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Joharatnam-Hogan N, Hatem D, Cafferty FH, Petrucci G, Cameron DA, Ring A, Kynaston HG, Gilbert DC, Wilson RH, Hubner RA, Swinson DEB, Cleary S, Robbins A, MacKenzie M, Scott-Brown MWG, Sothi S, Dawson LK, Capaldi LM, Churn M, Cunningham D, Khoo V, Armstrong AC, Ainsworth NL, Horan G, Wheatley DA, Mullen R, Lofts FJ, Walther A, Herbertson RA, Eaton JD, O'Callaghan A, Eichholz A, Kagzi MM, Patterson DM, Narahari K, Bradbury J, Stokes Z, Rizvi AJ, Walker GA, Kunene VL, Srihari N, Gentry-Maharaj A, Meade A, Patrono C, Rocca B, Langley RE. Thromboxane biosynthesis in cancer patients and its inhibition by aspirin: a sub-study of the Add-Aspirin trial. Br J Cancer 2023; 129:706-720. [PMID: 37420000 PMCID: PMC10421951 DOI: 10.1038/s41416-023-02310-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/09/2023] [Accepted: 06/05/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Pre-clinical models demonstrate that platelet activation is involved in the spread of malignancy. Ongoing clinical trials are assessing whether aspirin, which inhibits platelet activation, can prevent or delay metastases. METHODS Urinary 11-dehydro-thromboxane B2 (U-TXM), a biomarker of in vivo platelet activation, was measured after radical cancer therapy and correlated with patient demographics, tumour type, recent treatment, and aspirin use (100 mg, 300 mg or placebo daily) using multivariable linear regression models with log-transformed values. RESULTS In total, 716 patients (breast 260, colorectal 192, gastro-oesophageal 53, prostate 211) median age 61 years, 50% male were studied. Baseline median U-TXM were breast 782; colorectal 1060; gastro-oesophageal 1675 and prostate 826 pg/mg creatinine; higher than healthy individuals (~500 pg/mg creatinine). Higher levels were associated with raised body mass index, inflammatory markers, and in the colorectal and gastro-oesophageal participants compared to breast participants (P < 0.001) independent of other baseline characteristics. Aspirin 100 mg daily decreased U-TXM similarly across all tumour types (median reductions: 77-82%). Aspirin 300 mg daily provided no additional suppression of U-TXM compared with 100 mg. CONCLUSIONS Persistently increased thromboxane biosynthesis was detected after radical cancer therapy, particularly in colorectal and gastro-oesophageal patients. Thromboxane biosynthesis should be explored further as a biomarker of active malignancy and may identify patients likely to benefit from aspirin.
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Affiliation(s)
| | - Duaa Hatem
- Department of Safety and Bioethics, Division of Pharmacology, Catholic University School of Medicine, Rome, Italy
| | - Fay H Cafferty
- MRC Clinical Trials Unit, UCL, London, UK
- The Institute of Cancer Research, London, UK
| | - Giovanna Petrucci
- Department of Safety and Bioethics, Division of Pharmacology, Catholic University School of Medicine, Rome, Italy
| | - David A Cameron
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, The University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - Alistair Ring
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Howard G Kynaston
- Department of Urology, Cardiff University School of Medicine, Cardiff, UK
| | - Duncan C Gilbert
- MRC Clinical Trials Unit, UCL, London, UK
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Richard H Wilson
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
- The Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Richard A Hubner
- The Christie NHS Foundation Trust, Department of Medical Oncology, Manchester, UK
- University of Manchester, Division of Cancer Sciences, Manchester, UK
| | | | | | | | | | | | - Sharmila Sothi
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Lesley K Dawson
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | | | - Mark Churn
- Worcestershire Acute Hospitals NHS Trust, Worcester, UK
| | | | - Vincent Khoo
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Anne C Armstrong
- The Christie NHS Foundation Trust, Department of Medical Oncology, Manchester, UK
| | - Nicola L Ainsworth
- The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK
| | - Gail Horan
- The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK
| | | | - Russell Mullen
- The Highland Breast Centre, Raigmore Hospital, Inverness, UK
| | - Fiona J Lofts
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Axel Walther
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - John D Eaton
- University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal, UK
| | | | | | | | | | - Krishna Narahari
- University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
- Division of Cancer and Genetics, Cardiff University, Cardiff, UK
| | | | - Zuzana Stokes
- United Lincolnshire Hospitals NHS Trust, Lincoln City, UK
| | - Azhar J Rizvi
- Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | | | - Victoria L Kunene
- Walsall Manor Hospital and University Hospitals, Birmingham NHS Foundation Trust, Birmingham, UK
| | | | | | | | - Carlo Patrono
- Department of Safety and Bioethics, Division of Pharmacology, Catholic University School of Medicine, Rome, Italy
| | - Bianca Rocca
- Department of Safety and Bioethics, Division of Pharmacology, Catholic University School of Medicine, Rome, Italy
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Bulling J, Jurgelucks B, Prager J, Walther A. Defect reconstruction in a two-dimensional semi-analytical waveguide model via derivative-based optimization. J Acoust Soc Am 2022; 152:1217. [PMID: 36050181 DOI: 10.1121/10.0013574] [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] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
This paper considers an indirect measurement approach to reconstruct a defect in a two-dimensional waveguide model for a non-destructive ultrasonic inspection via derivative-based optimization. The propagation of the mechanical waves is simulated by the scaled boundary finite element method that builds on a semi-analytical approach. The simulated data are then fitted to given data associated with the reflected waves from a defect which is to be reconstructed. For this purpose, we apply an iteratively regularized Gauss-Newton method in combination with algorithmic differentiation to provide the required derivative information accurately and efficiently. We present numerical results for three kinds of defects, namely, a crack, delamination, and corrosion. The objective function and the properties of the reconstruction method are investigated. The examples show that the parameterization of the defect can be reconstructed efficiently as well as robustly in the presence of noise.
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Affiliation(s)
- J Bulling
- Bundesanstalt für Materialforschung und -pruefung, Unter den Eichen 87, 12205 Berlin, Germany
| | - B Jurgelucks
- Department of Mathematics, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - J Prager
- Bundesanstalt für Materialforschung und -pruefung, Unter den Eichen 87, 12205 Berlin, Germany
| | - A Walther
- Department of Mathematics, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
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Slomovitz B, Mirza M, Lortholary A, Vergote I, Cibula D, Walther A, Savarese A, Ginesta MPB, Ortac F, Papadimitriou C, Bodnar L, Lai CH, Hasegawa K, Chen X, Barber E, Coleman R, Keefe S, Orlowski R, Gorp TV. ENGOT-en11/GOG-3053/KEYNOTE-B21: A phase 3 study of pembrolizumab or placebo in combination with adjuvant chemotherapy with or without radiotherapy in patients with newly diagnosed high-risk endometrial cancer (570). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01791-7] [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]
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Morrison J, Balega J, Buckley L, Clamp A, Crosbie E, Drew Y, Durrant L, Forrest J, Fotopoulou C, Gajjar K, Ganesan R, Gupta J, Hughes J, Miles T, Moss E, Nanthakumar M, Newton C, Ryan N, Walther A, Taylor A. British Gynaecological Cancer Society (BGCS) uterine cancer guidelines: Recommendations for practice. Eur J Obstet Gynecol Reprod Biol 2022; 270:50-89. [DOI: 10.1016/j.ejogrb.2021.11.423] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/19/2021] [Indexed: 12/24/2022]
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Van Gorp T, Mirza MR, Lortholary A, Cibula D, Walther A, Savarese A, Barretina-Ginesta MP, Ortaç F, Papadimitriou C, Bodnar L, Lai CH, Korach J, Marth C, Hasegawa K, Xie X, Barber EL, Coleman RL, Keefe SM, Orlowski R, Slomovitz B. ENGOT-en11/GOG-3053/KEYNOTE-B21: Phase 3 study of pembrolizumab or placebo in combination with adjuvant chemotherapy with/without radiotherapy in patients with newly diagnosed high-risk endometrial cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps5608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS5608 Background: Pembrolizumab, a selective humanized anti–PD-1 monoclonal antibody, has demonstrated activity in patients with previously treated mismatch repair (MMR) deficient (dMMR; 57.1% ORR as monotherapy and 63.6% ORR as combination therapy with lenvatinib) and MMR proficient (pMMR; 36.2% ORR as combination therapy with lenvatinib) endometrial cancer (EC). ENGOT-en11/GOG-3053/KEYNOTE-B21 is a phase 3, randomized, double-blind study of pembrolizumab or placebo in combination with adjuvant chemotherapy with/without radiotherapy in patients with EC. Methods: Eligible patients are ≥18 years old with newly diagnosed, histologically confirmed high-risk (stage I/II non-endometrioid, stage III/IVa, p53 abnormality) EC (carcinoma or carcinosarcoma) following surgery with curative intent with no evidence of disease post-operatively or on imaging, and without prior systemic therapy/radiotherapy. In total, ̃990 patients are randomized to receive pembrolizumab 200 mg or placebo Q3W for 6 cycles + chemotherapy (carboplatin area under the curve [AUC] 5 or 6 + paclitaxel 175 mg/m2 Q3W or carboplatin AUC 2 or 2.7 + paclitaxel 60 mg/m2 QW) in stage 1. Patients receive pembrolizumab 400 mg or placebo Q6W for 6 cycles in stage 2 per their treatment assignment. At the investigator’s discretion, radiotherapy (external beam radiotherapy [EBRT] and/or brachytherapy) ± radiosensitizing cisplatin 50 mg/m2 (days 1 and 29) may be administered after completion of chemotherapy. Randomization is stratified by MMR status (pMMR vs dMMR) and, within pMMR, by planned radiation therapy (cisplatin-EBRT vs EBRT vs no EBRT), histology (endometrioid vs non-endometrioid), and International Federation of Gynecology and Obstetrics (FIGO) surgical stage (I/II vs III/IVA). Dual primary endpoints are disease-free survival (DFS; per investigator assessment) and overall survival (OS), both estimated by the Kaplan-Meier method, with a stratified log-rank test to assess treatment differences and a Cox proportional hazard model with Efron’s method of tie handling to assess the magnitude of treatment differences. Secondary endpoints include DFS (per blinded independent central review), DFS (per investigator assessment) and OS by biomarker status (PD-L1 and tumor mutational burden), safety (per National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0) and quality of life (per European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 [EORTC QLQ-C30] and Endometrial Cancer Module [EORTC QLQ-EN24]). The study began enrollment in December 2020. Clinical trial information: NCT04634877.
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Affiliation(s)
| | - Mansoor Raza Mirza
- NSGO-CTU & Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alain Lortholary
- Centre Catherine de Sienne, Hôpital Privé du Confluent, Nantes, France
| | - David Cibula
- Department of Obstetrics and Gynecology, General Faculty Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Axel Walther
- Bristol Cancer Institute, University Hospitals Bristol, Bristol, United Kingdom
| | | | - Maria Pilar Barretina-Ginesta
- Catalan Institute of Oncology and Girona Biomedical Research Institute, Medical School University of Girona, Girona, Spain
| | - Fırat Ortaç
- Ankara University School of Medicine, Ankara, Turkey
| | - Christos Papadimitriou
- Aretaieio University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lubomir Bodnar
- Department of Oncology and Immunooncology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration’s Hospital, Olsztyn, Poland
| | - Chyong-Huey Lai
- TGOG and Department of Gynecology and Obstetrics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Jacob Korach
- Gynecologic Oncology Department, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University, Hidaka, Saitama Prefecture, Japan
| | - Xing Xie
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Emma L. Barber
- Northwestern University Feinberg School of Medicine, Chicago, IL
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Walther A, Wehrli S, Kische H, Penz M, Wekenborg M, Gao W, Rothe N, Beesdo-Baum K, Kirschbaum C. Depressive symptoms are not associated with long-term integrated testosterone concentrations in hair. World J Biol Psychiatry 2021; 22:288-300. [PMID: 32657193 DOI: 10.1080/15622975.2020.1795253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The association between depressive symptomatology and endogenous testosterone levels is inconclusive. Large inter- and intra-individual testosterone differences suggest point measurements from saliva or serum to be inadequate to map basal testosterone concentrations highlighting the potential for long-term integrated testosterone levels from hair. METHODS Using data from a prospective cohort study, a total of 578 participants (74% female) provided complete data on depressive symptomatology, clinical features, and hair samples for quantification of testosterone concentrations at baseline. Available data of three annual follow-up examinations were used for longitudinal analyses. RESULTS Correlation analysis showed in both, men and women, hair testosterone across all the four time points not to be significantly related to depressive symptoms. Examined clinical features were not associated with testosterone levels, except for having a current diagnosis of a psychological disorder, which was associated with reduced testosterone levels in men, but not in women. Acceptable model fit for an autoregressive cross-lagged panel analysis emerged only for the female subsample suggesting inverse cross-relations for the prediction of testosterone by depressive symptomatology and vice versa. CONCLUSIONS Findings from this study add to the literature by showing no association between long-term integrated testosterone in hair and depressive symptomatology in men and women.
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Affiliation(s)
- A Walther
- Department of Biopsychology, TU Dresden, Dresden, Germany.,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - S Wehrli
- Department of Biopsychology, TU Dresden, Dresden, Germany.,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - H Kische
- Department of Behavioral Epidemiology, TU Dresden, Dresden, Germany
| | - M Penz
- University Hospital Dresden Clinic and Polyclinic for Psychotherapy and Psychosomatics, Dresden, Germany
| | - M Wekenborg
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - W Gao
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - N Rothe
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - K Beesdo-Baum
- Department of Behavioral Epidemiology, TU Dresden, Dresden, Germany
| | - C Kirschbaum
- Department of Biopsychology, TU Dresden, Dresden, Germany
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7
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Morgan RD, McNeish IA, Cook AD, James EC, Lord R, Dark G, Glasspool RM, Krell J, Parkinson C, Poole CJ, Hall M, Gallardo-Rincón D, Lockley M, Essapen S, Summers J, Anand A, Zachariah A, Williams S, Jones R, Scatchard K, Walther A, Kim JW, Sundar S, Jayson GC, Ledermann JA, Clamp AR. Objective responses to first-line neoadjuvant carboplatin-paclitaxel regimens for ovarian, fallopian tube, or primary peritoneal carcinoma (ICON8): post-hoc exploratory analysis of a randomised, phase 3 trial. Lancet Oncol 2021; 22:277-288. [PMID: 33357510 DOI: 10.1016/s1470-2045(20)30591-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Platinum-based neoadjuvant chemotherapy followed by delayed primary surgery (DPS) is an established strategy for women with newly diagnosed, advanced-stage epithelial ovarian cancer. Although this therapeutic approach has been validated in randomised, phase 3 trials, evaluation of response to neoadjuvant chemotherapy using Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST), and cancer antigen 125 (CA125) has not been reported. We describe RECIST and Gynecologic Cancer InterGroup (GCIG) CA125 responses in patients receiving platinum-based neoadjuvant chemotherapy followed by DPS in the ICON8 trial. METHODS ICON8 was an international, multicentre, randomised, phase 3 trial done across 117 hospitals in the UK, Australia, New Zealand, Mexico, South Korea, and Ireland. The trial included women aged 18 years or older with an Eastern Cooperative Oncology Group performance status of 0-2, life expectancy of more than 12 weeks, and newly diagnosed International Federation of Gynecology and Obstetrics (FIGO; 1988) stage IC-IIA high-grade serous, clear cell, or any poorly differentiated or grade 3 histological subtype, or any FIGO (1988) stage IIB-IV epithelial cancer of the ovary, fallopian tube, or primary peritoneum. Patients were randomly assigned (1:1:1) to receive intravenous carboplatin (area under the curve [AUC]5 or AUC6) and intravenous paclitaxel (175 mg/m2 by body surface area) on day 1 of every 21-day cycle (control group; group 1); intravenous carboplatin (AUC5 or AUC6) on day 1 and intravenous dose-fractionated paclitaxel (80 mg/m2 by body surface area) on days 1, 8, and 15 of every 21-day cycle (group 2); or intravenous dose-fractionated carboplatin (AUC2) and intravenous dose-fractionated paclitaxel (80 mg/m2 by body surface area) on days 1, 8, and 15 of every 21-day cycle (group 3). The maximum number of cycles of chemotherapy permitted was six. Randomisation was done with a minimisation method, and patients were stratified according to GCIG group, disease stage, and timing and outcome of cytoreductive surgery. Patients and clinicians were not masked to group allocation. The scheduling of surgery and use of neoadjuvant chemotherapy were determined by local multidisciplinary case review. In this post-hoc exploratory analysis of ICON8, progression-free survival was analysed using the landmark method and defined as the time interval between the date of pre-surgical planning radiological tumour assessment to the date of investigator-assessed clinical or radiological progression or death, whichever occurred first. This definition is different from the intention-to-treat primary progression-free survival analysis of ICON8, which defined progression-free survival as the time from randomisation to the date of first clinical or radiological progression or death, whichever occurred first. We also compared the extent of surgical cytoreduction with RECIST and GCIG CA125 responses. This post-hoc exploratory analysis includes only women recruited to ICON8 who were planned for neoadjuvant chemotherapy followed by DPS and had RECIST and/or GCIG CA125-evaluable disease. ICON8 is closed for enrolment and follow-up, and registered with ClinicalTrials.gov, NCT01654146. FINDINGS Between June 6, 2011, and Nov 28, 2014, 1566 women were enrolled in ICON8, of whom 779 (50%) were planned for neoadjuvant chemotherapy followed by DPS. Median follow-up was 29·5 months (IQR 15·6-54·3) for the neoadjuvant chemotherapy followed by DPS population. Of 564 women who had RECIST-evaluable disease at trial entry, 348 (62%) had a complete or partial response. Of 727 women who were evaluable by GCIG CA125 criteria at the time of diagnosis, 610 (84%) had a CA125 response. Median progression-free survival was 14·4 months (95% CI 9·2-28·0; 297 events) for patients with a RECIST complete or partial response and 13·3 months (8·1-20·1; 171 events) for those with RECIST stable disease. Median progression-free survival for women with a GCIG CA125 response was 13·8 months (95% CI 8·8-23·4; 544 events) and 9·7 months (5·8-14·5; 111 events) for those without a GCIG CA125 response. Complete cytoreduction (R0) was achieved in 187 (56%) of 335 women with a RECIST complete or partial response and 73 (42%) of 172 women with RECIST stable disease. Complete cytoreduction was achieved in 290 (50%) of 576 women with a GCIG CA125 response and 30 (30%) of 101 women without a GCIG CA125 response. INTERPRETATION The RECIST-defined radiological response rate was lower than that frequently quoted to patients in the clinic. RECIST and GCIG CA125 responses to neoadjuvant chemotherapy for epithelial ovarian cancer should not be used as individual predictive markers to stratify patients who are likely to benefit from DPS, but instead used in conjunction with the patient's clinical capacity to undergo cytoreductive surgery. A patient should not be denied surgery based solely on the lack of a RECIST or GCIG CA125 response. FUNDING Cancer Research UK, UK Medical Research Council, Health Research Board in Ireland, Irish Cancer Society, and Cancer Australia.
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Affiliation(s)
- Robert D Morgan
- The Christie NHS Foundation Trust and University of Manchester, Manchester, UK
| | - Iain A McNeish
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Adrian D Cook
- Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Elizabeth C James
- Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Rosemary Lord
- The Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, UK
| | - Graham Dark
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Jonathan Krell
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Christopher J Poole
- Arden Cancer Research Centre, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | | | | | | | - Jeff Summers
- Maidstone and Tunbridge Wells NHS Trust, Kent, UK
| | - Anjana Anand
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Abel Zachariah
- Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - Sarah Williams
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Rachel Jones
- South West Wales Cancer Centre, Singleton Hospital, Swansea, UK
| | | | - Axel Walther
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Jae-Weon Kim
- Seoul National University College of Medicine, Seoul, South Korea
| | - Sudha Sundar
- Pan Birmingham Gynaecological Cancer Centre and University of Birmingham, Birmingham, UK
| | - Gordon C Jayson
- The Christie NHS Foundation Trust and University of Manchester, Manchester, UK
| | | | - Andrew R Clamp
- The Christie NHS Foundation Trust and University of Manchester, Manchester, UK.
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Bell D, Ludwanowski S, Lüken A, Sarikaya B, Walther A, Wessling M. Hydrogel membranes made from crosslinked microgel multilayers with tunable density. J Memb Sci 2021. [DOI: 10.1016/j.memsci.2020.118912] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Ray-Coquard I, Mirza MR, Pignata S, Walther A, Romero I, du Bois A. Therapeutic options following second-line platinum-based chemotherapy in patients with recurrent ovarian cancer: Comparison of active surveillance and maintenance treatment. Cancer Treat Rev 2020; 90:102107. [PMID: 33099187 DOI: 10.1016/j.ctrv.2020.102107] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 12/30/2022]
Abstract
Most women with advanced ovarian cancer respond to initial treatment, consisting of surgical resection and ≈6 cycles of platinum-based chemotherapy. However, disease recurrence occurs in most patients, and subsequent therapies become necessary. Historically, close monitoring following treatment (active surveillance) was the only available option, as continued maintenance chemotherapy treatment led to increased toxicity without providing any meaningful clinical benefit. Recently, targeted therapy with the angiogenesis inhibitor bevacizumab and the poly(ADP-ribose) polymerase (PARP) inhibitors olaparib, niraparib, and rucaparib have demonstrated significant clinical benefits as maintenance treatment for recurrent disease. Despite consensus guidelines recommending their use, maintenance treatments are currently underutilized. Here, we review evidence from pivotal clinical trials of approved second-line maintenance treatments demonstrating efficacy in terms of progression-free survival and postprogression efficacy outcomes for patients with recurrent ovarian cancer. Adverse events frequently associated with bevacizumab include hypertension, proteinuria, and non-central nervous system bleeding, whereas PARP inhibitors are associated with nausea, vomiting, fatigue, and anemia. Patient-centered outcomes analyses show that PARP inhibitors provide significant benefits to patient health status, even when accounting for the toxicities associated with treatment. Many factors influence the selection of second-line maintenance treatment for patients with recurrent ovarian cancer, including the maintenance treatment received in the first-line setting. Overall, targeted maintenance treatment represents a new standard of care for patients with ovarian cancer, and we recommend that maintenance treatment should be offered to all eligible patients with recurrent ovarian cancer.
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Affiliation(s)
- Isabelle Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard and Université Claude Bernard and Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Lyon, France.
| | - Mansoor Raza Mirza
- Department of Oncology, Rigshospitalet Copenhagen University Hospital, and Nordic Society of Gynecological Oncology (NGSO), Copenhagen, Denmark.
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G Pascale, Naples, Italy.
| | - Axel Walther
- Bristol Cancer Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
| | - Ignacio Romero
- Medical Oncology Department, Instituto Valenciano de Oncologia, Valencia, Spain.
| | - Andreas du Bois
- Department of Gynecology and Gynecological Oncology, Evangelische Kliniken Essen-Mitte (KEM), Essen, Germany.
