1 years in IDC. These results indicate worse overall survival after chemotherapy (neo-adjuvant and adjuvant) in ILC compared to ER+HER2- IDC even when correcting for tumour grade, age, size, and nodal involvement, but validation is needed in a larger study population.
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Affiliation(s)
- Jasmine Timbres
- Breast Cancer Genetics, King’s College London, London SE1 9RT, UK;
- Correspondence:
| | - Charlotte Moss
- Translational Oncology and Urology Research, King’s College London, London SE1 9RT, UK; (C.M.); (A.H.); (M.V.H.)
| | - Anca Mera
- Guy’s & St. Thomas’ Hospital, London SE1 9RT, UK;
| | - Anna Haire
- Translational Oncology and Urology Research, King’s College London, London SE1 9RT, UK; (C.M.); (A.H.); (M.V.H.)
| | - Cheryl Gillett
- KHP Cancer Biobank, King’s College London, London SE1 9RT, UK;
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research, King’s College London, London SE1 9RT, UK; (C.M.); (A.H.); (M.V.H.)
| | - Elinor Sawyer
- Breast Cancer Genetics, King’s College London, London SE1 9RT, UK;
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15
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Beyer K, Moris L, Lardas M, Haire A, Barletta F, Scuderi S, Molnar M, Herrera R, Rauf A, Campi R, Greco I, Shiranov K, Dabestani S, Van Den Broeck T, Gacci M, Gandaglia G, Omar M, Maclennan S, Roobol M, Zong J, Maclennan S, Collette L, Briganti A, Bjartell A, Van Hemelrijck M. Diagnostic and prognostic factors in patients with prostate cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00685-0] [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: 10/20/2022]
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16
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Russell B, Moss CL, Palmer K, Sylva R, D’Souza A, Wylie H, Haire A, Cahill F, Steel R, Hoyes A, Wilson I, Macneil A, Shifa B, Monroy-Iglesias MJ, Papa S, Irshad S, Ross P, Spicer J, Kordasti S, Crawley D, Zaki K, Sita-Lumsden A, Josephs D, Enting D, Swampillai A, Sawyer E, Fields P, Wrench D, Rigg A, Sullivan R, Van Hemelrijck M, Dolly S. COVID-19 Risk Factors for Cancer Patients: A First Report with Comparator Data from COVID-19 Negative Cancer Patients. Cancers (Basel) 2021; 13:2479. [PMID: 34069565 PMCID: PMC8161328 DOI: 10.3390/cancers13102479] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 01/11/2023] Open
Abstract
Very few studies investigating COVID-19 in cancer patients have included cancer patients as controls. We aimed to identify factors associated with the risk of testing positive for SARS CoV2 infection in a cohort of cancer patients. We analyzed data from all cancer patients swabbed for COVID-19 between 1st March and 31st July 2020 at Guy's Cancer Centre. We conducted logistic regression analyses to identify which factors were associated with a positive COVID-19 test. Results: Of the 2152 patients tested for COVID-19, 190 (9%) tested positive. Male sex, black ethnicity, and hematological cancer type were positively associated with risk of COVID-19 (OR = 1.85, 95%CI:1.37-2.51; OR = 1.93, 95%CI:1.31-2.84; OR = 2.29, 95%CI:1.45-3.62, respectively) as compared to females, white ethnicity, or solid cancer type, respectively. Male, Asian ethnicity, and hematological cancer type were associated with an increased risk of severe COVID-19 (OR = 3.12, 95%CI:1.58-6.14; OR = 2.97, 95%CI:1.00-8.93; OR = 2.43, 95%CI:1.00-5.90, respectively). This study is one of the first to compare the risk of COVID-19 incidence and severity in cancer patients when including cancer patients as controls. Results from this study have echoed those of previous reports, that patients who are male, of black or Asian ethnicity, or with a hematological malignancy are at an increased risk of COVID-19.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Charlotte L. Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Kieran Palmer
- King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | - Rushan Sylva
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Andrea D’Souza
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Harriet Wylie
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Anna Haire
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Fidelma Cahill
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Renee Steel
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.S.); (E.S.)
| | - Angela Hoyes
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
| | - Isabelle Wilson
- Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK;
| | - Alyson Macneil
- Breast Surgery, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.M.); (B.S.)
| | - Belul Shifa
- Breast Surgery, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.M.); (B.S.)
| | - Maria J Monroy-Iglesias
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
| | - Sophie Papa
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Sheeba Irshad
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Paul Ross
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - James Spicer
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Shahram Kordasti
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Danielle Crawley
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Kamarul Zaki
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Debra Josephs
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Deborah Enting
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Angela Swampillai
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.S.); (E.S.)
| | - Elinor Sawyer
- Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.S.); (E.S.)
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Paul Fields
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
| | - David Wrench
- Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (A.H.); (S.K.); (P.F.); (D.W.)
| | - Anne Rigg
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Richard Sullivan
- School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK;
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK; (C.L.M.); (H.W.); (A.H.); (F.C.); (M.J.M.-I.); (D.C.); (D.J.); (D.E.)
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
| | - Saoirse Dolly
- Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London SE1 9RT, UK; (R.S.); (A.D.); (S.P.); (S.I.); (P.R.); (J.S.); (K.Z.); (A.S.-L.); (A.R.); (S.D.)
