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Schneider C, Bogatu D, Leahy J, Zen Y, Ross P, Sarker D, Suddle A, Agarwal K, Srinivasan P, Prachalias AA, Heaton N, Menon K. Predictors of recurrence following laparoscopic minor hepatectomy for hepatocellular carcinoma in the UK. Surg Oncol 2023; 49:101965. [PMID: 37348195 DOI: 10.1016/j.suronc.2023.101965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/10/2023] [Accepted: 06/07/2023] [Indexed: 06/24/2023]
Abstract
AIMS Minor hepatectomy, which is increasingly carried out laparoscopically (LLR), is a cornerstone of curative treatment for hepatocellular carcinoma (HCC). The majority of relevant publications however originate from regions with endemic viral hepatitis. Although the incidence of HCC in the UK is increasing, little is known about outcomes following LLR. METHODS Consecutive patients undergoing minor (involving ≤2 segments) LLR or open resection (OLR) at our institute between 2014 and 2021 were compared. Selection from a plethora of factors potentially impacting on overall (OS) and disease free survival (DFS) was optimised with Lasso regression. To enable analysis of patients having repeat resection, multivariate frailty modelling was utilised to calculate hazard ratios (HR). RESULTS The analysis of 111 liver resections included 55 LLR and 56 OLR. LLR was associated with a shorter hospital stay (5 ± 2 vs. 7 ± 2 days; p < 0.001) and a lower comprehensive complication index (4.43 vs. 9.96; p = 0.006). Mean OS (52.3 ± 2.3 vs. 49.9 ± 3.0 months) and DFS (33.9 ± 3.4 vs. 36.5 ± 3.6 months; p = 0.59) were comparable between LLR and OLR, respectively (median not reached). Presence of mixed cholangiocarcinoma/HCC, satellite lesions and AFP level predicted OS and DFS. In addition tumour size was predictive of DFS. CONCLUSIONS In the studied population minor LLR was associated with shorter hospital stay and fewer complications while offering non-inferior long-term outcomes. A number of predictors for disease free survival have been elucidated that may aid in identifying patients with a high risk of disease recurrence and need for further treatment.
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Affiliation(s)
- C Schneider
- Department of Hepatopancreatico-biliary Surgery, King's College Hospital, London, United Kingdom
| | - D Bogatu
- Department of Hepatopancreatico-biliary Surgery, King's College Hospital, London, United Kingdom
| | - J Leahy
- Department of Hepatopancreatico-biliary Surgery, King's College Hospital, London, United Kingdom
| | - Y Zen
- Institute of Liver Studies, King's College Hospital, London, United Kingdom
| | - P Ross
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, United Kingdom
| | - D Sarker
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, United Kingdom
| | - A Suddle
- Institute of Liver Studies, King's College Hospital, London, United Kingdom
| | - K Agarwal
- Institute of Liver Studies, King's College Hospital, London, United Kingdom
| | - P Srinivasan
- Department of Hepatopancreatico-biliary Surgery, King's College Hospital, London, United Kingdom
| | - A A Prachalias
- Department of Hepatopancreatico-biliary Surgery, King's College Hospital, London, United Kingdom
| | - N Heaton
- Department of Hepatopancreatico-biliary Surgery, King's College Hospital, London, United Kingdom
| | - K Menon
- Department of Hepatopancreatico-biliary Surgery, King's College Hospital, London, United Kingdom.
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Cho B, Dy G, Kim T, Sarker D, Hamid O, Williamson S, Sang-We K, Hatim H, Chen S, Mani J, Jankovic V, Paccaly A, Masinde S, Lowy I, Brennan L, Gullo G. 127P Phase I study of fianlimab: A human lymphocyte activation gene-3 (LAG-3) monoclonal antibody, in combination with cemiplimab in advanced NSCLC. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sarker D, Schinkel C, Portela L. Effect of N2 and CO2 Bubbles on Gas Volume Fraction and Flow Pattern in a Quasi-2D Bubble Column by Shadow Imaging. Chem Eng Res Des 2022. [DOI: 10.1016/j.cherd.2022.11.032] [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]
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Repana D, Shanmugalingam T, Gerrard G, Foot N, Kulkarni A, Naidoo K, Talukdar S, Snape K, Hanson H, Quigley K, Mokretar K, Du Parcq P, Ferguson B, Sarker D, Murugaesu N. 31P Liquid biopsies in clinical practice. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.032] [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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Laethem JLV, Borbath I, Karwal M, Verslype C, Van Vlierberghe H, Kardosh A, Zagonel V, Stal P, Sarker D, Palmer D, Vogel A, Edeline J, Cattan S, Kudo M, Cheng AL, Ogasawara S, Siegel A, Chisamore M, Wang A, Zhu A. 933P Updated results for pembrolizumab (pembro) monotherapy as first-line therapy for advanced hepatocellular carcinoma (HCC) in the phase II KEYNOTE-224 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.153] [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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Keam B, Hu M, Subbiah V, Wirth L, Schuler M, Mansfield A, Brose M, Curigliano G, Leboulleux S, Zhu V, Matos I, Adkins D, Baik C, Lopes G, Godbert Y, Sarker D, Zhang H, Turner C, Taylor M, Lin CC. 442P Results from the registrational phase I/II ARROW trial of pralsetinib (BLU-667) in patients (pts) with advanced RET mutation-positive medullary thyroid cancer (RET+ MTC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Massard C, Azaro A, Soria JC, Lassen U, Le Tourneau C, Sarker D, Smith C, Ohnmacht U, Oakley G, Patel BKR, Yuen ESM, Benhadji KA, Rodon J. First-in-human study of LY3039478, an oral Notch signaling inhibitor in advanced or metastatic cancer. Ann Oncol 2019; 29:1911-1917. [PMID: 30060061 DOI: 10.1093/annonc/mdy244] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Deregulated Notch signaling due to mutation or overexpression of