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Walther A, Walther T, Heald A. Hair cortisol concentrations as a biomarker of parental burnout by Maria Elena Brianda, Isabelle Roskam, Moïra Mikolajczak. Psychoneuroendocrinology 2020; 119:104788. [PMID: 32703649 DOI: 10.1016/j.psyneuen.2020.104788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/02/2020] [Indexed: 12/01/2022]
Affiliation(s)
- A Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany.
| | - T Walther
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
| | - A Heald
- The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; Dpartment of Diabetes and Endocrinology, Salford Royal Hospital, Salford, M6 8HD, UK
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Rothe N, Steffen J, Penz M, Kirschbaum C, Walther A. Examination of peripheral basal and reactive cortisol levels in major depressive disorder and the burnout syndrome: A systematic review. Neurosci Biobehav Rev 2020; 114:232-270. [DOI: 10.1016/j.neubiorev.2020.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 12/15/2022]
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12
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Lacker TJ, Walther A, Ehlert U. Age-Related Alterations in Endocrine Markers Do Not Match Changes in Psychosocial Measures: Findings From the Men's Health 40+ Longitudinal Study. Am J Mens Health 2020; 14:1557988320926332. [PMID: 32456528 PMCID: PMC7278106 DOI: 10.1177/1557988320926332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
While life expectancy continues to increase, aging can bring several distinct
endocrine and psychosocial changes. The study aimed to investigate the interplay
between biopsychosocial factors of healthy aging in specifically healthy aging
men. Ninety-seven healthy aging men were investigated at two time points
spanning 4 years. Participants completed questionnaires measuring several
psychosocial dimensions and gave saliva samples for hormone quantification
during a laboratory appointment. The study applied a random intercept
mixed-model approach. Age-related changes were found in most endocrine markers
(cortisol, testosterone, dehydroepiandrosterone-sulfate, and progesterone),
except for estradiol. Psychosocial measures remained stable, except for
increased social support. Further, changes in endocrine and psychosocial
measures were independent of each other. The results suggest that in healthy
aging men, age-related endocrine changes occur, but do not necessarily determine
a change in psychosocial measures. Potentially, preventive interventions can be
derived from these results.
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Affiliation(s)
- T J Lacker
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Switzerland
| | - A Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Switzerland.,Biopsychology, Technical University Dresden, Dresden, Germany
| | - U Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Switzerland
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Roghmans F, Evdochenko E, Martí-Calatayud M, Garthe M, Tiwari R, Walther A, Wessling M. On the permselectivity of cation-exchange membranes bearing an ion selective coating. J Memb Sci 2020. [DOI: 10.1016/j.memsci.2020.117854] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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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14
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Yarmolinsky J, Bull CJ, Vincent EE, Robinson J, Walther A, Smith GD, Lewis SJ, Relton CL, Martin RM. Association Between Genetically Proxied Inhibition of HMG-CoA Reductase and Epithelial Ovarian Cancer. JAMA 2020; 323:646-655. [PMID: 32068819 PMCID: PMC7042851 DOI: 10.1001/jama.2020.0150] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 01/06/2020] [Indexed: 12/18/2022]
Abstract
Importance Preclinical and epidemiological studies indicate a potential chemopreventive role of statins in epithelial ovarian cancer risk. Objective To evaluate the association of genetically proxied inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (ie, genetic variants related to lower function of HMG-CoA reductase, target of statins) with epithelial ovarian cancer among the general population and in BRCA1/2 mutation carriers. Design, Setting, and Participants Single-nucleotide polymorphisms (SNPs) in HMGCR, NPC1L1, and PCSK9 associated with low-density lipoprotein (LDL) cholesterol in a genome-wide association study (GWAS) meta-analysis (N ≤196 475) were used to proxy therapeutic inhibition of HMG-CoA reductase, Niemann-Pick C1-Like 1 (NPC1L1) and proprotein convertase subtilisin/kexin type 9 (PCSK9), respectively. Summary statistics were obtained for these SNPs from a GWAS meta-analysis of case-control analyses of invasive epithelial ovarian cancer in the Ovarian Cancer Association Consortium (OCAC; N = 63 347) and from a GWAS meta-analysis of retrospective cohort analyses of epithelial ovarian cancer among BRCA1/2 mutation carriers in the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA; N = 31 448). Across the 2 consortia, participants were enrolled between 1973 and 2014 and followed up through 2015. OCAC participants came from 14 countries and CIMBA participants came from 25 countries. SNPs were combined into multi-allelic models and mendelian randomization estimates representing lifelong inhibition of targets were generated using inverse-variance weighted random-effects models. Exposures Primary exposure was genetically proxied inhibition of HMG-CoA reductase and secondary exposures were genetically proxied inhibition of NPC1L1 and PCSK9 and genetically proxied circulating LDL cholesterol levels. Main Outcomes and Measures Overall and histotype-specific invasive epithelial ovarian cancer (general population) and epithelial ovarian cancer (BRCA1/2 mutation carriers), measured as ovarian cancer odds (general population) and hazard ratio (BRCA1/2 mutation carriers). Results The OCAC sample included 22 406 women with invasive epithelial ovarian cancer and 40 941 control individuals and the CIMBA sample included 3887 women with epithelial ovarian cancer and 27 561 control individuals. Median ages for the cohorts ranged from 41.5 to 59.0 years and all participants were of European ancestry. In the primary analysis, genetically proxied HMG-CoA reductase inhibition equivalent to a 1-mmol/L (38.7-mg/dL) reduction in LDL cholesterol was associated with lower odds of epithelial ovarian cancer (odds ratio [OR], 0.60 [95% CI, 0.43-0.83]; P = .002). In BRCA1/2 mutation carriers, genetically proxied HMG-CoA reductase inhibition was associated with lower ovarian cancer risk (hazard ratio, 0.69 [95% CI, 0.51-0.93]; P = .01). In secondary analyses, there were no significant associations of genetically proxied inhibition of NPC1L1 (OR, 0.97 [95% CI, 0.53-1.75]; P = .91), PCSK9 (OR, 0.98 [95% CI, 0.85-1.13]; P = .80), or circulating LDL cholesterol (OR, 0.98 [95% CI, 0.91-1.05]; P = .55) with epithelial ovarian cancer. Conclusions and Relevance Genetically proxied inhibition of HMG-CoA reductase was significantly associated with lower odds of epithelial ovarian cancer. However, these findings do not indicate risk reduction from medications that inhibit HMG-CoA reductase; further research is needed to understand whether there is a similar association with such medications.
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Affiliation(s)
- James Yarmolinsky
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Caroline J. Bull
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Emma E. Vincent
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Jamie Robinson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Axel Walther
- Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sarah J. Lewis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Caroline L. Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Richard M. Martin
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
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15
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Macintyre G, Goranova TE, Silva DD, Ennis D, Piskorz AM, Eldridge M, Sie D, Lewsley LA, Hanif A, Wilson C, Dowson S, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Paul J, Supernat A, Millan D, Hoyle A, Bryson G, Nourse C, Mincarelli L, Sanchez LN, Ylstra B, Jimenez-Linan M, Moore L, Hofmann O, Markowetz F, McNeish IA, Brenton JD. Abstract AP09: COPY-NUMBER SIGNATURES AND MUTATIONAL PROCESSES IN HIGH GRADE SEROUS OVARIAN CARCINOMA. Clin Cancer Res 2019. [DOI: 10.1158/1557-3265.ovcasymp18-ap09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: The genomic complexity of profound copy-number aberration has prevented effective molecular stratification of high grade serous ovarian carcinoma (HGSOC). Recent algorithmic advances have enabled interpretation of complex genomic changes by identifying mutational signatures—genomic patterns that are the imprint of mutagenic processes accumulated over the lifetime of a cancer cell. We hypothesized that specific features of copy-number (CN) abnormalities could represent the imprints of distinct mutational processes, and developed methods to identify signatures from copy-number features in HGSOC.
METHODS: We derived copy-number signatures from absolute copy number profiles from 253 primary and relapsed HGSOC samples from 132 patients in the BriTROC-1 cohort using low-cost shallow whole-genome sequencing (sWGS; 0.1×). A subset of 56 of these cases had deep whole-genome sequencing (dWGS) performed for mutation analysis and comparison with sWGS data. Independent validation was performed using 112 dWGS HGSOC cases from PCAWG and 415 HGSOC cases with SNP array and whole exome sequence from TCGA. CN signature exposures were correlated with mutation data, SNV signatures, and other measures derived from deep WGS and exome sequencing to identify statistically significant genomic associations using a false discovery rate <0.05.
RESULTS: We identified 7 CN signatures that provided a molecular framework to rederive the major defining elements of HGSOC genomes, including defective homologous recombination (HRD), tandem duplication, amplification of CCNE1 and amplification-associated fold-back inversions. Almost all patients with HGSOC demonstrated a mixture of signatures indicative of combinations of mutational processes, including those with early driver events such as BRCA2 mutation (in addition to HRD signatures). High exposure to CN signature 3, characterised by BRCA1/2-related HRD, was associated with improved overall survival. Conversely, high exposure to signature 1, which was characterised by oncogenic RAS signaling (including NF1, KRAS and NRAS mutation), predicted platinum-resistant relapse and poor survival.
CONCLUSIONS: HGSOC lacks clinically-relevant patient stratification, which is reflected in poor survival and is a significant barrier to precision medicine. Copy-number signature exposures at diagnosis predict both overall survival and the probability of platinum-resistant relapse. Our results suggest that early TP53 mutation, the ubiquitous initiating event in HGSOC, may permit multiple mutational processes to co-evolve, potentially simultaneously and that additional signature exposures may alter the risk of developing therapeutic resistance. Thus, our results suggest that HGSOC is a continuum of genomes.
We derived signatures using inexpensive sWGS of DNA from core biopsies. These approaches are rapid and cost effective, thus providing a clear path to clinical implementation. By dissecting the mutational forces shaping HGSOC genomes, our study paves the way to understanding extreme genomic complexity, as well as revealing the evolution of tumors as they relapse and acquire resistance to therapy.
Citation Format: Geoff Macintyre, Teodora E. Goranova, Dilrini De Silva, Darren Ennis, Anna M. Piskorz, Matthew Eldridge, Daoud Sie, Liz-Anne Lewsley, Aishah Hanif, Cheryl Wilson, Suzanne Dowson, Rosalind M. Glasspool, Michelle Lockley, Elly Brockbank, Ana Montes, Axel Walther, Sudha Sundar, Richard Edmondson, Geoff D. Hall, Andrew Clamp, Charlie Gourley, Marcia Hall, Christina Fotopoulou, Hani Gabra, James Paul, Anna Supernat, David Millan, Aoisha Hoyle, Gareth Bryson, Craig Nourse, Laura Mincarelli, Luis Navarro Sanchez, Bauke Ylstra, Mercedes Jimenez-Linan, Luiza Moore, Oliver Hofmann, Florian Markowetz, Iain A. McNeish, James D. Brenton. COPY-NUMBER SIGNATURES AND MUTATIONAL PROCESSES IN HIGH GRADE SEROUS OVARIAN CARCINOMA [abstract]. In: Proceedings of the 12th Biennial Ovarian Cancer Research Symposium; Sep 13-15, 2018; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2019;25(22 Suppl):Abstract nr AP09.
