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Roy AS, Banerjee K, Roy P, Shil R, Ravishankar R, Datta R, Sen A, Manna S, Ghosh TK, Mukherjee G, Rana TK, Kundu S, Nayak SS, Pandey R, Paul D, Atreya K, Basu S, Mukhopadhyay S, Pandit D, Kulkarni MS, Bhattacharya C. Measurement of energy and directional distribution of neutron ambient dose equivalent for the 7Li(p,n) 7Be reaction. Appl Radiat Isot 2024; 204:111140. [PMID: 38070360 DOI: 10.1016/j.apradiso.2023.111140] [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: 03/14/2023] [Revised: 11/13/2023] [Accepted: 12/02/2023] [Indexed: 12/31/2023]
Abstract
Double differential neutron fluence distributions were measured in the 7Li(p,n)7Be reaction for proton beam energies 7, 9 and 12 MeV. Seven liquid scintillator based detectors were employed to measure neutron fluence distributions using the Time of Flight technique. Neutron ambient dose equivalents were determined from the measured fluence distribution using ICRP (International Commission on Radiological Protection) recommended fluence to dose equivalent conversion coefficients. Neutron dose equivalents were also measured using a conventional BF3 detector based REM counter. Ambient dose equivalent measured by the REM counter is found to be in agreement with that determined from the neutron fluence spectra within their uncertainties. Angular distributions of the ambient dose equivalents were also determined from the measured fluence distributions at different angles.
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Affiliation(s)
- A S Roy
- Health Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - K Banerjee
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India.
| | - Pratap Roy
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - R Shil
- Visva Bharati University, Santiniketan, Bolpur, West Bengal 731235, India
| | - R Ravishankar
- Health Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - R Datta
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; RP&AD, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
| | - A Sen
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Manna
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - T K Ghosh
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - G Mukherjee
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - T K Rana
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Kundu
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S S Nayak
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - R Pandey
- Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - D Paul
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - K Atreya
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Basu
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - S Mukhopadhyay
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - Deepak Pandit
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
| | - M S Kulkarni
- Health Physics Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - C Bhattacharya
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India; Variable Energy Cyclotron Centre, 1/AF, Bidhannagar, Kolkata 700064, India
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Huang W, Paul D, Calin GA, Bayraktar R. miR-142: A Master Regulator in Hematological Malignancies and Therapeutic Opportunities. Cells 2023; 13:84. [PMID: 38201290 PMCID: PMC10778542 DOI: 10.3390/cells13010084] [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: 09/25/2023] [Revised: 11/29/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
MicroRNAs (miRNAs) are a type of non-coding RNA whose dysregulation is frequently associated with the onset and progression of human cancers. miR-142, an ultra-conserved miRNA with both active -3p and -5p mature strands and wide-ranging physiological targets, has been the subject of countless studies over the years. Due to its preferential expression in hematopoietic cells, miR-142 has been found to be associated with numerous types of lymphomas and leukemias. This review elucidates the multifaceted role of miR-142 in human physiology, its influence on hematopoiesis and hematopoietic cells, and its intriguing involvement in exosome-mediated miR-142 transport. Moreover, we offer a comprehensive exploration of the genetic and molecular landscape of the miR-142 genomic locus, highlighting its mutations and dysregulation within hematological malignancies. Finally, we discuss potential avenues for harnessing the therapeutic potential of miR-142 in the context of hematological malignancies.
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Affiliation(s)
- Wilson Huang
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (W.H.); (G.A.C.)
| | - Doru Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA;
| | - George A. Calin
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (W.H.); (G.A.C.)
- Center for RNA Interference and Non-Coding RNAs, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Recep Bayraktar
- Center for RNA Interference and Non-Coding RNAs, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Iacob R, Paul D, Popescu I. Editorial: The emerging role of liquid biopsy in gastrointestinal, pancreatic and liver cancers. Front Med (Lausanne) 2023; 10:1341739. [PMID: 38169840 PMCID: PMC10759217 DOI: 10.3389/fmed.2023.1341739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Razvan Iacob
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center for Excellence in Translation Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Doru Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY, United States
| | - Irinel Popescu
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center for Excellence in Translation Medicine, Fundeni Clinical Institute, Bucharest, Romania
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Arockiaraj M, Paul D, Clement J, Tigga S, Jacob K, Balasubramanian K. Novel molecular hybrid geometric-harmonic-Zagreb degree based descriptors and their efficacy in QSPR studies of polycyclic aromatic hydrocarbons. SAR QSAR Environ Res 2023; 34:569-589. [PMID: 37538006 DOI: 10.1080/1062936x.2023.2239149] [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] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
The physicochemical characteristics of polycyclic aromatic compounds critical to environmental modelling such as octanol partition coefficients, solubility, lipophilicity, polarity and several equilibrium constants are functions of their underlying molecular structures, prompting the development of mathematical models to predict such characteristics for which experimental results are difficult to obtain. We propose twelve novel descriptors derived from geometric, harmonic and Zagreb degree-based descriptors and then test the effectiveness of these descriptors on a data set consisting of 55 benzenoid hydrocarbons of environmental importance. Our computations show that the proposed descriptors have a good linear correlation and predictive power when compared to the degree and distance type descriptors. We have also derived the QSPR expressions for four properties of a large series of polycyclic aromatics arising from circumscribing coronenes and show that a scaling factor can be deduced to derive physicochemical properties of such series up to 2D graphene sheets.
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Affiliation(s)
- M Arockiaraj
- Department of Mathematics, Loyola College, Chennai, India
| | - D Paul
- Department of Mathematics, Sri Sairam Institute of Technology, Chennai, India
| | - J Clement
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
| | - S Tigga
- Department of Mathematics, Loyola College, Chennai, India
| | - K Jacob
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
| | - K Balasubramanian
- School of Molecular Sciences, Arizona State University, Tempe, AZ, USA
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Patras L, Paul D, Matei IR. Weaving the nest: extracellular matrix roles in pre-metastatic niche formation. Front Oncol 2023; 13:1163786. [PMID: 37350937 PMCID: PMC10282420 DOI: 10.3389/fonc.2023.1163786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023] Open
Abstract
The discovery that primary tumors condition distant organ sites of future metastasis for seeding by disseminating tumor cells through a process described as the pre-metastatic niche (PMN) formation revolutionized our understanding of cancer progression and opened new avenues for therapeutic interventions. Given the inherent inefficiency of metastasis, PMN generation is crucial to ensure the survival of rare tumor cells in the otherwise hostile environments of metastatic organs. Early on, it was recognized that preparing the "soil" of the distal organ to support the outgrowth of metastatic cells is the initiating event in PMN development, achieved through the remodeling of the organ's extracellular matrix (ECM). Remote restructuring of ECM at future sites of metastasis under the influence of primary tumor-secreted factors is an iterative process orchestrated through the crosstalk between resident stromal cells, such as fibroblasts, epithelial and endothelial cells, and recruited innate immune cells. In this review, we will explore the ECM changes, cellular effectors, and the mechanisms of ECM remodeling throughout PMN progression, as well as its impact on shaping the PMN and ultimately promoting metastasis. Moreover, we highlight the clinical and translational implications of PMN ECM changes and opportunities for therapeutically targeting the ECM to hinder PMN formation.
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Affiliation(s)
- Laura Patras
- Children’s Cancer and Blood Foundation Laboratories, Department of Pediatrics, Division of Hematology/Oncology, Drukier Institute for Children’s Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, United States
- Department of Molecular Biology and Biotechnology, Center of Systems Biology, Biodiversity and Bioresources, Faculty of Biology and Geology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Doru Paul
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Irina R. Matei
- Children’s Cancer and Blood Foundation Laboratories, Department of Pediatrics, Division of Hematology/Oncology, Drukier Institute for Children’s Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, United States
- Department of Molecular Biology and Biotechnology, Center of Systems Biology, Biodiversity and Bioresources, Faculty of Biology and Geology, Babes-Bolyai University, Cluj-Napoca, Romania
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Wang G, Li J, Bojmar L, Chen H, Li Z, Tobias GC, Hu M, Homan EA, Lucotti S, Zhao F, Posada V, Oxley PR, Cioffi M, Kim HS, Wang H, Lauritzen P, Boudreau N, Shi Z, Burd CE, Zippin JH, Lo JC, Pitt GS, Hernandez J, Zambirinis CP, Hollingsworth MA, Grandgenett PM, Jain M, Batra SK, DiMaio DJ, Grem JL, Klute KA, Trippett TM, Egeblad M, Paul D, Bromberg J, Kelsen D, Rajasekhar VK, Healey JH, Matei IR, Jarnagin WR, Schwartz RE, Zhang H, Lyden D. Tumour extracellular vesicles and particles induce liver metabolic dysfunction. Nature 2023; 618:374-382. [PMID: 37225988 PMCID: PMC10330936 DOI: 10.1038/s41586-023-06114-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/21/2023] [Indexed: 05/26/2023]
Abstract
Cancer alters the function of multiple organs beyond those targeted by metastasis1,2. Here we show that inflammation, fatty liver and dysregulated metabolism are hallmarks of systemically affected livers in mouse models and in patients with extrahepatic metastasis. We identified tumour-derived extracellular vesicles and particles (EVPs) as crucial mediators of cancer-induced hepatic reprogramming, which could be reversed by reducing tumour EVP secretion via depletion of Rab27a. All EVP subpopulations, exosomes and principally exomeres, could dysregulate hepatic function. The fatty acid cargo of tumour EVPs-particularly palmitic acid-induced secretion of tumour necrosis factor (TNF) by Kupffer cells, generating a pro-inflammatory microenvironment, suppressing fatty acid metabolism and oxidative phosphorylation, and promoting fatty liver formation. Notably, Kupffer cell ablation or TNF blockade markedly decreased tumour-induced fatty liver generation. Tumour implantation or pre-treatment with tumour EVPs diminished cytochrome P450 gene expression and attenuated drug metabolism in a TNF-dependent manner. We also observed fatty liver and decreased cytochrome P450 expression at diagnosis in tumour-free livers of patients with pancreatic cancer who later developed extrahepatic metastasis, highlighting the clinical relevance of our findings. Notably, tumour EVP education enhanced side effects of chemotherapy, including bone marrow suppression and cardiotoxicity, suggesting that metabolic reprogramming of the liver by tumour-derived EVPs may limit chemotherapy tolerance in patients with cancer. Our results reveal how tumour-derived EVPs dysregulate hepatic function and their targetable potential, alongside TNF inhibition, for preventing fatty liver formation and enhancing the efficacy of chemotherapy.
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Affiliation(s)
- Gang Wang
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Jianlong Li
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
- Department of Orthopedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Linda Bojmar
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Haiyan Chen
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
- Department of Radiation Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Hangzhou, China
| | - Zhong Li
- Duke Proteomics and Metabolomics Shared Resource, Duke University School of Medicine, Durham, NC, USA
| | - Gabriel C Tobias
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Mengying Hu
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Edwin A Homan
- Cardiovascular Research Institute and Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Serena Lucotti
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Fengbo Zhao
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
- Basic Medical Research Center, Medical School of Nantong University, Nantong, China
| | - Valentina Posada
- Departments of Molecular Genetics, Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA
| | - Peter R Oxley
- Samuel J. Wood Library, Weill Cornell Medicine, New York, NY, USA
| | - Michele Cioffi
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Han Sang Kim
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Brain Korea 21 FOUR Project for Medical Science, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Huajuan Wang
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Pernille Lauritzen
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Nancy Boudreau
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Zhanjun Shi
- Department of Orthopedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Christin E Burd
- Departments of Molecular Genetics, Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA
| | - Jonathan H Zippin
- Department of Dermatology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - James C Lo
- Cardiovascular Research Institute and Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Geoffrey S Pitt
- Cardiovascular Research Institute and Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Jonathan Hernandez
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Constantinos P Zambirinis
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Michael A Hollingsworth
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paul M Grandgenett
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Maneesh Jain
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Surinder K Batra
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dominick J DiMaio
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jean L Grem
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kelsey A Klute
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tanya M Trippett
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mikala Egeblad
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | - Doru Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Jacqueline Bromberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Kelsen
- Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Vinagolu K Rajasekhar
- Orthopedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John H Healey
- Orthopedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Irina R Matei
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - William R Jarnagin
- Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert E Schwartz
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
| | - Haiying Zhang
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.
| | - David Lyden
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.
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Paul D, Nedelcu AM. The underexplored links between cancer and the internal body climate: Implications for cancer prevention and treatment. Front Oncol 2022; 12:1040034. [PMID: 36620608 PMCID: PMC9815514 DOI: 10.3389/fonc.2022.1040034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
In order to effectively manage and cure cancer we should move beyond the general view of cancer as a random process of genetic alterations leading to uncontrolled cell proliferation or simply a predictable evolutionary process involving selection for traits that increase cell fitness. In our view, cancer is a systemic disease that involves multiple interactions not only among cells within tumors or between tumors and surrounding tissues but also with the entire organism and its internal "milieu". We define the internal body climate as an emergent property resulting from spatial and temporal interactions among internal components themselves and with the external environment. The body climate itself can either prevent, promote or support cancer initiation and progression (top-down effect; i.e., body climate-induced effects on cancer), as well as be perturbed by cancer (bottom-up effect; i.e., cancer-induced body climate changes) to further favor cancer progression and spread. This positive feedback loop can move the system towards a "cancerized" organism and ultimately results in its demise. In our view, cancer not only affects the entire system; it is a reflection of an imbalance of the entire system. This model provides an integrated framework to study all aspects of cancer as a systemic disease, and also highlights unexplored links that can be altered to both prevent body climate changes that favor cancer initiation, progression and dissemination as well as manipulate or restore the body internal climate to hinder the success of cancer inception, progression and metastasis or improve therapy outcomes. To do so, we need to (i) identify cancer-relevant factors that affect specific climate components, (ii) develop 'body climate biomarkers', (iii) define 'body climate scores', and (iv) develop strategies to prevent climate changes, stop or slow the changes, or even revert the changes (climate restoration).
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Affiliation(s)
- Doru Paul
- Weill Cornell Medicine, New York, NY, United States,*Correspondence: Doru Paul,
| | - Aurora M. Nedelcu
- Biology Department, University of New Brunswick, Fredericton, NB, Canada
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Jeklin A, Alamgeer M, Stirling R, Maccora J, Kumarahuru R, Paul D, Afsana A, Wiley J. P2.08-02 Burning the Candle at Both Ends-Sleep Quality Before and After Chemotherapy in Lung Cancer Patients - A Systematic Review and Meta-Analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.230] [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]
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Paul D, Bhuiya MI, Paul UK, Dey B, Khan MK. Chest HRCT Severity Scores among Hospitalized Patients with COVID-19. Mymensingh Med J 2022; 31:819-825. [PMID: 35780369] [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: 06/15/2023]
Abstract
Corona Virus Disease 2019 (COVID-19) was declared a pandemic in March 2020. This global health crisis caused thousands of pneumonia related death all over the world since December 2019. RT-PCR is the primary test for diagnosis of COVID-19, though its sensitivity and specificity is variable. Several studies revealed that chest HRCT complements RT-PCR in highly suspected cases or in false negative RT-PCR and helps to gauge disease severity. This study was carried out with an aim to find out the severity scores of chest HRCT in hospitalized patients with COVID-19. This cross sectional descriptive type of observational study was carried out at COVID-19 unit of Sylhet Women's Medical College Hospital, Bangladesh from April 2021 to September 2021. Data were collected from purposively selected 204 patients with COVID-19 by face to face interview, chest HRCT and necessary laboratory investigations. Informed written consent was taken from the participants of the study at the beginning of the interview. Data were analyzed by using SPSS version 21.0. The results of the study showed that mean age of the patients with COVID-19 was 57.9 years with a standard deviation of ±15.8 years. Majority of them (121, 59.3%) were female and the remaining (83, 40.7%) were male. Regarding co-morbidities it was found that each 115 (56.4%) patients were hypertensive and diabetic. Thirty five (16.2%) had ischemic heart disease; 3(1.5%) had congestive cardiac failure and 2(1.0%) had asthma. One (0.5%) patient has atrial fibrillation. In case of 160(78.4%) RT-PCR confirmed patients with COVID-19, chest HRCT was found positive and in 44(21.6%) it was found negative. Among the positive cases mild (7 or less) chest HRCT score was found in 26(12.7%) patients; moderate (8-17) score was found in highest number of patients (128, 62.7%) and severe (18 or more) chest HRCT score was found in 6(2.9%) patients with COVID-19. Chi-square test was carried out to assess the relation of chest HRCT scores with age group, sex, troponin-I, D-Dimer and clinical outcomes within CCU but statistically significant relation was not found (p>0.05). The negative scans were highest (20, 9.8%) in the age group of 41-60 years. Mild, moderate and severe chest HRCT scores was found highest in the age group of 61-80 years (13, 6.4%; 51, 25.0% and 5, 2.5% respectively) (p=0.508). Chest HRCT scans were negative in 18(8.8%) male and 26(12.7%) female. Mild scores were equally distributed between each sex i.e. male 13(6.4%) and female 13(6.4%). Both moderate and severe scores were found more in female (77, 37.7% and 5, 2.5% respectively) than male (51, 25.0% and 1, 0.5% respectively) (p=0.492). Negative chest HRCT scans, mild, moderate and severe scores-all were found more in patients with elevated D-Dimer (p=0.194). Among 204 patients one (0.5%) died in the CCU who had mild score of chest HRCT (p=0.076) but highly elevated Troponin-I (21.70ng/mL). Chest HRCT was found positive among 78.4% of patients with COVID-19 confirmed by RT-PCR. Chest HRCT can help physicians to detect suspected cases and to assess the severity and outcome of the disease. However, further research is recommended to clarify the role of chest HRCT in assessing severity of COVID-19 and prediction of prognosis.
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Affiliation(s)
- D Paul
- Dr Debashish Paul, Associate Professor, Department of Cardiology, Sylhet Women's Medical College, Bangladesh; E-mail:
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Burja B, Paul D, Gerber R, Edalat SG, Elhai M, Pachera E, Zingg RS, Pramotton FM, Madsen SF, Buerki K, Costanza G, Whitfield M, Bay-Jensen AC, Sodin-Šemrl S, Tomsic M, Kania G, Rehrauer H, Distler O, Rotar Z, Robinson M, Lakota K, Frank Bertoncelj M. OP0095 SINGLE-CELL RNA SEQUENCING REVEALS POTENT ANTI-INFLAMMATORY AND ANTIFIBROTIC ACTIVITIES OF DIMETHYL-ALPHA-KETOGLUTARATE ON EXPLANTED SKIN FROM PATIENTS WITH SYSTEMIC SCLEROSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundActivated fibroblasts are the main drivers of skin fibrosis in SSc. We have recently identified dimethyl alpha-ketoglutarate (dm-aKG) as a potential repressor of myofibroblast differentiation and profibrotic activity in cultured skin fibroblasts.ObjectivesTo further analyse the clinical translation of our findings by investigating the antifibrotic capacity of dm-aKG on explanted skin biopsies from SSc patients.MethodsWe cultured forearm punch skin biopsies from SSc patients (n=10) for 24h ex vivo in the presence/absence of 6 mM dm-aKG. Thereafter, skin biopsies (n=4) were dissociated into single cells using a combined mechanical-enzymatic dissociation protocol, followed by single cell (sc)RNA-seq library preparation (10x Genomics) and sequencing (Illumina, NovaSeq6000, 50,000 reads/cell). We mapped the scRNA-seq reads to the reference genome GRCh38.p13 and analysed the data with R/Bioconductor tools. We deconvoluted cell types in bulk skin transcriptomes from SSc cohorts (GSE: 45485, 59785, 9285, 32413) using human skin scRNA-seq data1. The secretion of IL-6, procollagen-1, PRO-C1 (N-terminal type I collagen pro-peptide), C1M (MMP-degradation fragment of type I collagen), and fibronectin (FBN-C) from cultured skin (n=10) was measured in supernatants by ELISA. We analysed gene and protein expression in TGFβ-activated healthy and SSc dermal fibroblasts (DF, n=10) treated or not with dm-aKG using qPCR, Western blot and ELISA. Contractile properties of DF were assessed by gel contraction assay. Traction forces generated by DF were determined by reference-free traction force microscopy.ResultsDissociated cultured SSc skin exhibited comparable cell yield and viability in the presence (20,203; 89%) and absence (25,280; 93%) of dm-aKG, respectively. scRNA-seq skin analysis included 20,869 high quality single cell profiles segregating into 10 distinct skin cell populations (Figure 1A). This analysis demonstrated decreased proportion of fibroblasts and increased proportion of keratinocytes in dm-aKG treated skin (p<0.05; Figure 1B). Among skin cell types, skin fibroblasts exhibited the largest amount of differentially expressed genes upon dm-aKG treatment (44%, n=779, x-fold>0.5, FDR<0.05), suggesting that these cells are key targets of dm-aKG therapy in SSc skin. We identified inflammatory/cytokine signalling (hub genes IL6, STAT1) and extracellular matrix (ECM) organization (hub genes MMP1, ITGB3) as top downregulated biological processes in fibroblasts in dm-aKG treated SSc skin (Figure 1C), coinciding with a decreased abundance of proinflammatory skin fibroblast subpopulation. Specifically, these cells were identified as the main source of IL6 (Figure 1D) and were enriched in SSc skin as revealed by deconvolution analysis of skin transcriptomes. Furthermore, dm-aKG reduced the secretion of IL-6, procollagen-1 and C1M, but not pro-C1 and FBN-C, from cultured skin explants. In cultured DF, dm-aKG blocked the inflammatory (IL-6, pSTAT3), profibrotic (aSMA, Fibronectin, Procollagen-1, Pro-C1) and contractile activities, and significantly diminished traction forces exerted by DF on the matrix substrate.Figure 1.scRNA-seq – comparison of untreated and dm-aKG treated paired skin biopsies. (A) UMAP plot with annotated skin cells, (B) differential abundance of main skin cell types, (C) volcano plot of DE genes with top downregulated gene ontology (GO) pathways in dm-aKG treated skin fibroblasts, (D) IL6 expression in untreated (blue) and treated (pink) skin fibroblasts.ConclusionDm-aKG broadly interferes with inflammatory and ECM organizational activities of skin fibroblasts in culture and in explanted skin from SSc patients. These results confirm that dm-aKG might represent a potential new therapeutic approach for efficient targeting of skin inflammation and fibrosis in SSc.References[1]He H et al. J Allergy Clin Immunol 2020AcknowledgementsThis work was supported by a research grant from FOREUM Foundation for Research in Rheumatology and University Medical Centre Ljubljana.Disclosure of InterestsBlaž Burja: None declared, Dominique Paul: None declared, Reto Gerber: None declared, Sam G. Edalat: None declared, Muriel Elhai Speakers bureau: BMS, Elena Pachera: None declared, Rahel S. Zingg: None declared, Francesca Michela Pramotton: None declared, Sofie Falkenløve Madsen: None declared, Kristina Buerki: None declared, Giampietro Costanza: None declared, Michael Whitfield: None declared, Anne-Christine Bay-Jensen: None declared, Snežna Sodin-Šemrl: None declared, Matija Tomsic: None declared, Gabriela Kania: None declared, Hubert Rehrauer: None declared, Oliver Distler Speakers bureau: Bayer, Boehringer Ingelheim, Janssen, Medscape, Consultant of: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, 4P Science, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur, Grant/research support from: Kymera, Mitsubishi Tanabe, Boehringer Ingelheim, Ziga Rotar: None declared, Mark Robinson: None declared, Katja Lakota: None declared, Mojca Frank Bertoncelj: None declared.
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Iacob R, Mandea M, Iacob S, Pietrosanu C, Paul D, Hainarosie R, Gheorghe C. Liquid Biopsy in Squamous Cell Carcinoma of the Esophagus and of the Head and Neck. Front Med (Lausanne) 2022; 9:827297. [PMID: 35572996 PMCID: PMC9098838 DOI: 10.3389/fmed.2022.827297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Squamous cell carcinomas of the esophagus (ESCC) and of the head and neck (HNSCC) are two neoplasms that share common risk factors and have the same embryological origin, but a very different prognosis, the 5-year survival of HNSCC being almost double (40–50%) compared to the 5-year survival of ESCC (20%). Current guidelines emphasize the importance of screening for ESCC in patients diagnosed with head and neck cancers. A liquid biopsy is a novel tool for diagnosis, prognostic stratification, and personalized therapy. Liquid biopsy biomarkers for these two malignancies could help both their early detection, facilitate residual disease identification, and provide prognosis information. The present systematic review of the literature was aimed at describing the liquid biopsy biomarkers present in these two malignancies, with an emphasis on potential clinical applications.
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Affiliation(s)
- Razvan Iacob
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Matei Mandea
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Speranta Iacob
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Catalina Pietrosanu
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Professor Doctor Dorin Hociota Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, Romania
| | - Doru Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Razvan Hainarosie
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Professor Doctor Dorin Hociota Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, Romania
- *Correspondence: Razvan Hainarosie
| | - Cristian Gheorghe
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
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Van Roekel D, LeBedis C, Santos J, Paul D, Qureshi M, Kasotakis G, Gupta A. Cholecystitis: association between ultrasound findings and surgical outcomes. Clin Radiol 2022; 77:360-367. [DOI: 10.1016/j.crad.2022.02.002] [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] [Received: 09/06/2021] [Accepted: 02/01/2022] [Indexed: 12/07/2022]
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Croitoru VM, Cazacu IM, Popescu I, Paul D, Dima SO, Croitoru AE, Tanase AD. Clonal Hematopoiesis and Liquid Biopsy in Gastrointestinal Cancers. Front Med (Lausanne) 2022; 8:772166. [PMID: 35127745 PMCID: PMC8814311 DOI: 10.3389/fmed.2021.772166] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/02/2021] [Indexed: 02/03/2023] Open
Abstract
The use of blood liquid biopsy is increasingly being incorporated into the clinical setting of gastrointestinal cancers care. Clonal hematopoiesis (CH) occurs naturally as a result of the accumulation of somatic mutations and the clonal proliferation of hematopoietic stem cells with normal aging. The identification of CH-mutations has been described as a source of biological noise in blood liquid biopsy. Incorrect interpretation of CH events as cancer related can have a direct impact on cancer diagnosis and treatment. This review summarizes the current understanding of CH as a form of biological noise in blood liquid biopsy and the reported clinical significance of CH in patients with GI cancers.
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Affiliation(s)
- Vlad M. Croitoru
- Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- Department of Medical Oncology, Fundeni Clinical Institute, Bucharest, Romania
| | - Irina M. Cazacu
- Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- Department of Medical Oncology, Fundeni Clinical Institute, Bucharest, Romania
| | - Ionut Popescu
- Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
| | - Doru Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY, United States
| | - Simona Olimpia Dima
- Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Adina Emilia Croitoru
- Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- Department of Medical Oncology, Fundeni Clinical Institute, Bucharest, Romania
- *Correspondence: Adina Emilia Croitoru
| | - Alina Daniela Tanase
- Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- Bone Marrow Transplant Unit, Fundeni Clinical Institute, Bucharest, Romania
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Popotte C, Devic C, Munier M, Moreno R, Rousseau H, Perlongo S, Pilleul F, Paul D. Multicentric comparative study of dose indexes using an “in vivo” optical fiber detection system. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00272-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Croitoru V, Cazacu I, Paul D, Colita A, Lungulescu C, Herlea V, Luca N, Bogdan D, Sandra I, Gramaticu IM, Buica F, Dinu M, Sorop A, Dima S, Popescu I, Croitoru A, Alina T. 83TiP Clinical implications of clonal hematopoiesis mutations in patients with solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2079] [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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Cazacu I, Filippi A, Croitoru V, Kitahara S, Matsui A, Lauwers G, Sorop A, Necula L, Matei L, Pechianu C, Croitoru A, Herlea V, Saftoiu A, Paul D, Chivu-Economescu M, Dima S, Duda D, Popescu I. 34P Validation of a new scoring system for molecular subtyping of gastric cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2030] [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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Cazacu I, Croitoru V, Paul D, Popa E, Matei I, Gheorghe C, Herlea V, Diculescu M, Bogdan D, Sandra I, Gramaticu IM, Luca N, Dinu I, Alexandrescu S, Sorop A, Croitoru A, Dima S, Popescu I, Lyden D. 84TiP Predictive value of exosomes for therapy response in resectable/borderline resectable pancreatic cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Paul B, Paul D. Comparative Analysis of Municipal Solid Waste Management in Kochi and Indore. NEPT 2021. [DOI: 10.46488/nept.2021.v20i03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Conventionally, the general understanding of Municipal Solid Waste (MSW) management is collecting solid waste and its disposal through its developed channels or outside contracts. However, depending upon the situation and context, the definition of MSW varies between countries across the globe. For instance, in countries like Singapore and Japan, Municipal Solid Waste is defined as general waste. However, while categorizing the general waste, the industrial waste component is considered for Singapore and not for Japan. Similarly, different countries associate different definitions for MSW and it becomes a difficult challenge to suggest a single unified definition applicable for all countries. This paper aims to do a comparative analysis of Waste management in Tier-II cities of India, Kochi and Indore. Kochi is ranked 372nd and the latter 1st according to the latest Swachh Survekshan undertaken as part of the Swachh Bharat Abhiyan (Urban) by the Ministry of Housing and Urban Affairs. This paper highlights what the key elements missing out in the management of waste in Kochi from the reference perspective of Indore and identifying the measures Kochi needs to undertake to improve its ranking among the cleanest city in India are.
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Paul D, Komarova NL. Multi-scale network targeting: A holistic systems-biology approach to cancer treatment. Prog Biophys Mol Biol 2021; 165:72-79. [PMID: 34428429 DOI: 10.1016/j.pbiomolbio.2021.08.004] [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] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/15/2022]
Abstract
The vulnerabilities of cancer at the cellular and, recently, with the introduction of immunotherapy, at the tissue level, have been exploited with variable success. Evaluating the cancer system vulnerabilities at the organismic level through analysis of network topology and network dynamics can potentially predict novel anti-cancer drug targets directed at the macroscopic cancer networks. Theoretical work analyzing the properties and the vulnerabilities of the multi-scale network of cancer needs to go hand-in-hand with experimental research that uncovers the biological nature of the relevant networks and reveals new targetable vulnerabilities. It is our hope that attacking cancer on different spatial scales, in a concerted integrated approach, may present opportunities for novel ways to prevent treatment resistance.
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Affiliation(s)
- Doru Paul
- Medical Oncology, Weill Cornell Medicine, 1305 York Avenue 12th Floor, New York, NY, 10021, USA.
| | - Natalia L Komarova
- Department of Mathematics, University of California Irvine, Irvine, CA, 92697, USA.
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Paul D. Cancer as a form of life: Musings of the cancer and evolution symposium. Prog Biophys Mol Biol 2021; 165:120-139. [PMID: 33991584 DOI: 10.1016/j.pbiomolbio.2021.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 12/12/2022]
Abstract
Advanced cancer is one of the major problems in oncology as currently, despite the recent technological and scientific advancements, the mortality of metastatic disease remains very high at 70-90%. The field of oncology is in urgent need of novel ideas in order to improve quality of life and prognostic of cancer patients. The Cancer and Evolution Symposium organized online October 14-16, 2020 brought together a group of specialists from different fields that presented innovative strategies for better understanding, preventing, diagnosing, and treating cancer. Today still, the main reasons behind the high incidence and mortality of advanced cancer are, on one hand, the paucity of funding and effort directed to cancer prevention and early detection, and, on the other hand, the lack of understanding of the cancer process itself. I argue that besides being a disease, cancer is also a form of life, and, this frame of reference may provide a fresh look on this complex process. Here, I provide a different angle to several contemporary cancer theories discussing them from the perspective of "cancer-forms of life" (i.e. bionts) point of view. The perspectives and the several "bionts" introduced here, by no means exclusive or comprehensive, are just a shorthand that will hopefully encourage the readers, to further explore the contemporary oncology theoretical landscape.
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Affiliation(s)
- Doru Paul
- Medical Oncology, Weill Cornell Medicine, 1305 York Avenue 12th Floor, New York, NY, 10021, USA.
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Surati U, Paul D. Animal genetic resources in Goa: an overview. Journal of Livestock Science 2021. [DOI: 10.33259/jlivestsci.2021.37-41] [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: 11/11/2022]
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Vempati P, Halthore AN, Teckie S, Rana Z, Gogineni E, Antone J, Zhang H, Marrero M, Beadle K, Frank DK, Aziz M, Paul D, Ghaly M. Phase I trial of dose-escalated stereotactic radiosurgery (SRS) boost for unfavorable locally advanced oropharyngeal cancer. Radiat Oncol 2020; 15:278. [PMID: 33308265 PMCID: PMC7731764 DOI: 10.1186/s13014-020-01718-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/13/2020] [Indexed: 12/28/2022] Open
Abstract
Background and purpose Patients with locally advanced oropharynx squamous cell carcinoma have suboptimal outcomes with standard chemoradiation. Here, we evaluated toxicity and oncologic outcomes of dose escalation using radiosurgical boost for patients with unfavorable oropharynx squamous cell carcinoma. Materials and methods Between 2010–2017, Thirty four patients with intermediate- or high-risk oropharynx squamous cell carcinoma were enrolled onto this prospective phase I trial. Each patient received concurrent cisplatin and fractionated radiotherapy totaling 60 Gy or 66 Gy followed by radiosurgery boost to areas of residual gross tumor: single fraction of 8 Gy or 10 Gy, or two fractions of 5 Gy each. Primary endpoint was treatment toxicity. Secondary endpoints were local, regional, and distant disease control. Results Eleven, sixteen and seven patients received radiosurgery boost with 8 Gy in 1 fraction, 10 Gy in 1 fraction, and 10 Gy in 2 fractions respectively. Acute toxicities include 4 patients with tumor necrosis causing grade 3 dysphagia, of which 3 developed grade 4 pharyngeal hemorrhage requiring surgical intervention. At 24 months after treatment, 7%, 9%, and 15% had grade 2 dysgeusia, xerostomia, and dysphagia, respectively, and two patients remained feeding tube dependent. No grade 5 toxicities occurred secondary to treatment. Local, regional, and distant control at a median follow up of 4.2 years were 85.3%, 85.3% and 88.2%, respectively. Five patients died resulting in overall survival of 85.3%. Conclusions This study is the first to report the use of radiosurgery boost dose escalation in patients with unfavorable oropharynx squamous cell carcinoma. Longer follow-up, larger cohorts, and further refinement of boost methodology are needed prior to implementation in routine clinical practice. Trial Registration: Northwell Health Protocol #09-309A (NCT02703493) (https://clinicaltrials.gov/ct2/show/NCT02703493)
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Affiliation(s)
- Prashant Vempati
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Aditya N Halthore
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Sewit Teckie
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Zaker Rana
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Emile Gogineni
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Jeffrey Antone
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA
| | - Honglai Zhang
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA
| | - Mihaela Marrero
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA
| | - Kristin Beadle
- Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Douglas K Frank
- Hofstra Northwell School of Medicine, Hempstead, NY, USA.,Department of Otolaryngology, Northwell Health, Lake Success, NY, USA
| | - Mohamed Aziz
- Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Doru Paul
- Hofstra Northwell School of Medicine, Hempstead, NY, USA.,Department of Hematology/Oncology, Northwell Health, Lake Success, NY, USA
| | - Maged Ghaly
- Department of Radiation Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 450 Lakeville Road, Lake Success, NY, 11040, USA. .,Hofstra Northwell School of Medicine, Hempstead, NY, USA.
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Dasgupta N, Paul D. Expansion and persistence of blaCTXM gene within clinical-environmental interface: A study from India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.191] [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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Chowdhury P, Baidya S, Saikia G, Paul D, Karmakar S, Kalita B. Distribution and breeding habitats of Aedes: Implications for risk of potential arboviral outbreaks in urban Tripura, India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.986] [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] Open
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Deshamukhya C, Bhattacharjee A, Das B, Paul D, Chanda DD. cupA1/cupA5 gene overexpressed at subinhibitory concentration of carbapenem in biofilm forming Pseudomonas aeruginosa: Transcriptomic study from India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.126] [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] Open
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Crouthamel B, Dixit A, Pearson E, Menzel J, Paul D, Shakhider A, Silverman J, Averbach S. P14 Intimate partner violence is associated with self-managed abortion in Bangladesh. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.033] [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: 10/23/2022]
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Brar G, Pinheiro LC, Shusterman M, Swed B, Reshetnyak E, Soroka O, Chen F, Yamshon S, Vaughn J, Martin P, Paul D, Hidalgo M, Shah MA. COVID-19 Severity and Outcomes in Patients With Cancer: A Matched Cohort Study. J Clin Oncol 2020; 38:3914-3924. [PMID: 32986528 DOI: 10.1200/jco.20.01580] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE SARS-CoV-2 (COVID-19) is a systemic infection. Patients with cancer are immunocompromised and may be vulnerable to COVID-related morbidity and mortality. The objectives of this study were to determine if patients with cancer have worse outcomes compared with patients without cancer and to identify demographic and clinical predictors of morbidity and mortality among patients with cancer. METHODS We used data from adult patients who tested positive for COVID-19 and were admitted to two New York-Presbyterian hospitals between March 3 and May 15, 2020. Patients with cancer were matched 1:4 to controls without cancer in terms of age, sex, and number of comorbidities. Using Kaplan-Meier curves and the log-rank test, we compared morbidity (intensive care unit admission and intubation) and mortality outcomes between patients with cancer and controls. Among those with cancer, we identified demographic and clinical predictors of worse outcomes using Cox proportional hazard models. RESULTS We included 585 patients who were COVID-19 positive, of whom 117 had active malignancy, defined as those receiving cancer-directed therapy or under active surveillance within 6 months of admission. Presenting symptoms and in-hospital complications were similar between the cancer and noncancer groups. Nearly one half of patients with cancer were receiving therapy, and 45% of patients received cytotoxic or immunosuppressive treatment within 90 days of admission. There were no statistically significant differences in morbidity or mortality (P = .894) between patients with and without cancer. CONCLUSION We observed that patients with COVID-19 and cancer had similar outcomes compared with matched patients without cancer. This finding suggests that a diagnosis of active cancer alone and recent anticancer therapy do not predict worse COVID-19 outcomes and therefore, recommendations to limit cancer-directed therapy must be considered carefully in relation to cancer-specific outcomes and death.
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Affiliation(s)
- Gagandeep Brar
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Laura C Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Michael Shusterman
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Brandon Swed
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Evgeniya Reshetnyak
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Orysya Soroka
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Frank Chen
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Samuel Yamshon
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - John Vaughn
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Peter Martin
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Doru Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Manuel Hidalgo
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Manish A Shah
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, NY
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Brar G, Pinheiro LC, Shusterman M, Swed B, Reshentnyak E, Soroka O, Chen F, Yamshon S, Vaughn J, Martin P, Paul D, Hidalgo M, Shah MA. Abstract S10-01: COVID-19 severity and outcomes in hospitalized patients with cancer at a New York City tertiary medical center: A matched cohort study. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-s10-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: New York City has been at the epicenter of the SARS-CoV-2 (COVID-19) pandemic. Immunocompromised cancer patients may be more vulnerable to COVID-related morbidity and mortality. The objectives of this study were to determine if patients with cancer have worse outcomes compared to their noncancer counterparts and to identify potential demographic and clinical predictors of morbidity and mortality among cancer patients.
Methods: We used data from a retrospective observational cohort of adult patients who tested positive for COVID-19 at New York-Presbyterian hospitals between March 3 and April 25, 2020. Patients with active cancer were matched 1:4 to noncancer controls on age, gender, and diabetes status. Using Kaplan-Meier curves and the log-rank test, we compared morbidity (intensive care unit admission and intubation) and mortality outcomes between cancer patients and controls. We identified demographic and clinical predictors of worse outcomes using Cox Proportional Hazard models. Hazard ratios and 95% confidence intervals were calculated for all estimates.
Results: We included 445 COVID-19 positive adult patients of whom 89 had active malignancy. Among cancer patients, the median age was 72 years, 54% were male, and 52% were non-white. Presenting symptoms were similar between cancer and noncancer groups. Nearly half of cancer patients were on active treatment including cytotoxic and immunosuppressive therapy, and 40.9% of patients received cytotoxic treatment within 90 days of admission. Both patients with and without cancer received hydroxychloroquine in similar proportions (64% vs. 65.5%), and more cancer patients received remdesivir (7.9% vs. 3.7%). Overall, age (HR 1.14; 95% CI 1.00-1.29; p=0.049), male sex (HR 1.43; 95% CI 1.04-1.96, p=0.07), dyspnea on presentation (HR 1.81, 95% CI 1.3-2.58; p=0.0005), and bilateral lung infiltrates (HR 1.94; 95% CI 1.30-2.89; p=0.001) were associated with worse outcomes. Observed complications were similar for cancer and noncancer patients, including myocardial infarction (3.4% vs. 4.2%), vasopressor requirements (24.7% vs. 26.2%), bacteremia (9% vs. 10.4%), and venous thromboembolic events (7.9% vs. 7.3%), respectively. There were no statistically significant differences in morbidity or mortality between cancer and noncancer patients (p=0.287).
Conclusion: We demonstrate that COVID-19 hospitalized patients with active malignancies have comparable morbidity and mortality to patients without cancer. In contrast to previous findings, we observed no differences in risk of ICU admission, intubation, or death between cancer and noncancer patients. Our findings suggest that active malignancy may not be a contributive risk factor in comparison to other significant comorbidities that may be more responsible for the unfavorable prognosis of COVID-19 in cancer patients. We should consider the consequences of limiting care for cancer patients on cancer-specific outcomes and mortality in the context of COVID-19.
Citation Format: Gagandeep Brar, Laura C. Pinheiro, Michael Shusterman, Brandon Swed, Evgeniya Reshentnyak, Orysya Soroka, Frank Chen, Samuel Yamshon, John Vaughn, Peter Martin, Doru Paul, Manuel Hidalgo, Manish A. Shah. COVID-19 severity and outcomes in hospitalized patients with cancer at a New York City tertiary medical center: A matched cohort study [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S10-01.
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Affiliation(s)
- Gagandeep Brar
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Laura C. Pinheiro
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Michael Shusterman
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Brandon Swed
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | | | - Orysya Soroka
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Frank Chen
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Samuel Yamshon
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - John Vaughn
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Peter Martin
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Doru Paul
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Manuel Hidalgo
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Manish A. Shah
- New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
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Gogineni E, Rana Z, Vempati P, Karten J, Sharma A, Taylor P, Pereira L, Frank D, Paul D, Seetharamu N, Ghaly M. Stereotactic body radiotherapy as primary treatment for elderly and medically inoperable patients with head and neck cancer. Head Neck 2020; 42:2880-2886. [PMID: 32691496 DOI: 10.1002/hed.26342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/23/2020] [Accepted: 05/30/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Patients with head and neck cancer (HNC) who are not candidates for definitive treatment represent an increasing challenge, with limited data to guide management. Conventional local therapies such as surgery and chemoradiation can significantly impact quality of life (QoL). There has been limited data published using stereotactic body radiotherapy (SBRT) as primary treatment in previously unirradiated patients. We hypothesize that SBRT provides high rates of control while limiting toxicity. METHODS A total of 66 medically unfit previously unirradiated patients with HNC were treated with SBRT, consisting of 35-40 Gy to gross tumor volume and 30 Gy to clinical target volume in five fractions. RESULTS Median age was 80 years. Local control (LC) and overall survival (OS) at 1 year were 73% and 64%. Two patients experienced grade 3 toxicity. CONCLUSION SBRT shows acceptable outcomes with relatively low toxicity in previously unirradiated patients with HNC who are medically unfit for conventional treatment. SBRT may provide an aggressive local therapy with high rates of LC and OS while maintaining QoL.
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Affiliation(s)
- Emile Gogineni
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Zaker Rana
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Prashant Vempati
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Jessie Karten
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Anurag Sharma
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Peter Taylor
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Lucio Pereira
- Department of Otolaryngology, Northwell Health, Lake Success, New York, USA
| | - Douglas Frank
- Department of Otolaryngology, Northwell Health, Lake Success, New York, USA
| | - Doru Paul
- Department of Medical Oncology, Northwell Health, Lake Success, New York, USA
| | | | - Maged Ghaly
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
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Gogineni E, Rana Z, Wotman M, Karten J, Riegel A, Marrero M, Maduro L, Kamdar D, Frank D, Paul D, Seetharamu N, Ghaly M. Impact of stereotactic body radiation therapy on geriatric assessment and management for older patients with head and neck cancer using G8. J Geriatr Oncol 2020; 12:122-127. [PMID: 32593669 DOI: 10.1016/j.jgo.2020.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/11/2020] [Accepted: 06/18/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Management of head and neck cancers (HNC) in older adults is a common but challenging clinical scenario. We assess the impact of Stereotactic Body Radiation Therapy (SBRT) on survival utilizing the Geriatric-8 (G8) questionnaire. MATERIALS AND METHODS 171 HNC patients, deemed medically unfit for definitive treatment, were treated with SBRT ± systemic therapy. G8 questionnaires were collected at baseline, at 4-6 weeks, and at 2-3 months post-treatment. Patients were stratified according to their baseline G8 score: <11 as 'vulnerable', 11-14 as 'intermediate', and >14 as 'fit'. Overall survival (OS) was assessed through univariate Kaplan Meier analysis. Repeated measures ANOVA was used to determine if baseline characteristics affected G8 score changes. RESULTS Median follow-up was seventeen months. 60% of patients presented with recurrent HNC, 30% with untreated HNC primaries, and 10% with metastatic non-HNC primaries. Median age was 75 years. Median Charlson Comorbidity Index score was 2. 51% of patients were 'vulnerable', 37% were 'intermediate', and 12% were 'fit' at baseline, with median survival of 13.2, 24.3, and 41.0 months, respectively (p = .004). Patients who saw a decrease in their follow-up G8 score (n = 69) had significantly lower survival than patients who had stable or increased follow-up G8 scores (n = 102), with median survival of 8.6 vs 36.0 months (p < .001). CONCLUSION The G8 questionnaire may be a useful tool in upfront treatment decision-making to predict prognosis and prevent older patients from receiving inappropriate anti-cancer treatment. Decline in follow-up G8 scores may also predict worse survival and aid in goals of care following treatment.
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Affiliation(s)
- Emile Gogineni
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA
| | - Zaker Rana
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA
| | - Michael Wotman
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA
| | - Jessie Karten
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA
| | - Adam Riegel
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA
| | - Mihaela Marrero
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA
| | - Luis Maduro
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA
| | - Dev Kamdar
- Department of Otolarygology, Head / Neck Surgery, Northwell Health, Lake Success, NY, USA
| | - Douglas Frank
- Department of Otolarygology, Head / Neck Surgery, Northwell Health, Lake Success, NY, USA
| | - Doru Paul
- Department of Medical Oncology, Northwell Health, Lake Success, NY, USA
| | | | - Maged Ghaly
- Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
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Erickson ML, Mey JT, Axelrod CL, Paul D, Gordesky L, Russell K, Barkoukis H, O'Tierney-Ginn P, Fielding RA, Kirwan JP, Catalano PM. Rationale and study design for lifestyle intervention in preparation for pregnancy (LIPP): A randomized controlled trial. Contemp Clin Trials 2020; 94:106024. [PMID: 32389808 DOI: 10.1016/j.cct.2020.106024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Maternal obesity increases neonatal risk for obesity and metabolic syndrome later in life. Prior attempts to break this intergenerational obesity cycle by limiting excessive gestational weight gain have failed to reduce neonatal adiposity. Alternatively, pre-conception lifestyle interventions may improve the in utero metabolic milieu during early pregnancy leading to improved fetal outcomes. This randomized controlled trial (RCT) is evaluating whether a lifestyle intervention to reduce weight and improve maternal metabolism in preparation for pregnancy (LIPP) attenuates neonatal adiposity, compared to standard medical advice. MATERIAL AND METHODS Overweight/class 1 obese women after a previous pregnancy, ~12 weeks postpartum, preparing for a subsequent pregnancy, will be block randomized (1:1) to either LIPP or standard of care in a parallel design. Randomization is stratified by lactation status and overweight vs. class 1 obesity. The LIPP program consists of intensive short-term weight loss followed by weight maintenance until conception using supervised exercise and a low glycemic Mediterranean diet. PRIMARY OUTCOMES Group differences in neonatal adiposity at birth assessed by PEA POD and placental mitochondrial lipid metabolism. SECONDARY OUTCOMES Group differences in maternal pregravid and gestational body composition, insulin sensitivity, β-cell function, fasting metabolic and inflammatory biomarkers, and overall quality of life. Exploratory outcomes include umbilical cord blood insulin resistance, lipid profile and inflammation. DISCUSSION This RCT will determine the efficacy of maternal weight loss prior to pregnancy on reducing neonatal adiposity. Findings may change standard obstetrical care by providing Level 1 evidence on lifestyle interventions improving neonatal outcomes for women planning for pregnancy. CLINICAL TRIAL REGISTRATION NCT03146156.
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Affiliation(s)
- M L Erickson
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - J T Mey
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - C L Axelrod
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America; Department of Translational Services, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America
| | - D Paul
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - L Gordesky
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America
| | - K Russell
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America
| | - H Barkoukis
- Department of Nutrition, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, United States of America
| | - P O'Tierney-Ginn
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America; Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America
| | - R A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St, Boston, MA 02111, United States of America
| | - J P Kirwan
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America.
| | - P M Catalano
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America; Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America.
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Maghami E, Ismaila N, Alvarez A, Chernock R, Duvvuri U, Geiger J, Gross N, Haughey B, Paul D, Rodriguez C, Sher D, Stambuk HE, Waldron J, Witek M, Caudell J. Diagnosis and Management of Squamous Cell Carcinoma of Unknown Primary in the Head and Neck: ASCO Guideline. J Clin Oncol 2020; 38:2570-2596. [PMID: 32324430 DOI: 10.1200/jco.20.00275] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To provide evidence-based recommendations to practicing physicians and other health care providers on the diagnosis and management of squamous cell carcinoma of unknown primary in the head and neck (SCCUP). METHODS The American Society of Clinical Oncology convened an Expert Panel of medical oncology, surgery, radiation oncology, radiology, pathology, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2008 through 2019. Outcomes of interest included survival, local and regional disease control, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 100 relevant studies to inform the evidence base for this guideline. Four main clinical questions were addressed, which included subquestions on preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate pathology techniques, and adjuvant therapy. RECOMMENDATIONS Evidence-based recommendations were developed to address preoperative evaluation for patients with a neck mass, surgical diagnostic and therapeutic procedures, appropriate treatment options in unilateral versus bilateral SCCUP.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | - Bruce Haughey
- Advent Health Medical Group, Otolaryngology, Head and Neck Surgery, Celebration, FL, and University of South Florida, Tampa, FL
| | - Doru Paul
- Weill Cornell Medical College, New York, NY
| | | | - David Sher
- University of Texas Southwestern, Dallas, TX
| | | | - John Waldron
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Matt Witek
- University of Wisconsin School of Medicine and Public Health, Madison, WI
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Choudhury N, Paul D, Das B, (Chanda) DD, Bhattacharjee A. Real time PCR based detection of broadhost range plasmids and their potential use as biomarker in detection of multidrug resistant gram negative bacteria. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.039] [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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Lungulescu C, Croitoru VM, Lungulescu C, Croitoru A, Paul D. DURABLE RESPONSE IN A CASE OF METASTATIC ANAPLASTIC THYROID CANCER USING A COMBINATION OF TYROSINE KINASE INHIBITORS AND A CHECK POINT INHIBITOR. Acta Endocrinol (Buchar) 2020; 16:236-241. [PMID: 33029242 DOI: 10.4183/aeb.2020.236] [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] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Anaplastic thyroid cancer (ATC) is a highly uncommon (less than 2% of thyroid malignancies) and aggressive type of cancer, with aggressive behavior and, therefore, exhibiting poor prognosis. ATC tumors are automatically labeled as stage IV disease regardless of standard criteria such as tumor burden or metastasis. ATC tumors require a diversified treatment approach that includes surgical resection, followed by a complete an aggressive combination of radiation and chemotherapy and/or palliative care. Despite best efforts, 1-year overall survival of patients is 20% to 40% with nearly universal mortality rate. Consequently, novel approaches (targeted therapy, immunotherapy) have been studied, alone or in combination, to improve the dire prognosis of these patients. BRAF V600E mutation is the most common genetic mutation found in ATC. We report the case of a 57-year-old man diagnosed with stage IVc (undifferentiated) ATC with hepatic and osseous metastases. The molecular analysis of the tumor revealed a V600E BRAF-mutation. The patient was treated with Dabrafenib and Trametinib, and achieved remission 5 weeks after starting the treatment. Subsequently, he had a thyroidectomy, and pembrolizumab was added to the two tyrosine kinase inhibitors. 9 months later he is still in remission. This case illustrates the importance of obtaining molecular information in anaplastic thyroid cancer and the urgent need of studies investigating the combination of tyrosine kinase inhibitors and check-point inhibitors in patients with V600E BRAF- mutations.
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Affiliation(s)
- C Lungulescu
- University of Medicine and Pharmacy of Craiova - Oncology, Bucharest, Romania
| | - V M Croitoru
- University of Medicine and Pharmacy of Craiova - Fundeni Clinical Institute - Medical Oncology, Bucharest, Romania
| | - C Lungulescu
- University of Medicine and Pharmacy of Craiova - Doctoral School, Craiova, Bucharest, Romania
| | - A Croitoru
- University of Medicine and Pharmacy of Craiova - Fundeni Clinical Institute - Medical Oncology, Bucharest, Romania.,University of Medicine and Pharmacy of Craiova - "Titu Maiorescu" University - "Acad. Nicolae Cajal" Institute of Medical Scientific Research, Bucharest, Romania
| | - D Paul
- University of Medicine and Pharmacy of Craiova - New York-Presbyterian Hospital/Weill Cornell Medical Center - Department of Medicine, Division of Hematology/Oncology, New York, United States of America
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Kashyap P, Pegu AK, Paul D. Study of Lipid Abnormalities in Non Diabetic Chronic Kidney Disease Patients with Special Reference to Hemodialysis. J Assoc Physicians India 2020; 68:77. [PMID: 31979753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | - A K Pegu
- Assam Medical College and Hospital
| | - D Paul
- Assam Medical College and Hospital
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Sweetman A, Catcheside P, Lack L, Antic N, Smith S, Chai-Coetzer C, Douglas J, O'Grady M, Dunn N, Robinson J, Paul D, McEvoy D. The effect of cognitive and behavioural therapy for insomnia on changes in sleep architecture and AHI in patients with co-occurring insomnia and sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sweetman A, Lack L, Catcheside P, Antic N, Smith S, Chai-Coetzer C, Douglas J, O'Grady M, Dunn N, Robinson J, Paul D, McEvoy D. Changes in initial, middle and late insomnia subtypes during CBT-i and cpap therapy in co-morbid insomnia and sleep apnea (COMISA). Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gogineni E, Wotman M, Rana Z, