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Gupta P, Chan A, Tai-Anh V, Man REK, Fenwick EK, Aravindhan A, Junxing C, Wood JM, Black AA, Ng JH, Cheng CY, Sabanayagam C, Lamoureux EL. Prevalence, associated risk factors; and patient and economic impact of multiple sensory impairment in a multi-ethnic elderly population in Singapore: the PIONEER study. BMC Public Health 2024; 24:1102. [PMID: 38649854 PMCID: PMC11034097 DOI: 10.1186/s12889-024-18635-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND To determine the prevalence, risk factors; and impact on patient health and economic outcomes across the laterality spectrum of multiple sensory impairment (MSI) in a multi-ethnic older Asian population. METHODS In this population-based study of Singaporeans aged ≥ 60 years, MSI was defined as concomitant vision (visual acuity > 0.3 logMAR), hearing (pure-tone air conduction average > 25 dB), and olfactory (score < 12 on the Sniffin' Sticks test) impairments across the spectrum of laterality (any, unilateral, combination [of unilateral and bilateral], and bilateral). RESULTS Among 2,057 participants (mean ± SD 72.2 ± 0.2 years; 53.1% female), the national census-adjusted prevalence rates of any, unilateral, combination, and bilateral MSI were 20.6%, 1.2%, 12.2%, and 7.2%, respectively. Older age, male gender, low socioeconomic status (SES), and smoking (all p < 0.05) were independently associated with higher likelihood of any MSI. Compared to those with no sensory loss, those with MSI had significantly decreased mobility (range 5.4%-9.2%), had poor functioning (OR range 3.25-3.45) and increased healthcare costs (range 4-6 folds) across the laterality spectrum. Additionally, bilateral MSI had a significant decrease in HRQoL (5.5%, p = 0.012). CONCLUSIONS MSI is a highly prevalent medical condition, with 1 in 5; and almost 1 in 10 community-dwelling older Asians having any and bilateral MSI, respectively, with a higher likelihood in men, smokers, and those with low SES. Critically, MSI has a substantial negative impact on patient health and economic outcomes across the laterality spectrum. Sensory testing is critical to detect and refer individuals with MSI for management to improve their functional independence and QoL.
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Affiliation(s)
- Preeti Gupta
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Aurora Chan
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
| | - Vu Tai-Anh
- Duke-NUS Medical School, Singapore, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Amudha Aravindhan
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | | | - Joanne M Wood
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Jia Hui Ng
- Singapore General Hospital (SGH), Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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Diem L, Ovchinnikov A, Friedli C, Hammer H, Kamber N, Chan A, Salmen A, Findling O, Hoepner R. Efficacy and safety of ocrelizumab in patients with relapsing multiple sclerosis: Real-world experience of two Swiss multiple sclerosis centers. Mult Scler Relat Disord 2024; 86:105570. [PMID: 38604001 DOI: 10.1016/j.msard.2024.105570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/07/2024] [Accepted: 03/21/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Ocrelizumab (OCR) is a humanized monoclonal antibody directed against CD-20 positive lymphocytes, mainly B-lymphocytes. OCR is approved for treatment of primary progressive (PPMS) and relapsing multiple sclerosis (RMS). This study aims to provide real-world safety and efficacy data of people with RMS treated with OCR in two Swiss Multiple Sclerosis (MS) centers. METHODS We have conducted a retrospective data analysis using the patient cohorts from the Cantonal Hospital Aarau and Bern University Hospital (RMS: n = 235). Statistical analyses were performed with Mann-Whitney U-Test, Chi-squared test and Spearman-Rho-Correlation. Adjustment for multiple testing was performed by Bonferroni procedure. RESULTS After initiation of OCR, there was a decrease in disease activity in RMS patients. In our study, 152/190 (80.0 %) RMS patients fulfilled the criteria for NEDA-3 12 months and 88/104 (84.6 %) showed NEDA-3 24 months after OCR initiation. The most frequent adverse events (AEs) in our study were infections, taking place in 78/235 (33.2 %) RMS patients. COVID-19 was the most common infection, followed by urinary infections and other respiratory infections and infectious adverse events occurred significantly more frequent in patients with reduced IgG serum concentration. CONCLUSIONS Our real-world study showed OCR being associated with low rates of any type of MS disease activity as indicated by NEDA-3. The adverse event profile is comparable to the known events especially infections and an association between infections and reduced IgG serum concentration was found.
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Affiliation(s)
- L Diem
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland; Neurocenter, Lucerne Cantonal Hospital, Lucerne, 6000, Switzerland.
| | - A Ovchinnikov
- Department of Neurology, Cantonal Hospital Aarau (Kantonsspital Aarau), Tellstrasse, Aarau, Switzerland
| | - C Friedli
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland; Department of Neurology, Waikato Hospital, Hamilton, New Zealand
| | - H Hammer
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - N Kamber
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - A Chan
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - A Salmen
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - O Findling
- Department of Neurology, Cantonal Hospital Aarau (Kantonsspital Aarau), Tellstrasse, Aarau, Switzerland
| | - R Hoepner
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
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Herrstedt J, Clark-Snow R, Ruhlmann CH, Molassiotis A, Olver I, Rapoport BL, Aapro M, Dennis K, Hesketh PJ, Navari RM, Schwartzberg L, Affronti ML, Garcia-Del-Barrio MA, Chan A, Celio L, Chow R, Fleury M, Gralla RJ, Giusti R, Jahn F, Iihara H, Maranzano E, Radhakrishnan V, Saito M, Sayegh P, Bosnjak S, Zhang L, Lee J, Ostwal V, Smit T, Zilic A, Jordan K, Scotté F. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO Open 2024; 9:102195. [PMID: 38458657 PMCID: PMC10937211 DOI: 10.1016/j.esmoop.2023.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 03/10/2024] Open
Abstract
•Nausea and vomiting are considered amongst the most troublesome adverse events for patients receiving antineoplastics. •The guideline covers emetic risk classification, prevention and management of treatment-induced nausea and vomiting. •The Consensus Committee consisted of 34 multidisciplinary, health care professionals and three patient advocates. •Recommendations are based on evidence-based data (level of evidence) and the authors’ collective expert opinion (grade). •All recommendations are for the first course of antineoplastic therapy; modifications may be needed in subsequent courses.
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Affiliation(s)
- J Herrstedt
- Department of Clinical Oncology, Zealand University Hospital Roskilde and Naestved, Roskilde; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - R Clark-Snow
- Oncology Supportive Care Consultant, Overland Park, USA
| | - C H Ruhlmann
- Department of Oncology, Odense University Hospital, Odense; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, UK
| | - I Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - B L Rapoport
- The Medical Oncology Centre of Rosebank, Johannesburg; Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - M Aapro
- Genolier Cancer Center, Genolier, Switzerland
| | - K Dennis
- Division of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Canada
| | - P J Hesketh
- Division of Hematology Oncology, Lahey Hospital and Medical Center, Burlington
| | | | - L Schwartzberg
- William N. Pennington Cancer Institute, University of Nevada, Reno School of Medicine, Reno
| | - M L Affronti
- Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham; Duke University School of Nursing, Duke University, Durham, USA
| | - M A Garcia-Del-Barrio
- Pharmacy Department, Clínica Universidad de Navarra, Madrid; School of Pharmacy and Nutrition, Universidad de Navarra, Pamplona, Spain
| | - A Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, USA
| | - L Celio
- Independent Medical Oncologist, Milan, Italy
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - M Fleury
- Department of Oncology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - R J Gralla
- Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, USA
| | - R Giusti
- Medical Oncology Unit, Sant' Andrea Hospital of Rome, Rome, Italy
| | - F Jahn
- Clinic for Internal Medicine IV, Oncology - Hematology - Hemostaseology, University Hospital Halle (Saale), Halle, Germany
| | - H Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | | | - V Radhakrishnan
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, India
| | - M Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - P Sayegh
- Department of Pharmacy, OU Health Stephenson Cancer Center, Oklahoma City, USA
| | - S Bosnjak
- Department of Supportive Oncology and Palliative Care, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - L Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - V Ostwal
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - T Smit
- The Medical Oncology Centre of Rosebank, Johannesburg
| | - A Zilic
- Department of Supportive Oncology and Palliative Care, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - K Jordan
- Department of Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - F Scotté
- ∗Interdisciplinary Patient Pathway Division, Gustave Roussy, Villejuif, France.