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17
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Tagliabue M, Russell B, Moss C, De Berardinis R, Chu F, Jeannon JP, Pietrobon G, Haire A, Grosso E, Wylie H, Zorzi S, Proh M, Brunet-Garcia A, Cattaneo A, Oakley R, De Benedetto L, Arora A, Riccio S, Fry A, Bruschini R, Townley W, Giugliano G, Orfaniotis G, Madini M, Dolly S, Borghi E, Aprile D, Zurlo V, Bibiano D, Mastrilli F, Chiocca S, Van Hemelrijck M, Gandini S, Simo R, Ansarin M. Outcomes of head and neck cancer management from two cancer centres in Southern and Northern Europe during the first wave of COVID-19. Tumori 2021; 108:230-239. [PMID: 33845703 DOI: 10.1177/03008916211007927] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To describe the approach and outcomes from two cancer centres in Southern and Northern Europe during the first wave of coronavirus disease 2019 (COVID-19) of patients with head and neck cancer (HNC). METHODS Data collection was performed on a retrospective cohort of patients surgically treated for primary HNC between March and May 2020, using data from two tertiary hospitals: the European Institute of Oncology (Milan) and Guy's & St Thomas' NHS Foundation Trust (London). RESULTS We included 77 patients with HNC. More patients with COVID-19 were taking angiotensin-converting enzyme (ACE) inhibitors and had Clavien-Dindo Classification grade I compared to negative patients, respectively (60% vs 22% [p = 0.058] and 40% vs 8% [p = 0.025]). Multivariate logistic regression analyses confirmed our data (p = 0.05 and 0.03, respectively). Sex and age were statistically significantly different (p = 0.05 and <0.001 respectively), showing more male patients (75% vs 53.66%, respectively) and more elderly patients in Italy than in the United Kingdom (patients aged >63 years: 69.44% vs 29.27%). CONCLUSIONS This study presents a large cohort of patients with HNC with nasopharyngeal swab during the first peak of the COVID-19 pandemic in Europe. Patients with HNC with COVID-19 appeared more likely to develop postsurgical complications and to be taking ACE inhibitors. The preventive measures adopted guaranteed the continuation of therapeutic surgical intervention.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy.,Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Beth Russell
- Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Charlotte Moss
- Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Jean-Pierre Jeannon
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Giacomo Pietrobon
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Anna Haire
- Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Enrica Grosso
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Harriet Wylie
- Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Stefano Zorzi
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Michele Proh
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Aina Brunet-Garcia
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Augusto Cattaneo
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Richard Oakley
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Luigi De Benedetto
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Asit Arora
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Stefano Riccio
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Alistair Fry
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Roberto Bruschini
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - William Townley
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Gioacchino Giugliano
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Georgios Orfaniotis
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Marzia Madini
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Saoirse Dolly
- Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ester Borghi
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Danila Aprile
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Zurlo
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Debora Bibiano
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Fabrizio Mastrilli
- Medical Administration, CMO, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Mieke Van Hemelrijck
- Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Ricard Simo
- Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
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Monroy-Iglesias MJ, Russell B, Moss C, George G, Palmer K, Papa S, Irshad S, Ross P, Spicer J, Kordasti S, Crawley D, Wylie H, Cahill F, Haire A, Sylva R, Zaki K, Rahman F, Sita-Lumsden A, Josephs D, Enting D, Lei M, Ghosh S, Harrison C, Swampillai A, Sawyer E, D'Souza A, Gomberg S, Fields P, Wrench D, Raj K, Gleeson M, Bailey K, Dillon R, Streetly M, Kulasekararaj A, Ko TK, Shah V, Rigg A, Sullivan R, Van Hemelrijck M, Dolly S. Abstract S12-03: Clinical and demographic characteristics associated with shorter time to COVID-19 death. Clin Cancer Res 2021. [DOI: 10.1158/1557-3265.covid-19-21-s12-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Cancer patients have been considered a high-risk population in the COVID-19 pandemic. We previously investigated risk of COVID-19 death in COVID-19 positive cancer patients during a median follow-up of 134 days, and identified the following risk factors: male sex, age >60 years, Asian ethnicity, hematological cancer type, cancer diagnosis for >2.5 years, patients presenting with fever or dyspnea, and high levels of ferritin and C-reactive protein (CRP). Here, we further investigate which factors are associated with a COVID-19 related death within 7 days of diagnosis. Methods: Using data from Guy’s Cancer Centre and one of its partner trusts (King’s College Hospital), we included 306 cancer patients with a confirmed COVID-19 diagnosis (February 29th-July 31st 2020). 72 patients had a COVID-19 related death (24%) of whom 35 died within 7 days (50%). Cox proportional hazards regression was used to identify which factors were associated with a COVID-19 related death <7 days of diagnosis. Results: Of the 72 cancer patients who had a COVID-19 related death, the mean age was 72 years (Standard Deviation (SD) 14). A total of 53 (74%) patients were men. 37 (52%) had a hematological cancer type, 47 (65%) had stage IV cancer, and 42 (58%) had been diagnosed with cancer more than 24 months before COVID-19 related death. In the group of patients who died within 7 days of diagnosis (n= 35), mean age was 73 years (SD 13.96), 24 (68%) were men, 20 (57%) had a hematological cancer type, 26 (74%) had stage IV cancer, and 24 (68%) had been diagnosed with cancer >24 months before COVID-19 diagnosis. Factors associated with COVID-19 related death <7 days of diagnosis were: hematological cancer (Hazard Ratio (HR): 2.74 (95% Confidence Interval (CI): 1.21-6.22)), 2-5 yrs since cancer diagnosis (HR: 4.81 (95%CI: 1.47-15.69)), and >5 yrs since cancer diagnosis (HR: 4.41 (95%CI: 1.38-14.06)). Additionally, patients who presented with dyspnea had increased risk of COVID-19 related death <7 days compared to asymptomatic patients (HR: 5.25 (95%CI 2.14-12.89)). CRP levels in the third tercile (146-528 mg/L) as compared to the first were also associated with increased risk of an early death due to COVID-19. Conclusion: From all the factors identified in our previous COVID-19 related death analysis, only hematological cancer type, a longer-established cancer diagnosis (2-5 years and more than 5 years), dyspnea at time of diagnosis and high levels of CRP were indicative of an early COVID-19 related death (within 7 days of diagnosis) in cancer patients.
Citation Format: Maria J. Monroy-Iglesias, Beth Russell, Charlotte Moss, Gincy George, Kieran Palmer, Sophie Papa, Sheeba Irshad, Paul Ross, James Spicer, Sharam Kordasti, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Rushan Sylva, Kamarul Zaki, Fareen Rahman, Ailsa Sita-Lumsden, Debra Josephs, Deborah Enting, Mary Lei, Sharmistha Ghosh, Claire Harrison, Angela Swampillai, Elinor Sawyer, Andrea D'Souza, Simon Gomberg, Paul Fields, David Wrench, Kavita Raj, Mary Gleeson, Kate Bailey, Richard Dillon, Matthew Streetly, Austin Kulasekararaj, Thinzar Ko Ko, Vallari Shah, Anne Rigg, Richard Sullivan, Mieke Van Hemelrijck, Saoirse Dolly. Clinical and demographic characteristics associated with shorter time to COVID-19 death [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S12-03.