ligands and/or receptors is implicated in various human malignancies. γ-Secretase inhibitors inhibit Notch signaling by preventing cleavage of transmembrane domain of Notch protein. LY3039478 is a novel, potent Notch inhibitor decreases Notch signaling and its downstream biologic effects. In this first-in-human study, we report the safety, pharmacokinetic (PK) profile, pharmacodynamic effects, and antitumor activity of LY3039478 in patients with advanced or metastatic cancer. Methods This phase I, open-label, multicenter, nonrandomized, and dose-escalation phase study determined and confirmed the recommended phase II dose of LY3039478 (oral dose: 2.5-100 mg, thrice weekly (TIW) on a 28-day cycle). The primary objectives are to determine (part A) and confirm (part B) a recommended phase II dose that may be safely administered to patients with advanced or metastatic cancer, and secondary objectives include evaluation of safety, tolerability, PK parameters, and preliminary antitumor activity of LY3039478. Results A total of 110 patients were treated with LY3039478 monotherapy between 31 October 2012 and 15 July 2016. Dose-limiting toxicities were thrombocytopenia, colitis, and nausea. Most adverse events were gastrointestinal. The recommended phase II dose was 50 mg TIW, because of its better tolerability compared with 75 mg. The PKs of LY3039478 appeared dose proportional. Pharmacodynamic data indicate an ∼80% inhibition of plasma Aβ, and >50% inhibition of Notch-regulated genes hairy and enhancer of split-1, cyclin D1, and Notch-regulated ankyrin repeat at 45-100-mg dose. Clinical activity (tumor necrosis, metabolic response, or tumor shrinkage) was observed in patients with breast cancer, leiomyosarcoma, and adenoid cystic carcinoma. Conclusion Potent inhibition of Notch signaling by LY3039478 was well tolerated at doses associated with target engagement, and demonstrated evidence of clinical activity in heavily pretreated patients. Further investigation with LY3039478 as monotherapy and in combination with targeted agent or chemotherapy is ongoing. Clinicaltrials.gov ID NCT01695005.
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Affiliation(s)
- C Massard
- Drug Development Department (DITEP), Inserm Unit U981, Université Paris Saclay, Université Paris-Sud, Gustave Roussy, Villejuif, France.
| | - A Azaro
- Molecular Therapeutics Research Unit, Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona; Department of Pharmacology, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J-C Soria
- Drug Development Department (DITEP), Inserm Unit U981, Université Paris Saclay, Université Paris-Sud, Gustave Roussy, Villejuif, France
| | - U Lassen
- Phase 1 Unit, Department of Oncology, The Finsen Centre - Rigshospitalet, Copenhagen, Denmark
| | - C Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Saint-Cloud, Paris; INSERM U900 Research unit, Saint-Cloud, Montigny-le-Bretonneux, France; Versailles-Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | - D Sarker
- King's College London, Guy's Hospital, London, UK
| | - C Smith
- Eli Lilly and Company, Indianapolis, USA
| | - U Ohnmacht
- Eli Lilly and Company, Indianapolis, USA
| | - G Oakley
- Eli Lilly and Company, Indianapolis, USA
| | | | - E S M Yuen
- Eli Lilly and Company, Indianapolis, USA
| | | | - J Rodon
- Early Clinical Drug Development Group, Vall d´Hebron University Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain
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Abou-Alfa GK, Qin S, Ryoo BY, Lu SN, Yen CJ, Feng YH, Lim HY, Izzo F, Colombo M, Sarker D, Bolondi L, Vaccaro G, Harris WP, Chen Z, Hubner RA, Meyer T, Sun W, Harding JJ, Hollywood EM, Ma J, Wan PJ, Ly M, Bomalaski J, Johnston A, Lin CC, Chao Y, Chen LT. Phase III randomized study of second line ADI-PEG 20 plus best supportive care versus placebo plus best supportive care in patients with advanced hepatocellular carcinoma. Ann Oncol 2019; 29:1402-1408. [PMID: 29659672 DOI: 10.1093/annonc/mdy101] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Arginine depletion is a putative target in hepatocellular carcinoma (HCC). HCC often lacks argininosuccinate synthetase, a citrulline to arginine-repleting enzyme. ADI-PEG 20 is a cloned arginine degrading enzyme-arginine deiminase-conjugated with polyethylene glycol. The goal of this study was to evaluate this agent as a potential novel therapeutic for HCC after first line systemic therapy. Methods and patients Patients with histologically proven advanced HCC and Child-Pugh up to B7 with prior systemic therapy, were randomized 2 : 1 to ADI-PEG 20 18 mg/m2 versus placebo intramuscular injection weekly. The primary end point was overall survival (OS), with 93% power to detect a 4-5.6 months increase in median OS (one-sided α = 0.025). Secondary end points included progression-free survival, safety, and arginine correlatives. Results A total of 635 patients were enrolled: median age 61, 82% male, 60% Asian, 52% hepatitis B, 26% hepatitis C, 76% stage IV, 91% Child-Pugh A, 70% progressed on sorafenib and 16% were intolerant. Median OS was 7.8 months for ADI-PEG 20 versus 7.4 for placebo (P = 0.88, HR = 1.02) and median progression-free survival 2.6 months versus 2.6 (P = 0.07, HR = 1.17). Grade 3 fatigue and decreased appetite occurred in <5% of patients. Two patients on ADI-PEG 20 had ≥grade 3 anaphylactic reaction. Death rate within 30 days of end of treatment was 15.2% on ADI-PEG 20 versus 10.4% on placebo, none related to therapy. Post hoc analyses of arginine assessment at 4, 8, 12 and 16 weeks, demonstrated a trend of improved OS for those with more prolonged arginine depletion. Conclusion ADI-PEG 20 monotherapy did not demonstrate an OS benefit in second line setting for HCC. It was well tolerated. Strategies to enhance prolonged arginine depletion and synergize the effect of ADI-PEG 20 are underway. Clinical Trial number www.clinicaltrials.gov (NCT 01287585).
