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Wu CJ, Pan KF, Chen JQ, Tao YC, Liu YC, Chen BR, Hsu C, Wang MY, Sheu BC, Hsiao M, Hua KT, Wei LH. Loss of LECT2 promotes ovarian cancer progression by inducing cancer invasiveness and facilitating an immunosuppressive environment. Oncogene 2024; 43:511-523. [PMID: 38177412 PMCID: PMC10857938 DOI: 10.1038/s41388-023-02918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Abstract
Leukocyte cell-derived chemotaxin 2 (LECT2) is a multifunctional cytokine that can bind to several receptors and mediate distinct molecular pathways in various cell settings. Changing levels of LECT2 have been implicated in multiple human disease states, including cancers. Here, we have demonstrated reduced serum levels of LECT2 in patients with epithelial ovarian cancer (EOC) and down-regulated circulating Lect2 as the disease progresses in a syngeneic mouse ID8 EOC model. Using the murine EOC model, we discovered that loss of Lect2 promotes EOC progression by modulating both tumor cells and the tumor microenvironment. Lect2 inhibited EOC cells' invasive phenotype and suppressed EOC's transcoelomic metastasis by targeting c-Met signaling. In addition, Lect2 downregulation induced the accumulation and activation of myeloid-derived suppressor cells (MDSCs). This fostered an immunosuppressive microenvironment in EOC by inhibiting T-cell activation and skewing macrophages toward an M2 phenotype. The therapeutic efficacy of programmed cell death-1 (PD-1)/PD-L1 pathway blockade for the ID8 model was significantly hindered. Overall, our data highlight multiple functions of Lect2 during EOC progression and reveal a rationale for synergistic immunotherapeutic strategies by targeting Lect2.
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Affiliation(s)
- Chin-Jui Wu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ke-Fan Pan
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Medical Education and Research, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of General Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Colorectal Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ji-Qing Chen
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03756, USA
| | - Yu -Chen Tao
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Cheng Liu
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Bo-Rong Chen
- Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan
| | - Ching Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Yang Wang
- Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan
| | - Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Michael Hsiao
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Kuo-Tai Hua
- Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
| | - Lin-Hung Wei
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Green BB, Anderson ML, McClure JB, Ehrlich K, Hall YN, Hansell L, Hsu C, Margolis KL, Munson SA, Thompson MJ. Is Hypertension Diagnostic Testing and Diagnosis Associated With Psychological Distress? Am J Hypertens 2024; 37:69-76. [PMID: 37688515 DOI: 10.1093/ajh/hpad083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/20/2023] [Accepted: 09/07/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Psychological impacts of hypertension diagnostic testing and new hypertension diagnoses are unclear. METHODS BP-CHECK was a randomized diagnostic study conducted in 2017-2019 in an integrated healthcare system. Participants with no hypertension diagnosis or medications and elevated blood pressure (BP) were randomized to one of three diagnostic regimens: (i) Clinic, (ii) Home, or (iii) Kiosk. Participants completed questionnaires at baseline, after completion of the diagnostic regimens, and at 6 months. Outcomes included changes from baseline in health-related quality of life (HRQOL), BP-related worry, and thoughts about having a stroke or heart attack. RESULTS Participants (n = 482) were mostly over age 50 (77.0%), and White race (80.3%). HRQOL did not significantly change from baseline to 3 weeks or 6 months. Among all participants, BP-related worry and concerns about having a heart attack or stroke increased significantly from baseline to 3 weeks, with heart attack and stroke concerns significantly higher in the Kiosk compared Clinic and Home groups. At 6 months, thoughts about having a heart attack or stroke returned to baseline overall and in the Kiosk group, however BP-related worry was significantly higher among those with, compared to those without, a new hypertension diagnosis. CONCLUSIONS The hypertension diagnostic process did not lead to short-term or intermediate-term changes in self-reported HRQOL. However, BP-related worry increased short-term and persisted at 6 months among individuals with a new hypertension diagnosis. Results warrant validation in more representative populations and additional exploration of the impacts of this worry on psychological well-being and hypertension control. CLINICALTRIALS.GOV IDENTIFIER NCT03130257.
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Affiliation(s)
- B B Green
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
- Washington Permanente Medical Group, Seattle, Washington, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California, USA
| | - M L Anderson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - J B McClure
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California, USA
| | - K Ehrlich
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Y N Hall
- VA Puget Sound Health Care System, Seattle, Washington, USA
| | - L Hansell
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - C Hsu
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - K L Margolis
- HealthPartners Institute, Minneapolis, Minnesota, USA
| | - S A Munson
- Department of Human Centered Design and Engineering, University of Washington, Seattle, Washington, USA
| | - M J Thompson
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
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El-Khoueiry AB, Trojan J, Meyer T, Yau T, Melero I, Kudo M, Hsu C, Kim TY, Choo SP, Kang YK, Yeo W, Chopra A, Soleymani S, Yao J, Neely J, Tschaika M, Welling TH, Sangro B. Nivolumab in sorafenib-naive and sorafenib-experienced patients with advanced hepatocellular carcinoma: 5-year follow-up from CheckMate 040. Ann Oncol 2023:S0923-7534(23)05115-3. [PMID: 38151184 DOI: 10.1016/j.annonc.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Patients with advanced hepatocellular carcinoma (aHCC) have a poor prognosis and high mortality. Nivolumab monotherapy demonstrated clinical benefit with an acceptable safety profile in patients with aHCC in the CheckMate 040 study. Five-year follow-up of the sorafenib-naive and sorafenib-experienced groups of CheckMate 040 is presented here. PATIENTS AND METHODS Patients received nivolumab monotherapy at dose levels of 0.1-10.0 mg/kg (dose-escalation phase) or 3 mg/kg (dose-expansion phase) every 2 weeks until disease progression or unacceptable toxicity. Primary endpoints were safety and tolerability (dose escalation), and objective response rate (ORR) by blinded independent central review (BICR) and by investigator as per RECIST version 1.1 (dose expansion). RESULTS Eighty sorafenib-naive and 154 sorafenib-experienced patients were treated. Minimum follow-up in both groups was 60 months. ORR as per BICR was 20% [95% confidence interval (CI) 12% to 30%] and 14% (95% CI 9% to 21%) in the sorafenib-naive and sorafenib-experienced groups, respectively. Responses occurred regardless of HCC etiology or baseline tumor cell programmed death-ligand 1 (PD-L1) expression levels. Median overall survival (OS) was 26.6 months (95% CI 16.6-30.6 months) and 15.1 months (95% CI 13.0-18.2 months) in sorafenib-naive and sorafenib-experienced patients, respectively. The 3-year OS rates were 28% in the sorafenib-naive and 20% in the sorafenib-experienced groups; 5-year OS rates were 14% and 12%, respectively. No new safety signals were identified; grade 3/4 treatment-related adverse events were observed in 33% and 21% of patients in the sorafenib-naive and sorafenib-experienced groups, respectively. Biomarker analyses showed that baseline PD-L1 expression ≥1% was associated with higher ORR and longer OS compared with PD-L1 <1%. In the sorafenib-naive group, patients with OS ≥3 years exhibited higher baseline CD8 T-cell density compared with those with OS <1 year. CONCLUSION With 5 years of follow-up, nivolumab monotherapy continued to provide durable clinical benefit with manageable safety in sorafenib-naive and sorafenib-experienced patients with aHCC.
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Affiliation(s)
- A B El-Khoueiry
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Los Angeles, USA.
| | - J Trojan
- Department of Medicine, Goethe University Hospital and Cancer Center, Frankfurt, Germany
| | - T Meyer
- Department of Oncology, Royal Free Hospital, London, UK
| | - T Yau
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - I Melero
- Department of Immunology, Clinica Universidad de Navarra and CIBERONC, Pamplona, Spain
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - C Hsu
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei; Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - T-Y Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - S-P Choo
- Division of Medical Oncology, National Cancer Center and Curie Oncology, Singapore, Republic of Singapore
| | - Y-K Kang
- Department of Oncology, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - W Yeo
- Department of Clinical Oncology, Chinese University of Hong Kong, Hong Kong, China
| | - A Chopra
- Department of Medical Oncology, Johns Hopkins Singapore International Medical Centre, Singapore, Republic of Singapore
| | - S Soleymani
- Global Biometrics & Data Sciences, Bristol Myers Squibb, Princeton
| | - J Yao
- Informatics and Predictive Sciences, Bristol Myers Squibb, Princeton
| | - J Neely
- Translational Medicine, Bristol Myers Squibb, Princeton
| | - M Tschaika
- Oncology Clinical Development, Bristol Myers Squibb, Princeton
| | - T H Welling
- Perlmutter Cancer Center and Department of Surgery, NYU Langone Health, New York, USA
| | - B Sangro
- Liver Unit and HPB Oncology Area, Clinica Universidad de Navarra and CIBEREHD, Pamplona, Spain
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Garrido C, Manoogian M, Ghambire D, Lucas S, Karnoub M, Olson MT, Hicks DG, Tozbikian G, Prat A, Ueno NT, Modi S, Feng W, Pugh J, Hsu C, Tsurutani J, Cameron D, Harbeck N, Fang Q, Khambata-Ford S, Liu X, Inge LJ, Vitazka P. Analytical and clinical validation of PATHWAY Anti-HER-2/neu (4B5) antibody to assess HER2-low status for trastuzumab deruxtecan treatment in breast cancer. Virchows Arch 2023:10.1007/s00428-023-03671-x. [PMID: 37857998 DOI: 10.1007/s00428-023-03671-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
In DESTINY-Breast04 (DB-04), safety and efficacy of HER2-targeted antibody-drug conjugate (ADC) trastuzumab deruxtecan (T-DXd) in previously treated HER2-low unresectable/metastatic breast cancer were established. This manuscript describes the analytical validation of PATHWAY Anti-HER2/neu (4B5) Rabbit Monoclonal Primary Antibody (PATHWAY HER2 (4B5)) to assess HER2-low status and its clinical performance in DB-04. Preanalytical processing and tissue staining parameters were evaluated to determine their impact on HER2 scoring. The recommended antibody staining procedure provided the optimal tumor staining, and deviations in cell conditioning and/or antibody incubation times resulted in unacceptable negative control staining and/or HER2-low status changes. Comparisons between antibody lots, kit lots, instruments, and day-to-day runs showed overall percent agreements (OPAs) exceeding 97.9%. Inter-laboratory reproducibility showed OPAs of ≥97.4% for all study endpoints. PATHWAY HER2 (4B5) was utilized in DB-04 for patient selection using 1340 tumor samples (59.0% metastatic, 40.7% primary, (0.3% missing data); 74.3% biopsy, 25.7% resection/excisions). Overall, 77.6% (823/1060) of samples were HER2-low by both central and local testing, with the level of concordance differing by sample region of origin and collection date. In DB-04, the efficacy of T-DXd over chemotherapy of physician's choice was consistent, regardless of the characteristics of the sample used (primary or metastatic, archival, or newly collected, biopsy or excision/resection). These results demonstrate that PATHWAY HER2 (4B5) is precise and reproducible for scoring HER2-low status and can be used with multiple breast cancer sample types for reliably identifying patients whose tumors have HER2-low expression and are likely to derive clinical benefit from T-DXd.
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Affiliation(s)
| | | | | | | | | | | | - David G Hicks
- The University of Rochester Medical Center, Rochester, USA
| | - Gary Tozbikian
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Aleix Prat
- Department of Medical Oncology, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Naoto T Ueno
- University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Shanu Modi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Ching Hsu
- Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - Junji Tsurutani
- The Innovative Center of Translational Research and Clinical Science for Cancer Therapy, Showa University Hospital, Tokyo, Japan
| | - David Cameron
- University of Edinburgh Cancer Centre, Institute of Genetics and Cancer, Edinburgh, UK
| | - Nadia Harbeck
- Breast Center, Depart of OB&GYN and CCC Munich, LMU University Hospital, Munich, Germany
| | - Qijun Fang
- Roche Tissue Diagnostics, Tucson, AZ, USA
| | | | - Xuemin Liu
- Roche Tissue Diagnostics, Tucson, AZ, USA
| | | | - Patrik Vitazka
- Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
- Teva Pharmaceuticals, Parsippany, NJ, USA
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5
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Huang RYJ, Huang KJ, Chen KC, Hsiao SM, Tan TZ, Wu CJ, Hsu C, Chang WC, Pan CY, Sheu BC, Wei LH. Immune-Hot tumor features associated with recurrence in early-stage ovarian clear cell carcinoma. Int J Cancer 2023; 152:2174-2185. [PMID: 36629283 DOI: 10.1002/ijc.34428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/03/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
Ovarian clear cell carcinoma (OCCC) is a distinct histotype of ovarian cancer, which usually presages a worse prognosis upon recurrence. Identifying patients at risk for relapse is an unmet need to improve outcomes. A retrospective cohort analysis of 195 early-stage OCCC patients diagnosed between January 2011 and December 2019 at National Taiwan University Hospital was conducted to identify prognostic factors for recurrence, progression-free survival (PFS) and overall survival (OS). Molecular profiling of tumors was performed in a case-controlled cohort matched for adjuvant therapy for biomarker discovery. Multivariate Cox proportional hazard model revealed that paclitaxel-based chemotherapy was associated with better PFS than nonpaclitaxel chemotherapy (HR = 0.19, P = .006). The addition of bevacizumab was associated with better PFS, compared to no bevacizumab (HR = 0.09, P = .02). Neither showed significant improvement in OS. Recurrence is associated with an Immune-Hot tumor feature (P = .03), the CTLA-4-high subtype (P = .01) and increased infiltration of immune cells in general. The Immune-Hot feature (HR = 3.39, P = .005) and the CTLA-4-high subtype (HR = 2.13, P = .059) were associated with worse PFS. Immune-Hot tumor features could prognosticate recurrence in early-stage OCCC.
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Affiliation(s)
- Ruby Yun-Ju Huang
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Hospital Yunlin Branch, Douliu City, Taiwan
| | - Ko-Chen Chen
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Tuan Zea Tan
- Cancer Science Institute of Singapore, National University of Singapore, Center for Translational Medicine, Singapore
| | - Chin-Jui Wu
- National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Ching Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chen-Yu Pan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
| | - Lin-Hung Wei
- Department of Obstetrics and Gynecology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, Taiwan
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Schmid-Grendelmeier P, Rapelanoro Rabenja F, Beshah AM, Ball MD, Dlova N, Faye O, Flohr C, Hsu C, Mavura D, Manuel RC, Ramarozatovo LS, Sendrasoa F, Wollenberg A, Ruiz Postigo JA, Taïeb A. How to integrate atopic dermatitis in the management of skin neglected tropical diseases in Sub-Saharan Africa? J Eur Acad Dermatol Venereol 2023; 37. [PMID: 37016962 DOI: 10.1111/jdv.19096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023]
Affiliation(s)
- P Schmid-Grendelmeier
- International Society of Atopic Dermatitis, Davos, Switzerland
- World Allergy Organization, Milwaukee, Wisconsin, USA
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | | | - A M Beshah
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - M D Ball
- University of Nouakchott, Nawakshut, Mauritania
| | - N Dlova
- University of KwaZulu-Natal, Durban, South Africa
| | - O Faye
- Department of Dermatology, Faculty of Medicine and Odontostomatology, Bamako, Mali
| | - C Flohr
- International League of Dermatological Societies, London, UK
- St John's Institute of Dermatology, King's College London and Guy's & St Thomas'Hospitals, London, UK
| | - C Hsu
- University Hospital, Basel, Switzerland
| | - D Mavura
- Regional Dermatology Training Centre, Moshi, Tanzania
| | - R C Manuel
- Central Hospital of Maputo, Maputo, Mozambique
| | - L S Ramarozatovo
- Department of Dermatology, Antananarivo University, Antananarivo, Madagascar
| | - F Sendrasoa
- Department of Dermatology, Antananarivo University, Antananarivo, Madagascar
| | - A Wollenberg
- International Society of Atopic Dermatitis, Davos, Switzerland
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian University, Munich, Germany
- Department of Dermatology, Free University Brussels, University Hospital Brussels, Brussels, Belgium
| | | | - A Taïeb
- International Society of Atopic Dermatitis, Davos, Switzerland
- INSERM U 1312, University of Bordeaux, Bordeaux, France
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Huang YY, Cheng PC, Hsu C, Jeng YM, Wei LH, Hung WT. Abstract 129: Determine the genetic similarity of synchronous endometrial and ovarian cancers with variants in polyguanine sequences. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-129] [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: 04/07/2023]
Abstract
Abstract
Endometrial and ovarian cancers are both fearsome gynecological diseases with high mortality rates worldwide. Due to their histological similarity, it is still a clinical challenge to distinguish between double primary cancer (DPC) and metastasis cancer (MC) in synchronous endometrial and ovarian cancers in which the latter represents a poor prognostic outcome. Clinically, the standard procedure for examining DPC and MC relies on their morphology and histopathology; however, showing poor accuracy even under explicating criteria. Here, we attempt to utilize indel variants within polyguanine (polyG) sequences to generate genetic distances of synchronous endometrial and ovarian tumors to normal tissue in a patient and then calculate the correlation coefficient for them. Polyguanine sequences are hypermutable guanine repeats that acquire insertion or deletion at a high incident rate (mutation rate: ~10-6 - 10-4; ~1000 folds higher than unique sequence) and, therefore, could serve as a very rich resource for comparing the genetic similarity between samples. The correlation between selected clinical variables, e.g., disease-free survival and the described correlation coefficient is then calculated to test whether this protocol can serve as an optimal tool for distinguishing between DPC and MC. We have assembled a cohort of 39 patients with synchronous endometrial and ovarian cancers in which pathologists cannot determine the relationship between endometrial and ovarian cancer in 23 of them. Preliminarily, we have collected DNA from formalin-fixed paraffin-embedded (FFPE) specimens and completed polyG genotyping for four of them. Indel variants, both insertions and deletions, are rich in all cases indicating the approach is technically rigid for this purpose even with FFPE specimens. Subsequently, we evaluate the similarity between endometrial and ovarian cancer by calculating Spearman's correlation with the genetic distances obtained from polyG genotyping. As the result of preliminary cases, we observe the correlation coefficient spreading between -0.14 to 0.95, implying this methodology can determine the genetic similarity between endometrial and ovarian tumor in a case and, therefore, could be a potential tool to supplement the current observation-based approach in the clinic. Our next step is to correlate the correlation coefficients with meaningful clinical variables once we complete genotyping the entire cohort. We anticipate this approach could provide additional information to distinguish DPC and MC and therefore benefit the patients.
Citation Format: Yu-Yi Huang, Pei-Chi Cheng, Ching Hsu, Yung-Ming Jeng, Lin-Hung Wei, Wei-Ting Hung. Determine the genetic similarity of synchronous endometrial and ovarian cancers with variants in polyguanine sequences [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 129.
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Affiliation(s)
| | | | - Ching Hsu
- 1National Taiwan University, Taipei, Taiwan
| | - Yung-Ming Jeng
- 2National Taiwan University College of Medicine, Taipei, Taiwan
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Zahir H, Yin O, Hsu C, Wagner AJ, Jiang J, Wang X, Greenberg J, Shuster DE, Kakkar T, LaCreta F. Dosing Recommendation Based on the Effects of Different Meal Types on Pexidartinib Pharmacokinetics in Healthy Subjects: Implementation of Model-informed Drug Development Strategy. Clin Pharmacol Drug Dev 2023; 12:475-483. [PMID: 36942508 DOI: 10.1002/cpdd.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/03/2023] [Indexed: 03/23/2023]
Abstract
Pexidartinib, an oral small molecule inhibitor of the colony-stimulating factor 1 receptor, is approved for treatment of adults with symptomatic tenosynovial giant cell tumor associated with severe morbidity or functional limitations and not amenable to improvement with surgery. The original dosing regimen is 400 mg of pexidartinib (2 × 200-mg capsules) twice daily, administered on an empty stomach at least 1 hour before or 2 hours after a meal or snack. Because pexidartinib is likely to be taken over an extended period of time, the ability to take pexidartinib with a meal would simplify timing of administration and potentially improve compliance. Since administering 400 mg of pexidartinib with a low-fat meal increases exposure by ≈60% relative to the fasted state, administering 250 mg of pexidartinib with a low-fat meal (low-fat meal dosing regimen) was predicted to achieve an exposure similar to 400 mg administered during a fasted state (original dosing regimen). Based on clinical trial simulations with two one-sided t-tests and bootstrapping (ie, resampling) analyses, a bioequivalence study (n = 24) would have >90% power to conclude that the original dosing regimen (400 mg fasted twice daily) and the low-fat meal dosing regimen (250 mg with a low-fat meal twice daily) are bioequivalent. This report provides the outcome of the implementation of the model-informed drug development strategy to recommend and justify a low-fat meal dosing regimen for pexidartinib that has the potential to improve patient compliance while maintaining drug exposure.
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Affiliation(s)
- Hamim Zahir
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | - Ophelia Yin
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | - Ching Hsu
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | | | - Jason Jiang
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | - Xiaoning Wang
- Metrum Research Group, Tariffville, Connecticut, USA
| | - Jon Greenberg
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
| | | | | | - Frank LaCreta
- Daiichi Sankyo, Inc., Basking Ridge, New Jersey, USA
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Yang JCH, Su WC, Chiu CH, Shiah HS, Lee KY, Hsia TC, Uno M, Crawford N, Terakawa H, Chen WC, Takayama G, Hsu C, Hong Y, Saintilien C, McGill J, Chang GC. Evaluation of combination treatment with DS-1205c, an AXL kinase inhibitor, and osimertinib in metastatic or unresectable EGFR-mutant non-small cell lung cancer: results from a multicenter, open-label phase 1 study. Invest New Drugs 2023; 41:306-316. [PMID: 36892745 PMCID: PMC10140009 DOI: 10.1007/s10637-023-01341-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/15/2023] [Indexed: 03/10/2023]
Abstract
The objective of this study was to evaluate the safety and tolerability of DS-1205c, an oral AXL-receptor inhibitor, in combination with osimertinib in metastatic or unresectable EFGR-mutant non-small cell lung cancer (NSCLC) patients who developed disease progression during EGFR tyrosine kinase inhibitor (TKI) treatment. An open-label, non-randomized phase 1 study was conducted in Taiwan, in which 13 patients received DS-1205c monotherapy at a dosage of 200, 400, 800, or 1200 mg twice daily for 7 days, followed by combination treatment with DS-1205c (same doses) plus osimertinib 80 mg once daily in 21-day cycles. Treatment continued until disease progression or other discontinuation criteria were met. At least one treatment-emergent adverse event (TEAE) was reported in all 13 patients treated with DS-1205c plus osimertinib; with ≥ 1 grade 3 TEAE in 6 patients (one of whom also had a grade 4 increased lipase level), and 6 patients having ≥ 1 serious TEAE. Eight patients experienced ≥ 1 treatment-related AE (TRAE). The most common (2 cases each) were anemia, diarrhea, fatigue, increased AST, increased ALT, increased blood creatinine phosphokinase, and increased lipase. All TRAEs were non-serious, with the exception of an overdose of osimertinib in 1 patient. No deaths were reported. Two-thirds of patients achieved stable disease (one-third for > 100 days), but none achieved a complete or partial response. No association between AXL positivity in tumor tissue and clinical efficacy was observed. DS-1205c was well-tolerated with no new safety signals in patients with advanced EGFR-mutant NSCLC when administered in combination with the EFGR TKI osimertinib. ClinicalTrials.gov ; NCT03255083.
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Affiliation(s)
- James Chih-Hsin Yang
- National Taiwan University Cancer Center, No. 57, Ln. 155, Sec. 3, Keelung Rd., Da'an Dist., Taipei City, 106, Taiwan.
| | - Wu-Chou Su
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chao-Hua Chiu
- Taipei Cancer Center and Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Her-Shyong Shiah
- Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kang-Yun Lee
- Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan
| | - Te-Chun Hsia
- China Medical University Hospital, Taichung, Taiwan
| | | | | | | | | | | | - Ching Hsu
- Daiichi Sankyo Inc., Basking Ridge, NJ, USA
| | - Ying Hong
- Daiichi Sankyo Inc., Basking Ridge, NJ, USA
| | | | | | - Gee-Chen Chang
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Li YX, Huang KJ, Hsu C, Sheu BC, Chang WC. A method of laparoscopic treatment of large adnexal cysts - Two port trocar suction. Taiwan J Obstet Gynecol 2023; 62:286-290. [PMID: 36965897 DOI: 10.1016/j.tjog.2022.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 03/27/2023] Open
Abstract
OBJECTIVE The size of the adnexal cyst is a limitation to perform laparoscopic adnexal surgery. Large adnexal cysts may constrain the surgery space and may increase the risk of inadvertent cyst rupture during the surgery. Here, we offer a method to solve the difficulty in laparoscopic management of large adnexal cysts. MATERIALS AND METHODS This is a retrospective study of 43 patients with large (≧10 cm) adnexal cysts, managed laparoscopically at one center from October 2016 to October 2019. All the surgeries were performed by an experienced laparoscopic surgeon. Malignancy was excluded before the surgeries according to the sonographic features. Cystectomy or salpingo-oophorectomy was decided according to the age, the sonographic pattern of the cyst and the patients' willingness. A 2 cm vertical incision was made at the umbilicus, and an open laparoscopy method was used to enter the peritoneal cavity. A wound protector was applied with a glove and two trocars being set up. The second wound was made at the left abdomen, and a 5 mm trocar was inserted. Then the cyst was punctured by means of the 5 mm trocar, and the content of the cyst was then soon aspirated by means of the air-flow hole of the trocar. Afterward, cystectomy or salpingo-oophorectomy was performed. Data are expressed as mean ± standard deviation unless stated otherwise. RESULTS The mean operative duration was 54.7 ± 33.4 min, and the result was shorter than the previous study (P < 0.05, CI (-32.92, -12.38)) according to one sample t-test. Most estimated blood loss (EBL) was minimum. No obvious complication was found. CONCLUSION Two-port trocar suction in laparoscopic management of large adnexal cysts is feasible after proper evaluation, and it takes short operative time.
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Affiliation(s)
- Ying-Xuan Li
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Ju Huang
- National Taiwan University Hospital Yunlin Branch, Taiwan
| | - Ching Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Prat A, Modi S, Tsurutani J, Cameron D, Harbeck N, Garrido C, Karnoub M, Hsu C, Feng W, Yung L, Wang Y, Gambhire D, Ford SK, Vitazka P, Ueno NT. Abstract HER2-18: HER2-18 Determination of HER2-low status in tumors of patients with unresectable and/or metastatic breast cancer in DESTINY-Breast04. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-her2-18] [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: 03/06/2023]
Abstract
Abstract
Background In DESTINY-Breast04, the HER2-targeted antibody drug conjugate trastuzumab deruxtecan (T-DXd) demonstrated significant survival benefit vs treatment of physician’s choice (TPC) in patients (pts) with HER2-low unresectable or metastatic breast cancer (mBC) (Modi et al. N Engl J Med 2022). These results emphasize the importance of accurately identifying HER2 expression in breast tumor tissue. Here, we describe concordance between previously determined (historical) HER2 scores and central HER2 scores, and tumor sample characteristics for pts with mBC screened and enrolled in DESTINY-Breast04. Methods DESTINY-Breast04 was a randomized, open-label, phase 3 study in pts with centrally determined HER2-low (immunohistochemistry [IHC] 1+ or IHC 2+ with negative in situ hybridization [ISH]) mBC who had previously received 1-2 lines of chemotherapy. Pts were randomized 2:1 to T-DXd or TPC. HER2 scores were determined via central testing of tumor specimens by the investigational Ventana PATHWAY 4B5 IHC assay, using the 2018 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) testing guidelines HER2 scoring algorithm, and Ventana INFORM HER2 dual ISH assay (as applicable). Results 1340 pts identified as having HER2-low mBC per historical data submitted tumor samples for central HER2-low testing. Of those, 557 pts met all eligibility criteria and were enrolled in DESTINY-Breast04. The proportion of samples from metastatic vs primary tumors was 59% vs 41% for all submitted tumor samples and 65% vs 35% for enrolled patients. Of those with available data, most were biopsy specimens (995 [74%] vs 344 [26%] resection/excisions) and were submitted as archived formalin-fixed, paraffin-embedded tissue (1183 [88%] vs 157 [12%] freshly collected samples); historical testing dates ranged from 2000-2020. Of samples with data on the historical HER2 IHC test used (31%), most were scored using local Ventana 4B5 (63%) or Agilent HercepTest (32%) assays. Tumor distribution characteristics were similar between screened and enrolled pts. For samples with historical and central HER2 results (N = 1108), 849/1108 (77%) were centrally scored as HER2-low. Of the samples that were not centrally scored as HER2-low, 88% were scored as HER2 IHC 0. Historical and central HER2 score concordance was assessed by sample region of origin (North America, Europe, China, or Asia without China) and collection date (2013 or earlier, 2104-2018, or 2019 or after) and scoring agreement was associated with these factors. Efficacy of T-DXd vs TPC for pts in DESTINY-Breast04 was consistent across all tumor sample characteristics (primary vs metastatic, specimen type, archival vs fresh, and tissue collection date). Conclusions Despite the lack of prior clinical utility and training in distinguishing HER2 IHC 0 from HER2-low (IHC 1+, 2+/ISH–), evolving guidelines since historical HER2 status provision, differences in local testing methods, and differences in key sample characteristics (primary vs metastatic; archived vs fresh; widely variable sample biopsy and testing dates), there was a 77% agreement between historical and central HER2-low status using the Ventana PATHWAY 4B5 IHC assay and Ventana INFORM HER2 Dual ISH assay. This rate is comparable to the reported initial concordance rates for HER2 overexpression IHC testing (range 74-82%; Roche J. Natl Cancer Inst 2002, Perez. J Clin Oncol 2006). Moreover, consistent benefit of T-DXd vs TPC was generally seen across patient groups with various tumor sample characteristics in DESTINY-Breast04. Determination of HER2-low status using the Ventana PATHWAY 4B5 IHC assay (and ISH when applicable) demonstrated the ability of the test, analyzed by pathologists using current ASCO/CAP guidelines, to identify pts who benefit from T-DXd. Funding This study was funded by Daiichi Sankyo and AstraZeneca.
Citation Format: Aleix Prat, Shanu Modi, Junji Tsurutani, David Cameron, Nadia Harbeck, Charo Garrido, Maha Karnoub, Ching Hsu, Wenquin Feng, Lotus Yung, Yibin Wang, Dhiraj Gambhire, Shirin K. Ford, Patrik Vitazka, Naoto T. Ueno. HER2-18 Determination of HER2-low status in tumors of patients with unresectable and/or metastatic breast cancer in DESTINY-Breast04 [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr HER2-18.
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Affiliation(s)
| | - Shanu Modi
- 2Memorial Sloan Cancer Center, New York, NY
| | - Junji Tsurutani
- 3Advanced Cancer Translational Research Institute at Showa University, Tokyo, Shinagawa, Japan
| | - David Cameron
- 4Edinburgh University Cancer Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Maha Karnoub
- 7Daiichi Sankyo, Inc., Basking Ridge, NJ, New Jersey, USA
| | - Ching Hsu
- 8Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | - Wenquin Feng
- 9Daiichi Sankyo, Inc., Basking Ridge, NJ, New Jersey USA
| | - Lotus Yung
- 10Daiichi Sankyo, Inc., Basking Ridge, NJ, New Jersey, USA
| | - Yibin Wang
- 11Daiichi Sankyo, Inc., Basking Ridge, NJ, New Jersey, USA, Basking Ridge
| | | | - Shirin K. Ford
- 13Daiichi Sankyo, Inc., Basking Ridge, NJ, New Jersey, USA
| | - Patrik Vitazka
- 14Daiichi Sankyo, Inc., Basking Ridge, NJ, New Jersey, USA
| | - Naoto T. Ueno
- 15The University of Texas MD Anderson Cancer Center, Houston, TX, Texas, USA, Houston
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Zahir H, Greenberg J, Hsu C, Watanabe K, Makino C, He L, LaCreta F. Pharmacokinetics of the Multi-kinase Inhibitor Pexidartinib: Mass Balance and Dose Proportionality. Clin Pharmacol Drug Dev 2023; 12:159-167. [PMID: 36369799 PMCID: PMC10099993 DOI: 10.1002/cpdd.1186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/22/2022] [Indexed: 11/15/2022]
Abstract
Pexidartinib is an oral small-molecule tyrosine kinase inhibitor that selectively targets colony-stimulating factor 1 receptor. Two phase 1 single-center trials were conducted in healthy subjects to determine the absorption, distribution, metabolism, and excretion of pexidartinib using radiolabeled drug and to assess the dose proportionality of pexidartinib following single oral doses. In the mass balance study, eight male subjects received a single oral dose of [14 C]-pexidartinib 400 mg with radioactivity assessed in plasma, urine, and feces samples taken at various timepoints postdose. In the dose-proportionality study, 18 subjects received single doses of pexidartinib 200, 400, and 600 mg using randomization sequences. Peak pexidartinib and total radioactivity were observed at 1.75-2.0 hours after the oral dose and then declined in a multiphasic manner. The overall mean recovery of administered radioactivity was 92.2% over 240 hours with 64.8% in the feces and 27.4% in the urine. Major components detected in plasma were pexidartinib and glucuronide (M5, ZAAD-1006a), with M5 and pexidartinib detected in urine and feces, respectively. A glucuronide of dealkylated form (M1) in the urine and multiple oxidized forms (M2, M3, and M4) in feces were detected. The dose-proportionality study found dose-proportional drug exposure between the 200- and 400-mg doses and slightly less than proportional exposure between the 400- and 600-mg doses. These results from these studies provide insight into pexidartinib disposition after oral administration and support the development of dosing guidance in subjects with renal or hepatic impairment or subjects taking cytochrome P450 3A and uridine disphosphate-glucuronosyl transferase inhibitors and inducers.
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Affiliation(s)
- Hamim Zahir
- Daiichi Sankyo, Inc, Basking Ridge, New Jersey, USA
| | | | - Ching Hsu
- Daiichi Sankyo, Inc, Basking Ridge, New Jersey, USA
| | | | | | - Ling He
- Daiichi Sankyo, Inc, Basking Ridge, New Jersey, USA
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Yang M, Hsu C. 544 Incontinentia pigmenti in a male infant and a proposed diagnostic algorithm. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.559] [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: 11/19/2022]
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Lin Y, Lee Y, Chang Y, Huang H, Hong Y, Aala W, Tu W, Tsai M, Chou Y, Hsu C. 312 Genetic Diagnosis of Rubinstein–Taybi Syndrome With Multiplex Ligation-Dependent Probe Amplification (MLPA) and Whole-Exome Sequencing (WES): Case Series With a Novel CREBBP Variant. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.324] [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: 11/19/2022]
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Ren Z, Li Z, Zhang T, Fang W, Hu S, Pan H, Yen C, Hou J, Chen Y, Shao G, Hsu C, Bai Y, Meng Z, Hou M, Xie C, Liu Y, Wu J, Li B, Chica-Duque S, Cheng A. P-25 Tislelizumab monotherapy for patients with previously treated advanced hepatocellular carcinoma (HCC): RATIONALE-208 Chinese subpopulation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.116] [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: 11/01/2022] Open
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Melero I, Yau T, Kang Y, Kim T, Santoro A, Sangro B, Kudo M, Hou M, Matilla A, Tovoli F, Knox J, He A, El-Rayes B, Acosta-Rivera M, Lim H, Soleymani S, Yao J, Neely J, Tschaika M, Hsu C, El-Khoueiry A. SO-12 Nivolumab (NIVO) plus ipilimumab (IPI) combination therapy in patients with advanced hepatocellular carcinoma (aHCC): 5-year results from CheckMate 040. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.411] [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: 11/01/2022] Open
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Chau I, Ajani J, Doki Y, Xu J, Wyrwicz L, Motoyama S, Ogata T, Kawakami H, Hsu C, Adenis A, El Hajbi F, Di Bartolomeo M, Braghiroli M, Holtved E, Blum Murphy M, Abdullaev S, Soleymani S, Lei M, Kato K, Kitagawa Y. O-3 Nivolumab (NIVO) plus chemotherapy (chemo) or ipilimumab (IPI) vs chemo as first-line treatment for advanced esophageal squamous cell carcinoma (ESCC): Expanded efficacy and safety analyses from CheckMate 648. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.444] [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: 11/01/2022] Open
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Hsu C, Patell R, Zwicker J. PO-16: Prevalence of thrombocytopenia in patients with acute cancer-associated thrombosis. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zahir H, Greenberg J, Hsu C, Marbury TC, Lasseter KC, Xu L, Tap WD, Healey JH, Stacchiotti S, LaCreta F. Effect of Mild and Moderate Hepatic Impairment (defined by Child Pugh classification and National Cancer Institute-Organ Dysfunction Working Group criteria) on Pexidartinib Pharmacokinetics. J Clin Pharmacol 2022; 62:992-1005. [PMID: 35247274 PMCID: PMC9288539 DOI: 10.1002/jcph.2042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/01/2022] [Indexed: 11/07/2022]
Abstract
Pexidartinib is a novel oral small‐molecule tyrosine kinase inhibitor targeting the colony‐stimulating factor 1 receptor. Pexidartinib undergoes extensive hepatic metabolism via multiple cytochrome P450 and uridine 5'‐diphospho‐glucuronosyl transferase enzymes, with ZAAD‐1006a as the only major metabolite in human plasma. As pexidartinib is extensively metabolized, hepatic impairment (HI) could lead to increased exposure to pexidartinib. The objective of the two phase 1, open‐label studies was to determine the pharmacokinetics of pexidartinib after a single 200‐mg dose in subjects with mild and moderate HI, based on Child–Pugh classification (PL3397‐A‐U123: 8 mild HI and 8 moderate HI vs 16 matched healthy controls) and National Cancer Institute Organ Dysfunction Working Group (NCI‐ODWG) criteria (PL3397‐A‐U129: 8 moderate HI versus 8 matched healthy controls [NCT04223635]). Based on Child–Pugh classification, exposure to pexidartinib (maximum observed concentration [Cmax], area under the plasma concentration–time curve up to the last measurable concentration [AUClast], and extrapolated to infinity [AUCinf]) was similar in subjects with mild and moderate HI and in respective matched healthy controls, whereas ZAAD‐1006a exposure (AUC) was approximately 27% to 28% and 41% to 48% higher in mild and moderate HI, respectively. According to NCI‐ODWG criteria, total pexidartinib exposure was 42% to 46% higher in subjects with moderate HI, compared with healthy controls, and total ZAAD‐1006a exposure was 70% to 79% higher for subjects with moderate HI, compared with matched healthy controls with normal hepatic function. These findings were used to develop appropriate dose recommendations in patients with hepatic impairment.
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Affiliation(s)
- Hamim Zahir
- Daiichi Sankyo, Inc.Basking RidgeNew JerseyUSA
| | | | - Ching Hsu
- Daiichi Sankyo, Inc.Basking RidgeNew JerseyUSA
| | | | | | - Li‐An Xu
- Daiichi Sankyo, Inc.Basking RidgeNew JerseyUSA
| | - William D. Tap
- Memorial Sloan Kettering Cancer Centerand Weill Cornell Medical CollegeNew YorkNew YorkUSA
| | - John H. Healey
- Memorial Sloan Kettering Cancer Centerand Weill Cornell Medical CollegeNew YorkNew YorkUSA
| | - Silvia Stacchiotti
- Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Istituto Nazionale dei TumoriMilanItaly
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Zahir H, Greenberg J, Shuster D, Hsu C, Watanabe K, LaCreta F. Evaluation of Absorption and Metabolism-Based DDI Potential of Pexidartinib in Healthy Subjects. Clin Pharmacokinet 2022; 61:1623-1639. [PMID: 36264536 PMCID: PMC9652259 DOI: 10.1007/s40262-022-01172-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVE Pexidartinib is a novel oral small-molecule inhibitor that selectively targets colony-stimulating factor 1 receptor, KIT proto-oncogene receptor tyrosine kinase, and FMS-like tyrosine kinase 3 harboring an internal tandem duplication mutation. It is approved in the United States for the treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery. Pexidartinib in vitro data indicate the potential for absorption- and metabolism-related drug-drug interactions (DDIs). The objective was to present a comprehensive DDI risk assessment of agents that can impact pexidartinib exposure by altering its absorption and metabolism potentially affecting efficacy and safety of pexidartinib. METHODS Four open-label crossover studies were performed to assess the effects of a pH modifier (esomeprazole), a strong cytochrome P450 (CYP) 3A4 inhibitor (itraconazole), a strong CYP3A/5'-diphospho-glucuronosyltransferase (UGT) inducer (rifampin), and a UGT inhibitor (probenecid) on the single-dose pharmacokinetics of pexidartinib. In addition, a physiologically based pharmacokinetic model was developed to predict the effect of a moderate CYP3A4 inhibitor (fluconazole) and a moderate CYP3A inducer (efavirenz) on the pharmacokinetics of pexidartinib. RESULTS Co-administration of pexidartinib with esomeprazole modestly decreased pexidartinib exposure (maximum plasma concentration [Cmax], ng/mL: geometric mean ratio [90% confidence interval (CI)], 45.4% [36.8-55.9]; area under the drug plasma concentration-time curve from time 0 to infinity [AUC∞], ng•h/mL: geometric mean ratio [90% CI], 53.1% [47.4-59.3]), likely related to decreased solubility of pexidartinib at increased pH levels. As expected, the strong CYP3A4 inhibitor itraconazole increased pexidartinib exposure (Cmax, ng/mL: geometric mean ratio [90% CI], 148.3% [127.8-172.0]; AUC∞, ng•h/mL: geometric mean ratio [90% CI], 173.0% [160.7-186.3]) while the strong CYP3A/UGT inducer rifampin decreased exposure (Cmax, ng/mL: geometric mean ratio [90% CI], 67.1% [53.1-84.8]; AUC∞, ng•h/mL: geometric mean ratio [90% CI], 37.0% [30.6-44.8]). In addition, UGT inhibition increased pexidartinib exposure (Cmax, ng/mL: geometric mean ratio [90% CI], 105.8% [92.4-121.0]; AUC∞, ng•h/mL: geometric mean ratio [90% CI], 159.8% [143.4-178.0]), consistent with the fact that pexidartinib is a substrate of the UGT1A4 enzyme, which is responsible for the generation of the major metabolite, ZAAD-1006a. CONCLUSIONS The physiologically based pharmacokinetic model predicted that a moderate CYP3A4 inhibitor and a moderate CYP3A inducer would produce modest increases and decreases, respectively, in pexidartinib exposure. These results provide a basis for pexidartinib dosing recommendations when administered concomitantly with drugs with drug-drug interaction potential, including dose adjustments when concomitant administration cannot be avoided. CLINICAL TRIAL REGISTRATION Probenecid: phase I trial, NCT03138759, 3 May, 2017; esomeprazole, itraconazole, rifampin: phase I trials, not registered with ClinicalTrials.gov.
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Affiliation(s)
- Hamim Zahir
- Global Precision Medicine, Daiichi Sankyo, Inc., 211 Mt. Airy Road, Basking Ridge, NJ, 07920, USA
- Current affiliation: Reata Pharmaceuticals, Plano, TX, USA
| | - Jonathan Greenberg
- Global Precision Medicine, Daiichi Sankyo, Inc., 211 Mt. Airy Road, Basking Ridge, NJ, 07920, USA
| | - Dale Shuster
- Global Research and Development, Daiichi Sankyo, Inc., 211 Mt. Airy Road, Basking Ridge, NJ, USA
| | - Ching Hsu
- Biostatistics and Data Management, Daiichi Sankyo Inc., 211 Mt. Airy Road, Basking Ridge, NJ, USA
| | - Kengo Watanabe
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi Sankyo Co, Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, Japan
| | - Frank LaCreta
- Global Precision Medicine, Daiichi Sankyo, Inc., 211 Mt. Airy Road, Basking Ridge, NJ, 07920, USA.
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Chang CW, Lai F, Christian M, Chen YC, Hsu C, Chen YS, Chang DH, Roan TL, Yu YC. Deep Learning-Assisted Burn Wound Diagnosis: Diagnostic Model Development Study. JMIR Med Inform 2021; 9:e22798. [PMID: 34860674 PMCID: PMC8686480 DOI: 10.2196/22798] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/19/2020] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Accurate assessment of the percentage total body surface area (%TBSA) of burn wounds is crucial in the management of burn patients. The resuscitation fluid and nutritional needs of burn patients, their need for intensive unit care, and probability of mortality are all directly related to %TBSA. It is difficult to estimate a burn area of irregular shape by inspection. Many articles have reported discrepancies in estimating %TBSA by different doctors. OBJECTIVE We propose a method, based on deep learning, for burn wound detection, segmentation, and calculation of %TBSA on a pixel-to-pixel basis. METHODS A 2-step procedure was used to convert burn wound diagnosis into %TBSA. In the first step, images of burn wounds were collected from medical records and labeled by burn surgeons, and the data set was then input into 2 deep learning architectures, U-Net and Mask R-CNN, each configured with 2 different backbones, to segment the burn wounds. In the second step, we collected and labeled images of hands to create another data set, which was also input into U-Net and Mask R-CNN to segment the hands. The %TBSA of burn wounds was then calculated by comparing the pixels of mask areas on images of the burn wound and hand of the same patient according to the rule of hand, which states that one's hand accounts for 0.8% of TBSA. RESULTS A total of 2591 images of burn wounds were collected and labeled to form the burn wound data set. The data set was randomly split into training, validation, and testing sets in a ratio of 8:1:1. Four hundred images of volar hands were collected and labeled to form the hand data set, which was also split into 3 sets using the same method. For the images of burn wounds, Mask R-CNN with ResNet101 had the best segmentation result with a Dice coefficient (DC) of 0.9496, while U-Net with ResNet101 had a DC of 0.8545. For the hand images, U-Net and Mask R-CNN had similar performance with DC values of 0.9920 and 0.9910, respectively. Lastly, we conducted a test diagnosis in a burn patient. Mask R-CNN with ResNet101 had on average less deviation (0.115% TBSA) from the ground truth than burn surgeons. CONCLUSIONS This is one of the first studies to diagnose all depths of burn wounds and convert the segmentation results into %TBSA using different deep learning models. We aimed to assist medical staff in estimating burn size more accurately, thereby helping to provide precise care to burn victims.
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Affiliation(s)
- Che Wei Chang
- Graduate Institute of Biomedical Electronics & Bioinformatics, National Taiwan University, Taipei, Taiwan.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics & Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Mesakh Christian
- Department of Computer Science & Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Yu Chun Chen
- Department of Computer Science & Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Ching Hsu
- Graduate Institute of Biomedical Electronics & Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Yo Shen Chen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Dun Hao Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Department of Information Management, Yuan Ze University, Chung-Li, Taiwan
| | - Tyng Luen Roan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yen Che Yu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan
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Hong Y, Hwang D, Yang C, Cheng S, Aala W, Harn H, Onoufriadis A, Lu K, McGrath J, Hsu C. 360 Pathogenic role of specific macrophage and fibroblast subpopulations in acne keloidalis identified by single cell RNA sequencing. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hou P, Tu W, Wang H, Yang H, Huang H, Lin C, McGrath J, Hsu C. LB732 Intravenous gentamicin therapy in adult junctional and recessive dystrophic Epidermolysis Bullosa with nonsense mutations does not result in sustained clinical improvement. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ding S, Wang Z, Hsu C, Hsu D, Shen X. 3O Patient-derived micro-organospheres (MOS) recapitulate tumor microenvironment and heterogeneity for precision oncology. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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25
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Tsai H, Yang S, Hsiao C, Kao H, Shan Y, Lin Y, Yen C, Du J, Hsu C, Wu I, Chen L. P-140 A phase I study of biweekly abraxane in combination with oxaliplatin and oral S-1/leucovorin as first line treatment for advanced gastric, pancreatic and biliary tract cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chen S, Lai H, Tsou H, Shao Y, Chang C, Su T, Liu T, Chen L, Cheng A, Hsu C. P-126 Atezolizumab plus bevacizumab for patients with advanced hepatocellular carcinoma and chronic hepatitis B virus infection with high viral load. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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27
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Yang S, Lin K, Yu C, Hsu C, Wang S, Shueng P, Wu T. PH-0165: Integration of radiation doses and myocardial function in radiotherapy plans for breast cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00189-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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28
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Hsu C, Chang L, Chen P, Lee Y. PNS31 Increased Cigarette Taxes and Quitting Behavior Among Adults. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.450] [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: 11/28/2022]
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29
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Kuo C, Hwu W, Chien Y, Hsu C, Hung M, Lin I, Lai F, Lee N. Frequency and spectrum of actionable pathogenic secondary findings in Taiwanese exomes. Mol Genet Genomic Med 2020; 8:e1455. [PMID: 32794656 PMCID: PMC7549563 DOI: 10.1002/mgg3.1455] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/29/2020] [Accepted: 07/27/2020] [Indexed: 01/29/2023] Open
Abstract
Background Exome sequencing has recently become more readily available, and more information about incidental findings has been disclosed. However, data from East Asia are scarce. We studied the application of exome sequencing to the identification of pathogenic/likely pathogenic variants in the ACMG 59 gene list and the frequency of these variants in the Taiwanese population. Methods This study screened 161 Taiwanese exomes for variants from the ACMG 59 gene list. The identified variants were reviewed based on information from different databases and the available literature and classified according to the ACMG standard guidelines. Results We identified seven pathogenic/likely pathogenic variants in eight individuals, with five participants with autosomal recessive variants in one allele and three participants with autosomal dominant variants. Approximately 1.86% (3/161) of the Taiwanese individuals had a reportable pathogenic/likely pathogenic variant as determined by whole‐exome sequencing (WES), which was comparable to the proportions published previously in other countries. We further investigated the high carrier rate of rare variants in the ATP7B gene, which might indicate a founder effect in our population. Conclusion This study was the first to provide Taiwanese population data of incidental findings and emphasized a high carrier rate of candidate pathogenic/likely pathogenic variants in the ATP7B gene.
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Affiliation(s)
- Chieh‐Wen Kuo
- College of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Wuh‐Liang Hwu
- Department of PediatricsNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
- Department of Medical GeneticsNational Taiwan University HospitalTaipeiTaiwan
| | - Yin‐Hsiu Chien
- Department of PediatricsNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
- Department of Medical GeneticsNational Taiwan University HospitalTaipeiTaiwan
| | - Ching Hsu
- Graduate Institute of Biomedical Electronics and BioinformaticsNational Taiwan UniversityTaipeiTaiwan
| | - Miao‐Zi Hung
- Department of Medical GeneticsNational Taiwan University HospitalTaipeiTaiwan
| | - I‐Lin Lin
- Department of Medical GeneticsNational Taiwan University HospitalTaipeiTaiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics and BioinformaticsNational Taiwan UniversityTaipeiTaiwan
| | - Ni‐Chung Lee
- Department of PediatricsNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
- Department of Medical GeneticsNational Taiwan University HospitalTaipeiTaiwan
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Abstract
Telemedizin findet seit Jahrzehnten Anwendung im Alltag von Dermatologen. Insbesondere in afrikanischen Ländern mit begrenzter medizinischer Versorgung, zu überbrückenden geografischen Distanzen und einem zwischenzeitlich relativ gut ausgebauten Telekommunikationssektor liegen die Vorteile auf der Hand. Nationale und internationale Arbeitsgruppen unterstützen den Aufbau von teledermatologischen Projekten und bedienen sich in den letzten Jahren zunehmend KI(künstliche Intelligenz)-gestützter Technologien, um Ärzte vor Ort zu unterstützen. Vor diesem Hintergrund stellen ethnische Variationen eine besondere Herausforderung in der Entwicklung automatisierter Algorithmen dar. Um die Genauigkeit der Systeme weiter zu verbessern und globalisieren zu können, ist es wichtig, die Zahl der verfügbaren klinischen Daten zu erhöhen. Dies kann nur mit der aktiven Beteiligung der lokalen Gesundheitsversorger sowie der dermatologischen Gemeinschaft gelingen und muss stets im Interesse des einzelnen Patienten erfolgen.
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Affiliation(s)
- C Greis
- Klinik für Dermatologie, Universitätsspital Zürich, Gloriastr. 31, 8091, Zürich, Schweiz.
| | - L V Maul
- Klinik für Dermatologie, Universitätsspital Basel, Basel, Schweiz
| | - C Hsu
- Klinik für Dermatologie, Universitätsspital Basel, Basel, Schweiz
| | - V Djamei
- Klinik für Dermatologie, Universitätsspital Zürich, Gloriastr. 31, 8091, Zürich, Schweiz
| | - P Schmid-Grendelmeier
- Klinik für Dermatologie, Universitätsspital Zürich, Gloriastr. 31, 8091, Zürich, Schweiz
| | - A A Navarini
- Klinik für Dermatologie, Universitätsspital Basel, Basel, Schweiz
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31
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Yau T, Hsu C, Kang Y, Kim T, Hou M, Lim H, Chao Y, Kim Y, Ikeda M, Choo S, Neely J, Shen Y, Tschaika M, Kudo M. O-5 Efficacy and safety of nivolumab + ipilimumab in Asian patients with advanced hepatocellular carcinoma: Subanalysis of the CheckMate 040 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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32
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Schmid-Grendelmeier P, Takaoka R, Ahogo KC, Belachew WA, Brown SJ, Correia JC, Correia M, Degboe B, Dorizy-Vuong V, Faye O, Fuller LC, Grando K, Hsu C, Kayitenkore K, Lunjani N, Ly F, Mahamadou G, Manuel RCF, Kebe Dia M, Masenga EJ, Muteba Baseke C, Ouedraogo AN, Rapelanoro Rabenja F, Su J, Teclessou JN, Todd G, Taïeb A. Position Statement on Atopic Dermatitis in Sub-Saharan Africa: current status and roadmap. J Eur Acad Dermatol Venereol 2020; 33:2019-2028. [PMID: 31713914 PMCID: PMC6899619 DOI: 10.1111/jdv.15972] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub-Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE). RESULTS AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health. CONCLUSIONS A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow-up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.
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Affiliation(s)
| | - R Takaoka
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - K C Ahogo
- Département de médecine et Spécialités Médicales, Dermatologie et Vénérologie, CHU Treichville, Université Félix Houphouët-Boigny UFR Sciences Médicales, Abidjan, Côte d'Ivoire
| | - W A Belachew
- College of Health Science, Ayder Comprehensive Specialized Teaching Hospital, Mekelle University, Mekelle, Ethiopia
| | - S J Brown
- Skin Research Group, School of Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - J C Correia
- Division of Therapeutic Education for Chronic Diseases, WHO Collaborating Center, Department of First Aid Medecine, Geneva University Hospitals, Geneva, Switzerland
| | - M Correia
- Department of Dermatology, Hospital Cuf Descobertas and Hospital Cuf Torres Vedras, Torres Vedras, Portugal
| | - B Degboe
- Department of Dermatology, Faculty of Health Sciences, National and Teaching Hospital HKM of Cotonou, University of Abomey-Calavi, Cotonou, Benin
| | - V Dorizy-Vuong
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, Bordeaux, France.,INSERM U 1035, University of Bordeaux, Bordeaux, France
| | - O Faye
- Department of Dermatology, Faculty of Medicine, CNAM, Bamako, Mali
| | - L C Fuller
- Chair of International Foundation for Dermatology, Chelsea and Westminster Hospital, London, UK
| | - K Grando
- Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland
| | - C Hsu
- Department of Dermatology, Teledermatology and AI, University Hospital of Basel, Basel, Switzerland
| | - K Kayitenkore
- Kigali Dermatology Center, University of Rwanda, Kigali, Rwanda
| | - N Lunjani
- University of Cape Town, Cape Town, South Africa
| | - F Ly
- Université Cheikh Anta Diop, Dakar, Senegal
| | - G Mahamadou
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, Bordeaux, France.,Service de Dermatologie-Vénéréologie, CHU Sylvanus Olympio, Lomé, Togo
| | - R C F Manuel
- Department of Dermatology, Ministry of Health, Hospital Central de Maputo, Maputo, Mozambique
| | | | - E J Masenga
- Regional Dermatology Training Center, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - C Muteba Baseke
- Clinique Bondeko, Kinshasa-Limete, Democratic Republic of the Congo
| | - A N Ouedraogo
- University Hospital Yalgado Ouedraogo of Ouagadougou, University Ouaga I Pr Joseph Ki-Zerbo Ouagadougou, Ouagadougou, Burkina Faso
| | - F Rapelanoro Rabenja
- Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar
| | - J Su
- Department of Paediatrics, Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - J N Teclessou
- Service dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | - G Todd
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - A Taïeb
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, Bordeaux, France.,INSERM U 1035, University of Bordeaux, Bordeaux, France
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Kazui T, Hsu C, Mogan C, Smith R, Lick S, Hypes C, Natt B, Malo J, Mosier J, Bull D. Interfacility Transfer via a Mobile Intensive Care Unit Following a Double Lumen Catheter Cannulation at the Referring Facility for Veno-Venous Extracorporeal Membrane Oxygenation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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34
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Chen LT, Martinelli E, Cheng AL, Pentheroudakis G, Qin S, Bhattacharyya GS, Ikeda M, Lim HY, Ho GF, Choo SP, Ren Z, Malhotra H, Ueno M, Ryoo BY, Kiang TC, Tai D, Vogel A, Cervantes A, Lu SN, Yen CJ, Huang YH, Chen SC, Hsu C, Shen YC, Tabernero J, Yen Y, Hsu CH, Yoshino T, Douillard JY. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with intermediate and advanced/relapsed hepatocellular carcinoma: a TOS-ESMO initiative endorsed by CSCO, ISMPO, JSMO, KSMO, MOS and SSO. Ann Oncol 2020; 31:334-351. [PMID: 32067677 DOI: 10.1016/j.annonc.2019.12.001] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/18/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of hepatocellular carcinoma (HCC) was published in 2018, and covered the diagnosis, management, treatment and follow-up of early, intermediate and advanced disease. At the ESMO Asia Meeting in November 2018 it was decided by both the ESMO and the Taiwan Oncology Society (TOS) to convene a special guidelines meeting immediately after the Taiwan Joint Cancer Conference (TJCC) in May 2019 in Taipei. The aim was to adapt the ESMO 2018 guidelines to take into account both the ethnic and the geographic differences in practice associated with the treatment of HCC in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with intermediate and advanced/relapsed HCC representing the oncology societies of Taiwan (TOS), China (CSCO), India (ISMPO) Japan (JSMO), Korea (KSMO), Malaysia (MOS) and Singapore (SSO). The voting was based on scientific evidence, and was independent of the current treatment practices, the drug availability and reimbursement situations in the individual participating Asian countries.
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Affiliation(s)
- L-T Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan; Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - E Martinelli
- Department of Clinical and Experimental Medicine 'F Magrassi' - Medical Oncology, Università degli Studi della Campania L Vanvitelli, Naples, Italy
| | - A-L Cheng
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan; Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - S Qin
- Chinese PLA Cancer Center, Jinling Hospital, Nanjing, China
| | | | - M Ikeda
- Department of Hepatobiliary & Pancreatic Oncology, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Japan
| | - H-Y Lim
- Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - G F Ho
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - S P Choo
- Curie Oncology, Singapore; National Cancer Centre Singapore, Singapore, Singapore
| | - Z Ren
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - H Malhotra
- Department of Medical Oncology, Sri Ram Cancer Center, Mahatma Gandhi Medical College Hospital, Jaipur, India
| | - M Ueno
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - B-Y Ryoo
- Department of Oncology, Asan Medical Center University of Ulsan College of Medicine, Seoul, South Korea
| | - T C Kiang
- Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
| | - D Tai
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - A Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Hannover, Germany
| | - A Cervantes
- CIBERONC, Department of Medical Oncology, Institute of Health Research, INCLIVIA, University of Valencia, Valencia, Spain
| | - S-N Lu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - C-J Yen
- Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Y-H Huang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - S-C Chen
- Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - C Hsu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Y-C Shen
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - J Tabernero
- Medical Oncology Department, Vall d' Hebron University Hospital and Institute of Oncology (VHIO), UVic, IOB-Quiron, Barcelona, Spain
| | - Y Yen
- Taipei Medical University, Taipei, Taiwan
| | - C-H Hsu
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - T Yoshino
- Department of Hepatobiliary & Pancreatic Oncology, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Japan
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Banda A, Cohen E, Lynskey G, Fernandez S, Hsu C, Kim A. 4:12 PM Abstract No. 325 Transjugular intrahepatic portosystemic shunt improves liver function in patients with alcohol-induced cirrhosis. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.380] [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: 11/28/2022] Open
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Wang Y, Yu S, Hsu C, Tsai C, Cheng T. Underestimated fracture risk in postmenopausal women-application of the hybrid intervention threshold. Osteoporos Int 2020; 31:475-483. [PMID: 31696272 DOI: 10.1007/s00198-019-05201-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/16/2019] [Indexed: 01/07/2023]
Abstract
UNLABELLED This study evaluated the fragility fracture risk of Taiwanese postmenopausal women with osteopenia. With the incorporation of FRAX and hybrid intervention threshold (HIT), 25% of the participants had high fracture risk. We suggest intervention for fragility fracture for postmenopausal women should be guided by FRAX and HIT instead of bone mineral density alone. INTRODUCTION To explore the risk of fragility fracture in Taiwanese postmenopausal women with osteopenia using the hybrid intervention threshold (HIT) and Fracture Risk Assessment tool (FRAX). METHODS The Taiwan Osteoporosis Association (TOA) conducted a nationwide bone mineral density (BMD) survey between 2008 and 2011 using a bus equipped with a dual-energy X-ray absorptiometry (DXA) machine. All participants completed a structured questionnaire, which included the elements in the FRAX. Based on the results, the group made up of postmenopausal women with osteopenia was identified. In order to explore the risk of fragility fracture by HIT and FRAX among Taiwan postmenopausal women with osteopenia, the 10-year probability of fracture (FRAX score) and individual intervention threshold (IIT) in this group were calculated. If the FRAX score of a participant was higher than or equal to the IIT or fixed intervention threshold (FIT), the participant was considered as above the HIT (HIT could be reached by being over a threshold at either major osteoporotic fracture or hip fracture) and categorized as having a high FRAX fracture risk. RESULTS A total of 13,068 postmenopausal women were enrolled in the program. A total of 5743 (43.9%) participants had osteopenia, of which 1434 (25.0%) had high FRAX fracture risk. CONCLUSIONS One quarter of Taiwanese postmenopausal women with osteopenia had high fragility fracture risk evaluated by FRAX and HIT. Due to the poor sensitivity of BMD for fragility fracture, we suggest that intervention for fragility fracture for postmenopausal women should also be guided by FRAX and HIT instead of BMD alone.
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Affiliation(s)
- Y Wang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan
| | - S Yu
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan
| | - C Hsu
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan
| | - C Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan.
| | - T Cheng
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan.
- College of Medicine, Chang Gung University, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan.
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Banda A, Lynskey G, Cohen E, Hsu C, Kim A. 3:36 PM Abstract No. 251 MELD and ALBI score correlation increases with time following transjugular intrahepatic portosystemic shunt. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Hsu C, Hsueh P. Molecular epidemiology and clinical characteristics of drug resistant Mycobacterium kansasii in Taiwan, 2000-2015. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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De Silva K, Rao K, Sood A, Denniss A, Hsu C. 130 Ischaemic Scar vs Myocardial Injury in Patients With Troponin Elevation and Non-Obstructive Coronary Arteries. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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De Silva K, Rao K, Sood A, Denniss A, Hsu C. 115 GRACE Score and Delta Change in Serial Troponin can Help Predict MINOCA Prior to Coronary Angiography in Patients With Acute Myocardial Infarction. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.122] [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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Hsu C, Henderson-Cleland C, Nasser M, Caulkin R, Newsom-Davis T. Chemoimmunotherapy for small cell lung cancer: will UK clinical practice change or persist? Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30183-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hsu C, Lin E, Shyr Y. P2.04-50 Advanced Statistical Approach Tells the Difference: Taylor-Expansion Adjustment for Survival Analyses in Immunotherapy Trials. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lin SM, Hsu C, Lee Y, Li TC, Kuo SH, Wang W. Efficacy evaluation of optimal patient selection for hypopharyngeal cancer organ preservation therapy using MRI-derived radiomic signature: Bi-institutional propensity score matched analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hsu C, Kuo SH, Wang W, Chen TWW, Lee Y. Radiographic phenotyping to identify intracranial disseminated recurrence in brain metastases treated with radiosurgery using contrast-enhanced MR imaging. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz243.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arnold LM, Whitaker S, Hsu C, Jacobs D, Merante D. Efficacy and safety of mirogabalin for the treatment of fibromyalgia: results from three 13-week randomized, double-blind, placebo- and active-controlled, parallel-group studies and a 52-week open-label extension study. Curr Med Res Opin 2019; 35:1825-1835. [PMID: 31284771 DOI: 10.1080/03007995.2019.1629757] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To investigate the efficacy and safety of mirogabalin, an α2δ ligand, in patients with fibromyalgia (FM). Methods: In three 13-week, multicenter, double-blind, phase 3 studies (studies A, B, and C), patients with FM (n = 1293, 1270, and 1301, respectively) were randomized (1:1:1:1) to placebo, pregabalin 150 mg twice daily, mirogabalin 15 mg once daily or mirogabalin 15 mg twice daily. The primary endpoint was the change in weekly average daily worst pain score (ADPS) at week 13. Key secondary endpoints included Patient Global Impression of Change and change in the Fibromyalgia Impact Questionnaire total score. Long-term safety of mirogabalin was assessed in a 52-week extension study. Results: Neither mirogabalin dose demonstrated a significant ADPS reduction from baseline vs. placebo at week 13 in any of the three studies. Pregabalin significantly reduced ADPS from baseline vs. placebo in studies B and C (p = .0008 and .0001, respectively). The effect of mirogabalin compared with placebo on key secondary endpoints was variable across the studies. Mirogabalin was well tolerated by most patients in the phase 3 studies; no unexpected adverse events occurring during the 52-week extension study. Conclusion: While both mirogabalin doses were well tolerated by most patients and showed potential for reducing pain associated with FM, the primary endpoint of significant pain reduction in patients on mirogabalin compared with placebo was not achieved in any of the three randomized controlled studies. Clinical trial registration: NCT02146430; NCT02187159; NCT02187471; and NCT02234583 (extension study).
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Affiliation(s)
- Lesley M Arnold
- Women's Health Research Program, University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | | | - Ching Hsu
- Daiichi Sankyo Inc. , Basking Ridge , NJ , USA
| | | | - Domenico Merante
- Global Clinical Development, Daiichi Sankyo Development , Gerrards Cross , United Kingdom
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Metges J, François E, Shah M, Adenis A, Enzinger P, Kojima T, Muro K, Bennouna J, Hsu C, Moriwaki T, Kim S, Lee S, Kato K, Shen L, Qin S, Ferreira P, Wang R, Bhagia P, Kang S, Doi T. The phase 3 KEYNOTE-181 study: pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tsai M, Hsu C, Yang P, Lin T, Chen D, Luo C, Hu Y, Roan J. Role of Extracorporeal Membrane Oxygenation Support as a Bridge to Medical Therapy in Decompensated Pulmonary Hypertension. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Chen X, Chih C, Hsu C, Chen P, Lee T, Teng L, Hsueh P. Rapid identification of pathogens from flagged blood cultures by multiplex PCR using the FilmArray system. J Infect Public Health 2019. [DOI: 10.1016/j.jiph.2018.10.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Chiang NJ, Chen LT, Chen JS, Yang SH, Hsu C, Shan YS, Yen CJ, Chen MH, Tsou HH. TCOG T1308 study: The final results of a phase II trial of modified gemcitabine plus S-1 combination as the first-line treatment in patients with advanced biliary tract cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wu I, Hsu C, Chen C, Wu M, Hsiung C. GLYCATED HEMOGLOBIN LEVELS AND PHYSICAL FUNCTIONING DECLINE: THE HEALTHY AGING LONGITUDINAL STUDY IN TAIWAN. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- I Wu
- National Health Research Institutes, Taiwan
| | - C Hsu
- National Health Research Institutes, Taiwan
| | - C Chen
- Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - M Wu
- National Health Research Institutes, Taiwan
| | - C Hsiung
- National Health Research Institutes, Taiwan
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