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Herrstedt J, Celio L, Hesketh PJ, Zhang L, Navari R, Chan A, Saito M, Chow R, Aapro M. 2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following high-emetic-risk antineoplastic agents. Support Care Cancer 2023; 32:47. [PMID: 38127246 PMCID: PMC10739516 DOI: 10.1007/s00520-023-08221-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE This systematic review updates the MASCC/ESMO recommendations for high-emetic-risk chemotherapy (HEC) published in 2016-2017. HEC still includes cisplatin, carmustine, dacarbazine, mechlorethamine, streptozocin, and cyclophosphamide in doses of > 1500 mg/m2 and the combination of cyclophosphamide and an anthracycline (AC) in women with breast cancer. METHODS A systematic review report following the PRISMA guidelines of the literature from January 1, 2015, until February 1, 2023, was performed. PubMed (Ovid), Scopus (Google), and the Cochrane Database of Systematic Reviews were searched. The literature search was limited to randomized controlled trials, systematic reviews, and meta-analyses. RESULTS Forty-six new references were determined to be relevant. The main topics identified were (1) steroid-sparing regimens, (2) olanzapine-containing regimens, and (3) other issues such as comparisons of antiemetics of the same drug class, intravenous NK1 receptor antagonists, and potentially new antiemetics. Five updated recommendations are presented. CONCLUSION There is no need to prescribe steroids (dexamethasone) beyond day 1 after AC HEC, whereas a 4-day regimen is recommended in non-AC HEC. Olanzapine is now recommended as a fixed part of a four-drug prophylactic antiemetic regimen in both non-AC and AC HEC. No major differences between 5-HT3 receptor antagonists or between NK1 receptor antagonists were identified. No new antiemetic agents qualified for inclusion in the updated recommendations.
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Affiliation(s)
- Jørn Herrstedt
- Department of Clinical Oncology, Zealand University Hospital, Sygehusvej 10, DK-4000, Roskilde, Denmark.
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | | | - P J Hesketh
- Division of Hematology Oncology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - L Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - R Navari
- World Health Organization, Birmingham, Alabama, USA
| | - A Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA, USA
| | - M Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Aapro
- Genolier Cancer Center, Genolier, Switzerland
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Hoang T, Sutera P, Nguyen T, Chang JH, Jagtap S, Song Y, Shetty A, Chowdhury DD, Chan A, Carrieri FAA, Song D, DeWeese TL, Lafargue A, Van der Eecken K, Bunz F, Ost P, Tran PT, Deek MP. The Impact of TP53 Mutations and Use of the TP53-Mutation-Reactivating Agent APR-246 on Metastatic Castrate-Sensitive Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e443. [PMID: 37785435 DOI: 10.1016/j.ijrobp.2023.06.1621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) TP53 mutations appear to be enriched over the spectrum of metastatic castration-sensitive prostate cancer (mCSPC) and are associated with worse survival outcomes. We chose to further explore the impact of dominant negative (DN) TP53 mutations on mCSPC progression and pro-metastatic behaviors in addition to studying the ability of APR-246, a small molecule targeting TP53 mutants, to blunt pro-metastatic behaviors. MATERIALS/METHODS We retrospectively analyzed 531 mCSPC patients who underwent next-generation sequencing. Patients were stratified by metastasis timing (synchronous if metastasis present at diagnosis or metachronous if arising after definitive treatment of localized disease) and the number of metastatic lesions (oligometastatic ≤5 or polymetastatic >5 lesions). Tumors were classified based on TP53 mutation status (missense, truncating, or wild-type [WT]) and dominant negativity, which was defined as the production of a mutant protein that reduces the residual WT protein's transcriptional activity according to the World Health Organization TP53 database. Clinical outcomes were radiographic progression-free survival (rPFS) and overall survival (OS), evaluated with Kaplan-Meier and multivariable Cox regression. To verify the impact of TP53 mutation on metastasis, we created isogenic 22Rv1 prostate cancer cell lines that carried either TP53 WT or TP53 R175H and tested this mutation for migration, invasion, and anchorage-independent growth. APR-246 (25-80 µM) was tested for anti-metastatic properties in vitro and anti-tumor growth in 22Rv1 xenografted nude mice. RESULTS In our cohort, 155 (29.2%) had a TP53 mutation, which mostly occurred in the DNA-binding domain (85.16%). DN TP53 mutations were associated with more aggressive disease states: DN TP53 mutations were enriched in patients with synchronous (vs. metachronous: 20.7% vs. 6.3%, p < 0.01) and polymetastatic disease (vs. oligometastatic: 14.4% vs. 7.9%, p < 0.01). On multivariable analysis, DN TP53 mutations were correlated with shorter rPFS (HR = 1.97, 95% CI: 1.31-2.98, p < 0.01) and OS (HR = 2.05, 95% CI: 1.14-3.68, p = 0.02) compared to those with TP53 WT. In vitro, 22Rv1 cells with DN TP53 R175H mutation had increased abilities to migrate, invade, and form colonies compared to TP53 WT. APR-246 treatment of TP53 R175H mutants blunted the pro-metastatic effects of the cell line in vitro (p < 0.01 for all assays by unpaired t-test). Interestingly, APR-246 also inhibited xenograft tumor growth of 22Rv1 TP53 R175H mutants (p < 0.0001 by two-way ANOVA). CONCLUSION DN TP53 mutations were associated with poorer survival outcomes for mCSPC patients. DN TP53 mutations also promoted prostate cancer pro-metastatic behaviors in vitro, which was effectively counteracted by APR-246, making it a promising treatment option that should be explored further in early-phase clinical studies.
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Affiliation(s)
- T Hoang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - P Sutera
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - T Nguyen
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - J H Chang
- University of Maryland, Baltimore, MD
| | - S Jagtap
- University of Maryland, Baltimore, MD
| | - Y Song
- University of Maryland, Baltimore, MD
| | - A Shetty
- University of Maryland, Baltimore, MD
| | | | - A Chan
- University of Maryland, Baltimore, MD
| | | | - D Song
- Johns Hopkins University School of Medicine, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD
| | - T L DeWeese
- Johns Hopkins University School of Medicine, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, MD
| | - A Lafargue
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - F Bunz
- Johns Hopkins Medicine, Baltimore, MD, United States
| | - P Ost
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - P T Tran
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| | - M P Deek
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, NJ
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Chan A, Stathakis P, Goldsmith P, Smith S, Macutkiewicz C. The reorganisation of emergency general surgery services during the COVID-19 pandemic in the UK: outcomes of delayed presentation, socio-economic deprivation and Black, Asian and Minority Ethnic patients. Ann R Coll Surg Engl 2023; 105:S46-S53. [PMID: 35639022 PMCID: PMC10390243 DOI: 10.1308/rcsann.2022.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is a global public health emergency. Lockdown restrictions and the reconfiguration of healthcare systems to accommodate an increase in critical care capacity have had an impact on 'non-COVID' specialties. This study characterises the utilisation of emergency general surgery (EGS) services during the UK lockdown period at a university teaching hospital with a catchment population that represents one of the most deprived and ethnically diverse areas in the UK. METHODS EGS admissions during the UK lockdown period (March to May 2020) were compared with the same period in 2019. Patient demographics were recorded together with clinical presentation, hospital stay and treatment outcomes, and readmission data. RESULTS The study included 645 patients, comprising 223 in the COVID-19 period and 422 in the non-COVID-19 period. There was no difference in age, sex, comorbidity or socio-economic status. A lower proportion of patients of Black, Asian and Minority Ethnicity (BAME) were admitted during the pandemic (20.6% vs 35.4%, p < 0.05). The duration of symptoms prior to presentation was longer, and admission clinical parameters and serum inflammatory markers. More patients presented with an acute kidney injury (9.9% vs 4.7%, p = 0.012). There was no difference in perioperative outcomes or 30-day mortality, but more patients were readmitted following conservative management (10.6% vs 4.7%, p = 0.023). CONCLUSIONS The reorganisation of EGS to a senior-led model has been successful in terms of outcomes and access to treatment despite a more unwell population. There was a significantly lower proportion of BAME admissions suggesting additional barriers to healthcare access under pandemic lockdown conditions.