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Affiliation(s)
- Maria J. Monroy-Iglesias
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Beth Russell
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Charlotte Moss
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Gincy George
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Kieran Palmer
- 2King’s College Hospital NHS Foundation Trust, London, United Kingdom,
| | - Sophie Papa
- 3Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology; School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Sheeba Irshad
- 4Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology; School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Paul Ross
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - James Spicer
- 4Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology; School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Sharam Kordasti
- 6Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology; Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Danielle Crawley
- 7Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London; Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - Harriet Wylie
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Fidelma Cahill
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Anna Haire
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Rushan Sylva
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - Kamarul Zaki
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - Fareen Rahman
- 8Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom, London, United Kingdom,
| | - Ailsa Sita-Lumsden
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - Debra Josephs
- 9Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom; Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Deborah Enting
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Mary Lei
- 2King’s College Hospital NHS Foundation Trust, London, United Kingdom,
| | - Sharmistha Ghosh
- 2King’s College Hospital NHS Foundation Trust, London, United Kingdom,
| | - Claire Harrison
- 10King’s College Hospital NHS Foundation Trust; School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Angela Swampillai
- 2King’s College Hospital NHS Foundation Trust, London, United Kingdom,
| | - Elinor Sawyer
- 4Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology; School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Andrea D'Souza
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - Simon Gomberg
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - Paul Fields
- 11Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - David Wrench
- 11Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Kavita Raj
- 11Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Mary Gleeson
- 11Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Kate Bailey
- 11Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Richard Dillon
- 12Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT); Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, King’s College London, London, United Kingdom,
| | - Matthew Streetly
- 11Haematology Department, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Austin Kulasekararaj
- 13Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, United Kingdom,
| | - Thinzar Ko Ko
- 13Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, United Kingdom,
| | - Vallari Shah
- 13Department of Haematological Medicine, King’s College Hospital NHS Foundation Trust, London, United Kingdom,
| | - Anne Rigg
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
| | - Richard Sullivan
- 14School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Mieke Van Hemelrijck
- 1Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom,
| | - Saoirse Dolly
- 5Guy’s and St Thomas’ NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom,
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Flanders L, Russell B, Moss C, Palmer K, Sylva R, George G, Crawley D, Wylie H, Cahill F, Haire A, D'Souza A, Gomberg S, Sullivan R, Rigg A, Van Hemelrijck M, Harries M, De Francesco I, Morris S, Papa S, Dolly S. Abstract P28: COVID-19 infection and mortality in patients with skin malignancies receiving systemic anti-cancer therapy (SACT): The Guy’s Cancer Centre experience. Clin Cancer Res 2021. [DOI: 10.1158/1557-3265.covid-19-21-p28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The COVID-19 pandemic has influenced treatment decisions in cancer patients. There is increasing evidence that not all oncology patients are at increased risk of COVID-19 infection or death. This study aimed to look at rate of SARS-CoV-2 infection and mortality in patients with skin malignancies receiving systemic anti-cancer therapy (SACT) during the pandemic in Guy’s Cancer Centre. Methods: All patients with skin cancer receiving SACT at Guy’s Cancer Centre between March 1st and May 31st 2020 were included. Demographic data: sex, age, socio-economic status (SES), ethnicity, comorbidities, medications and smoking history were collected along with cancer characteristics: cancer type, stage, treatment paradigm, modality and line. COVID-19 infection was confirmed by PCR and severity defined by the World Health Organisation classification. Patients with radiological or clinical diagnoses alone were excluded. Results: Of 116 skin cancer patients on SACT over the 3-month period, 89% had Melanoma, 5% Kaposi’s Sarcoma (KS), 3% Squamous Cell, 2% Merkel Cell, 1% Basal Cell Carcinoma and 1% Angiosarcoma. 53% were male and 78% were of low SES. 62% were being treated with palliative intent and 70% of these were on first line palliative treatment. The median age was 57.6 years in COVID-19 positive patients (n=3) compared to 60.3 years in the negative group (n=113). 58.6% received immunotherapy, 28.4% targeted therapy, 7.8% chemotherapy and 4.3% combined treatment. Of the 3 patients (2.6%) with confirmed COVID-19 infection, the two patients with KS were receiving liposomal doxorubicin hydrochloride and the other paclitaxel chemotherapy and the patient with Melanoma was receiving encorafenib and binimetinib. All COVID-19 positive patients were of low SES, 2 females and 1 male. There was a low rate of co-morbidities with hypertension in 1 COVID-19 positive patient and none in the negative group. All 3 confirmed COVID-19 patients developed severe pneumonia and were diagnosed within 7 days of the onset of symptoms. There were no COVID related deaths and one disease-related death in the negative cohort. Conclusion: There was a low rate of COVID-19 infection in the 116 skin cancer patients on SACT (2.6%) with 60% of patients on immunotherapy. All 3 confirmed cases had severe pneumonia with no COVID-19 related deaths (0%); 2 were receiving chemotherapy and 1 on targeted therapy. Patients on treatment were encouraged to shield between hospital attendances during this period which may account for the reduced rate of SARS-CoV-2 infection. This data supports the emerging observations that immunotherapy does not confer an increased risk of severe COVID-19 infection in cancer patients. This observation is confounded by the relatively young age and low co-morbidity rates in the cohort which may have contributed to the low infection and mortality rate.
Citation Format: Lucy Flanders, Beth Russell, Charlotte Moss, Kieran Palmer, Rushan Sylva, Gincy George, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Andrea D'Souza, Simon Gomberg, Richard Sullivan, Anne Rigg, Mieke Van Hemelrijck, Mark Harries, Irene De Francesco, Stephen Morris, Sophie Papa, Saiorse Dolly. COVID-19 infection and mortality in patients with skin malignancies receiving systemic anti-cancer therapy (SACT): The Guy’s Cancer Centre experience [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr P28.
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Affiliation(s)
- Lucy Flanders
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | | | | | | | - Rushan Sylva
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | | | - Danielle Crawley
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | | | | | - Anna Haire
- 2King’s College London, London, United Kingdom
| | - Andrea D'Souza
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Simon Gomberg
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Richard Sullivan
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Anne Rigg
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | | | - Mark Harries
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Irene De Francesco
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Stephen Morris
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Sophie Papa
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
| | - Saiorse Dolly
- 1Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, United Kingdom,
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Sylva R, Russell B, Moss C, George G, Palmer K, Shah V, Ko TK, Kalsi T, Harari D, De Michele L, Kordasti S, Crawley D, Wylie H, Cahill F, Haire A, D'Souza A, Gomberg S, Kulasekararaj A, Van Hemelrijck M, Dolly S. Abstract S11-03: The impact of COVID-19 in the cancer population stratified by age: A real-world data study from Guy’s Cancer Center. Clin Cancer Res 2021. [DOI: 10.1158/1557-3265.covid-19-21-s11-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background It is widely accepted that advancing age is associated with worse COVID-19 outcomes. However, there is insufficient data analyzing the impact of COVID-19 in the older cancer population. The aim of the study is to establish if age has an influence on severity and mortality of COVID-19 in cancer patients. Methods We reviewed 306 oncology patients with PCR-confirmed COVID-19 from Guy’s Cancer Centre and its partner Trust King’s College Hospital, between 29 February – 31 July 2020. Demographic and tumor characteristics in relation to COVID-19 severity and death were assessed with logistic and Cox proportional hazards regression models, stratified by age (≤65 and >65 years). Severity of COVID-19 was classified by World Health Organization (WHO) grading. Results A total of 135 patients were aged ≤65 years (44%) and 171 aged >65 (56%). Severe COVID-19 presentation was seen in 27% of those aged ≤65 and 30% of those aged >65. The COVID-19 mortality rate was 19% in those aged ≤65 and 27% in those aged >65. In the older cohort, there was an increased incidence of severe disease in Caucasian ethnicity compared to the younger cohort (55% vs 43%) and compared to severe disease in Black and Asian ethnicities. There were increased co-morbidities in the older cohort including hypertension (54% vs 32%), diabetes (30% vs 12%) with increased rate of poly-pharmacy (62% vs 40%) compared to the younger cohort. In terms of cancer characteristics in the older cohort, there was a higher rate of patients with cancer for more than 2 years (53% vs 32%) and performance status of 3 (22% vs 6%). In terms of severity, Asian ethnicity [OR: 3.1 (95% CI: 0.88-10.96) p=0.64] had greater association with increasing COVID-19 severity in those aged >65. Interestingly, there were no positive associations between number of co-morbidities, treatment paradigm or performance status with severity of disease in the older group. The risk of mortality was greater in the elderly cohort with hematological cancer types [HR: 2.69 (1.31-5.53) p=0.85] and having cancer for more than 2 years [2.20 (1.09-4.42) p=0.28] compared to the younger cohort. Conclusions In our study we demonstrate that severity and mortality of COVID-19 did not significantly differ between the two age cohorts except in regards to Asian ethnicity, hematological malignancies and having cancer for more than 2 years. As expected, the older population had more co-morbidities and polypharmacy. Despite this, the incidence of severe COVID-19 was similar regardless of age. Further analyses for other geriatric presentations are ongoing to understand their interaction with COVID-19 in the cancer population.