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Affiliation(s)
- Geoff Macintyre
- 1Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK,
| | | | - Dilrini De Silva
- 1Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK,
| | - Darren Ennis
- 2Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK,
| | - Anna M. Piskorz
- 1Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK,
| | - Matthew Eldridge
- 1Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK,
| | - Daoud Sie
- 3VU University Medical Center, Amsterdam 1007 MB, The Netherlands,
| | - Liz-Anne Lewsley
- 4Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, G12 0YN, UK,
| | - Aishah Hanif
- 4Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, G12 0YN, UK,
| | - Cheryl Wilson
- 4Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, G12 0YN, UK,
| | - Suzanne Dowson
- 2Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK,
| | | | - Michelle Lockley
- 6Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK,
- 7University College London Hospital, London, WC1E 6BD, UK,
| | | | | | - Axel Walther
- 10Bristol Cancer Institute, Bristol, BS2 8ED, UK,
| | | | - Richard Edmondson
- 12Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St
- 13Mary's Hospital, Manchester, UK,
| | - Geoff D. Hall
- 14Department of Obstetrics and Gynaecology, Manchester Academic Health Science Centre, St Mary's
| | - Andrew Clamp
- 15Hospital, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre,
| | | | - Marcia Hall
- 17St James's Institute of Oncology, Leeds, LS9 7TF UK,
| | | | - Hani Gabra
- 18The Christie Hospital, Manchester, M20 4BX, UK,
- 19Nicola Murray Centre for Ovarian Cancer Research, MRC IGMM, University of Edinburgh, Edinburgh, EH4 2XR, UK,
| | - James Paul
- 4Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, G12 0YN, UK,
| | - Anna Supernat
- 1Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK,
| | - David Millan
- 20Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK,
| | - Aoisha Hoyle
- 20Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK,
| | - Gareth Bryson
- 20Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK,
| | - Craig Nourse
- 2Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK,
| | - Laura Mincarelli
- 2Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK,
| | | | - Bauke Ylstra
- 3VU University Medical Center, Amsterdam 1007 MB, The Netherlands,
| | - Mercedes Jimenez-Linan
- 21Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer,
| | - Luiza Moore
- 21Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer,
| | - Oliver Hofmann
- 2Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK,
- 22Imperial College, London, W12 0NN, UK,
| | | | - Iain A. McNeish
- 2Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK,
- 5Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, UK,
- 18The Christie Hospital, Manchester, M20 4BX, UK,
| | - James D. Brenton
- 1Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK,
- 21Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer,
- 23Early Clinical Development, IMED Biotech Unit, AstraZeneca, Cambridge, UK,Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK,Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK,Centre for Cancer Research, University of Melbourne, VIC 3010 Australia,Department of Oncology, University of Cambridge, CB2 0XZ, UK
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16
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Walther A, Tsao C, Pande R, Kirschbaum C, Field E, Berkman L. Do dehydroepiandrosterone, progesterone, and testosterone influence women's depression and anxiety levels? Evidence from hair-based hormonal measures of 2105 rural Indian women. Psychoneuroendocrinology 2019; 109:104382. [PMID: 31374371 PMCID: PMC6842697 DOI: 10.1016/j.psyneuen.2019.104382] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 06/16/2019] [Accepted: 07/16/2019] [Indexed: 01/19/2023]
Abstract
Depressive and anxiety disorders substantially contribute to the global burden of disease, particularly in poor countries. Higher prevalence rates for both disorders among women indicate sex hormones may be integrated in the pathophysiology of these disorders. The Kshetriya Gramin Financial Services study surveyed a random sample of 4160 households across 876 villages in rural Tamil Nadu, India. An interviewer-administered questionnaire was conducted to quantify depressive (K6-D) and anxiety (K6-A) symptoms. Alongside, hair samples for sex hormone profiling were collected from a subsample of 2105 women aged 18-85 years. Importantly, 5.9%, 14.8%, and 46.3% of samples contained non-detectable hormone levels for dehydroepiandrosterone, progesterone, and testosterone, respectively. Our primary analysis imputes values for the non-detectable sample and we check robustness of results when non-detectable values are dropped. In this cohort of women from rural India, higher depressive symptomatology is associated with lower levels of dehydroepiandrosterone and higher depressive and anxiety symptoms are associated with higher levels of testosterone. Progesterone shows no clear association with either depressive or anxiety symptoms. These results support a potential protective effect of higher endogenous dehydroepiandrosterone levels. An important caveat on the potential negative effect of hair testosterone levels on women's mental health is that the testosterone analysis is sensitive to how non-detectable values are treated.
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Affiliation(s)
- A Walther
- Biological Psychology, TU Dresden, Germany.
| | - C Tsao
- Princeton University, USA
| | - R Pande
- Department of Economics, Yale University, USA
| | | | - E Field
- Economics Department, Duke Trinity College of Arts & Sciences, USA
| | - L Berkman
- Center for Population and Development Studies, Harvard University, USA
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17
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Yarmolinsky J, Relton CL, Lophatananon A, Muir K, Menon U, Gentry-Maharaj A, Walther A, Zheng J, Fasching P, Zheng W, Yin Ling W, Park SK, Kim BG, Choi JY, Park B, Davey Smith G, Martin RM, Lewis SJ. Appraising the role of previously reported risk factors in epithelial ovarian cancer risk: A Mendelian randomization analysis. PLoS Med 2019; 16:e1002893. [PMID: 31390370 PMCID: PMC6685606 DOI: 10.1371/journal.pmed.1002893] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 07/15/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Various risk factors have been associated with epithelial ovarian cancer risk in observational epidemiological studies. However, the causal nature of the risk factors reported, and thus their suitability as effective intervention targets, is unclear given the susceptibility of conventional observational designs to residual confounding and reverse causation. Mendelian randomization (MR) uses genetic variants as proxies for risk factors to strengthen causal inference in observational studies. We used MR to evaluate the association of 12 previously reported risk factors (reproductive, anthropometric, clinical, lifestyle, and molecular factors) with risk of invasive epithelial ovarian cancer, invasive epithelial ovarian cancer histotypes, and low malignant potential tumours. METHODS AND FINDINGS Genetic instruments to proxy 12 risk factors were constructed by identifying single nucleotide polymorphisms (SNPs) that were robustly (P < 5 × 10-8) and independently associated with each respective risk factor in previously reported genome-wide association studies. These risk factors included genetic liability to 3 factors (endometriosis, polycystic ovary syndrome, type 2 diabetes) scaled to reflect a 50% higher odds liability to disease. We obtained summary statistics for the association of these SNPs with risk of overall and histotype-specific invasive epithelial ovarian cancer (22,406 cases; 40,941 controls) and low malignant potential tumours (3,103 cases; 40,941 controls) from the Ovarian Cancer Association Consortium (OCAC). The OCAC dataset comprises 63 genotyping project/case-control sets with participants of European ancestry recruited from 14 countries (US, Australia, Belarus, Germany, Belgium, Denmark, Finland, Norway, Canada, Poland, UK, Spain, Netherlands, and Sweden). SNPs were combined into multi-allelic inverse-variance-weighted fixed or random effects models to generate effect estimates and 95% confidence intervals (CIs). Three complementary sensitivity analyses were performed to examine violations of MR assumptions: MR-Egger regression and weighted median and mode estimators. A Bonferroni-corrected P value threshold was used to establish strong evidence (P < 0.0042) and suggestive evidence (0.0042 < P < 0.05) for associations. In MR analyses, there was strong or suggestive evidence that 2 of the 12 risk factors were associated with invasive epithelial ovarian cancer and 8 of the 12 were associated with 1 or more invasive epithelial ovarian cancer histotypes. There was strong evidence that genetic liability to endometriosis was associated with an increased risk of invasive epithelial ovarian cancer (odds ratio [OR] per 50% higher odds liability: 1.10, 95% CI 1.06-1.15; P = 6.94 × 10-7) and suggestive evidence that lifetime smoking exposure was associated with an increased risk of invasive epithelial ovarian cancer (OR per unit increase in smoking score: 1.36, 95% CI 1.04-1.78; P = 0.02). In analyses examining histotypes and low malignant potential tumours, the strongest associations found were between height and clear cell carcinoma (OR per SD increase: 1.36, 95% CI 1.15-1.61; P = 0.0003); age at natural menopause and endometrioid carcinoma (OR per year later onset: 1.09, 95% CI 1.02-1.16; P = 0.007); and genetic liability to polycystic ovary syndrome and endometrioid carcinoma (OR per 50% higher odds liability: 0.89, 95% CI 0.82-0.96; P = 0.002). There was little evidence for an association of genetic liability to type 2 diabetes, parity, or circulating levels of 25-hydroxyvitamin D and sex hormone binding globulin with ovarian cancer or its subtypes. The primary limitations of this analysis include the modest statistical power for analyses of risk factors in relation to some less common ovarian cancer histotypes (low grade serous, mucinous, and clear cell carcinomas), the inability to directly examine the association of some ovarian cancer risk factors that did not have robust genetic variants available to serve as proxies (e.g., oral contraceptive use, hormone replacement therapy), and the assumption of linear relationships between risk factors and ovarian cancer risk. CONCLUSIONS Our comprehensive examination of possible aetiological drivers of ovarian carcinogenesis using germline genetic variants to proxy risk factors supports a role for few of these factors in invasive epithelial ovarian cancer overall and suggests distinct aetiologies across histotypes. The identification of novel risk factors remains an important priority for the prevention of epithelial ovarian cancer.
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Affiliation(s)
- James Yarmolinsky
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Caroline L. Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Usha Menon
- MRC Clinical Trials Unit, Institute for Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute for Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Axel Walther
- Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Jie Zheng
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Peter Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen–EMN, Friedrich-Alexander University Erlangen–Nuremberg, Erlangen, Germany
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Woo Yin Ling
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Cancer Research Institute, Seoul National University, Seoul, South Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, South Korea
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji-Yeob Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Cancer Research Institute, Seoul National University, Seoul, South Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, South Korea
| | - Boyoung Park
- Department of Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Richard M. Martin
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Sarah J. Lewis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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18
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Klimas C, Ehlert U, Lacker TJ, Waldvogel P, Walther A. Higher testosterone levels are associated with unfaithful behavior in men. Biol Psychol 2019; 146:107730. [PMID: 31326436 DOI: 10.1016/j.biopsycho.2019.107730] [Citation(s) in RCA: 9] [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: 09/15/2018] [Revised: 05/22/2019] [Accepted: 07/10/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Infidelity in romantic relationships is a common, but severe issue often causing breakup and severe psychological impairment. Higher levels of testosterone are related to mating-behavior, sexual desire, and infidelity in men with sexual dysfunctions. Previous studies, have insufficiently addressed the potential role of testosterone in infidelity in healthy men. METHODS A sample of 224 middle-aged self-reporting healthy men being currently in a relationship completed questionnaires on relationship characteristics, infidelity, and provided overnight-fasting saliva samples for testosterone quantification. RESULTS In the sample, 37.5% men answered having been unfaithful in the current relationship, while 29% were identified as fulfilling criteria for a sexual dysfunction. Adjusting for covariates, a significant positive association for the frequency of unfaithful behavior and testosterone levels emerged. Subsample analysis indicates a positive association between testosterone and infidelity only to be present in men without sexual dysfunction. CONCLUSION Unfaithful behavior in males is associated with higher testosterone levels.
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Affiliation(s)
- C Klimas
- Biological Psychology, TU Dresden, Dresden, Germany
| | - U Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Dynamics of Healthy Aging, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - T J Lacker
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Dynamics of Healthy Aging, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - P Waldvogel
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - A Walther
- Biological Psychology, TU Dresden, Dresden, Germany; Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Dynamics of Healthy Aging, University Research Priority Program, University of Zurich, Zurich, Switzerland.