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Affiliation(s)
- A Chan
- Manchester University NHS Foundation Trust, UK
| | - P Stathakis
- Manchester University NHS Foundation Trust, UK
| | - P Goldsmith
- Manchester University NHS Foundation Trust, UK
| | - S Smith
- Manchester University NHS Foundation Trust, UK
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Kiuchi S, Cooray U, Aida J, Osaka K, Chan A, Malhotra R, Peres MA. Effect of Tooth Loss on Cognitive Function among Older Adults in Singapore. J Dent Res 2023:220345231172109. [PMID: 37278356 DOI: 10.1177/00220345231172109] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Evidence suggests a longitudinal association between tooth loss and cognitive function. However, the temporality of this association is not well understood. We investigated the effect of several emulated tooth loss prevention scenarios on cognitive function. We used data from 3 waves (baseline: 2009, second wave: 2011-2012, and third wave: 2015) of the Panel on Health and Ageing of Singaporean Elderly (PHASE). PHASE targeted older adults, aged ≥60 y, in Singapore. Number of teeth was used as a time-varying exposure (baseline, second wave). Cognitive function (Short Portable Mental Status Questionnaire score) in the third wave was assessed as the outcome. Multiple time-invariant (baseline) and time-varying (baseline and second wave) covariates were included. The "longitudinal modified treatment policy approach" combined with targeted minimum loss-based estimation was used to define and estimate additive effects of emulated tooth loss prevention scenarios. Emulated scenarios were the following: what if edentate people retained 1 to 4 teeth (scenario 1), what if those with <5 teeth retained 5 to 9 teeth (scenario 2), what if those with <10 teeth retained 10 to 19 teeth (scenario 3), and what if everyone retained ≥20 teeth (scenario 4)? A total of 1,516 participants, excluding those with severe cognitive impairment, were included (male: 41.6%). The mean age at baseline was 70.6 y (SD = 7.1). The mean SPMSQ score at baseline was 2.06 (SD = 0.02) for edentulous, 1.55 (SD = 0.04) for 1 to 4 teeth, 1.61 (SD = 0.03) for 5 to 9 teeth, 1.73 (SD = 0.02) for 10 to 19 teeth, and 1.71 (SD = 0.02) for ≥20 teeth. Additive effect of hypothetical intervention gradually increased with intensity of prevention from scenario 1 to scenario 4 (scenario 1: -0.02 [95% CI, -0.08 to 0.04], scenario 2: -0.05 [95% CI, -0.11 to -0.00], scenario 3: -0.07 [95% CI, -0.14 to -0.00], scenario 4: -0.15 [95% CI, -0.23 to -0.06]). Emulated tooth loss prevention interventions were associated with better cognitive function score. Therefore, preventing tooth loss could potentially benefit maintenance of cognitive function among older adults.
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Affiliation(s)
- S Kiuchi
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Aoba-ku, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - U Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Japan
| | - A Chan
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - R Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - M A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
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Chan VWS, Rahman L, Ng HHL, Tang KP, Mok A, Tang A, Liu JPH, Ho KSC, Chan SM, Wong S, Teoh AYB, Chan A, Wong MCS, Yuan Y, Teoh JYC. Mitigation of COVID-19 transmission in endoscopic and surgical aerosol-generating procedures: a narrative review of early-pandemic literature. Hong Kong Med J 2023. [PMID: 37217445 DOI: 10.12809/hkmj209089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Affiliation(s)
- V W S Chan
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - L Rahman
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - H H L Ng
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - K P Tang
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Mok
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Tang
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - J P H Liu
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K S C Ho
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S M Chan
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S Wong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Y B Teoh
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - A Chan
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Hong Kong SAR, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Y Yuan
- Department of Medicine, McMaster University, Hamilton, Canada
| | - J Y C Teoh
- SH Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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Hecht JR, Raman SS, Chan A, Kalinsky K, Baurain JF, Jimenez MM, Garcia MM, Berger MD, Lauer UM, Khattak A, Carrato A, Zhang Y, Liu K, Cha E, Keegan A, Bhatta S, Strassburg CP, Roohullah A. Phase Ib study of talimogene laherparepvec in combination with atezolizumab in patients with triple negative breast cancer and colorectal cancer with liver metastases. ESMO Open 2023; 8:100884. [PMID: 36863095 PMCID: PMC10163149 DOI: 10.1016/j.esmoop.2023.100884] [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: 05/09/2022] [Revised: 12/01/2022] [Accepted: 01/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Talimogene laherparepvec (T-VEC), a first-in-class oncolytic viral immunotherapy, enhances tumor-specific immune activation. T-VEC combined with atezolizumab, which blocks inhibitor T-cell checkpoints, could provide greater benefit than either agent alone. Safety/efficacy of the combination was explored in patients with triple negative breast cancer (TNBC) or colorectal cancer (CRC) with liver metastases. METHODS In this phase Ib, multicenter, open-label, parallel cohort study of adults with TNBC or CRC with liver metastases, T-VEC (106 then 108 PFU/ml; ≤4 ml) was administered into hepatic lesions via image-guided injection every 21 (±3) days. Atezolizumab 1200 mg was given on day 1 and every 21 (±3) days thereafter. Treatment continued until patients experienced dose-limiting toxicity (DLT), had complete response, progressive disease, needed alternative anticancer treatment, or withdrew due to an adverse event (AE). The primary endpoint was DLT incidence, and secondary endpoints included efficacy and AEs. RESULTS Between 19 March 2018 and 6 November 2020, 11 patients with TNBC were enrolled (safety analysis set: n = 10); between 19 March 2018 and 16 October 2019, 25 patients with CRC were enrolled (safety analysis set: n = 24). For the 5 patients in the TNBC DLT analysis set, no patient had DLT; for the 18 patients in the CRC DLT analysis set, 3 (17%) had DLT, all serious AEs. AEs were reported by 9 (90%) TNBC and 23 (96%) CRC patients, the majority with grade ≥3 [TNBC, 7 (70%); CRC, 13 (54%)], and 1 was fatal [CRC, 1 (4%)]. Evidence of efficacy was limited. Overall response rate was 10% (95% confidence interval 0.3-44.5) for TNBC; one (10%) patient had a partial response. For CRC, no patients had a response; 14 (58%) were unassessable. CONCLUSIONS The safety profile reflected known risks with T-VEC including risks of intrahepatic injection; no unexpected safety findings from addition of atezolizumab to T-VEC were observed. Limited evidence of antitumor activity was observed.
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Affiliation(s)
- J R Hecht
- Division of Hematology/Oncology, David Geffen School of Medicine at UCLA, Santa Monica, USA.
| | - S S Raman
- Department of Radiology, David Geffen School of Medicine at UCLA, Santa Monica, USA
| | - A Chan
- Breast Cancer Research Centre - WA & Curtin University, Perth Breast Cancer Institute Hollywood Consulting Centre, Nedlands, Australia
| | - K Kalinsky
- Emory Winship Cancer Institute, Atlanta, USA
| | - J-F Baurain
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - M M Jimenez
- Hospital General Universitario Gregorio Marañon, Universidad Complutense, CIBERONC, Madrid, Spain
| | - M M Garcia
- Department of Medical Oncology, Hospital del Mar, CIOCC Barcelona, CIBERONC, Barcelona, Spain
| | - M D Berger
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - U M Lauer
- Department of Medical Oncology and Pneumology, Virotherapy Center Tübingen, University Hospital Tübingen, Tübingen, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), partner site Tübingen, Tübingen, Germany
| | - A Khattak
- Fiona Stanley Hospital & Edith Cowan University, Perth, Australia
| | - A Carrato
- Medical Oncology Department, Ramon y Cajal University Hospital, Alcala University, IRYCIS, CIBERONC, Madrid, Spain; Pancreatic Cancer Europe Chairman, Brussels, Belgium
| | - Y Zhang
- Virginia Oncology Associates, Norfolk, USA
| | - K Liu
- Amgen Inc., Thousand Oaks, USA
| | - E Cha
- Genentech, South San Francisco, USA
| | | | | | - C P Strassburg
- Department of Medicine I, University Hospital Bonn, Medical Clinic and Polyclinic I, Bonn, Germany
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Loh J, Wu J, Chieng J, Chan A, Yong WP, Sundar R, Lee SC, Wong A, Lim JSJ, Tan DSP, Soo R, Goh BC, Tai BC, Chee CE. Clinical outcome and prognostic factors for Asian patients in Phase I clinical trials. Br J Cancer 2023; 128:1514-1520. [PMID: 36797357 PMCID: PMC10070409 DOI: 10.1038/s41416-023-02193-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 01/15/2023] [Accepted: 01/27/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Patient selection is key in Phase I studies, and prognosis can be difficult to estimate in heavily pre-treated patients. Previous prognostic models like the Royal Marsden Hospital (RMH) score or using the neutrophil-lymphocyte ratio (NLR) have not been validated in current novel therapies nor in the Asian Phase I population. METHODS We conducted a retrospective review of 414 patients with solid tumours participating in Phase I studies at our centre between October 2013 and December 2020. RESULTS The RMH model showed poorer prognosis with increasing scores [RMH score 1, HR 1.28 (95% CI: 0.96-1.70); RMH score 2, HR 2.27 (95% CI: 1.62-3.17); RMH score 3, HR 4.14 (95% CI: 2.62-6.53)]. NLR did not improve the AUC of the model. Poorer ECOG status (ECOG 1 vs. 0: HR = 1.59 (95% CI = 1.24-2.04), P < 0.001) and primary tumour site (GI vs. breast cancer: HR = 3.06, 95% CI = 2.16-4.35, P < 0.001) were prognostic. CONCLUSIONS We developed a NCIS prognostic score with excellent prognostic ability for both short-term and longer-term survival (iAUC: 0.71 [95% CI 0.65-0.76]), and validated the RMH model in the largest Asian study to date.