Citation Format: Rushan Sylva, Beth Russell, Charlotte Moss, Gincy George, Kieran Palmer, Vallari Shah, Thinzar Ko Ko, Tania Kalsi, Danielle Harari, Luigi De Michele, Shahram Kordasti, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Andrea D'Souza, Simon Gomberg, Austin Kulasekararaj, Mieke Van Hemelrijck, Saoirse Dolly. The impact of COVID-19 in the cancer population stratified by age: A real-world data study from Guy’s Cancer Center [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S11-03.
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21
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Timbres J, Moss C, Mera A, Haire A, Gillett C, Van Hemelrijck M, Sawyer E. Abstract PS8-06: Survival outcomes after chemotherapy in invasive lobular carcinoma compared to estrogen receptor positive invasive ductal carcinoma. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps8-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Invasive lobular breast cancer (ILC) accounts for 10-15% of all invasive breast carcinomas and has distinct clinical and biological characteristics compared with the more common invasive ductal carcinoma (IDC). They are generally ER-positive (ER+) with the exception of a small number of pleomorphic cases and there is some evidence that the 10-year survival rate of women with ILC is lower than that for ER+ IDC. Furthermore, studies have shown that ILC may be less sensitive to chemotherapy than IDC, with lower rates of complete pathological response after neoadjuvant chemotherapy, but it is not clear what effects this has on long term survival. The aim of this study was to investigate whether ER+ ILC patients who received chemotherapy (neoadjuvant or adjuvant) had similar outcomes to ER+ IDC patients who received chemotherapy.
Methods
Patients were diagnosed at Guy’s & St Thomas’ NHS Foundation Trust between 1971 and 2016 and were eligible for inclusion into the study if they were female, had been diagnosed with either IDC or ILC, if their tumours were ER+, and if they received chemotherapy. They were followed up from date of primary diagnosis until 30th June 2019 and were assumed to be alive in the absence of a reported death date. Patients with estrogen receptor negative (ER-) tumours were excluded, due to well-known chemosensitivity in these breast cancer subtypes. Data used was requested from the Guy’s & St Thomas’ Breast Cancer Database.
Results
Of 5526 patients diagnosed with ILC or IDC between 1971 and 2016, 3945 were ER+ with 3436 IDC and 509 ILC. ER+ IDC and ILC had similar survival for the first 10 years after diagnosis after which outcomes began to diverge with worse outcomes in ILC. The 10-year and 15-year survival of 59.3% and 47.5% respectively were seen in IDC, and 58.6% and 44.6% in ILC. 1327 ER+ patients who received chemotherapy were selected for analysis, of which 161 (12.1%) were ILC and 1166 (87.9%) were IDC. 159 (12.0%) of patients received neo-adjuvant chemotherapy, while 1168 (88.0%) received adjuvant chemotherapy. In chemotherapy patients, 10-year survival was 53.1% in ILC and 54.0% in IDC, and by 15 years this was 35.1% and 44.7% respectively. In ER+ chemotherapy patients, there was no evidence of a crude association between histological subtype and survival (HR: 1.19, 95% CI: 0.97, 1.47) using Cox regression. However, the multivariate Cox regression model estimated a significantly worse outcome in ILC compared to IDC (HR: 1.28, 95% CI: 1.02, 1.60), adjusted for chemotherapy (neo-adjuvant or adjuvant), stage (I-IV), grade, HER2 status, time period of diagnosis, and surgery type (mastectomy or excision). When stratified by chemotherapy, this association was only observed in patients that received adjuvant treatment.
Conclusion
This study suggests that ER+ ILC patients who received adjuvant chemotherapy may have a worse outcome than ER+ IDC when adjusted for stage and grade. This is a potentially important finding but needs to be studied in a larger population treated with modern chemotherapy regimens. Other studies have shown that the outcome for ILC is better in the first 5 years after diagnosis compared to ER+ IDC but worsens after 10 years, as it does in this study. Thus, having long follow up is essential in order to be able to detect any differences in survival between ILC and ER+ IDC. Nonetheless, this study has displayed a significant difference in survival between ER+ ILC and ER+ IDC receiving adjuvant chemotherapy, and thus recommendations for adjuvant chemotherapy may need to be considered separately for the two subtypes. Furthermore, it would be beneficial to develop a tool that could help in identifying cases of ILC that would most benefit from chemotherapy.
Citation Format: Jasmine Timbres, Charlotte Moss, Anca Mera, Anna Haire, Cheryl Gillett, Mieke Van Hemelrijck, Elinor Sawyer. Survival outcomes after chemotherapy in invasive lobular carcinoma compared to estrogen receptor positive invasive ductal carcinoma [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS8-06.
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Affiliation(s)
| | | | - Anca Mera
- King’s College London, London, United Kingdom
| | - Anna Haire
- King’s College London, London, United Kingdom
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22
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Beyer K, Moris L, Lardas M, Haire A, Barletta F, Scuderi S, Vradi E, Gandaglia G, Omar MI, MacLennan S, Zong J, Farahmand B, Maclennan SJ, Devecseri Z, Asiimwe A, Collette L, Bjartell A, Ndow J, Briganti A, Van Hemelrijck M. Diagnostic and prognostic factors in patients with prostate cancer: a systematic review protocol. BMJ Open 2021; 11:e040531. [PMID: 33574142 PMCID: PMC7880102 DOI: 10.1136/bmjopen-2020-040531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION As part of the PIONEER (Prostate Cancer Diagnosis and Treatment Enhancement Through the Power of Big Data in Europe) Consortium, we will explore which diagnostic and prognostic factors (DPFs) are currently being researched to previously defined clinical and patient-reported outcomes for prostate cancer (PCa). METHODS AND ANALYSIS This research project will follow the following four steps: (1) a broad systematic literature review of DPFs for all stages of PCa, covering evidence from 2014 onwards; (2) discussion of systematic review findings by a multidisciplinary expert panel; (3) risk of bias assessment and applicability with Prediction model Risk Of Bias Assessment Tool criteria, Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and the Quality In Prognosis Studies tool (QUIPS) and (4) additional quantitative assessments if required. ETHICS AND DISSEMINATION We aim to develop an online tool to present the DPFs identified in this research and make them available across all stakeholders. There are no ethical implications.