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Affiliation(s)
- G K Abou-Alfa
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical College, New York, USA.
| | - S Qin
- Department of Oncology, The Chinese People's Liberation Army 81 Hospital, Nanjing, China
| | - B-Y Ryoo
- Department of Oncology, Asan Medical Center, Seoul, South Korea
| | - S-N Lu
- Department of Medical Oncology, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Chang Gung University College of Medicine, Taiwan
| | - C-J Yen
- Department of Oncology, National Cheng Kung University Hospital, Taiwan
| | - Y-H Feng
- Department of Oncology, Chi Mei Medical Center-Yong Kang, Taiwan
| | - H Y Lim
- Department of Medical Oncology, Samsung Medical Center, Seoul, South Korea
| | - F Izzo
- Department of Medicine, Fondazione Giovanni Pascale, Napoli
| | - M Colombo
- Department of Medicine, Fondazione IRCCS Ca, Milan, Italy
| | - D Sarker
- Department of Medicine, King's College Hospital, London, UK
| | - L Bolondi
- Department of Medicine, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - G Vaccaro
- Department of Medicine, Oregon Health Sciences University, Portland
| | - W P Harris
- Department of Medicine, University of Washington Medical Center, Seattle, USA
| | - Z Chen
- Department of Oncology, 2nd Hospital of Anhui Medical University, Hefei, China
| | - R A Hubner
- Department of Medicine, The Christie NHS Foundation Trust, Manchester, UK
| | - T Meyer
- Department of Medicine, Royal Free Hospital and UCL Cancer Institute, London, UK
| | - W Sun
- Department of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - J J Harding
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical College, New York, USA
| | - E M Hollywood
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J Ma
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - P J Wan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M Ly
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J Bomalaski
- Department of Research and Development, Polaris Pharmaceuticals, Inc., San Diego, USA
| | - A Johnston
- Department of Research and Development, Polaris Pharmaceuticals, Inc., San Diego, USA
| | - C-C Lin
- Department of Medical Oncology, Chang Gung Medical Foundation LK, Taipei, Tainan
| | - Y Chao
- Department of Medicine, Veterans General Hospital-Taipei, Taipei, Tainan
| | - L-T Chen
- Chang Gung University College of Medicine, Taiwan; Department of Medical Oncology, National Institute of Cancer Research, National Health Research Institutes, Tainan; Department of Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Kapiris M, Josephs D, Kulkarni A, Valganon M, De Souza B, Campbell J, Churm F, Nickless G, Ross P, De Naurois J, Maisey N, Thillai K, Roca J, George M, Schizas A, Datta V, Westcott E, Sarker D. A retrospective analysis of 66 colorectal cancer cases from Guy’s and St Thomas’ (GSTT) Molecular Tumour Board. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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10
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Kocher H, Basu B, Froeling F, Sarker D, Slater S, Carlin D, Coetzee C, de Souza N, Goulart M, Hughes C, Imrali A, Lawrence C, Mousa K, North B, Prendergast A, Roberts R, Sasieni P, Propper D. STAR-PAC: Phase I clinical trial repurposing all trans retinoic acid (ATRA) as stromal targeting agent in a novel drug combination for pancreatic cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tong D, Nintos G, Sarker D, Mansi J, Sawyer E. Experience of Next-generation Somatic Mutation Testing in Advanced Breast Cancer at Guy's Cancer Centre. Clin Oncol (R Coll Radiol) 2019. [DOI: 10.1016/j.clon.2019.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yau T, Merle P, Rimassa L, Ryoo BY, Cicin I, Harris W, Banu E, Sarker D, Tan B, van Vlierberghe H, Sen S, Love C, Cheng AL, Meyer T, Kelley R, Abou-Alfa G. Assessment of tumor response, alpha-fetoprotein (AFP) response, and time to progression (TTP) in the phase III CELESTIAL trial of cabozantinib (C) versus placebo (P) in advanced hepatocellular carcinoma (HCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Merle P, Rimassa L, Ryoo B, Cicin I, Harris W, Banu E, Sarker D, Tan B, Van Vlierberghe H, Sen S, Love C, Cheng A, Meyer T, Kelley R, Abou-Alfa G. Assessment of tumor response, AFP response, and time to progression in the phase 3 CELESTIAL trial of cabozantinib versus placebo in advanced hepatocellular carcinoma (HCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Sollie S, Michaud D, Sarker D, Karagiannis S, Josephs D, Hammar N, Santaolalla A, Walldius G, Junger I, Hemelrijck MV. PO-083 The role of the humoral immune system in pancreatic cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kim R, Sarker D, Macarulla T, Yau T, Choo S, Meyer T, Hollebecque A, Whisenant J, Sung M, Yoon JH, Lim H, Zhu A, Park JW, Faivre S, Mazzaferro V, Shi H, Schmidt-Kittler O, Clifford C, Wolf B, Kang YK. Phase 1 safety and clinical activity of BLU-554 in advanced hepatocellular carcinoma (HCC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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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Akter R, Nessa A, Sarker D, Yesmin M. Effect of Obesity on Hemoglobin Concentration. Mymensingh Med J 2017; 26:230-234. [PMID: 28588155] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Obesity is a disorder of body weight regulatory systems characterized by an accumulation of excess body fat. World Health Organization recommended that 66% of deaths now occur in developing countries and recognizes obesity as a leading risk factor. Obesity is associated with chronic, low grade, systemic inflammation. The inflammatory state play a causal role in the development of insulin resistance, type 2 diabetes and the metabolic syndrome. This descriptive type of cross sectional study will design to evaluate the relation between obesity with hemoglobin concentration. One hundred obese and 100 normal weight persons from both sexes, aged between 25 to 60 years will be selected from Mymensingh Medical College, Mymensingh and locality from July 2014 to January 2016. Data are collected through a simple questionnaire after informed consent taken. The result was calculated and analyzed by using SPSS (statistical package for social science, version 11.5). Statistical significance of difference between two groups were evaluated by unpaired Student's 't' test. Data were expressed as Mean±SE. P value less than 0.05 was taken as the level of significance. Anthropometric measurements such as height and weight were taken in meter and kilogram respectively. Pulse, systolic and diastolic blood pressure was measured by aneroid sphygmomanometer (ALPK2, Japan), laboratory analysis of hemoglobin was done by Cyanmethemoglobin Method. In this study we found that hemoglobin concentration is significantly increased in both male and female obese persons.