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19
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Jazaeri AA, Zsiros E, Amaria RN, Artz AS, Edwards RP, Wenham RM, Slomovitz BM, Walther A, Thomas SS, Chesney JA, Morris R, Matsuo K, Gaillard S, Rose PG, Donas JG, Tromp JM, Tavakkoli F, Li H, Fardis M, Monk BJ. Safety and efficacy of adoptive cell transfer using autologous tumor infiltrating lymphocytes (LN-145) for treatment of recurrent, metastatic, or persistent cervical carcinoma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.2538] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2538 Background: There is a high unmet medical need for effective treatments for patients with recurrent, metastatic, or persistent cervical cancer. Most patients are young and survival rates are poor. ORR for second line therapies is between 4 and 14% for chemotherapy and recently approved immunotherapy. Adoptive cell transfer using tumor infiltrating lymphocytes (TIL) have demonstrated durable responses in some patients with recurrent cervical cancer thus offering the potential for long-term disease control. Methods: Study C-145-04 is an ongoing, open-label, multicenter Phase 2 clinical trial evaluating the safety and efficacy of LN-145 TIL therapy in patients with advanced cervical cancer who have undergone at least one prior line of chemotherapy. Prior checkpoint inhibitor therapy is an exclusion criterion. The primary endpoint is ORR per RECIST 1.1; secondary endpoints include duration of response (DOR), disease control rate (DCR), and LN-145 safety. Tumors surgically harvested at local institutions are shipped to central GMP facilities for TIL generation in a 22-day manufacturing process. Final LN-145 TIL product is cryopreserved and shipped to sites. Patients receive one week of preconditioning lymphodepletion (cyclophosphamide, fludarabine), a single LN-145 infusion, followed by up to 6 doses of IL-2 (600,000 IU/kg). Results: As of 4 Feb 2019, 27 efficacy-c patients have received Gen 2 of LN-145, with a mean age of 47 years and 2.6 mean prior lines of therapy. Preliminary efficacy results: ORR was 44% (1 CR, 9 PR, 2 uPR), DCR was 89% at 3.5-month median study follow-up with 11/12 patients maintaining their response. Improved responses were observed in 4 patients with longer follow-up. Mean TIL cells infused was 28x109. Median IL-2 doses administered was 6.0. The adverse event profile was generally consistent with the underlying advanced disease and the profile of the lymphodepletion and IL-2 regimens. Conclusions: LN-145 results in 44% ORR in previously treated cervical cancer patients with acceptable safety and efficacy profile. LN-145 offers patients a viable therapeutic option warranting further investigation. Clinical trial information: NCT03108495.
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Affiliation(s)
- Amir A. Jazaeri
- The University of Texas - MD Anderson Cancer Center, Houston, TX
| | | | | | - Andrew S. Artz
- University of Chicago Comprehensive Cancer Center, Chicago, IL
| | - Robert P. Edwards
- Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | - Axel Walther
- University Hospitals Bristol, Bristol, United Kingdom
| | | | - Jason Alan Chesney
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY
| | - Robert Morris
- Barbara A. Karmanos Cancer Center, Wayne State University, Detroit, MI
| | - Koji Matsuo
- Los Angeles County Hospital-University of Southern California, Los Angeles, CA
| | | | | | | | | | | | - Huiling Li
- Iovance Biotherapeutics, Inc., San Carlos, CA
| | | | - Bradley J. Monk
- University of Arizona Cancer Center at Dignity Health St. Joseph’s Hospital and Medical Center, Phoenix, AZ
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20
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Langley RE, Wilson RH, Cafferty FH, Joharatnam N, Graham JS, Swinson D, Iveson T, Din FVN, Steele RJ, Henson V, Crossley A, Pramesh CS, Walther A, Adams R, Dawson LK, Agarwal R, Khabra K, Parmar MKB. Aspirin as adjuvant treatment for colorectal cancer: Rationale and progress of the Add-Aspirin trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps3624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS3624 Background: There is now a body of evidence indicating a potential role for aspirin in colorectal cancer (CRC) prevention. In cardiovascular trials, effects on incidence of cancer metastases and short-term mortality suggest further possible roles in the treatment setting, supported by observational studies of aspirin use after cancer diagnosis. In the prevention setting, aspirin use has been limited by toxicity concerns, particularly of serious bleeding. In the adjuvant setting, benefits associated with reducing recurrence and subsequent treatment may outweigh these risks. The Add-Aspirin trial will investigate this, and will also consider possible mechanisms of action for aspirin effects, including the impact of PIK3CA mutations, where there are currently several theories and conflicting data. Methods: Add-Aspirin (ISRCTN74358648) is an international, phase III, double-blind, randomised, placebo-controlled trial recruiting patients who have undergone surgery and relevant adjuvant treatment for stage II or III CRC, as well as those with completely resected CRC liver metastases. Parallel randomised cohorts will address the question in breast, gastro-oesophageal and prostate cancer. Participants take aspirin 100mg daily for an 8-week run-in, to assess adherence and toxicity, and those suitable to proceed are randomised (1:1:1) to aspirin 100mg, aspirin 300mg or placebo daily for at least 5 years. A number of measures – including blood pressure control and PPI use where relevant - are in place to reduce bleeding risk. The primary outcome is disease-free survival (target hazard ratio = 0.8, n = 2600 in 5 years) with a long term analysis of survival planned across the tumour groups. Translational work includes a sub-study monitoring urinary thromboxane B2 as a marker of platelet activation in a subgroup (n = 500) to investigate mechanisms of action. Add-Aspirin opened in 2015 and recruited 1505 CRC patients during the first 3 years from 137 UK centres. 1282 (85%) proceeded to randomisation. A pre-planned feasibility analysis of run-in data (n = 2253 across all 4 tumour groups) provided reassuring data on safety, tolerability and adherence, and recruitment continues with centres in India and Republic of Ireland recently joining. Clinical trial information: 74358648.
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Affiliation(s)
- Ruth E Langley
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | | | - Fay Helen Cafferty
- Medical Research Council Clinical Trials Unit at UCL, London, United Kingdom
| | - Nalinie Joharatnam
- Medical Research Council Clinical Trials Unit at UCL, London, United Kingdom
| | | | | | - Timothy Iveson
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Farhat Vanessa Nasim Din
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Robert J.C. Steele
- Medical Research Institute Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Verity Henson
- University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Anne Crossley
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | - Axel Walther
- Bristol Cancer Institute, Bristol, United Kingdom
| | | | | | - Roshan Agarwal
- Northampton General Hospital, Northampton, United Kingdom
| | - Komel Khabra
- Medical Research Council Clinical Trials Unit at UCL, London, United Kingdom
| | - Mahesh K B Parmar
- Medical Research Center Clinical Trials Unit at University College London, London, United Kingdom
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21
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Goranova T, Ennis D, Piskorz AM, Macintyre G, Lewsley LA, Stobo J, Wilson C, Kay D, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Freeman S, Moore L, Jimenez-Linan M, Paul J, Brenton JD, McNeish IA. Correction: Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma-experience of the BriTROC consortium. Br J Cancer 2019; 120:868. [PMID: 30862952 PMCID: PMC6474310 DOI: 10.1038/s41416-019-0433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This article was originally published under a CC BY NC SA License, but has now been made available under a CC BY 4.0 License.
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Affiliation(s)
- T Goranova
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - D Ennis
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - A M Piskorz
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - G Macintyre
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
| | - L A Lewsley
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - J Stobo
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - C Wilson
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - D Kay
- Department of Radiology, Gartnavel General Hospital, Glasgow, G12 0YN, UK
| | - R M Glasspool
- Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, UK
| | - M Lockley
- Barts Cancer Institute, London, EC1M 6BQ, UK
- University College Hospital, London, WC1E 6BD, UK
| | - E Brockbank
- Barts Cancer Institute, London, EC1M 6BQ, UK
| | - A Montes
- Guy's Hospital, London, SE1 9RT, UK
| | - A Walther
- Bristol Haematology and Oncology Centre, Bristol, BS2 8ED, UK
| | - S Sundar
- City Hospital, Birmingham, B18 7QH, UK
| | | | - G D Hall
- St James Hospital, Leeds, LS9 7TF, UK
| | - A Clamp
- The Christie Hospital, Manchester, M20 4BX, UK
| | - C Gourley
- Edinburgh Cancer Research Centre, Edinburgh, EH4 2XR, UK
| | - M Hall
- Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK
| | | | - H Gabra
- Imperial College, London, W12 0HS, UK
| | - S Freeman
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - L Moore
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | | | - J Paul
- Cancer Research UK Clinical Trials Unit, Glasgow, G12 0YN, UK
| | - J D Brenton
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK.
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - I A McNeish
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK.
- Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN, UK.
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22
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Walther A, Breidenstein J, Bösch M, Sefidan S, Ehlert U, Annen H, Wyss T, La Marca R. Associations between digit ratio (2D4D), mood, and autonomic stress response in healthy men. Psychophysiology 2019; 56:e13328. [PMID: 30623451 DOI: 10.1111/psyp.13328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 01/16/2023]
Abstract
The ratio between the length of the second (index) and the fourth (ring) finger (2D4D) is a putative biomarker of prenatal testosterone (T) exposure, with higher exposure leading to a smaller ratio. 2D4D has further been linked to mental and somatic disorders. Healthy male Swiss recruits (N = 245; Mage = 20.30 years) underwent a psychosocial stress test. Mood and salivary alpha-amylase (sAA) were assessed before and after the stress test, while heart rate (HR) and heart rate variability (HRV) were measured continuously. Additionally, 2D4D (right: R2D4D; left: L2D4D) was determined and divided into quartile groups. Correlation analysis showed no associations between R/L2D4D and outcome measures. Comparing calculated quartiles for R2D4D, subjects in the lowest R2D4D quartile expressed trendwise (p < 0.10) lower positive and higher negative affect, significantly elevated sAA activity (p < 0.05), but no HR and HRV differences at baseline as compared to subjects in the upper three quartiles. With regard to acute stress, subjects in the lowest as compared to subjects in the upper three R2D4D quartiles showed a higher increase of negative affect and a stronger cardiac response (p < 0.05), but no alterations in positive affect and sAA activity. Young healthy men in the lowest R2D4D quartile revealed a more negative affect and increased physiological activity at baseline and in response to acute stress. An exposure to high levels of prenatal T might constitute a risk factor potentially increasing vulnerability to stress-related disorders in men.
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Affiliation(s)
- A Walther
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.,Department of Biopsychology, Technical University Dresden, Dresden, Germany
| | - J Breidenstein
- Department of Biopsychology, Technical University Dresden, Dresden, Germany
| | - M Bösch
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.,Military Academy, ETH Zurich, Zurich, Switzerland
| | - S Sefidan
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.,Military Academy, ETH Zurich, Zurich, Switzerland
| | - U Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - H Annen
- Military Academy, ETH Zurich, Zurich, Switzerland
| | - T Wyss
- Swiss Federal Institute of Sport Magglingen (SFISM), Magglingen, Switzerland
| | - R La Marca
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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23
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Debus ES, Heidemann F, Gross-Fengels W, Mahlmann A, Muhl E, Pfister K, Roth S, Stroszczynski C, Walther A, Weiss N, Wilhelmi M, Grundmann RT. Kurzfassung S3-Leitlinie zu Screening, Diagnostik, Therapie und Nachsorge des Bauchaortenaneurysmas. Gefässchirurgie 2018. [DOI: 10.1007/s00772-018-0435-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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24
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Macintyre G, Goranova TE, De Silva D, Ennis D, Piskorz AM, Eldridge M, Sie D, Lewsley LA, Hanif A, Wilson C, Dowson S, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Paul J, Supernat A, Millan D, Hoyle A, Bryson G, Nourse C, Mincarelli L, Sanchez LN, Ylstra B, Jimenez-Linan M, Moore L, Hofmann O, Markowetz F, McNeish IA, Brenton JD. Copy number signatures and mutational processes in ovarian carcinoma. Nat Genet 2018; 50:1262-1270. [PMID: 30104763 PMCID: PMC6130818 DOI: 10.1038/s41588-018-0179-8] [Citation(s) in RCA: 239] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 06/19/2018] [Indexed: 01/22/2023]
Abstract
The genomic complexity of profound copy number aberrations has prevented effective molecular stratification of ovarian cancers. Here, to decode this complexity, we derived copy number signatures from shallow whole-genome sequencing of 117 high-grade serous ovarian cancer (HGSOC) cases, which were validated on 527 independent cases. We show that HGSOC comprises a continuum of genomes shaped by multiple mutational processes that result in known patterns of genomic aberration. Copy number signature exposures at diagnosis predict both overall survival and the probability of platinum-resistant relapse. Measurement of signature exposures provides a rational framework to choose combination treatments that target multiple mutational processes.
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Affiliation(s)
| | | | | | - Darren Ennis
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | | | - Daoud Sie
- VU University Medical Center, Amsterdam, the Netherlands
| | - Liz-Anne Lewsley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Aishah Hanif
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Cheryl Wilson
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Suzanne Dowson
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Michelle Lockley
- Barts Cancer Institute, Queen Mary University of London, London, UK
- University College London Hospital, London, UK
| | | | | | | | | | - Richard Edmondson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
- Department of Obstetrics and Gynaecology, Manchester Academic Health Science Centre, St Mary's Hospital, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | - Charlie Gourley
- Nicola Murray Centre for Ovarian Cancer Research, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | | | - Christina Fotopoulou
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College, London, UK
| | - Hani Gabra
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College, London, UK
- Early Clinical Development, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - James Paul
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Anna Supernat
- Cancer Research UK Cambridge Institute, Cambridge, UK
| | - David Millan
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Aoisha Hoyle
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Gareth Bryson
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Craig Nourse
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Laura Mincarelli
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Bauke Ylstra
- VU University Medical Center, Amsterdam, the Netherlands
| | | | | | - Oliver Hofmann
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Centre for Cancer Research, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Iain A McNeish
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College, London, UK.
| | - James D Brenton
- Cancer Research UK Cambridge Institute, Cambridge, UK.
- Addenbrooke's Hospital, Cambridge, UK.
- Department of Oncology, University of Cambridge, Cambridge, UK.
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25
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Macintyre G, Goranova TE, De Silva D, Ennis D, Piskorz AM, Eldridge M, Sie D, Lewsley LA, Hanif A, Wilson C, Dowson S, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Paul J, Supernat A, Millan D, Hoyle A, Bryson G, Nourse C, Mincarelli L, Sanchez LN, Ylstra B, Jimenez-Linan M, Moore L, Hofmann O, Markowetz F, McNeish IA, Brenton JD. Copy number signatures and mutational processes in ovarian carcinoma. Nat Genet 2018. [PMID: 30104763 DOI: 10.1038/s41588-018-0179-8]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The genomic complexity of profound copy number aberrations has prevented effective molecular stratification of ovarian cancers. Here, to decode this complexity, we derived copy number signatures from shallow whole-genome sequencing of 117 high-grade serous ovarian cancer (HGSOC) cases, which were validated on 527 independent cases. We show that HGSOC comprises a continuum of genomes shaped by multiple mutational processes that result in known patterns of genomic aberration. Copy number signature exposures at diagnosis predict both overall survival and the probability of platinum-resistant relapse. Measurement of signature exposures provides a rational framework to choose combination treatments that target multiple mutational processes.
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Affiliation(s)
| | | | | | - Darren Ennis
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | | | - Daoud Sie
- VU University Medical Center, Amsterdam, the Netherlands
| | - Liz-Anne Lewsley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Aishah Hanif
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Cheryl Wilson
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Suzanne Dowson
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Michelle Lockley
- Barts Cancer Institute, Queen Mary University of London, London, UK.,University College London Hospital, London, UK
| | | | | | | | | | - Richard Edmondson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK.,Department of Obstetrics and Gynaecology, Manchester Academic Health Science Centre, St Mary's Hospital, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | - Charlie Gourley
- Nicola Murray Centre for Ovarian Cancer Research, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | | | - Christina Fotopoulou
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College, London, UK
| | - Hani Gabra
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College, London, UK.,Early Clinical Development, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - James Paul
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Anna Supernat
- Cancer Research UK Cambridge Institute, Cambridge, UK
| | - David Millan
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Aoisha Hoyle
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Gareth Bryson
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Craig Nourse
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Laura Mincarelli
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Bauke Ylstra
- VU University Medical Center, Amsterdam, the Netherlands
| | | | | | - Oliver Hofmann
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.,Centre for Cancer Research, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Iain A McNeish
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK. .,Beatson West of Scotland Cancer Centre, Glasgow, UK. .,Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College, London, UK.
| | - James D Brenton
- Cancer Research UK Cambridge Institute, Cambridge, UK. .,Addenbrooke's Hospital, Cambridge, UK. .,Department of Oncology, University of Cambridge, Cambridge, UK.
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26
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Hoppler S, Walther A, La Marca-Ghaemmaghami P, Ehlert U. Lower birthweight and left-/mixed-handedness are associated with intensified age-related sex steroid decline in men. Findings from the Men's Health 40+ Study. Andrology 2018; 6:896-902. [PMID: 29993200 PMCID: PMC6585816 DOI: 10.1111/andr.12516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/29/2018] [Accepted: 05/26/2018] [Indexed: 11/29/2022]
Abstract
In males, age‐related decline in free testosterone (T) and dehydroepiandrosterone (DHEA) by 2–3% per year has been reported. Estradiol (E2) and progesterone (P) seem to decrease as well, but to a lesser extent. Lower sex steroid levels in men have been related to physical and mental symptoms. Low birthweight and left‐/mixed‐handedness (L/MH) are indicators of an adverse fetal environment during pregnancy, and both have been linked to morbidity in later life. The aim of this study is to examine the relationship between lower birthweight as well as L/MH and age‐related sex steroid decline. In a cross‐sectional study design, saliva samples were collected under standardized conditions from healthy men for subsequent steroid hormone analysis using standard luminescence immunoassays. T (M = 67.57 pg/mL), DHEA (M = 247.91 pg/mL), E2 (M = 1.29 pg/mL), and P (M = 28.20 pg/mL) have been quantified leading to a final sample of 256 men providing complete data on sex hormones (MAge=57.8; SDAge = 10.8). Information on participants’ birthweight was obtained from birth reports (N = 134), and participants were asked about their handedness (right‐handed, left‐handed, mixed‐handed) (N = 256). Multivariate‐adjusted linear regression models relating each sex hormone individually and the principal component of declining steroid hormones (DSH)—an integrated hormonal parameter—with handedness and birthweight did not identify significant associations except for handedness and E2. Moderation analysis using robust regression accounting for bias due to influential data points detected a significant association between age and DSH for handedness (β = −0.0314, p = 0.040) but only a trend for birthweight (β = 0.0309, p = 0.073). For lower birthweight, a trend toward intensified age‐related sex steroid decline in men was observed, while for L/MH, a significant association with intensified age‐related sex steroid decline was identified. These results indicate that L/MH and potentially also lower birthweight might be considered as early risk factors for endocrine health in later life.
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Affiliation(s)
- S Hoppler
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - A Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.,University Research Priority Program - Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.,Biological Psychology, TU Dresden, Dresden, Germany
| | | | - U Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.,University Research Priority Program - Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
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27
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Zollman C, Walther A, Seers HE, Jolliffe RC, Polley MJ. Integrative Whole-Person Oncology Care in the UK. J Natl Cancer Inst Monogr 2018; 2017:4617817. [PMID: 29140483 DOI: 10.1093/jncimonographs/lgx002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 08/04/2017] [Indexed: 11/13/2022] Open
Abstract
The term "whole-person cancer care"-an approach that addresses the needs of the person as well as treating the disease-is more widely understood in the United Kingdom than its synonym "integrative oncology." The National Health Service (NHS) provides free access to care for all, which makes it harder to prioritize NHS funding of whole-person medicine, where interventions may be multimodal and lacking in cost-effectiveness data. Despite this, around 30% of cancer patients are known to use some form of complementary or alternative medicine (CAM). This is virtually never medically led, and usually without the support or even the knowledge of their oncology teams, with the exception of one or two large cancer centers. UK oncology services are, however, starting to be influenced from three sides; first, by well-developed and more holistic palliative care services; second, by directives from central government via the sustainable health care agenda; and third, by increasing pressure from patient-led groups and cancer charities. CAM remains unlikely to be provided through the NHS, but nutrition, physical activity, mindfulness, and stress management are already becoming a core part of the NHS "Living With and Beyond Cancer" agenda. This supports cancer survivors into stratified pathways of care, based on individual, self-reported holistic needs and risk assessments, which are shared between health care professionals and patients. Health and well-being events are being built into cancer care pathways, designed to activate patients into self-management and support positive lifestyle change. Those with greater needs can be directed toward appropriate external providers, where many examples of innovative practice exist. These changes in policy and vision for the NHS present an opportunity for integrative oncology to develop further and to reach populations who would, in many other countries, remain underserved or hard to reach by whole-person approaches.
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Affiliation(s)
- Catherine Zollman
- Penny Brohn UK, Pill, Bristol, UK; Bristol Cancer Institute, University Hospitals Bristol, Bristol, UK; School of Medical Sciences, University of Bristol Cancer Theme, Bristol, UK; Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, UK
| | - Axel Walther
- Penny Brohn UK, Pill, Bristol, UK; Bristol Cancer Institute, University Hospitals Bristol, Bristol, UK; School of Medical Sciences, University of Bristol Cancer Theme, Bristol, UK; Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, UK
| | - Helen E Seers
- Penny Brohn UK, Pill, Bristol, UK; Bristol Cancer Institute, University Hospitals Bristol, Bristol, UK; School of Medical Sciences, University of Bristol Cancer Theme, Bristol, UK; Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, UK
| | - Rachel C Jolliffe
- Penny Brohn UK, Pill, Bristol, UK; Bristol Cancer Institute, University Hospitals Bristol, Bristol, UK; School of Medical Sciences, University of Bristol Cancer Theme, Bristol, UK; Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, UK
| | - Marie J Polley
- Penny Brohn UK, Pill, Bristol, UK; Bristol Cancer Institute, University Hospitals Bristol, Bristol, UK; School of Medical Sciences, University of Bristol Cancer Theme, Bristol, UK; Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, UK
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Yarmolinsky J, Walther A, Muir K, Lophatananon A, Relton C, Martin R, Lewis S. PO-068 Atlas of causal risk factors for epithelial ovarian cancer risk: a mendelian randomization analysis in up to 66 450 women. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.598] [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: 11/04/2022] Open
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Schønning A, Walther A, Machold S, Huse M. The Effects of Directors’ Exploratory, Transformative and Exploitative Learning on Boards’ Strategic Involvement: An Absorptive Capacity Perspective. European Management Review 2018. [DOI: 10.1111/emre.12186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Weller A, Walther A, Georgi R. Fiberoptische Intubation des spontan atmenden Patienten – Schritt für Schritt. Pneumologie 2017; 71:600-609. [PMID: 28859213 DOI: 10.1055/s-0042-123427] [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: 10/19/2022]
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31
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Leach VA, McGeagh JD, Margelyte R, Redmond NM, Walther A, Redwood S, Martin RM, Donovan JL. Facilitating access to health research through a participatory research register: a feasibility study in outpatient clinics. Pilot Feasibility Stud 2017. [PMID: 28649418 PMCID: PMC5480169 DOI: 10.1186/s40814-017-0148-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background A research register (Reach West) has been established to facilitate recruitment of people and patients to health-related research. We conducted a prospective feasibility study to investigate the practicality of recruiting through outpatient clinics. Methods Patients over 18 years of age attending dental, eye or oncology outpatient clinics in an acute hospital in the West of England were provided with the opportunity to participate in Reach West. In Phase I, recruitment packs were handed to clinic attendees who could place completed consent forms in secure drop-box or return them later on-line or by post. In Phase II, recruitment packs were posted directly to patients with consent forms to be returned by post or on-line. Response rates by age, sex, postcode (for level of deprivation), and clinic type were recorded for those agreeing to participate on paper or on-line. Results In Phase I, 2,314 of 4,500 (51.4%) of recruitment packs were handed out to clinic attendees, and 114 (5%) consented to join Reach West. In Phase II, 7,173 of 9000 packs were posted (79.7%), and 387 (5.4%) consented to participate. The overall consent rate was 6% (580), with the majority doing so on paper (87%) rather than on-line. The sample was balanced by sex, but mostly comprised people over 50 years located in less deprived postcodes. Non-staff costs for postal recruitment were lower than hand-outs in clinic (£6.84 compared with £8.05 per participant). Conclusions Recruiting participants to the Reach West register was feasible among those with oncology, dental or eye outpatient appointments by post or with packs given out in the clinic. Response rates were similar to those achieved for other registers. Recruitment of participants can be achieved through outpatient clinics but other strategies will also be required to attract large numbers of participants and more diverse populations.
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Affiliation(s)
- Verity A Leach
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, Whitefriars, Bristol, BS1 2NT UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK.,Department of Genetic Medicine, St Mary's Hospital, Oxford Road, Manchester, M13 9WL UK
| | - John D McGeagh
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, Whitefriars, Bristol, BS1 2NT UK
| | - Ruta Margelyte
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, Whitefriars, Bristol, BS1 2NT UK
| | - Niamh M Redmond
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, Whitefriars, Bristol, BS1 2NT UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Axel Walther
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Sabi Redwood
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, Whitefriars, Bristol, BS1 2NT UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Richard M Martin
- National Institute for Health Research Bristol Nutrition Biomedical Research Unit, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jenny L Donovan
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, Whitefriars, Bristol, BS1 2NT UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
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32
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Goranova T, Ennis D, Piskorz AM, Macintyre G, Lewsley LA, Stobo J, Wilson C, Kay D, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Freeman S, Moore L, Jimenez-Linan M, Paul J, Brenton JD, McNeish IA. Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma-experience of the BriTROC consortium. Br J Cancer 2017; 116:1294-1301. [PMID: 28359078 PMCID: PMC5482731 DOI: 10.1038/bjc.2017.86] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Investigating tumour evolution and acquired chemotherapy resistance requires analysis of sequential tumour material. We describe the feasibility of obtaining research biopsies in women with relapsed ovarian high-grade serous carcinoma (HGSC). METHODS Women with relapsed ovarian HGSC underwent either image-guided biopsy or intra-operative biopsy during secondary debulking, and samples were fixed in methanol-based fixative. Tagged-amplicon sequencing was performed on biopsy DNA. RESULTS We screened 519 patients in order to enrol 220. Two hundred and two patients underwent successful biopsy, 118 of which were image-guided. There were 22 study-related adverse events (AE) in the image-guided biopsies, all grades 1 and 2; pain was the commonest AE. There were pre-specified significant AE in 3/118 biopsies (2.5%). 87% biopsies were fit-for-purpose for genomic analyses. Median DNA yield was 2.87 μg, and was higher in biopsies utilising 14 G or 16 G needles compared to 18 G. TP53 mutations were identified in 94.4% patients. CONCLUSIONS Obtaining tumour biopsies for research in relapsed HGSC is safe and feasible. Adverse events are rare. The large majority of biopsies yield sufficient DNA for genomic analyses-we recommend use of larger gauge needles and methanol fixation for such biopsies, as DNA yields are higher but with no increase in AEs.
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Affiliation(s)
- T Goranova
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - D Ennis
- Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK
| | - A M Piskorz
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - G Macintyre
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - L A Lewsley
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - J Stobo
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - C Wilson
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - D Kay
- Department of Radiology, Gartnavel General Hospital, Glasgow G12 0YN, UK
| | - R M Glasspool
- Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK
| | - M Lockley
- Barts Cancer Institute, London EC1M 6BQ, UK
- University College Hospital, London WC1E 6BD, UK
| | | | - A Montes
- Guy’s Hospital, London SE1 9RT, UK
| | - A Walther
- Bristol Haematology and Oncology Centre, Bristol BS2 8ED, UK
| | - S Sundar
- City Hospital, Birmingham B18 7QH, UK
| | | | - G D Hall
- St James Hospital, Leeds LS9 7TF, UK
| | - A Clamp
- The Christie Hospital, Manchester M20 4BX, UK
| | - C Gourley
- Edinburgh Cancer Research Centre, Edinburgh EH4 2XR, UK
| | - M Hall
- Mount Vernon Cancer Centre, Northwood HA6 2RN, UK
| | | | - H Gabra
- Imperial College, London W12 0HS, UK
| | - S Freeman
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - L Moore
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | | | - J Paul
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - J D Brenton
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - I A McNeish
- Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK
- Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK
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Sundar S, Balega J, Crosbie E, Drake A, Edmondson R, Fotopoulou C, Gallos I, Ganesan R, Gupta J, Johnson N, Kitson S, Mackintosh M, Martin-Hirsch P, Miles T, Rafii S, Reed N, Rolland P, Singh K, Sivalingam V, Walther A. BGCS uterine cancer guidelines: Recommendations for practice. Eur J Obstet Gynecol Reprod Biol 2017; 213:71-97. [PMID: 28437632 DOI: 10.1016/j.ejogrb.2017.04.015] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022]
Abstract
The British Gynaecological Cancer Society has issued the first Endometrial (Uterine) Cancer guidelines as recommendation for practice for the UK.
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Affiliation(s)
- Sudha Sundar
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Janos Balega
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Emma Crosbie
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Alasdair Drake
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Richard Edmondson
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Christina Fotopoulou
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom.
| | - Ioannis Gallos
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Raji Ganesan
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Janesh Gupta
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Nick Johnson
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Sarah Kitson
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Michelle Mackintosh
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Pierre Martin-Hirsch
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Tracie Miles
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Saeed Rafii
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Nick Reed
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Phil Rolland
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Kavita Singh
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Vanitha Sivalingam
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
| | - Axel Walther
- British Gynaecological Cancer Society, C/O Williams Denton CYF, Bangor LL57 4FE, United Kingdom
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Heinen L, Walther A. Temporal control of i-motif switch lifetimes for autonomous operation of transient DNA nanostructures. Chem Sci 2017; 8:4100-4107. [PMID: 28580123 PMCID: PMC5439531 DOI: 10.1039/c7sc00646b] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/28/2017] [Indexed: 01/05/2023] Open
Abstract
System integration of the DNA i-motif switch with a tunable pH environment allows programmable lifetimes of DNA duplex hybridization and higher level self-assemblies in closed and autonomous systems.
Functional DNA nanotechnology creates increasingly complex behaviors useful for sensing, actuation or computation, as enabled via the integration of dynamic and responsive structural DNA motifs. However, temporally controlled and dynamic DNA structures with programmable lifetimes, that are able to operate autonomously and self-revert to the starting state are challenging to achieve due to tedious and very system-specific sequence design. Here, we present a straightforward concept to program transient lifetimes into DNA duplexes based on the pH-sensitive DNA i-motif switch. We integrate the i-motif switch with an internal, non-linear pH-resetting function using a rationally designed chemical reaction framework, by which the switch autonomously undergoes a complete “off–on–off”-cycle without the use of additional external triggers. The lifetime of the activated “on”-state (i.e. the hybridized state) can be systematically programmed over several hours. The system can be readily implemented into hybrid DNA structures on larger length scales. Focusing on autonomous materials, we demonstrate temporal control of transient fluorescence signals and temporary aggregation of gold nanoparticles.
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Affiliation(s)
- L Heinen
- Institute for Macromolecular Chemistry , University of Freiburg , Stefan-Meier-Str. 31 , 79104 Freiburg , Germany . .,Freiburg Materials Research Center , University of Freiburg , Stefan-Meier-Str. 21 , 79104 Freiburg , Germany.,Freiburg Center for Interactive Materials and Bioinspired Technologies , University of Freiburg , Georges-Köhler-Allee 105 , 79110 Freiburg , Germany
| | - A Walther
- Institute for Macromolecular Chemistry , University of Freiburg , Stefan-Meier-Str. 31 , 79104 Freiburg , Germany . .,Freiburg Materials Research Center , University of Freiburg , Stefan-Meier-Str. 21 , 79104 Freiburg , Germany.,Freiburg Center for Interactive Materials and Bioinspired Technologies , University of Freiburg , Georges-Köhler-Allee 105 , 79110 Freiburg , Germany
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Michael A, Lord R, Hall G, Hanna L, Anand A, Walther A, Nicum S, Clamp AR, Kristeleit RS, Hackshaw A, Parmar G, Ngai Y, Farrelly L, Essapen S, McNeish IA, Harrop R, Ledermann JA. TRIOC: A randomised parallel group double-blind phase II study to assess the activity of MVA-5T4 vaccine versus placebo in patients with relapsed asymptomatic epithelial ovarian, fallopian tube, or primary peritoneal cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.tps5604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Rosemary Lord
- The Clatterbridge Cancer Centre, Liverpool and Wirral, United Kingdom
| | - Geoff Hall
- St James's University Hospital, Leeds, United Kingdom
| | | | - Anjana Anand
- City Hospital Nottingham UK, Nottingham, United Kingdom
| | - Axel Walther
- University Hospitals Bristol, Bristol, United Kingdom
| | - Shibani Nicum
- Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | | | | | - Alan Hackshaw
- Cancer Research UK and UCL Cancer Trials Centre, London, United Kingdom
| | - Gita Parmar
- Cancer Research UK & UCL Cancer Trials Centre, London, United Kingdom
| | - Yen Ngai
- Cancer Research UK and UCL Cancer Trials Centre/UCL Cancer Institute, London, United Kingdom
| | - Laura Farrelly
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | | | - Iain A. McNeish
- Institute of Cancer Sciences, University of Glasgow, Glasgow, Scotland
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Leach V, Redwood S, Lasseter G, Walther A, Reid C, Blazeby J, Martin R, Donovan J. Research participation registers can increase opportunities for patients and the public to participate in health services research. J Health Serv Res Policy 2016; 21:183-7. [PMID: 26769574 DOI: 10.1177/1355819615625699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Members of the public and patients repeatedly indicate their willingness to take part in research, but current United Kingdom research governance involves complex rules about gaining consent. Research participation registers that seek consent from participants to be approached about future studies have several potential benefits, including: increased research participation across clinical and healthy populations; simplified recruitment to health care research; support for people's autonomy in decision making; and improved efficiency and generalizability of research. These potential benefits have to be balanced against ethical and governance considerations. With appropriate processes in place, seeking prospective consent from patients and members of the public to be approached about future studies could potentially increase public participation in health research without compromising informed consent and other ethical principles.
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Affiliation(s)
- Verity Leach
- School of Social & Community Medicine, University of Bristol, Bristol, UK NIHR CLAHRC West, Bristol, UK
| | - Sabi Redwood
- School of Social & Community Medicine, University of Bristol, Bristol, UK NIHR CLAHRC West, Bristol, UK
| | - Gemma Lasseter
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Axel Walther
- School of Social & Community Medicine, University of Bristol, Bristol, UK University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Colette Reid
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Jane Blazeby
- School of Social & Community Medicine, University of Bristol, Bristol, UK University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Richard Martin
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Jenny Donovan
- School of Social & Community Medicine, University of Bristol, Bristol, UK NIHR CLAHRC West, Bristol, UK
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Rösslein M, Bürkle H, Walther A, Stuck BA, Verse T. [Position Paper: Perioperative Management of Adult Patients with Obstructive Sleep Apnea in ENT Surgery]. Laryngorhinootologie 2015; 94:516-23. [PMID: 26243632 DOI: 10.1055/s-0035-1549926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder with an increasing prevalence. Affected individuals suffer from a repetitive partial or complete occlusion of the pharyngeal airway despite continued respiratory efforts leading to sleep fragmentation, abnormal gas exchange and significant cardiovascular and metabolic morbidity. Surgical patients with OSA, which in the majority of cases has not been diagnosed prior to surgery, have an increased risk of developing a variety of pulmonary, cardiovascular and other complications throughout the perioperative period. Certain actions may contribute to increase the safety of patients with OSA during this time. Among them are preoperatively, a timely recognition and assessment of OSA and potentially co-existing diseases, intraoperatively, the selection of an appropriate anaesthesia and monitoring technique, and postoperatively, the continuation of monitoring for an adequate period of time with the option of intensive care treatment. The actual clinical approach should follow the risk profile of the individual patient which is determined by OSA severity, invasiveness of the surgical procedure and requirement for postoperative opioids as well as the incidence of critical events in the early postoperative period. Initiated and mandated by the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery, and conceived on the basis of the available literature and existing guidelines, the following paper provides recommendations for the perioperative management of adult patients with OSA in ENT surgery.
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Affiliation(s)
- M Rösslein
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Freiburg
| | - H Bürkle
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Freiburg
| | - A Walther
- Klinik für Anästhesiologie und operative Intensivmedizin, Katharinenhospital, Klinikum Stuttgart
| | - B A Stuck
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen
| | - T Verse
- Abteilung für HNO-Heilkunde, Kopf- und Halschirurgie, Asklepios Klinikum Harburg
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Schulte B, Rahimi K, Keul H, Demco DE, Walther A, Möller M. Blending of reactive prepolymers to control the morphology and polarity of polyglycidol based microgels. Soft Matter 2015; 11:943-953. [PMID: 25515704 DOI: 10.1039/c4sm02116a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The compartmentalization of microgels is a challenging task for synthetic polymer chemistry. Although the complexation with low molecular weight compounds or the use of microfluidic techniques offer attractive possibilities for other length scales, it is difficult to implement compartments in the mesoscale range of 10-100 nm. Herein we show how simple blending of reactive prepolymers is suitable to design new microgel morphologies with tailored compartments. We use poly(EEGE)-block-poly(AGE) as crosslinkable, pro-hydrophilic prepolymer in blends with varying amounts of crosslinkable, yet hydrophobic poly(THF-stat-AllylEHO) or inert and hydrophobic polystyrene, and crosslink the allyl functional prepolymer(s) in a thiol-ene click-type reaction after miniemulsification. Our strategy shows how arrested versus free nanophase separation can be used to control easily the morphology and polarity of microgel particles.
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Affiliation(s)
- B Schulte
- DWI - Leibniz Institute for Interactive Materials and Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Forckenbeckstraße 50, D-52074 Aachen, Germany.
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Schmidt C, Zwingenberger S, Walther A, Reuter U, Kasten P, Seifert J, Günther KP, Stiehler M. Prevalence of Low Back Pain in Adolescent Athletes – an Epidemiological Investigation. Int J Sports Med 2014; 35:684-9. [DOI: 10.1055/s-0033-1358731] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- C. Schmidt
- Department of Orthopaedics, Trauma and Paraplegic, Klinik Bavaria Kreischa, Germany
| | - S. Zwingenberger
- Center for Orthopaedics and Traumatology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Germany
| | - A. Walther
- Center for Orthopaedics and Traumatology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Germany
| | - U. Reuter
- Center for Orthopaedics and Traumatology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Germany
| | - P. Kasten
- Center for Orthopaedics and Traumatology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Germany
| | - J. Seifert
- Center for Orthopaedics and Traumatology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Germany
| | - K.-P. Günther
- Center for Orthopaedics and Traumatology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Germany
| | - M. Stiehler
- Center for Orthopaedics and Traumatology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Germany
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Moorcraft SY, Chau I, Peckitt C, Cunningham D, Rao S, Yim KL, Walther A, Jackson CGCA, Stamp G, Webb J, Smith G, Gillbanks A, Swanton C. Patupilone in patients with pretreated metastatic/locally recurrent colorectal cancer: results of the Phase II CINATRA trial. Invest New Drugs 2013; 31:1339-44. [DOI: 10.1007/s10637-013-9990-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 06/12/2013] [Indexed: 01/09/2023]
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42
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Dunlop MG, Tenesa A, Farrington SM, Ballereau S, Brewster DH, Koessler T, Pharoah P, Schafmayer C, Hampe J, Völzke H, Chang-Claude J, Hoffmeister M, Brenner H, von Holst S, Picelli S, Lindblom A, Jenkins MA, Hopper JL, Casey G, Duggan D, Newcomb PA, Abulí A, Bessa X, Ruiz-Ponte C, Castellví-Bel S, Niittymäki I, Tuupanen S, Karhu A, Aaltonen L, Zanke B, Hudson T, Gallinger S, Barclay E, Martin L, Gorman M, Carvajal-Carmona L, Walther A, Kerr D, Lubbe S, Broderick P, Chandler I, Pittman A, Penegar S, Campbell H, Tomlinson I, Houlston RS. Cumulative impact of common genetic variants and other risk factors on colorectal cancer risk in 42,103 individuals. Gut 2013; 62:871-81. [PMID: 22490517 PMCID: PMC5105590 DOI: 10.1136/gutjnl-2011-300537] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Colorectal cancer (CRC) has a substantial heritable component. Common genetic variation has been shown to contribute to CRC risk. A study was conducted in a large multi-population study to assess the feasibility of CRC risk prediction using common genetic variant data combined with other risk factors. A risk prediction model was built and applied to the Scottish population using available data. DESIGN Nine populations of European descent were studied to develop and validate CRC risk prediction models. Binary logistic regression was used to assess the combined effect of age, gender, family history (FH) and genotypes at 10 susceptibility loci that individually only modestly influence CRC risk. Risk models were generated from case-control data incorporating genotypes alone (n=39,266) and in combination with gender, age and FH (n=11,324). Model discriminatory performance was assessed using 10-fold internal cross-validation and externally using 4187 independent samples. The 10-year absolute risk was estimated by modelling genotype and FH with age- and gender-specific population risks. RESULTS The median number of risk alleles was greater in cases than controls (10 vs 9, p<2.2 × 10(-16)), confirmed in external validation sets (Sweden p=1.2 × 10(-6), Finland p=2 × 10(-5)). The mean per-allele increase in risk was 9% (OR 1.09; 95% CI 1.05 to 1.13). Discriminative performance was poor across the risk spectrum (area under curve for genotypes alone 0.57; area under curve for genotype/age/gender/FH 0.59). However, modelling genotype data, FH, age and gender with Scottish population data shows the practicalities of identifying a subgroup with >5% predicted 10-year absolute risk. CONCLUSION Genotype data provide additional information that complements age, gender and FH as risk factors, but individualised genetic risk prediction is not currently feasible. Nonetheless, the modelling exercise suggests public health potential since it is possible to stratify the population into CRC risk categories, thereby informing targeted prevention and surveillance.
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Affiliation(s)
- Malcolm G Dunlop
- Colon Cancer Genetics Group, Institute of Genetics and Molecular Medicine, University of Edinburgh and MRC Human Genetics Unit, Edinburgh EH4 2XU, UK.
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Schiff JH, Köninger J, Teschner J, Henn-Beilharz A, Rost M, Dubb R, Danassis M, Walther A. Veno-venous extracorporeal membrane oxygenation (ECMO) support during anaesthesia for oesophagectomy. Anaesthesia 2013; 68:527-30. [DOI: 10.1111/anae.12152] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2012] [Indexed: 11/27/2022]
Affiliation(s)
- J. H. Schiff
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
| | - J. Köninger
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
| | - J. Teschner
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
| | - A. Henn-Beilharz
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
| | - M. Rost
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
| | - R. Dubb
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
| | - M. Danassis
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
| | - A. Walther
- Department of Anaesthesia and Intensive Care; Katharinen Hospital; Klinikum Stuttgart; Stuttgart; Germany
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Schmidt K, Doerr M, Brenner T, Hofer S, Walther A. Effect of cdp-choline on microcirculatory alterations during endotoxemia. Crit Care 2013. [PMCID: PMC3642794 DOI: 10.1186/cc11941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Di Dio DF, Grabner C, Walther A, Sittel C. ["Sudden dyspnea: case report of a important differential diagnosis in ENT-surgery"]. Laryngorhinootologie 2013; 92:406-8. [PMID: 23364861 DOI: 10.1055/s-0032-1333249] [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: 10/27/2022]
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Saur P, Roggenbach J, Meinl S, Klinger A, Stasche N, Martin E, Walther A. Ambulante Anästhesie bei Patienten mit obstruktivem Schlafapnoesyndrom. Somnologie 2012. [DOI: 10.1007/s11818-012-0563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McBride PJ, Schmidt KS, Pilewskie P, Walther A, Heidinger AK, Wolfe DE, Fairall CW, Lance S. CalNex cloud properties retrieved from a ship-based spectrometer and comparisons with satellite and aircraft retrieved cloud properties. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2012jd017624] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hernekamp JF, Harenberg PS, Lehnhardt M, Germann G, Walther A, Kremer T. [Microvascular effects of burn plasma transfer and therapeutic options in a rat model]. HANDCHIR MIKROCHIR P 2012; 44:209-19. [PMID: 22932853 DOI: 10.1055/s-0032-1321890] [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: 10/27/2022] Open
Abstract
INTRODUCTION Thermal injuries with more than 20% of burned body surface area (BSA) lead to systemic shock with generalised oedema in addition to local tissue destruction. This condition, known as burn injury, is caused by immunmodulative mediators whose individual significance is not known in detail. We present an experimental model where plasma of burned animals (burn plasma) is transmitted to healthy animals, to trigger burn iniury without performing direct burn trauma. MATERIAL AND METHODS The systemic oedema is measured by extravasation of fluorescent albumin in mesenterial venules of Wistar rats. In addition, leukocyte-endothelial interactions ("leukocyte rolling and sticking") is examined. RESULTS The systemic capillary leak is induced by both direct thermal trauma as well as by infusion of burn plasma. This is evident even after plasma dilution (1% in Ringer's lactate) of the burn plasma. In addition, topical therapy for burned animals (donors) with cerium nitrate led to a significant reduction of plasma extravasation in receiver animals. In addition, systemic antioxidant therapy with high-dose vitamin C of receiver animals, led to a significant reduction of the capillary leak. Leukocyte-endothelial interactions are not significantly affected in either case. CONCLUSION In summary, for the first time a reliable model of burn injury has been established, which eliminates mediator-independent effects. In addition, our studies show that antioxidant therapy with high doses of vitamin C and topical treatment with cerium nitrate both reduce the systemic capillary leak in receiver animals. Their positive influence could therefore soon be integrated in clinical treatment algorithms.
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Affiliation(s)
- J F Hernekamp
- BG Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische- und Rekonstruktive Chirurgie-Schwerbrandverletztenzentrum, Ludwigshafen
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Walther A, Ziesel F, Ruster T, Dawkins ST, Ott K, Hettrich M, Singer K, Schmidt-Kaler F, Poschinger U. Controlling fast transport of cold trapped ions. Phys Rev Lett 2012; 109:080501. [PMID: 23002727 DOI: 10.1103/physrevlett.109.080501] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Indexed: 06/01/2023]
Abstract
We realize fast transport of ions in a segmented microstructured Paul trap. The ion is shuttled over a distance of more than 10(4) times its ground state wave function size during only five motional cycles of the trap (280 μm in 3.6 μs). Starting from a ground-state-cooled ion, we find an optimized transport such that the energy increase is as low as 0.10±0.01 motional quanta. In addition, we demonstrate that quantum information stored in a spin-motion entangled state is preserved throughout the transport. Shuttling operations are concatenated, as a proof-of-principle for the shuttling-based architecture to scalable ion trap quantum computing.
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Affiliation(s)
- A Walther
- QUANTUM, Institut für Physik, Universität Mainz, Mainz, Germany
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Nili H, Walther A, Alink A, Kriegeskorte N. Testing within-category exemplar discriminability in pattern-information analysis. J Vis 2012. [DOI: 10.1167/12.9.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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