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Affiliation(s)
- Katharina Beyer
- Translational Oncology and Urology Research (TOUR), King's College London, London, UK
| | - Lisa Moris
- Department of Urology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Michael Lardas
- Department of Urology, Metropolitan Hospital Athens, Athens, Attike, Greece
| | - Anna Haire
- Translational Oncology and Urology Research (TOUR), King's College London, London, UK
| | - Francesco Barletta
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
| | - Simone Scuderi
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
| | - Eleni Vradi
- Medical Affairs and PV, Bayer Pharma AG, Berlin, Germany
| | - Giorgio Gandaglia
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
| | - Muhammad Imran Omar
- Academic Urology Unit, Health Services Research Unit, University of Aberdeen, Aberdeen, Aberdeen, UK
| | - Steven MacLennan
- Academic Urology Unit, Health Services Research Unit, University of Aberdeen, Aberdeen, Aberdeen, UK
| | - Jihong Zong
- Epidemiology, Bayer U.S, Whippany, New Jersey, USA
| | | | - Sara J Maclennan
- Academic Urology Unit, Health Services Research Unit, University of Aberdeen, Aberdeen, Aberdeen, UK
| | | | - Alex Asiimwe
- Medical Affairs and PV, Bayer Pharma AG, Berlin, Germany
| | | | | | - James Ndow
- Guidelines Office, European Association of Urology, Arnhem, Netherlands
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, Vita-Salute University San Raffaele, RCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), King's College London, London, UK
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23
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Fox L, Wylie H, Cahill F, Haire A, Green S, Kibaru J, Hartley C, Sullivan R, Van Hemelrijck M. Gender Differences in Concerns About Participating in Cancer Research During the COVID-19 Pandemic. Cancer Control 2021; 28:1073274821989315. [PMID: 33491475 PMCID: PMC8482716 DOI: 10.1177/1073274821989315] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The ongoing SARS-CoV-2 pandemic is having major effects on cancer research, including major reductions in participant accrual to cancer clinical trials. Existing research has indicated that these steep drops in accrual rates to cancer clinical trials may be disproportionately affecting women. We sought to determine if there were gender differences in a dataset collected to examine participants' concerns about taking part in cancer research during the pandemic. METHODS Between 5-19 June 2020, we distributed a fully anonymized survey via social media. We contacted 85 UK cancer patient organizations/charities and asked them to share our questionnaire on their platforms, of which 26 obliged. Patients aged 18 with a cancer diagnosis were eligible to participate and asked about their clinical and demographic characteristics, concerns about research participation given the COVID-19 pandemic, anxiety levels measured using the Generalized Anxiety Disorder-7 (GAD-7) scale, amongst other questions. Anxiety levels and concerns about participating were compared between men and women using univariate and multivariate analyses. RESULTS 93 individuals, comprising n = 37 women and n = 56 men of various cancer types, provided survey responses. Independent t-tests showed that women reported higher anxiety scores, and concerns about participating in cancer research during COVID-19, than men. Linear regression analyses showed that anxiety scores predicted concerns about research participation in women but not men (pinteraction = 0.002). CONCLUSIONS Cancer patients have concerns about participating in research during the COVID-19 pandemic that range from mild to serious. Furthermore, the relationship between general anxiety and concerns about research participation may be both more relevant and more pronounced in women than in men. Future work should examine the reasons why women are less likely to enrol in cancer trials during the COVID-19 pandemic.
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Affiliation(s)
- Louis Fox
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom
- Louis Fox, King’s College London, Translational Oncology and Urology Research, Guy’s Hospital, 3rd Floor, Bermondsey Wing, London SE1 9RT, United Kingdom.
| | - Harriet Wylie
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom
| | - Fee Cahill
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom
| | - Anna Haire
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom
| | - Saran Green
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom
| | - Joyce Kibaru
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom
| | | | - Richard Sullivan
- Institute of Cancer Policy, King's College London, United Kingdom
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom
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24
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Bessa A, Bosco C, Cahill F, Russell B, Fox L, Moss C, Wylie H, Haire A, Green S, Enting D, Khan S, Nair R, Thurairaja R, Chatterton K, Amery S, Peat N, Smith S, Spear S, Bryan RT, Frodsham L, Burke D, Rigby J, Makaroff L, Kelly P, Costin M, Häggström C, Van Hemelrijck M. Designing a Pragmatic Intervention to Help Improve the Bladder Cancer Patient Experience. Inquiry 2021; 58:469580211030217. [PMID: 34271831 PMCID: PMC8287348 DOI: 10.1177/00469580211030217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/29/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022]
Abstract
Bladder cancer (BC) is the 10th most common malignancy worldwide and the patient experience is found to be worse than that for patients diagnosed with other cancer types. We aimed to develop a wellbeing intervention to help improve the bladder cancer patient experience by ameliorating their health-related Quality of Life (HRQoL). We followed the 3 phases of the modified Medical Research Council (MRC) Framework for development of complex interventions. Following a systematic review of the literature on mental, sexual, and physical wellbeing, we conducted discussion groups with patients and healthcare professionals on these 3 themes. A consultation phase was then conducted with all relevant stakeholders to co-design a wellbeing intervention as part of a feasibility study. A pragmatic wellbeing feasibility trial was designed based on the hypothesis that a wellbeing program will increase patient awareness and attendance to services available to them and will better support their needs to improve HRQoL. The primary feasibility endpoints are patient attendance to the services offered and changes in HRQoL. The principle of patient centered care has strengthened the commitment to provide a holistic approach to support BC patients. In this study, we developed a wellbeing intervention in collaboration with patients and healthcare professionals to meet an unmet need in terms of the BC patient experience.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Deborah Enting
- King’s College London, London, UK
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | - Shamim Khan
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | - Rajesh Nair
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | | | | | - Suzanne Amery
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | - Nicola Peat
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | - Sue Smith
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | - Stuart Spear
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | | | | | - Danny Burke
- Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
| | | | | | - Phil Kelly
- Action Bladder Cancer, Gloucestershire,
UK
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25
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George G, Rudman S, Fleure L, Garmo H, Cahill F, Fox L, Moss C, Wylie H, Haire A, Van Hemelrijck M. Factors contributing to non‐adherence to
GnRH
agonists in men with prostate cancer. Int J Urol Nurs 2020. [DOI: 10.1111/ijun.12252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Gincy George
- Translational Oncology and Urology Research King's College London London UK
| | - Sarah Rudman
- Medical Oncology, Guy's and St Thomas' Foundation Trust London UK
| | - Louisa Fleure
- Medical Oncology, Guy's and St Thomas' Foundation Trust London UK
| | - Hans Garmo
- Translational Oncology and Urology Research King's College London London UK
| | - Fidelma Cahill
- Translational Oncology and Urology Research King's College London London UK
| | - Louis Fox
- Translational Oncology and Urology Research King's College London London UK
| | - Charlotte Moss
- Translational Oncology and Urology Research King's College London London UK
| | - Harriet Wylie
- Translational Oncology and Urology Research King's College London London UK
| | - Anna Haire
- Translational Oncology and Urology Research King's College London London UK
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26
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Russell B, Moss CL, Papa S, Wylie H, Haire A, Cahill F, Lei M, Ghosh S, Sullivan R, Rigg AS, Dolly S, Van Hemelrijck M. Disparities in COVID-19 severity and risk of death in cancer patients: Experiences from a U.K. cancer center. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
285 Background: There has been widespread evidence emerging regarding disparities between COVID-19 outcomes in patients of varying ethnicities and background. It is, however, unclear how various patient characteristics affect COVID-19 severity and risk of death in a cancer population. Methods: Our Cancer Centre was at the epicentre of the COVID-19 outbreak in the UK. A total of 156 cancer patients had a confirmed COVID-19 diagnosis between the 29th of February through the 12th of May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. The regression models were defined through a directed acyclic graph (DAG) to decide upon the minimal adjustments required for each statistical model. Results: Of the 156 COVID-19 positive cancer patients, the most frequently reported tumour types were urological/gynaecological (29%), followed by haematological (18%) and breast (15%). 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with severe disease. Initial diagnosis of cancer >24m before COVID-19 (OR:1.74 (95%CI: 0.71-4.26)), presenting with fever (6.21 (1.76-21.99)), dyspnoea (2.60 (1.00-6.76)), gastro-intestinal symptoms (7.38 (2.71-20.16)), or higher levels of CRP (9.43 (0.73-121.12)) were linked with greater COVID-19 severity. During median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Asian ethnicity (3.73 (1.28-10.91), palliative treatment (5.74 (1.15-28.79), initial diagnosis of cancer >24m before (2.14 (1.04-4.44), dyspnoea (4.94 (1.99-12.25), and increased CRP levels (10.35 (1.05-52.21)) were positively associated with COVID-19 death. Socioeconomic status (SES) was not found to be associated with either COVID-19 severity or risk of death. We will present updated data with more mature follow-up. Conclusions: In cancer patients, Asian ethnicity was found to be positively associated with COVID-19 death compared to Caucasian patients. However, SES was not associated with COVID-19 severity or risk of death thereby implying this was not due to poor access to healthcare. Future studies hence need to identify the underlying biological and/or societal reasons explaining these ethnic disparities in COVID-19 outcomes for cancer patients.
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Affiliation(s)
- Beth Russell
- King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
| | - Charlotte L Moss
- King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
| | - Sophie Papa
- Guy's And St Thomas NHS Foundation Trust, London, United Kingdom
| | | | - Anna Haire
- Guy's Cancer Centre, London, United Kingdom
| | - Fidelma Cahill
- King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
| | - Mary Lei
- Guy's and St Thomas NHS Foundation Trust, London, United Kingdom
| | | | - Richard Sullivan
- King’s Health Partners Comprehensive Cancer Centre, London, United Kingdom
| | - Anne Sagar Rigg
- Guys and St Thomas' Hospitals NMS Foundation Trust, Beckenham, United Kingdom
| | - Saoirse Dolly
- Guy's and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Mieke Van Hemelrijck
- King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
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Fox L, Wylie H, Cahill F, Haire A, Kibaru J, Green S, Hartley C, Sullivan R, Van Hemelrijck M. C-CRES: COVID-19 and cancer research engagement study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
182 Background: Emerging reports suggest that continuation of clinical trials is feasible and safe even in hospitals admitting COVID-19 patients-given the appropriate safety procedures. However, to our knowledge no studies have yet addressed how to again engage patients in cancer research. C-CRES was developed to identify factors that may be affecting participation in cancer research during the COVID-19 pandemic. We aimed to examine patient-specific concerns around research participation. This information will help inform future strategies for mitigating the impact of COVID-19 on cancer research. Methods: Between 5-13 June 2020, we advertised an anonymous survey using our research group’s Twitter account and tagged a variety of cancer patient organisations/charities. Patients aged 18 with a current cancer diagnosis were eligible to participate and asked about their diagnosis/treatment, experience in cancer research, and beliefs about future cancer research participation given the COVID-19 pandemic. We specifically asked about potential concerns relating to research engagement. Results: A total of 75 patients filled out our questionnaire, of whom 89% were UK-based. 65% of respondents were male and the majority was of a white background (89%). The median age category was 60-69 years. 47% of patients had prostate cancer, 15% breast, 12% bladder, and 9% kidney cancer–a reflection of the cancer types our research team focuses on. Interestingly, 49% of participants had never participated previously in research. We therefore set out to make comparisons of patient concerns with regards to research participation during the COVID-19 outbreak between those with and without research experience. Those who had never taken part in research before were more likely to have concerns about currently being on cancer treatment (p=0.02) and about the type of cancer they had been diagnosed with (p≤0.05), with regards to taking part in cancer research during the current COVID-19 outbreak. Conclusions: Those with no prior experience of taking part in cancer research may be more likely to have concerns related to their cancer type and current treatment, in terms of participation during COVID-19. Efforts should be made to reassure potential cancer research participants about safety of participating during the COVID-19 pandemic.
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Affiliation(s)
- Louis Fox
- King's College London, London, United Kingdom
| | | | - Fidelma Cahill
- King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
| | - Anna Haire
- Guy's Cancer Centre, London, United Kingdom
| | | | - Saran Green
- King's College London, London, United Kingdom
| | | | - Richard Sullivan
- King’s Health Partners Comprehensive Cancer Centre, London, United Kingdom
| | - Mieke Van Hemelrijck
- King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
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28
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Kotecha P, Moss CL, Enting D, Gillett C, Joseph M, Josephs D, Rudman S, Hughes S, Cahill F, Wylie H, Haire A, Rosekilly J, Khan MS, Nair R, Thurairaja R, Malde S, Van Hemelrijck M. Cohort profile: King's Health Partners bladder cancer biobank. BMC Cancer 2020; 20:920. [PMID: 32977748 PMCID: PMC7519499 DOI: 10.1186/s12885-020-07437-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bladder cancer (BC) is the 9th most common cancer worldwide, but little progress has been made in improving patient outcomes over the last 25 years. The King's Health Partners (KHP) BC biobank was established to study unanswered, clinically relevant BC research questions. Donors are recruited from the Urology or Oncology departments of Guy's Hospital (UK) and can be approached for consent at any point during their treatment pathway. At present, patients with bladder cancer are approached to provide their consent to provide blood, urine and bladder tissue. They also give access to medical records and linkage of relevant clinical and pathological data across the course of their disease. Between June 2017 and June 2019, 531 out of 997 BC patients (53.3%) gave consent to donate samples and data to the Biobank. During this period, the Biobank collected fresh frozen tumour samples from 90/178 surgical procedures (of which 73 were biopsies) and had access to fixed, paraffin embedded samples from all patients who gave consent. Blood and urine samples have been collected from 38 patients, all of which were processed into component derivatives within 1 to 2 h of collection. This equates to 193 peripheral blood mononuclear cell vials; 238 plasma vials, 224 serum vials, 414 urine supernatant vials and 104 urine cell pellets. This biobank population is demographically and clinically representative of the KHP catchment area. CONCLUSION The King's Health Partners BC Biobank has assembled a rich data and tissue repository which is clinically and demographically representative of the local South East London BC population, making it a valuable resource for future BC research.
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Affiliation(s)
- Pinky Kotecha
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Charlotte L Moss
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.
| | - Deborah Enting
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Cheryl Gillett
- King's Health Partners Cancer Biobank, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Magdalene Joseph
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Debra Josephs
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sarah Rudman
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Simon Hughes
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Fidelma Cahill
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Harriet Wylie
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Anna Haire
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - James Rosekilly
- King's Health Partners Cancer Biobank, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Rajesh Nair
- King's Health Partners Cancer Biobank, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Ramesh Thurairaja
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sachin Malde
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mieke Van Hemelrijck
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
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29
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Russell B, Moss C, Papa S, Irshad S, Ross P, Spicer J, Kordasti S, Crawley D, Wylie H, Cahill F, Haire A, Zaki K, Rahman F, Sita-Lumsden A, Josephs D, Enting D, Lei M, Ghosh S, Harrison C, Swampillai A, Sullivan R, Rigg A, Dolly S, Van Hemelrijck M. Abstract S09-03: Factors affecting COVID-19 outcomes in cancer patients: A first report from Guy’s Cancer Centre in London. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-s09-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Current precautionary management decisions being made for cancer patients are based on assumptions supported by limited evidence, based on small case series from China and Italy and larger series from New York and a recent consortium of 900 patients from over 85 hospitals in the USA, Canada, and Spain. Hence, there is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies.
Methods: We used data from a single large UK Cancer Centre to assess demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February-12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death.
Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with severe disease. Initial diagnosis of cancer >24m before COVID-19 (OR:1.74 (95%CI: 0.71-4.26)), presenting with fever (6.21 (1.76-21.99)), dyspnea (2.60 (1.00-6.76)), gastrointestinal symptoms (7.38 (2.71-20.16)), or higher levels of CRP (9.43 (0.73-121.12)) were linked with greater COVID-19 severity. During median follow-up of 47d, 34 patients had died of COVID-19 (22%). Asian ethnicity (3.73 (1.28-10.91), palliative treatment (5.74 (1.15-28.79), initial diagnosis of cancer >24m before (2.14 (1.04-4.44), dyspnea (4.94 (1.99-12.25), and increased CRP levels (10.35 (1.05-52.21)) were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin (0.04 (0.01-0.04).
Conclusions: Our analysis of one of the largest single-center series of COVID-19-positive cancer patients to date confirms a similar distribution of age, sex, and comorbidities as reported for other populations. With respect to cancer-specific observations, patients who have lived longer with their cancer were found to be more susceptible to a greater infection severity, possibly reflecting the effect of more advanced malignant disease, as almost half of the severe cohort were on third-line metastatic treatment, or the impact of this infection. The latter was also found to be associated with COVID-19 death in cancer patients, as were Asian ethnicity and palliative treatment. Further validation will be provided from other large case series, as well as from those including longer follow-up, to provide more definite guidance for oncologic care.
Citation Format: Beth Russell, Charlotte Moss, Sophie Papa, Sheeba Irshad, Paul Ross, James Spicer, Shahram Kordasti, Danielle Crawley, Harriet Wylie, Fidelma Cahill, Anna Haire, Kamarul Zaki, Fareen Rahman, Ailsa Sita-Lumsden, Debra Josephs, Deborah Enting, Mary Lei, Sharmista Ghosh, Claire Harrison, Angela Swampillai, Richard Sullivan, Anne Rigg, Saoirse Dolly, Mieke Van Hemelrijck, Guy's Cancer Real World Evidence Programme. Factors affecting COVID-19 outcomes in cancer patients: A first report from Guy’s Cancer Centre in London [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S09-03.
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Affiliation(s)
| | | | - Sophie Papa
- 1King's College London, London, United Kingdom,
| | | | - Paul Ross
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | | | | | | | | | | | - Anna Haire
- 1King's College London, London, United Kingdom,
| | - Kamarul Zaki
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Fareen Rahman
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | | | | | | | - Mary Lei
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Sharmista Ghosh
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Claire Harrison
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | | | | | - Anne Rigg
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Saoirse Dolly
- 2Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
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Russell B, Moss C, Papa S, Irshad S, Ross P, Spicer J, Kordasti S, Crawley D, Wylie H, Cahill F, Haire A, Zaki K, Rahman F, Sita-Lumsden A, Josephs D, Enting D, Lei M, Ghosh S, Harrison C, Swampillai A, Sawyer E, D'Souza A, Gomberg S, Fields P, Wrench D, Raj K, Gleeson M, Bailey K, Dillon R, Streetly M, Rigg A, Sullivan R, Dolly S, Van Hemelrijck M. Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy's Cancer Center in London. Front Oncol 2020; 10:1279. [PMID: 32903324 PMCID: PMC7396540 DOI: 10.3389/fonc.2020.01279] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022] Open
Abstract
Background: There is insufficient evidence to support clinical decision-making for cancer patients diagnosed with COVID-19 due to the lack of large studies. Methods: We used data from a single large UK Cancer Center to assess the demographic/clinical characteristics of 156 cancer patients with a confirmed COVID-19 diagnosis between 29 February and 12 May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. Results: 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with a severe case of the disease. An initial cancer diagnosis >24 months before COVID-19 [OR: 1.74 (95% CI: 0.71-4.26)], presenting with fever [6.21 (1.76-21.99)], dyspnea [2.60 (1.00-6.76)], gastro-intestinal symptoms [7.38 (2.71-20.16)], or higher levels of C-reactive protein [9.43 (0.73-121.12)] were linked with greater COVID-19 severity. During a median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Being of Asian ethnicity [3.73 (1.28-10.91)], receiving palliative treatment [5.74 (1.15-28.79)], having an initial cancer diagnosis >24 months before [2.14 (1.04-4.44)], dyspnea [4.94 (1.99-12.25)], and increased CRP levels [10.35 (1.05-52.21)] were positively associated with COVID-19 death. An inverse association was observed with increased levels of albumin [0.04 (0.01-0.04)]. Conclusions: A longer-established diagnosis of cancer was associated with increased severity of infection as well as COVID-19 death, possibly reflecting the effects a more advanced malignant disease has on this infection. Asian ethnicity and palliative treatment were also associated with COVID-19 death in cancer patients.
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Affiliation(s)
- Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Charlotte Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Sophie Papa
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Sheeba Irshad
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Paul Ross
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - James Spicer
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Shahram Kordasti
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Danielle Crawley
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Harriet Wylie
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Fidelma Cahill
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Anna Haire
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Kamarul Zaki
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Fareen Rahman
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Ailsa Sita-Lumsden
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Debra Josephs
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Deborah Enting
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Mary Lei
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Sharmistha Ghosh
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Claire Harrison
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Angela Swampillai
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Elinor Sawyer
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Andrea D'Souza
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Simon Gomberg
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Paul Fields
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - David Wrench
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Kavita Raj
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Mary Gleeson
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Kate Bailey
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Richard Dillon
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Matthew Streetly
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Anne Rigg
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Richard Sullivan
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Saoirse Dolly
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, United Kingdom
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Bessa A, Martin R, Häggström C, Enting D, Amery S, Khan MS, Cahill F, Wylie H, Broadhead S, Chatterton K, Malde S, Nair R, Thurairaja R, Kumar P, Haire A, Green S, Northover M, Briggs K, Van Hemelrijck M. Unmet needs in sexual health in bladder cancer patients: a systematic review of the evidence. BMC Urol 2020; 20:64. [PMID: 32493286 PMCID: PMC7268732 DOI: 10.1186/s12894-020-00634-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023] Open
Abstract
Background Bladder cancer (BC) treatment can have a detrimental effect on the sexual organs of patients and yet assessment of sexual health needs has been greatly overlooked for these patients compared to those who have undergone other cancer therapies. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines in July 2019. Studies were identified by conducting searches for Medline (using the PubMed interface), the Cochrane Central Register of Controlled Trials (CENTRAL) and Ovid Gateway (Embase and Ovid) using a list of defined search terms. Results 15 out of 37 studies included men only, 10 studies women only and 11 both sexes. Most participants were aged 50 to 65 years. Most studies (n = 34) focused on muscle invasive BC and only three on non-muscle invasive BC. Measurements of sexual dysfunction, including erection, ejaculation, firmness and desire, were the most commonly used measurements to report sexual health in men. In women, lubrification/dryness, desire, orgasm and dyspareunia were the most commonly reported. Twenty-one studies evaluated sexual dysfunction based on validated questionnaires, two with a non-validated questionnaire and through interviewing participants. Conclusion While recognition of the importance of the inclusion of psychometric measurements to assess sexual health is growing, there is a lack of consistent measures to assess sexual health in BC. With the focus on QoL arising in cancer survivorship, further studies are needed to develop, standardize and implement use of sexual health questionnaires with appropriate psychometrics and social measures to evaluate QoL in BC patients. Trial registration “PROSPERO does not currently accept registrations for scoping reviews, literature reviews or mapping reviews. PROSPERO is therefore unable to accept your application or provide a registration number. This decision should not stop you from submitting your project for publication to a journal.”