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Affiliation(s)
- R Akter
- Dr Rehena Akter, M Phil Student (Final Part), Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh
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Kim R, Sharma S, Meyer T, Sarker D, Macarulla T, Sung M, Choo S, Shi H, Schmidt-Kittler O, Clifford C, Wolf B, Llovet J. First-in-human study of BLU-554, a potent, highly-selective FGFR4 inhibitor designed for hepatocellular carcinoma (HCC) with FGFR4 pathway activation. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32704-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ghosh J, Lazaridis G, Viney Z, Verma H, Sheriff I, Wang Y, Moller H, Spicer J, Sarker D. Does dose affect tumour response in phase I oncology trials of non-cytotoxic agents? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.49] [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: 11/15/2022] Open
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Aravind P, Thillai K, Suddel A, Karani J, Lewis D, Heaton N, Kane P, Alkadhimi G, Sarker D, Ross P. P-098 Prognostic significance of comorbidities in elderly patients with Hepatocellular carcinoma (HCC) treated with Transarterial Chemoembolization: a Single Centre Experience. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Aravind P, Thillai K, Heaton N, Suddel A, Kane P, Karani J, Peddu P, Lewis D, Alkadhimi G, Sarker D, Ross P. PD-021 A single centre experience of the prognostic variables in hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Oikonomopoulos G, Payne S, Ngan S, Chowdhury S, Hession M, Sarker D, Ross P, Maisey N. P-115 Weight loss during 1st-line chemotherapy for upper gastrointestinal malignancies (UGI) may impact survival and access to further treatment lines. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.109] [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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Baird RD, Arkenau HT, Deva S, Cresti N, Garcia-Corbacho J, Hogarth L, Frenkel E, Kawaguchi K, Arimura A, Donaldson K, Posner J, Sarker D, Jodrell D, Plummer R, Spicer J, Italiano A. Abstract P4-14-26: Phase I expansion of S-222611, a reversible inhibitor of EGFR and HER2, in advanced solid tumors, including HER2-positive breast cancer patients with brain metastases. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-14-26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
S-222611 is an oral, reversible ErbB tyrosine kinase inhibitor of EGFR and HER2 with potent pre-clinical activity. MTD was not reached during the dose-escalation phase, (maximum dose 1600 mg QD). PK and efficacy data supported a daily dose of 800 mg. An expansion cohort of patients has been treated to further explore safety and efficacy.
METHODS
Subjects with advanced solid tumors expressing EGFR and/or overexpressing HER2 were enrolled. S-222611 800 mg daily was administered until disease progression or unacceptable toxicity.
RESULTS
76 patients were included in this phase 1 expansion cohort with a variety of tumor types. Dose reduction was required because of adverse events in 15 patients; the most frequent of which being diarrhea and elevated bilirubin. Two patients discontinued treatment due to drug- related adverse events. Of the 25 patients with HER2-positive metastatic breast cancer (MBC), 4 partial responses were observed, and prolonged stable disease (≥ 6 months) was observed in 3 additional patients. These 25 patients had received prior HER2-directed therapy as shown in Table 1.
Table 1. Prior therapies received by patients with HER2-positive MBCPrior therapyn (%)Trastuzumab22 (88)T-DM13 (12)Lapatinib16 (64)Chemotherapy23 (92)
Six of these patients had brain metastases, in whom 1 intracranial response and 2 prolonged stable disease (≥ 6 months) were observed (Table 2).
Table 2. HER2-positive MBC patients with brain metastases - best overall response to S-222611Pts #HER2 IHCBrain metastasesBest overall response (RECIST 1.1)Patient 13+Target lesionPRPatient 23+Target lesionSD (≥12 M)Patient 33+Target lesionSD (6.0 M)Patient 43+Non-target lesionSD (4.7 M)Patient 53+Non-target lesionSD (3.3 M)Patient 63+Non-target lesionNE
The patient showing intracranial response was previously treated with lapatinib and capecitabine after diagnosis of BM.
CONCLUSIONS
S-222611 was well tolerated at a dose of 800 mg once daily. Anti-tumour activity, including shrinkage of brain metastases, was evident in a heavily pre-treated population of patients with HER2-positive breast cancer.
Citation Format: Baird RD, Arkenau H-T, Deva S, Cresti N, Garcia-Corbacho J, Hogarth L, Frenkel E, Kawaguchi K, Arimura A, Donaldson K, Posner J, Sarker D, Jodrell D, Plummer R, Spicer J, Italiano A. Phase I expansion of S-222611, a reversible inhibitor of EGFR and HER2, in advanced solid tumors, including HER2-positive breast cancer patients with brain metastases. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-14-26.
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Affiliation(s)
- RD Baird
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - H-T Arkenau
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - S Deva
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - N Cresti
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - J Garcia-Corbacho
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - L Hogarth
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - E Frenkel
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - K Kawaguchi
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - A Arimura
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - K Donaldson
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - J Posner
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - D Sarker
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - D Jodrell
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - R Plummer
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - J Spicer
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
| | - A Italiano
- University of Cambridge, Cambridge, United Kingdom; Sarah Cannon Research, London, UK, London, United Kingdom; King's College London, Guy's Hospital, London, UK, London, United Kingdom; Northern Centre for Cancer Care, Newcastle Upon Tyne, UK, Newcastle, United Kingdom; University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, TX; Shionogi & Co. Ltd., Osaka, Japan, Osaka, Japan; Institut Bergonie, Bordeaux, France, Bordeaux, France
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Oikonomopoulos G, Payne S, Ngan S, Chosdhury S, Hession M, AlRifai D, Sarker D, Ross P, Maisey N. P-143 Weight Loss during chemotherapy in patients with advanced Oesophagogastric (OG) and Hepatobiliary-Pancreatic (HPB) cancers is not a surrogate for disease progression. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Spicer J, Baird R, Suder A, Cresti N, Corbacho JG, Hogarth L, Frenkel E, Matsumoto S, Kawabata I, Donaldson K, Posner J, Sarker D, Jodrell D, Plummer R. Phase 1 dose-escalation study of S-222611, an oral reversible dual tyrosine kinase inhibitor of EGFR and HER2, in patients with solid tumours. Eur J Cancer 2015; 51:137-45. [PMID: 25434923 DOI: 10.1016/j.ejca.2014.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 10/27/2014] [Accepted: 11/10/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND S-222611 is a reversible inhibitor of EGFR, HER2 and HER4 with preclinical activity in models expressing these proteins. We have performed a Phase 1 study to determine safety, maximum tolerated dose (MTD), pharmacokinetic profile (PK) and efficacy in patients with solid tumours expressing EGFR or HER2. PATIENTS AND METHODS Subjects had advanced tumours not suitable for standard treatment, expressing EGFR or HER2, and/or with amplified HER2. Daily oral doses of S-222611 were escalated from 100mg to 1600 mg. Full plasma concentration profiles for drug and metabolites were obtained. RESULTS 33 patients received S-222611. It was well tolerated, and the most common toxicities, almost all mild (grade 1 or 2), were diarrhoea, fatigue, rash and nausea. Only two dose-limiting toxicities occurred (diarrhoea and rash), which resolved on interruption. MTD was not reached. Plasma exposure increased with dose up to 800 mg, exceeding levels eliciting pre-clinical responses. The plasma terminal half-life was more than 24h, supporting once daily dosing. Responses were seen over a wide range of doses in oesophageal, breast and renal tumours, including a complete clinical response in a patient with HER2-positive breast carcinoma previously treated with lapatinib and trastuzumab. Four patients have remained on treatment for more than 12 months. Downregulation of pHER3 was seen in paired tumour biopsies from a responding patient. CONCLUSIONS Continuous daily oral S-222611 is well tolerated, modulates oncogenic signalling, and has significant antitumour activity. The recommended Phase 2 dose, based on PK and efficacy, is 800 mg/day.
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Affiliation(s)
- J Spicer
- King's College London, Guy's Hospital, London, UK.
| | - R Baird
- University of Cambridge, Department of Oncology, Cambridge, UK
| | - A Suder
- King's College London, Guy's Hospital, London, UK
| | - N Cresti
- Northern Centre for Cancer Care, Newcastle upon Tyne, UK
| | | | - L Hogarth
- Northern Centre for Cancer Care, Newcastle upon Tyne, UK
| | - E Frenkel
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | | | - J Posner
- Shionogi & Co. Ltd., Osaka, Japan
| | - D Sarker
- King's College London, Guy's Hospital, London, UK
| | - D Jodrell
- University of Cambridge, Department of Oncology, Cambridge, UK
| | - R Plummer
- Northern Centre for Cancer Care, Newcastle upon Tyne, UK
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Plummer R, Dua D, Cresti N, Suder A, Drew Y, Prathapan V, Stephens P, Thornton J, Heras B, Ink B, Lee L, Matijevic M, McGrath S, Sarker D. Phase 1 Study of the Parp Inhibitor E7449 As a Single Agent in Patients with Advanced Solid Tumors or B-Cell Lymphoma. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu331.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Noor AM, Vizor S, McLennan B, Sarker D, Moller H, Spicer J, Papa S. The Impact of Patient Socio-Econonomic Status on Access to Early Phase Cancer Trials. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33040-4] [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: 11/16/2022] Open
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27
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Thakur SK, Roy SK, Paul K, Khanam M, Khatun W, Sarker D. Effect of nutrition education on exclusive breastfeeding for nutritional outcome of low birth weight babies. Eur J Clin Nutr 2011; 66:376-81. [PMID: 22085870 DOI: 10.1038/ejcn.2011.182] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND/OBJECTIVES Low birth weight (LBW), defined as the body weight at birth of less than 2500 g, is a major public health problem in Bangladesh, where 37% of the babies are born with LBW. The objective of this study is to see the impact of nutrition education on growth of LBW babies with early initiation and exclusive breastfeeding compared to control group. SUBJECTS/METHODS A total of 184 LBW babies and their mothers who attended the Maternal Care and Health Training Institute and Dhaka Medical College Hospital were randomly allocated to either intervention or control group. Enrollment of the study population started in May 2008 and was completed in October 2008. Nutrition education was given to mothers twice weekly for 2 months, on initiation of breastfeeding within 1 h, exclusive breastfeeding and increasing their dietary intake. Nutritional status of LBW babies was assessed for length and weight every 2 weeks. Data were analyzed using SPSS/Window's version 12. Comparison of mean of data was done using standard Student's t-test. RESULTS Mean initial body weight and length of LBW babies were similar in both groups (2261±198 g vs 2241±244 g, P=0.535 and 43.0±1.3 cm vs 43.0±1.7 cm, P=0.77). Body weight and length of the LBW babies after 2 months increased significantly (3620±229 g vs 3315±301 g, P<0.001 and 50.2±1.3 cm vs 48.7±1.6 cm, P<0.001). It was found that the intervention group suffered less from respiratory illness compared with the control group (39% vs 66%, P<0.001). The rate of early initiation of breastfeeding was also significantly higher with nutrition intervention (59.8% vs 37.2%, P<0.001). Exclusive breastfeeding rate was significantly higher in intervention group (59.8% vs 37%, P=0.003). CONCLUSIONS The present study showed that weight and length gain of LBW babies significantly increased by breastfeeding and nutrition education. Therefore, nutrition education on breastfeeding proves to be a strong tool to reduce the high risk of malnutrition and mortality of the LBW babies.
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Affiliation(s)
- S K Thakur
- Department of Food and Nurtition, College of Home Economics, Dhaka, Bangladesh
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Blanco-Codesido M, Brunetto A, Frentzas S, Moreno Garcia V, Papadatos-Pastos D, Pedersen JV, Trani L, Puglisi M, Sarker D, Molife LR, Banerji U. Clinical outcome of patients with metastasic melanoma undergoing phase I clinical trials. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8564] [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: 11/20/2022] Open
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29
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Moreno Garcia V, Baird RD, Shah KJ, Basu B, Tunariu N, Blanco M, Cassier PA, Pedersen JV, Puglisi M, Sarker D, Papadatos-Pastos D, Omlin AG, Biondo A, Ware JA, Koeppen H, Levy GG, Mazina KE, De Bono JS. A phase I study evaluating GDC-0941, an oral phosphoinositide-3 kinase (PI3K) inhibitor, in patients with advanced solid tumors or multiple myeloma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Basu B, Ang JE, Crawley D, Folkerd E, Sarker D, Blanco-Codesido M, Moran K, Wan S, Dobbs N, Raynaud F, Johnston SRD, Dowsett M, Tutt ANJ, Spicer JF, Swanton C, De Bono JS. Phase I study of abiraterone acetate (AA) in patients (pts) with estrogen receptor– (ER) or androgen receptor (AR) –positive advanced breast carcinoma resistant to standard endocrine therapies. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2525] [Citation(s) in RCA: 4] [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: 11/20/2022] Open
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Brunetto AT, Sarker D, Papadatos-Pastos D, Fehrmann R, Kaye SB, Johnston S, Allen M, De Bono JS, Swanton C. A retrospective analysis of clinical outcome of patients with chemo-refractory metastatic breast cancer treated in a single institution phase I unit. Br J Cancer 2010; 103:607-12. [PMID: 20664586 PMCID: PMC2938255 DOI: 10.1038/sj.bjc.6605812] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 06/24/2010] [Accepted: 06/25/2010] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND METHODS Novel approaches to treat chemo-refractory metastatic breast cancer (MBC) are currently under investigation. This retrospective series reviews the outcome of 70 MBC patients who have participated in 30 phase I trials at the Royal Marsden Hospital from 2002 to 2009. RESULTS The median treatment lines before phase I trial entry for MBC was 5 (range: 1-12 lines). The overall response rate was 11.4% (95% CI: 4.0-18.9%) and the clinical benefit rate at 4 months was 20% (95% CI: 10.6-29.3). The median time to progression was 7.0 weeks (95% CI: 6.4-7.5) and median overall survival was 8.7 months (95% CI: 7.6-9.8) from start of first phase I treatment. No patients discontinued trial because of treatment-related toxicities. Abnormal lactate dehydrogenase, serum albumin <35 mg per 100 ml, >or=5 previous treatment lines, liver metastases and Eastern Cooperative Group performance status >or=2 at study entry were significantly associated with poor overall survival in multivariate analysis. CONCLUSION This retrospective analysis provides evidence that patients with MBC tolerate phase I clinical trials and a significant proportion of patients with chemo-refractory disease, particularly those with triple-negative or Her2-positive breast cancer, may benefit from treatment.
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Affiliation(s)
- A T Brunetto
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - D Sarker
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - D Papadatos-Pastos
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - R Fehrmann
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - S B Kaye
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - S Johnston
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - M Allen
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - J S De Bono
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
| | - C Swanton
- The Royal Marsden Hospital Drug Development and Breast Units and Institute of Cancer Research, Sutton, UK
- Translational Cancer Therapeutics Laboratory, Cancer Research UK, London Research Institute, UK
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Alam SM, Fehrmann RS, Olmos D, Shah K, Puglisi M, Sarker D, Brunetto A, Postel-Vinay S, Baird RD, Molife LR. Defining the risk of toxicity in phase I oncology trials of novel molecularly targeted agents: A single-center experience. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Baird RD, Kristeleit RS, Sarker D, Olmos D, Sandhu SK, Yan Y, Koeppen H, Levy GG, Jin J, De Bono JS. A phase I study evaluating the pharmacokinetics (PK) and pharmacodynamics (PD) of the oral pan-phosphoinositide-3 kinase (PI3K) inhibitor GDC-0941. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2613] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kristeleit R, Sarker D, Forster M, Lolkema M, Olmos D, Mazina K, Dolezal M, Ware J, Yan Y, de Bono J. 1204 A Phase I study evaluating the pharmacokinetics (PK) and pharmacodynamics (PD) of the oral pan-phosphoinositide-3 kinase (PI3K) inhibitor GDC-0941. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70416-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sarker D, Kristeleit R, Mazina KE, Ware JA, Yan Y, Dresser M, Derynck MK, De-Bono J. A phase I study evaluating the pharmacokinetics (PK) and pharmacodynamics (PD) of the oral pan-phosphoinositide-3 kinase (PI3K) inhibitor GDC-0941. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3538] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3538 Background: The PI3K-PTEN-AKT signaling pathway is deregulated in a wide variety of cancers. GDC-0941 is a potent and selective oral inhibitor of class I PI3K and demonstrates activity in a broad range of preclinical models (breast, ovarian, lung, and prostate). Methods: Patients (pts) with histologically confirmed advanced solid tumors and ECOG PS 0–1 were treated with GDC-0941 using a 3+3 escalation design at a single institution. Treatment was a single dose with 1wk washout, followed by GDC-0941 qd on a 3wk on, 1wk off schedule. Objectives were to determine MTD and DLT, evaluate PD endpoints in surrogate (pAKT in platelet rich plasma) and tumor (pAKT and pS6 in paired tumor biopsies and FDG uptake via PET imaging) tissues, and describe anti-tumor activity. Results: Thirteen patients have been enrolled in 4 successive cohorts (15–60 mg qd). GDC-0941 was generally well-tolerated with no drug related Grade 3 or 4 AEs or DLTs to date. Grade 1 diarrhea, nausea, dysgeusia, peripheral sensory neuropathy, dry mouth, thrombocytopenia, and increased aspartate aminotransferase have been observed. Preliminary PK data suggest dose-proportional increases in fasting mean Cmax and AUC. Preliminary PD data show decreased levels of pAKT in platelet rich plasma correlated with GDC-0941 plasma concentrations. GDC-0941 effects on FDG-PET imaging is being assessed, with 1 patient with HER2+ metastatic breast cancer showing a reduction in FDG uptake and improvement of a chest wall lesion (dose level 60 mg qd). Evaluation of PI3K pathway modulation from paired tumor biopsies is underway. Conclusions: GDC-0941 is generally well tolerated when administered qd at doses associated with inhibition of pAKT in surrogate tissues. Evidence of PD activity in tumor tissue has also been observed. Dose-escalation continues and updated PK/PD data will be presented. [Table: see text]
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Affiliation(s)
- D. Sarker
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
| | - R. Kristeleit
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
| | - K. E. Mazina
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
| | - J. A. Ware
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
| | - Y. Yan
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
| | - M. Dresser
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
| | - M. K. Derynck
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
| | - J. De-Bono
- Royal Marsden Hospital, Sutton, United Kingdom; Genentech, Inc., South San Francisco, CA
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LoRusso P, Sarker D, Von Hoff D, Tibes R, Derynck M, Ware J, Yan Y, Demetri G, de Bono J, Wagner A. 223 POSTER Pharmacokinetics and pharmacodynamic biomarkers for the pan-PI3K inhibitor GDC-0941: Initial Phase I evaluation. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)72155-4] [Citation(s) in RCA: 4] [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: 11/26/2022] Open
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Sarker D, Anderson D, Spanswick VJ, Davies S, Agarwal R, Aitken G, Kerr DJ, Hartley JA, Judson I, Middleton MR. Preliminary results of a Cancer Research UK phase I trial combining the dinitrobenzamide prodrug CB1954 (tretazicar) and the NQO2 substrate EP-0152R (caricotamide) intravenously (IV) every 3 weeks. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.2505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wahed F, Latif SA, Uddin MM, Mahamud MM, Sarker D, Hossain MZ. Persistence of low serum iron and high total iron binding capacity in pregnant women. Mymensingh Med J 2007; 16:132-6. [PMID: 17703147] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
A cross sectional descriptive type of study was done in 98 women of reproductive age. Among them 25 were in control group of non pregnant women and 73 were pregnant women of 1st, 2nd and 3rd trimester of pregnancy with and without iron supplementation. The period of study was July 2004 to June 2005. The main objective of our study was to compare serum iron and total iron binding capacity in pregnant and non pregnant women. In present study serum iron was significantly increased in 2nd and 3rd trimester of pregnancy that was supplemented with iron when compared with the same category of women who were not supplemented with iron. On the other hand serum total iron binding capacity (TIBC) was significantly increased in 3rd trimester of pregnancy that was not supplemented with iron when compared with the same category of women who were supplemented with iron. It is evident that the significantly low serum iron and high TIBC in pregnant women is due in part to dietary iron deficiency. Therefore, iron therapy in pregnancy is helpful to maintain the serum iron and TIBC nearer to that of non pregnant normal women.
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Affiliation(s)
- F Wahed
- Community Based Medical College, Winnerpar, Mymensingh, Bangladesh
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Attard G, Sarker D, Reid A, Molife R, Parker C, de Bono JS. Improving the outcome of patients with castration-resistant prostate cancer through rational drug development. Br J Cancer 2006; 95:767-74. [PMID: 16983403 PMCID: PMC2360544 DOI: 10.1038/sj.bjc.6603223] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [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] [Indexed: 01/21/2023] Open
Abstract
Castration-resistant prostate cancer (CRPC) is now the second most common cause of male cancer-related mortality. Although docetaxel has recently been shown to extend the survival of patients with CRPC in two large randomised phase III studies, subsequent treatment options remain limited for these patients. A greater understanding of the molecular causes of castration resistance is allowing a more rational approach to the development of new drugs and many new agents are now in clinical development. Therapeutic targets include the adrenal steroid synthesis pathway, androgen receptor signalling, the epidermal growth factor receptor family, insulin growth factor-1 receptor, histone deacetylase, heat shock protein 90 and the tumour vasculature. Drugs against these targets are giving an insight into the molecular pathogenesis of this disease and promise to improve patient quality of life and survival. Finally, the recent discovery of chromosomal translocations resulting in the upregulation of one of at least 3 ETS genes (ERG, ETV1, ETV4) may lead to novel agents for the treatment of this disease.
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Affiliation(s)
- G Attard
- Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK
| | - D Sarker
- Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK
| | - A Reid
- Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK
| | - R Molife
- Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK
| | - C Parker
- Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK
| | - J S de Bono
- Cancer Research UK Centre for Cancer Therapeutics, Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK
- E-mail:
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Sarker D, Evans J, Hardie M, Molife R, Marriott C, Morrison R, Garzon F, Heise C, Michelson G, De-Bono J. A phase 1, pharmacokinetic (PK) and pharmacodynamic (PD) study of CHIR-258, a novel oral multiple receptor tyrosine kinase (RTK) inhibitor. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3043 Background: CHIR-258 is a potent small molecule inhibitor of VEGF, FGF, PDGF and c-KIT RTKs with IC50≤10nM that demonstrates activity in a variety of angiogenesis, tumour and metastasis models. Methods: Patients (pts) with histologically confirmed advanced solid tumors, ECOG PS 0–2 were treated in cohorts of 3–6 with CHIR-258. Treatment was as single daily doses on a repeated 7 days (d) on/7d off schedule (25–100mg), with a subsequent protocol amendment to continuous (cont) daily dosing. The objectives were to determine maximum tolerated dose (MTD) and dose limiting toxicity (DLT), evaluate PK and PD endpoints - ERK phosphorylation in PBL - and describe anti-tumour activity. Results: 35pts (median age 56.5 yrs; 15F/20M) were treated in 4 intermittent dosing cohorts (25, 50, 75, 100 mg/d) and 3 continuous dosing cohorts (100,125, 175 mg/d). The most common drug related adverse events were (grade [gr], number of pts): nausea (gr 1–3, 12); fatigue (gr 1–2, 9); headache (gr 1–3, 8); vomiting (gr 1–2, 7); anorexia (gr 1–2, 7); diarrhoea (gr 1–2, 6); dysgeusia (gr1–2, 6); anaemia (gr 2–3, 4); hypertension (gr 1–3, 3) and reversible asymptomatic drop in left ventricular ejection fraction (gr 2, 2). DLTs were gr 3 hypertension (HTN) in 1 pt with pre-existing HTN (100mg, cont); asymptomatic uncomplicated grade 2 elevation in cardiac troponin I (125mg); gr 3 anorexia/fatigue and gr 3 rise in alkaline phosphatase (both at 175mg). 3 pts have had prolonged stable disease (all 4m+; parotid, renal and imatinib-refractory GIST). The plasma PKs of CHIR-258 were linear over the dose range of 25–175 mg with respect to Cmax and AUC. On d1, the mean Cmax was 13.5(5.3) ng/mL to 109 (26) ng/mL, the mean AUC (0–24) was 224(97.4)ng*h/mL to 1740(466)ng*h/mL, and the t½ was 17h. Trough CHIR-258 concentrations at doses >50 mg/d were above the concentrations known to inhibit target receptor activation in vitro. Data on evaluable samples demonstrate up to 90% inhibition of basal ERK phosphorylation. Conclusions: CHIR-258 was safely administered at continuous daily doses up to 175mg/d. Modulation of p-ERK was demonstrated. Treatment is associated with disease stabilization. [Table: see text]
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Affiliation(s)
- D. Sarker
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - J. Evans
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - M. Hardie
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - R. Molife
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - C. Marriott
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - R. Morrison
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - F. Garzon
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - C. Heise
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - G. Michelson
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
| | - J. De-Bono
- Royal Marsden Hospital, Sutton, United Kingdom; Beatson Oncology Centre, Glasgow, United Kingdom; Chiron Corporation, Uxbridge, United Kingdom; Chiron Corporation, Emeryville, CA
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Sarker D, Evans J, Judson I, Butzberger P, Marriott C, Morrison R, Vora J, Heise C, Hannah A, de Bono J. CHIR-258: first-in-human phase 1 dose escalating trial of an oral, selectively targeted tyrosine kinase inhibitor in patients with solid tumors. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D. Sarker
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - J. Evans
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - I. Judson
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - P. Butzberger
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - C. Marriott
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - R. Morrison
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - J. Vora
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - C. Heise
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - A. Hannah
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
| | - J. de Bono
- Royal Marsden Hosp, Sutton, United Kingdom; Beatson Oncology Ctr, Glasgow, United Kingdom; Chiron Corp, Emeryville, CA
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Chakrabarti S, Aich P, Sarker D, Bhattacharyya D, Dasgupta D. Role of Mg2+ in the interaction of anticancer antibiotic, chromomycin A3 with DNA: does neutral antibiotic bind DNA in absence of the metal ion? J Biomol Struct Dyn 2000; 18:209-18. [PMID: 11089642 DOI: 10.1080/07391102.2000.10506659] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Antitumor antibiotic, Chromomycin A3 (CHR), inhibits DNA replication and transcription via reversible interaction with double stranded DNA with GC-base specificity. The interaction, at and above physiological pH, requires the presence of bivalent metal ions, such as Mg2+. Anionic antibiotic does not bind DNA in the absence of Mg2+. In this paper we have examined the structural potential of neutral CHR at pH 5.2 to bind DNA in the absence of Mg2+. We have demonstrated the ability of the neutral antibiotic to bind DNA by means of different spectroscopic techniques and evaluated the necessary thermodynamic parameters for elucidation of the molecular basis of recognition. The results are compared with the scenario when Mg2+ is present in the system, because the ultimate aim of these studies is to elucidate the role of Mg2+ in CHR-DNA recognition. Neutral CHR binds to Mg2+ with lesser affinity than its anionic form. Spectroscopic features of the drug and its Mg2+ complex indicate self association of the antibiotic in the absence and presence of Mg2+. GC-base specificity of the drug and its Mg2+ complex are retained at pH 5.2, though the modes of recognition of DNA by the two ligands are different. Minor groove width of DNA plays a role in the accommodation of the ligand(s) during the GC base specific recognition while positive charge of Mg2+ in CHR:Mg2+ complex further facilitates the association. Relatively lower affinity of the neutral drug and its Mg2+ complex for DNA can be ascribed to the self association of these ligands in the absence of DNA.
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Affiliation(s)
- S Chakrabarti
- Biophysics Division, Saha Institute of Nuclear Physics, Calcutta, India
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Abstract
Key Words: Bagging materials; control; mango fruit fly. DOI: 10.3329/bjar.v34i1.5766Bangladesh J. Agril. Res. 34(1) : 165-168, March 2009
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