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Affiliation(s)
- Jerold Loh
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - Jiaxuan Wu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jenny Chieng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Aurora Chan
- NUS Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Wei-Peng Yong
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - Raghav Sundar
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Soo-Chin Lee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Andrea Wong
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - Joline S J Lim
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - David S P Tan
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ross Soo
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - Boon-Cher Goh
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - Bee-Choo Tai
- NUS Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Cheng E Chee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore. .,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Chan A, Begum Y, Robertson A, Walker K, Westmacott R, Shroff M, Dlamini N, Narang I. The Impact of Experimental Sleep Restriction on Neurocognition in Healthy Adolescents. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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12
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Yoon A, Payne J, Suh H, Chan A, Oh H. Complications associated with mini-screw assisted rapid palatal expansion. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Chan A, Begum Y, Robertson A, Walker K, Westmacott R, Shroff M, Dlamini N, Narang I. The Impact of Experimental Sleep Restriction on Endothelial Function in Healthy Adolescents. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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14
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Diem L, Evangelopoulos ME, Karathanassis D, Natsis V, Kamber N, Hammer H, Friedli C, Chan A, Helbling A, Penner IK, Salmen A, Walther S, Stegmayer K, Hoepner R. Hypogammaglobulinemia: A contributing factor to multiple sclerosis fatigue? Mult Scler Relat Disord 2022; 68:104148. [PMID: 36063730 DOI: 10.1016/j.msard.2022.104148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/04/2022] [Accepted: 08/25/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Fatigue is one of the most disabling and difficult to treat symptoms of autoimmune diseases and frequently presents in people with multiple sclerosis (PwMS). Hypogammaglobulinemia for immunoglobulin G (IgG) affects approximately 8-25% of PwMS. We performed a retrospective analysis to investigate the association of MS-fatigue and IgG hypogammaglobulinemia. METHODS PwMS, treated at Eginition University Hospital Athens or at the University Hospital Bern, were included (n = 134 patients (Bern n = 99; Athens n = 35)). Mann Whitney U-test (MWT), ANOVA test, Chi2 test and multivariable linear regression models were run. RESULTS 97/134 (72.4%) PwMS reported fatigue. In the multivariable linear regression analysis, IgG serum concentration (-1.6, 95%CI -2.7 - -0.5, p = 0.006), daytime sleepiness (0.8, 95%CI 0.2-1.4, p = 0.009), and a depressive mood (1.1, 95%CI 0.8-1.4, p < 0.001) were significantly associated with fatigue. The impact of IgG serum concentration (-2.9 95%CI -4.7 - -1.1, p = 0.002) remained significant also in the subcohort of PwMS without depressive symptoms or daytime sleepiness. CONCLUSIONS We found an association between IgG hypogammaglobulinemia and fatigue in PwMS (Level of Evidence IV), which might be translated to other autoimmune diseases. It bears a potential therapeutic consequence considering IgG supplementation strategies, if our finding can be validated prospectively.
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Affiliation(s)
- L Diem
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland.
| | - M E Evangelopoulos
- Department of Neurology, Aiginitio University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - D Karathanassis
- Department of Neurology, Aiginitio University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - V Natsis
- Department of Neurology, Aiginitio University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - N Kamber
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - H Hammer
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - C Friedli
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - A Chan
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - A Helbling
- Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital and University of Bern, Switzerland
| | - I K Penner
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - A Salmen
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
| | - S Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Bern, Switzerland
| | - K Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Bern, Switzerland
| | - R Hoepner
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse, Bern, Switzerland
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Lim M, Lee C, Chan A. Correlation between endometrial age and blastocyst age: Implantation and Pregnancy Rates with Euploid FET. Reprod Biomed Online 2022. [DOI: 10.1016/j.rbmo.2022.08.053] [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: 10/07/2022]
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16
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Tolaney S, Chan A, Petrakova K, Delaloge S, Campone M, Iwata H, Peddi P, Kaufman P, de Kermadec E, Liu Q, Cohen P, Paux G, Im SA. 212MO AMEERA-3, a phase II study of amcenestrant (AMC) versus endocrine treatment of physician’s choice (TPC) in patients (pts) with endocrine-resistant ER+/HER2− advanced breast cancer (aBC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.251] [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: 11/17/2022] Open
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Chan A, Rigler K, Ahmad N, Lafont T. POS0958 PROGRESSIVE IMPROVEMENT IN TIME TO DIAGNOSIS IN AXIAL SPONDYLOARTHRITIS THROUGH AN INTEGRATED REFERRAL AND EDUCATION SYSTEM. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundDespite the advances in the treatment and management of axial spondyloarthritis (axSpA), there remains a significant delay in the diagnosis of the condition. The diagnostic delay is 8-10 years in Europe and 8.5 years on average in the United Kingdom. This is contributed by the lack of awareness of axSpA, limited access to diagnostic tests and unstructured referral pathways. The delayed diagnosis leads to higher morbidity from the condition.ObjectivesTo assess the delay in the diagnosis of axSpA over time in a real world axSpA cohort diagnosed over a 7 year period from 2015 and to evaluate factors associated with this delay. During this time, we evaluated the effectiveness of the interventions to reduce the delay to diagnosis.MethodsA cohort of axSpA patients newly diagnosed between 2015 to 2021, were studied. This was a cross-sectional study on patients with axSpA who visited a specialist rheumatology clinic at a single centre. The demographic, clinical and diagnostic variables were recorded. Diagnostic delay was defined as the time interval between the year of first symptom and year of diagnosis. The mean and median diagnostic delay were calculated. An integrated educational and referral system were implemented from 20151. This included education to the main referrers in to the system including general practitioners (GPs) and community musculoskeletal (MSK) triage physiotherapists. The electronic referral systems were updated annually according to best practice guidelines2. An impact analysis was performed evaluating diagnostic delay for axSpA during this period.ResultsOf the 110 axSpA patients studied, 60 (54.4%) were male and 50 (45.5%) female. The mean (range) age was 37 (18-52) years. All patients met the ASAS classification criteria for axSpA. Radiographic axSpA (Ankylosing spondylitis) fulfilling New York criteria, was diagnosed in (62%) of the patients. There were more patients with radiographic axSpA in the earlier years of diagnosis (100% in 2015) and more of non-radiographic axSpA in the later years (83% in 2021). HLA-B*27 positivity was found in 79 (71.8%) of patients. The majority of referrals were from general practitioners 63 (57.2%), physiotherapists 19 (17.3%), orthopaedics 18 (16.4%) and other specialties 10 (9.1%). There was no significant difference in the mean (years) delay to diagnosis from the source of the clinic referral. The mean and median delay to diagnosis by year of diagnosis were 9.9, 9.5 (±3.1) years in 2015, 7.1, 7(±1) in 2016, 5.3,5 (±2.7) in 2017, 4.9, 4 (±3) in 2018, 4.4, 2.5 (±4.8) in 2019, 3.6, 2 (±3.2) in 2020, 2.2, 1 (±2.6) in 2021. The majority of the patients were diagnosed between 31-40 years (41%), 22% between 18-30 years, 31% between 41-50 years and 4% after the age of 50 years. Higher age at diagnosis was associated with a longer diagnostic delay. Diagnosis of disease at 18-30 years of age was associated with shorter mean delay to diagnosis (2.9 years), age 31-40 (4.6), age 41-50 (5.9), and age > 51 (6.5).ConclusionDelay in axSpA diagnosis has significantly improved in this real-world cohort during the last seven years. The mean diagnostic delay was 2 years indicating diagnostic delay may be for most patients shorter than previously reported. The factors associated with a faster diagnosis were a) more recent year of first rheumatology consult b) earlier age at presentation. Increased educational and awareness campaigns in primary care and musculoskeletal triage has led to the early recognition of axSpA. Early referral to a rheumatology service using electronic referral symptom can improve the diagnostic delay of axSpA. With continuous improvement cycles, our aim is to get reduce delays to diagnosis to under 1 year with line with the Gold Standard to Diagnosis in axSpA.References[1]All Party Parliamentary Group (APPG) on Axial Spondyloarthritis. 2019.[2]https://nass.co.uk/wp-content/uploads/2020/03/APPG-on-Axial-SpA-Second-Meeting-Minutes.pdf[3]NICE Guideline NG65. Spondyloarthritis in over 16s: diagnosis and management. 2017. https://www.nice.org.uk/guidance/ng65Disclosure of InterestsAntoni Chan Speakers bureau: Janssen, Novartis, Amgen, Abbvie, Celgene, UCB, Consultant of: Novartis, Lilly, Abbvie, Grant/research support from: Novartis, UCB, Kathryn Rigler: None declared, Nadia Ahmad: None declared, Tanguy Lafont: None declared
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Hui DSC, Ng SSS, Wong GLH, Chu WCW, Chan A, Wong VWS. Obstructive sleep apnoea and continuous positive airway pressure therapy for patients with non-alcoholic fatty liver disease: abridged secondary publication. Hong Kong Med J 2022; 28 Suppl 1:42-45. [PMID: 35260517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- D S C Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - S S S Ng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - G L H Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - W C W Chu
- Department of Imaging & Interventional Radiology, The Chinese University of Hong Kong
| | - A Chan
- Department of Pathology, The Chinese University of Hong Kong
| | - V W S Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong
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Taylor AB, Chan A, Saewyc EM. Role models and well-being among trans and non-binary youth. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
It is important for young people to see themselves represented in stories, on television and in different job opportunities, so they can have an awareness of what is possible. While we often hear the words “representation matters,” research on how representation affects health outcomes of trans and non-binary (TNB) youth is lacking. In this presentation, we will use the Social Cognitive Theory to identify how the presence of role models relates to social and health outcomes of TNB youth across Canada.
Methods
The 2019 online Canadian Trans Youth Health Survey included 1,519 TNB youth ranging from 14-25 years old. Youth identified as 43.7% trans masculine, 12.3% trans feminine, and 44% non-binary. Analyses explore differences in the relationship between the presence of TNB role models and social and health outcomes using crosstabulations and chi square tests, logistic regressions, and ANOVAs, by age and across gender identity groups.
Results
Youth with role models had a higher odds of participating in school sports [OR = 1.3, 95% CI: 1.03 - 1.59] and youth who had a role model they want to be like were significantly more likely to report living in their felt gender (p = .036). The relationship between TNB youth's identification of role models and being able to think of something they are good at, living in their felt gender, avoiding public spaces, future school plans, sports involvement, self-rated physical and mental health, emotional wellbeing and general health outcomes across developmental groupings will be discussed. Demographic and contextual factors that moderate the relationship between role models and social/health outcomes will also be presented.
Conclusions
Youth with role models have better social and emotional well-being. The importance of role models for TNB youth should not be diminished. We will share the implications of our findings for health promotion and public health policy, as well as recommendations for further research.
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Affiliation(s)
- AB Taylor
- Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia, Vancouver, Canada
| | - A Chan
- Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia, Vancouver, Canada
| | - EM Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia, Vancouver, Canada
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Chan RJ, Crichton M, Crawford-Williams F, Agbejule OA, Yu K, Hart NH, de Abreu Alves F, Ashbury FD, Eng L, Fitch M, Jain H, Jefford M, Klemanski D, Koczwara B, Loh K, Prasad M, Rugo H, Soto-Perez-de-Celis E, van den Hurk C, Chan A. The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews. Ann Oncol 2021; 32:1552-1570. [PMID: 34509615 DOI: 10.1016/j.annonc.2021.09.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Telemedicine services have been increasingly used to facilitate post-treatment cancer survivorship care, including improving access; monitoring health status, health behaviors, and symptom management; enhancing information exchange; and mitigating the costs of care delivery, especially since the COVID-19 pandemic. To inform guidance for the use of telemedicine in the post-COVID era, the aim of this overview of systematic reviews (SRs) was to evaluate the efficacy of, and survivor engagement in, telemedicine interventions in the post-treatment survivorship phase, and to consider implementation barriers and facilitators. METHODS PubMed, Cochrane CENTRAL, CINAHL, Embase, and Web of Science databases were searched. SRs that examined the use of telemedicine in the post-treatment phase of cancer survivorship, published between January 2010 and April 2021, were included. Efficacy data were synthesized narratively. Implementation barriers and facilitators were synthesized using the Consolidated Framework for Implementation Research. RESULTS Twenty-nine SRs were included. A substantive body of evidence found telemedicine to benefit the management of psychosocial and physical effects, particularly for improving fatigue and cognitive function. There was a lack of evidence on the use of telemedicine in the prevention and surveillance for recurrences and new cancers as well as management of chronic medical conditions. This overview highlights a range of diverse barriers and facilitators at the patient, health service, and system levels. CONCLUSIONS This review highlights the benefits of telemedicine in addressing psychosocial and physical effects, but not in other areas of post-treatment cancer survivorship care. This large review provides practical guidance for use of telemedicine in post-treatment survivorship care.
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Affiliation(s)
- R J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia.
| | - M Crichton
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, Australia
| | - F Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - O A Agbejule
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - K Yu
- Department of Pharmacy, National University of Singapore, Singapore
| | - N H Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, Australia
| | - F de Abreu Alves
- Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - F D Ashbury
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Department of Oncology, University of Calgary, Calgary, Canada
| | - L Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, Canada; University Health Network, University of Toronto, Toronto, Canada
| | - M Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - H Jain
- Adult Hematolymphoid Division, Medical Oncology, Tata Memorial Centre, Affiliated to Homi Bhabha National Institute, Mumbai, India
| | - M Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - D Klemanski
- Cancer Support Service Line, The Ohio State University Comprehensive Cancer Center - James Cancer Hospital, Columbus, USA
| | - B Koczwara
- Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - K Loh
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - M Prasad
- Paediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - H Rugo
- Division of Hematology and Oncology, University of California San Francisco, San Francisco, USA
| | - E Soto-Perez-de-Celis
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C van den Hurk
- Netherlands Comprehensive Cancer Organisation, Department of Research and Development, Utrecht, the Netherlands
| | - A Chan
- School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, USA
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Klempner S, Beeram M, Sabanathan D, Chan A, Hamilton E, Loi S, Oh DY, Emens L, Patnaik A, Kim J, Park Y, Odegard V, Hamke S, Jang G, Jacquemont C, Hunder N, Piha-Paul S. 209P Interim results of a phase I/Ib study of SBT6050 monotherapy and pembrolizumab combination in patients with advanced HER2-expressing or amplified solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Mahajan S, Oostvogels A, Balcioglu H, Chan A, Lo K, Hui E, Ma B, Debets R. 999P NPC patients with post-RT EBV clearance show a higher frequency of peripheral CD8 T-cells expressing chemo-attractant receptors at baseline and during radiation therapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1383] [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: 12/01/2022] Open
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Loh J, Wu J, Chieng J, Chan A, Yong WP, Sundar R, Lee S, Wong A, Lim J, Tan D, Soo R, Chng W, Goh B, Tai B, Chee C. 1835P Clinical outcome and prognostic factors for Asian patients in phase I clinical trials. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Fasching P, Harbeck N, Jerusalem G, Colleoni M, Neven P, Franke F, De Laurentiis M, Tripathy D, Martin M, Babu G, Yardley D, Wheatley-Price P, Chan A, Villanueva Vazquez R, Nusch A, Gu E, Hu H, Pathak P, Thuerigen A, Bardia A. 233P Association of quality of life (QOL) with overall survival (OS) in patients (pts) with HR+/HER2− advanced breast cancer (ABC) treated with ribociclib (RIB) + endocrine therapy (ET) in the MONALEESA-3 (ML-3) and ML-7 trials. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.516] [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] Open
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Tree A, Hall E, Ostler P, van der Voet H, Loblaw A, Chu W, Ford D, Tolan S, Jain S, Martin A, Staffurth J, Camilleri P, Kancherla K, Frew J, Brand D, Chan A, Dayes I, Brown S, Pugh J, Burnett S, Dufton A, Griffin C, Mahmud M, Naismith O, van As N, of the O. OC-0289 Comparison of side effects at 2 years in the randomised PACE-B trial (SBRT vs standard radiotherapy). Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06839-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ksienski D, Truong PT, Wai ES, Croteau NS, Chan A, Patterson T, Clarkson M, Hackett S, Irons S, Lesperance M. Survival Outcomes Following Discontinuation of Ipilimumab and Nivolumab for Advanced Melanoma in a Population-based Cohort. Clin Oncol (R Coll Radiol) 2021; 33:e561-e569. [PMID: 34226113 DOI: 10.1016/j.clon.2021.06.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/14/2021] [Indexed: 11/17/2022]
Abstract
AIMS Induction ipilimumab and nivolumab followed by maintenance nivolumab improve overall survival compared with ipilimumab alone in patients with advanced melanoma, but immune-related adverse events (irAE) occur commonly. The need for induction discontinuation because of irAE and the relationship between irAE and survival in non-trials patients are unclear. MATERIALS AND METHODS Patients with unresectable stage III-IV melanoma receiving first-line combination immunotherapy at one of six centres between December 2017 and February 2020 outside of trials were identified retrospectively. Landmark 12-week Kaplan-Meier analyses and log-rank tests were used to evaluate associations between discontinuation of induction therapy on overall survival and time to treatment failure (TTF). Multivariable analysis of factors influencing overall survival and TTF was undertaken. RESULTS Among 95 patients, the median age was 62 years, 38.9% had Eastern Cooperative Oncology Group performance status ≥1 and 22.1% had brain metastases. The median follow-up for the whole cohort was 19.8 months by the reverse Kaplan-Meier method. Any grade and grade 3-4 irAE were noted in 78.9% and 44.2% of the cohort, respectively. 44.2% of patients completed induction immunotherapy, whereas 41.1% did not due to irAE. Twelve-week landmark overall survival and TTF were similar in patients who completed induction versus those who did not due to irAE. On multivariable analysis, any grade irAE (versus none) was associated with longer overall survival (hazard ratio = 0.35, 95% confidence interval 0.15-0.82, P = 0.02) and TTF (hazard ratio = 0.38, 95% confidence interval = 0.17-0.81, P = 0.01). Grade 3-4 irAE correlated with longer TTF (hazard ratio = 0.45, 95% confidence interval = 0.20-1.01, P = 0.05). CONCLUSION In this population-based cohort, discontinuation of induction immunotherapy as a result of irAE did not adversely affect overall survival or TTF. irAE observed during ipilimumab and nivolumab induction were associated with improved survival outcomes.
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Affiliation(s)
- D Ksienski
- BC Cancer-Victoria, British Columbia, Canada; University of British Columbia, British Columbia, Canada.
| | - P T Truong
- BC Cancer-Victoria, British Columbia, Canada; University of British Columbia, British Columbia, Canada
| | - E S Wai
- BC Cancer-Victoria, British Columbia, Canada; University of British Columbia, British Columbia, Canada
| | - N S Croteau
- Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, British Columbia, Canada
| | - A Chan
- University of British Columbia, British Columbia, Canada; BC Cancer-Surrey, British Columbia, Canada
| | - T Patterson
- BC Cancer-Victoria, British Columbia, Canada
| | - M Clarkson
- BC Cancer-Victoria, British Columbia, Canada
| | - S Hackett
- BC Cancer-Victoria, British Columbia, Canada
| | - S Irons
- BC Cancer-Victoria, British Columbia, Canada
| | - M Lesperance
- Department of Mathematics and Statistics, University of Victoria, British Columbia, Canada
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D'Atri D, Zerrillo L, Garcia J, Oieni J, Lupu-Haber Y, Schomann T, Chan A, Cruz LJ, Creemers LB, Machluf M. Nanoghosts: Mesenchymal Stem cells derived nanoparticles as a unique approach for cartilage regeneration. J Control Release 2021; 337:472-481. [PMID: 34015401 DOI: 10.1016/j.jconrel.2021.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) is a chronic degenerative disease, which affects the joints and is characterized by inflammation, cartilage loss and bone changes. Nowadays, there are no treatments for OA, and current therapies are focused on relieving the symptoms. As a new therapy approach, micro and nanoparticles have been extensively explored and among all the studied particles, the use of cell-membrane-based particles is expanding. Another promising approach studied to treat OA, is the use of mesenchymal stem cells (MSCs) which play an important role modulating inflammation. We developed a novel kind of MSCs' cytoplasmic-membrane-based nanoparticles, termed nano-ghosts (NGs). Retaining MSCs' surface properties and lacking cells' internal machinery allow the NGs to have immunomodulatory capacity and to be immune-evasive while not susceptible to host-induced changes. In this study, we demonstrate NGs' ability to target cartilage tissues, in vitro and in vivo, while modulating the inflammatory process. In vivo studies demonstrated NGs ability to act as an immunomodulatory drug slowing down cartilage degeneration process. Our proof-of-concept experiments show that NGs system is a versatile nano-carrier system, capable of therapeutics loading, with targeting capabilities towards healthy and inflamed cartilage cells. Our results, along with previously published data, clearly reveal the NGs system as a promising nano-carrier platform and as a potential immunomodulatory drug for several inflammation-related diseases.
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Affiliation(s)
- D D'Atri
- Faculty of Biotechnology and Food Engineering, Technion Israel Institute of Technology, Technion City, Haifa, Israel
| | - L Zerrillo
- Department of Radiology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - J Garcia
- Department of Orthopaedics, University Medical Center, 3584, CX, Utrecht, the Netherlands
| | - J Oieni
- Faculty of Biotechnology and Food Engineering, Technion Israel Institute of Technology, Technion City, Haifa, Israel
| | - Y Lupu-Haber
- Faculty of Biotechnology and Food Engineering, Technion Israel Institute of Technology, Technion City, Haifa, Israel
| | - T Schomann
- Department of Radiology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - A Chan
- Department of Radiology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - L J Cruz
- Department of Radiology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - L B Creemers
- Department of Orthopaedics, University Medical Center, 3584, CX, Utrecht, the Netherlands
| | - Marcelle Machluf
- Faculty of Biotechnology and Food Engineering, Technion Israel Institute of Technology, Technion City, Haifa, Israel.
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Fasching P, Bardia A, Nusch A, Jerusalem G, Chan A, El Saghir N, Alba Conejo E, Im SA, Janni W, Chandiwana D, Lanoue B, Thuerigen A, Gu E, Harbeck N. 91O Pooled analysis of patient (pt)-reported outcomes (PROs) in the MONALEESA (ML)-2, -3, and -7 trials: Additional results and key subgroup findings. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.105] [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: 10/21/2022] Open
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Martin M, Holmes F, Moy B, Mansi J, Gnant M, Buyse M, Barrios C, Bryce R, Wong A, Chan A. Continued efficacy of neratinib in patients with HER2-positive (HER2+) early-stage breast cancer: final overall survival (OS) analysis from the randomized phase 3 ExteNET trial. Breast 2021. [PMID: 33183970 DOI: 10.1016/s0960-9776(21)00093-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Ruiz-Borrego M, Chan A, Marx G, Brufsky A, Trudeau M, Egle D, McCulloch L, Tripathy D, Barcenas C. Bringing diarrhea under CONTROL: dose escalation reduces neratinib-associated diarrhea and improves tolerability in HER2-positive early-stage breast cancer. Breast 2021. [DOI: 10.1016/s0960-9776(21)00092-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Diem L, Hoepner R, Bagnoud M, Salmen A, Chan A, Friedli C. Natalizumab induced blood eosinophilia: A retrospective pharmacovigilance cohort study and review of the literature. J Neuroimmunol 2021; 353:577505. [PMID: 33548621 DOI: 10.1016/j.jneuroim.2021.577505] [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] [Received: 12/03/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To describe frequency of natalizumab related eosinophilia and clinical symptoms of eosinophilic disease in our monocentric cohort. METHODS Comparison of clinical characteristics of 115 natalizumab treated and 116 untreated RRMS patients and review of literature. RESULTS 38% of natalizumab treated patients had eosinophilia, which occurred significantly more frequently compared to untreated MS patients (3%, p-value<0.001). In symptomatic patients, mean eosinophil counts were significantly higher than in asymptomatic patients and symptoms developed within one year. DISCUSSION Eosinophilia is a side effect of natalizumab and mostly asymptomatic. However, few patients develop within one year after start of natalizumab an eosinophilic disease as severe side effect.
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Affiliation(s)
- L Diem
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - R Hoepner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - M Bagnoud
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - A Salmen
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - A Chan
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Friedli
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Chan A, Dinsfriend W, Kim J, Steingart R, Weinsaft J. Prognostic utility of differential contrast-enhancement patterns on late gadolinium enhancement cardiac MRI (LGE-CMR) in patients with cancer-associated cardiac masses. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
LGE-CMR tissue characterization is widely used to identify cardiac masses (CMASS) in cancer patients – including neoplasm (NEO) and thrombus (THR). Prognostic utility of their differential LGE patterns is unknown.
Purpose
To determine incremental prognostic utility of LGE patterns in CMASS
Methods
The population comprised of cancer patients with CMASS on LGE-CMR, for which etiology was classified based on presence (NEO) or absence (THR) of enhancement, and controls matched for cancer type/stage. LGE-CMR tissue properties of NEO was classified based on extent of contrast enhancement – diffusely enhancing (DE), mixed (ME), and predominantly avascular (PA). Clinical follow up was performed for embolic events within 6 months of CMR and all-cause mortality.
Results
330 cancer patients (55% M; 55±16yo) with an array of cancer diagnoses (19% sarcoma, 17% GI, 13% GU) were studied. Among CMASS+ pts (n=190), 66% had NEO and 34% had THR on LGE. All THR were non-enhancing. Among NEO, LGE pattern was variable (46% DE, 41% ME, 13% PA); ME lesions were larger than other groups (Fig. 1A). Quantitative tissue properties were consistent with qualitative groups, as evidenced by stepwise variation in signal intensity and CNR. Cumulative embolic events were 3-fold higher in CMASS+ than controls (All: 20% vs. 7%, p=0.001; PE: 13% vs. 5%, p=0.02; CVA/systemic embolism: 10% vs. 3%, p=0.01). Median time to event was 1.3 months [IQR 0.1–2.3] from CMR. Aggregate events were similar between NEO and THR, reflecting similar rates of PE and CVA (p=NS). Among CMASS pts with embolic events, 56% were on anticoagulation at time of event (59% NEO, 50% THR, p=0.61). Regarding CMASS morphology, emboli were 3-fold higher among intracavitary (IC) or highly mobile (HM) CMASS (IC: 25% vs 7%, p<0.001; HM: 38% vs 12%, p=0.001). Regarding location, right sided CMASS were associated with a 3–5 fold increase in PE (IC: 19% vs 6%; HM: 35% vs 7%, both p<0.001) and similar CVA events among left sided CMASS (IC: 17% vs. 6%, p=0.02; HM: 33% vs 6%, p=0.05). Embolic events were similar when partitioned based on quantitative LGE patterns between patients with and without embolic events. As for all-cause mortality, NEO on CMR conferred increased mortality than THR (HR 3.06 [CI=1.84–5.1], p<0.001) and matched controls (HR 2.08 [CI=1.42–3.04], p<0.001) during a median follow-up of 9.4 months [IQR 3.6–23.2]. Among NEO subgroups (Fig. 1B), survival was lower in patients with heterogeneous LGE patterns vs matched controls: the lowest survival in ME (p=0.002) suggests increased vascularity and tumor hypoxia/necrosis associated with aggressive tumors and hence larger lesions.
Conclusions
Among cancer patients, CMR-evidenced CMASS confers high short-term embolic risk, which are equivalently common between NEO and THR. Intra-cavitary location and increased mobility augment embolic risk irrespective of CMASS tissue properties whereas differential LGE patterns on CMR strongly impact prognosis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Chan
- Memorial Sloan Kettering Cancer Center, New York City, United States of America
| | - W Dinsfriend
- Memorial Sloan Kettering Cancer Center, New York City, United States of America
| | - J Kim
- Weill Cornell Medicine, New York, United States of America
| | - R Steingart
- Memorial Sloan Kettering Cancer Center, New York City, United States of America
| | - J.W Weinsaft
- Weill Cornell Medicine, New York, United States of America
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Hearn N, Cahill K, Atwell D, Bugg W, Chan A, Vignarajah D, Lagopoulos J, Min M. Quantitative Approaches to Locally Advanced Rectal Cancer GTV and Subvolume Contouring with Diffusion-Weighted MRI: Implications for MRI-Guided Boost Strategies. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Deshpande D, Chan A, Scalchunes C, Milner J. P257 CHARACTERIZING ASTHMA AMONG ADULTS WITH PRIMARY ANTIBODY DEFICIENCIES: RESULTS FROM A NATIONWIDE PATIENT SURVEY. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Smit T, Chan A, Chasen M, Bhargava R, Bošnjak S, Zilic A, Chia J, Jabbar A, Yaxiong Z, de Necker M, Mhazo T, Heyman L, Rapoport B. 1816MO ICES (International Carboplatin Emesis Survey) for the evaluation of the emetogenicity of carboplatin-based chemotherapy – with a focus on nausea. MASCC Antiemetic Study Group survey. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Barcenas CH, Hurvitz SA, Di Palma JA, Bose R, Chien AJ, Iannotti N, Marx G, Brufsky A, Litvak A, Ibrahim E, Alvarez RH, Ruiz-Borrego M, Chan N, Manalo Y, Kellum A, Trudeau M, Thirlwell M, Garcia Saenz J, Hunt D, Bryce R, McCulloch L, Rugo HS, Tripathy D, Chan A. Improved tolerability of neratinib in patients with HER2-positive early-stage breast cancer: the CONTROL trial. Ann Oncol 2020; 31:1223-1230. [PMID: 32464281 DOI: 10.1016/j.annonc.2020.05.012] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Neratinib is an irreversible pan-HER tyrosine kinase inhibitor approved for extended adjuvant treatment in early-stage HER2-positive breast cancer based on the phase III ExteNET study. In that trial, in which no antidiarrheal prophylaxis was mandated, grade 3 diarrhea was observed in 40% of patients and 17% discontinued due to diarrhea. The international, open-label, sequential-cohort, phase II CONTROL study is investigating several strategies to improve tolerability. PATIENTS AND METHODS Patients who completed trastuzumab-based adjuvant therapy received neratinib 240 mg/day for 1 year plus loperamide prophylaxis (days 1-28 or 1-56). Sequential cohorts evaluated additional budesonide or colestipol prophylaxis (days 1-28) and neratinib dose escalation (DE; ongoing). The primary end point was the incidence of grade ≥3 diarrhea. RESULTS Final data for loperamide (L; n = 137), budesonide + loperamide (BL; n = 64), colestipol + loperamide (CL; n = 136), and colestipol + as-needed loperamide (CL-PRN; n = 104) cohorts, and interim data for DE (n = 60; completed ≥six cycles or discontinued; median duration 11 months) are available. No grade 4 diarrhea was observed. Grade 3 diarrhea rates were lower than ExteNET in all cohorts and lowest in DE (L 31%, BL 28%, CL 21%, CL-PRN 32%, DE 15%). Median number of grade 3 diarrhea episodes was one; median duration per grade 3 episode was 1.0-2.0 days across cohorts. Most grade 3 diarrhea and diarrhea-related discontinuations occurred in month 1. Diarrhea-related discontinuations were lowest in DE (L 20%, BL 8%, CL 4%, CL-PRN 8%, DE 3%). Decreases in health-related quality of life did not cross the clinically important threshold. CONCLUSIONS Neratinib tolerability was improved with preemptive prophylaxis or DE, which reduced the rate, severity, and duration of neratinib-associated grade ≥3 diarrhea compared with ExteNET. Lower diarrhea-related treatment discontinuations in multiple cohorts indicate that proactive management can allow patients to stay on neratinib for the recommended time period. CLINICALTRIALS.GOV: NCT02400476.
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Affiliation(s)
- C H Barcenas
- The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - S A Hurvitz
- University of California Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, USA
| | - J A Di Palma
- University of South Alabama College of Medicine, Mobile, USA
| | - R Bose
- Washington University School of Medicine, St Louis, USA
| | - A J Chien
- University of California San Francisco Comprehensive Cancer Center, San Francisco, USA
| | - N Iannotti
- Hematology Oncology Associates of the Treasure Coast, Port St. Lucie, USA
| | - G Marx
- Adventist Health Care, Wahroonga, Australia
| | - A Brufsky
- Magee-Womens Hospital of UPMC, Pittsburgh, USA
| | - A Litvak
- Saint Barnabas Medical Center, Livingston, USA
| | - E Ibrahim
- Redlands Community Hospital, Redlands, USA
| | - R H Alvarez
- Southeastern Regional Medical Center, Inc., Newnan, USA
| | | | - N Chan
- Rutger Cancer Institute of New Jersey, New Brunswick, USA
| | - Y Manalo
- Coastal Bend Cancer Center, Corpus Christi, USA
| | - A Kellum
- North Mississippi Medical Center Hematology and Oncology Clinic, Tupelo, USA
| | - M Trudeau
- Sunnybrook Research Institute, Toronto, Canada
| | - M Thirlwell
- McGill University Health Centre, Montreal, Canada
| | | | - D Hunt
- Puma Biotechnology Inc., Los Angeles, USA
| | - R Bryce
- Puma Biotechnology Inc., Los Angeles, USA
| | | | - H S Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, USA
| | - D Tripathy
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Chan
- Breast Cancer Research Centre-WA & Curtin University, Perth, WA, Australia
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Affiliation(s)
- A. Chan
- Department of Renal Medicine and Transplantation Royal London Hospital Whitechapel, London, United Kingdom
| | - C. Flores
- Department of Renal Medicine and Transplantation Royal London Hospital Whitechapel, London, United Kingdom
| | - S.L.-S. Fan
- Department of Renal Medicine and Transplantation Royal London Hospital Whitechapel, London, United Kingdom
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Langford BJ, Beriault D, Schwartz KL, Seah J, Pasic MD, Cirone R, Chan A, Downing M. A real-world assessment of procalcitonin combined with antimicrobial stewardship in a community ICU. J Crit Care 2020; 57:130-133. [PMID: 32145655 DOI: 10.1016/j.jcrc.2020.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/08/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE We evaluated the feasibility and impact of PCT-guided antibiotic duration combined with an established antibiotic stewardship program (ASP) in a community hospital intensive care unit (ICU). METHODS We implemented daily PCT levels for ICU patients receiving antibiotics. Our protocol recommended stopping antibiotic therapy if PCT met an absolute or relative stopping threshold. We evaluated the adherence to stopping criteria within 48 h, antibiotic use [days of therapy (DOT) per 1000 patient-days (PD)], length of stay and ICU-mortality. We performed interrupted time series analysis to compare 24 months before and 12 months after implementation. RESULTS A total of 297 antibiotic courses were monitored with PCT in 217 patients. Protocol adherence was 34% (absolute threshold: 39%, relative threshold: 12%). Antibiotic use pre-PCT was 935 DOTs/1000 PDs and post-PCT was 817 DOTs/1000 PDs (RRadj 0.73, 95% CI: 0.62 to 0.86). No statistically significant changes in clinical outcomes were noted. CONCLUSION In the context of an established ASP in a community hospital ICU, PCT monitoring was feasible and associated with an adjusted overall decrease of 27% in antibiotic use with no adverse impact on clinical outcomes. Incorporating PCT testing to guide antibiotic duration can be successful if integrated into workflow and paired with ASP guidance.
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Affiliation(s)
- B J Langford
- Unity Health Toronto, Toronto, Canada; Public Health Ontario, Toronto, Canada.
| | - D Beriault
- Unity Health Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada
| | - K L Schwartz
- Unity Health Toronto, Toronto, Canada; Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada
| | - J Seah
- Unity Health Toronto, Toronto, Canada
| | - M D Pasic
- Unity Health Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada
| | - R Cirone
- Unity Health Toronto, Toronto, Canada; Department of Medicine, University of Toronto, Canada
| | - A Chan
- Unity Health Toronto, Toronto, Canada
| | - M Downing
- Unity Health Toronto, Toronto, Canada
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Yap N, Ho H, Zheng H, Tan C, Toh Y, Ng C, Chan A. An in vitro evaluation of CYP2D6 enzymatic inhibition activities of a Chinese herbal medicine formulation (Xiang Bei Yangrong Tang) for the management of cancer-related fatigue. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz434.012] [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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Chan A, Feuille E, Bassetti J, Pereira E, Demirdag Y. M232 VARIABLE PHENOTYPES ASSOCIATED WITH P.H648TFSX20 PATHOGENIC VARIANT IN CARMIL2 GENE: A REPORT OF TWO CASES. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tan C, Tan L, Loh K, Neo P, Finkelstein E, Chan A. Work-related outcomes among cancer survivors in Singapore. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz432.011] [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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Guo Y, Ahn MJ, Chan A, Wang CH, Kang JH, Kim SB, Bello M, Arora RS, Zhang Q, He X, Li P, Dechaphunkul A, Kumar V, Kamble K, Li W, Kandil A, Cohen EEW, Geng Y, Zografos E, Tang PZ. Afatinib versus methotrexate as second-line treatment in Asian patients with recurrent or metastatic squamous cell carcinoma of the head and neck progressing on or after platinum-based therapy (LUX-Head & Neck 3): an open-label, randomised phase III trial. Ann Oncol 2019; 30:1831-1839. [PMID: 31501887 PMCID: PMC6927323 DOI: 10.1093/annonc/mdz388] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Treatment options are limited for patients with recurrent or metastatic squamous cell carcinoma of the head and neck (HNSCC) following progression after first-line platinum-based therapy, particularly in Asian countries. PATIENTS AND METHODS In this randomised, open-label, phase III trial, we enrolled Asian patients aged ≥18 years, with histologically or cytologically confirmed recurrent/metastatic HNSCC following first-line platinum-based therapy who were not amenable for salvage surgery or radiotherapy, and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0/1. Patients were randomised (2 : 1) to receive oral afatinib (40 mg/day) or intravenous methotrexate (40 mg/m2/week), stratified by ECOG performance status and prior EGFR-targeted antibody therapy. The primary end point was progression-free survival (PFS) assessed by an independent central review committee blinded to treatment allocation. RESULTS A total of 340 patients were randomised (228 afatinib; 112 methotrexate). After a median follow-up of 6.4 months, afatinib significantly decreased the risk of progression/death by 37% versus methotrexate (hazard ratio 0.63; 95% confidence interval 0.48-0.82; P = 0.0005; median 2.9 versus 2.6 months; landmark analysis at 12 and 24 weeks, 58% versus 41%, 21% versus 9%). Improved PFS was complemented by quality of life benefits. Objective response rate was 28% with afatinib and 13% with methotrexate. There was no significant difference in overall survival. The most common grade ≥3 drug-related adverse events were rash/acne (4% with afatinib versus 0% with methotrexate), diarrhoea (4% versus 0%), fatigue (1% versus 5%), anaemia (<1% versus 5%) and leukopenia (0% versus 5%). CONCLUSIONS Consistent with the phase III LUX-Head & Neck 1 trial, afatinib significantly improved PFS versus methotrexate, with a manageable safety profile. These results demonstrate the efficacy and feasibility of afatinib as a second-line treatment option for certain patients with recurrent or metastatic HNSCC. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01856478.
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Affiliation(s)
- Y Guo
- Department of Medical Oncology, Shanghai East Hospital, Tongji University, Shanghai, China.
| | - M-J Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - A Chan
- State Key Laboratory in Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - C-H Wang
- Department of Medical Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - J-H Kang
- The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul
| | - S-B Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - M Bello
- Department of Oncology, St Luke's Medical Center, Quezon City, Philippines
| | - R S Arora
- Department Oncology, Sujan Surgical Cancer Hospital and Amravati Cancer Foundation, Amravati, India
| | - Q Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - X He
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Science, Beijing
| | - P Li
- West China Hospital, Sichuan University, Chengdu, China
| | - A Dechaphunkul
- Division of Medical Oncology, Prince of Songkla University, Songkhla, Thailand
| | - V Kumar
- Department of Surgical Oncology, King George's Medical University, Lucknow
| | - K Kamble
- Department of Medicine, Government Medical College and Hospital, Nagpur, India
| | - W Li
- Department of Hematology and Oncology, First Hospital Affiliated to Jilin University, Jilin, China
| | - A Kandil
- Internal Medicine, Alexandria University Hospital, Alexandria, Egypt
| | - E E W Cohen
- Department of Medicine, University of California, San Diego, USA
| | - Y Geng
- Biostatistics, Boehringer Ingelheim (China) Investment Co., Ltd, China
| | - E Zografos
- Clinical Development and Medical Affairs, Boehringer Ingelheim Ltd, Bracknell, Berkshire, UK
| | - P Z Tang
- Department of Oncology, Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Toh Y, Maung S, Chan A. Evaluating mitochondrial biomarkers between fatigue subclasses identified using latent class analysis in early-stage breast cancer patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz434.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Manzie T, Vujcich N, Chan A. Osteonecrosis of the jaw in an anti‐resorptive naïve patient taking trastuzumab and pertuzumab: case report. Aust Dent J 2019; 65:305-307. [DOI: 10.1111/adj.12723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
- T Manzie
- Oral and Maxillofacial Surgery Royal Perth Hospital Perth Western Australia Australia
| | - N Vujcich
- Oral and Maxillofacial Surgery Royal Perth Hospital Perth Western Australia Australia
| | - A Chan
- Breast Cancer Research Centre Western Australia & Curtin University Perth WA Australia
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Ocaña A, Chacón JILM, Calvo L, Antón A, Mansutti M, Alba E, Lluch A, Lahuerta A, Bisagni G, Bermejo B, Semiglazov V, Thill M, Chan A, Morales S, Albanell J, Herranz J, Trias Bes IT, Valagussa P, Chiesa M, Gianni L. Association of derived neutrophil-to-lymphocyte ratio (dNLR) with pathological complete response (pCR) after neoadjuvant chemotherapy (CT). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.094] [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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Ksienski D, Wai E, Croteau N, Freeman A, Fiorino L, Chan A, Fenton D, Geller G, Brooks E, Poonja Z, Irons S, Lesperance M. MA07.11 Survival Outcomes Based on Gender of Advanced Nonsmall Cell Lung Cancer Patients Treated with Pembrolizumab or Nivolumab in Everyday Clinical Practice. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.555] [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: 10/25/2022]
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Tolaney S, Wardley A, Zambelli S, Hilton J, Troso-Sandoval T, Ricci F, Im SA, Kim SB, Johnston S, Chan A, Goel S, Catron K, Yang Z, Gainford C, André F. MonarcHER: A randomized phase II study of abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with HR+, HER2+ advanced breast cancer (ABC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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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Petersen L, Mcneil R, Dean M, Chan A, Orton S, Kovalchuk O, Bebb G. P2.04-30 Seq-ing a Better Way to Detect PD-L1 in NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Khan R, Kohli N, Douglas A, Chan A, Charania J, Philipp R, Simkus G, Vuurmans T. COMPARING ANGIOGRAPHIC BURDEN OF CORONARY ARTERY DISEASE AND 30-DAY OUTCOMES BETWEEN SOUTH ASIAN AND NON-SOUTH ASIAN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.460] [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: 10/25/2022] Open
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Tolaney S, Blum J, Bondarenko I, Chan A, DaCosta N, Feng YH, Izarzugaza Y, Kim SB, Liu MC, Oliveira M, Ow S, Pavic M, Peréz Lopéz M, Rugo H, Schwartzberg L, Stradella A, Kroll S, O’Connell J, Wei T, Mittendorf E. CONTESSA TRIO: A multinational, multicenter, phase II study of tesetaxel plus 3 different PD-(L)1 inhibitors in patients with metastatic triple negative breast cancer (TNBC) and tesetaxel monotherapy in elderly patients with her2- metastatic breast cancer (MBC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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