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Affiliation(s)
- Agustina Bessa
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.
| | | | - Christel Häggström
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Deborah Enting
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.,Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Suzanne Amery
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Fidelma Cahill
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Harriet Wylie
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Samantha Broadhead
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Kathryn Chatterton
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sachin Malde
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rajesh Nair
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ramesh Thurairaja
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Anna Haire
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Saran Green
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - Margaret Northover
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Karen Briggs
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mieke Van Hemelrijck
- King's College London, School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), TOUR, Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
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Moss C, Haire A, Cahill F, Enting D, Hughes S, Smith D, Sawyer E, Davies A, Zylstra J, Haire K, Rigg A, Van Hemelrijck M. Guy's cancer cohort - real world evidence for cancer pathways. BMC Cancer 2020; 20:187. [PMID: 32178645 PMCID: PMC7077127 DOI: 10.1186/s12885-020-6667-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 02/21/2020] [Indexed: 12/15/2022] Open
Abstract
Background The burden of disease due to cancer remains substantial. Since the value of real-world evidence has also been recognised by regulatory agencies, we established a Research Ethics Committee (REC) approved research database for cancer patients (Reference: 18/NW/0297). Construction and content Guy’s Cancer Cohort introduces the concept of opt-out consent processes for research in a subset of oncology patients diagnosed and treated at a large NHS Trust in the UK. From April 2016 until March 2017, 1388 eligible patients visited Guy’s and St Thomas’ NHS Foundation Trust (GSTT) for breast cancer management. For urological cancers this number was 1757 and for lung cancer 677. The Cohort consists of a large repository of routinely collected clinical data recorded both retrospectively and prospectively. The database contains detailed clinical information collected at various timepoints across the treatment pathway inclusive of diagnostic data, and data on disease progression, recurrence and survival. Conclusions Guy’s Cancer Cohort provides a valuable infrastructure to answer a wide variety of research questions of a clinical, mechanistic, and supportive care nature. Clinical research using this database will result in improved patient safety and experience. Guy’s Cancer Cohort promotes collaborative research and will accept applications for the release of anonymised datasets for research purposes.
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Affiliation(s)
- C Moss
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.
| | - A Haire
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - F Cahill
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - D Enting
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.,Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Hughes
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.,Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - D Smith
- Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - E Sawyer
- Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Davies
- Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Zylstra
- Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Haire
- South East London (SEL) Accountable Cancer Network, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Rigg
- Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Van Hemelrijck
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
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DeSouza K, Zammit RR, Haire A, Sinha R, Simcock R, Moss CH, Mera A, Mansi J, Karapanagiotou E, Sawyer E, Patel GS. Estrogen receptor (ER) status and survival outcomes in HER2 positive (+) metastatic breast cancer (mBC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12503 Background: The oncological management of HER2+ mBC is complicated by the development of resistance to HER2-directed therapies (HER2-DTs). This project analyses real-world clinical data to determine disease response patterns that may guide treatment sequencing decisions. Methods: This collaborative project analysed HER2+ mBC datasets held by the Sussex Cancer Centre and Guy’s Cancer Centre, UK. The datasets were generated by reviewing clinical notes, radiology and e-prescribing records to collect clinical data on patients diagnosed with HER2+ mBC between 01/01/2013 – 30/09/2018. Results: 138 patients with a median age of 59 years (30 - 89 years) were diagnosed with HER2+ mBC during this time period: 88 were ER+ (63.7%) and 50 were ER- (36.3%); the median OS is 41.1 mos. (range 0.7 - 62 mos.). Patients with HER2+ mBC were more likely to present with visceral metastases (68.1%, n = 94). A poorer median OS was identified in patients with ER+ HER2+ mBC (35.5 mos.) vs ER- HER2+ mBC (MNR). A benefit to median OS was observed with first line treatment using Docetaxel/Trastuzumab/Pertuzumab (THP) compared to other HER2-DTs ((54.5 mos. (n = 76) vs 26.7 mos. (n = 40)) 65.2% (n = 90) were previously treated for early breast cancer (EBC), evenly distributed across the 2 groups ER+ (64.7%, n = 57) vs ER- (66%, n = 33). 53.7% (n = 50) received trastuzumab with neo-adjuvant/adjuvant therapy (NACT/ACT). Patients previously treated for EBC demonstrated a poorer median OS (34 mos.) when compared to patients with de-novo mBC (MNR). When treated for EBC, ER+ disease was less likely to have a pathological complete response (pCR) with NACT (ER+ 22.2% (n = 4/18) vs ER- 50% (n = 5/10)). PFS data in response to an array of prescribed systemic therapies will be presented. Conclusions: Though, HER2 signalling is considered the dominant signalling pathway in HER2+ breast cancer, pre-clinical research indicates that the ER pathway represents an important escape mechanism influencing the development of resistance. Lack of efficacy (pCR) to NACT in ER+HER2+ EBC may translate to poorer outcomes (OS) when these patients develop MBC. Earlier targeting of the ER pathway in conjunction with HER2-DTs may contribute to improving patient outcomes.
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Affiliation(s)
- Karen DeSouza
- Brighton and Sussex Medical School, Brighton, United Kingdom
| | | | - Anna Haire
- Guy's Cancer Centre, London, United Kingdom
| | | | | | | | - Anca Mera
- King's College, London, London, United Kingdom
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Kotecha P, Moss C, Beckmann K, Russel B, Santaolalla A, Wylie H, Cahill F, Haire A, Gillett C, Drescher R, Enting D, Khan M, JosephsShamim Khan, Muhammad D, Nair R, Hughes S, Thurairaja R, Rudman S, Malde S, Chatterton K, Amery S, Chowdhury S, Van Hemelrijck M. Cohort Profile: King’s Health Partners Bladder Cancer Biobank (KHP BCaBB). Front Oncol 2019. [DOI: 10.3389/conf.fonc.2019.01.00016] [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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Abstract
OBJECTIVE To determine what contact people with mental handicap had had with their general practitioner in the previous year; what prescribed drugs they were taking and whether these had been reviewed; when hearing and vision had last been screened; and what medical problems were found on examination. DESIGN Case series. SETTING-Day centre for adults with mental handicap. SUBJECTS A balanced sample of 75 of the 150 people attending the day centre. 10 Were excluded because consent was not given. RESULTS The subjects did not consult their general practitioners more frequently than the general population but were more likely to be taking prescribed drugs, and 57% of these prescriptions had not been reviewed by a doctor. Thirty three people failed vision screening, including 13 who wore glasses. Twenty seven of the 62 who were testable had a hearing impairment. CONCLUSIONS As only eight out of 65 people examined in the study did not have an appreciable problem brought to light, screening seems to be worth while. Whether such screening needs to be done by a medically qualified person needs further research.
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Affiliation(s)
- D N Wilson
- Department of Mental Handicap, University of Nottingham Queens Medical Centre
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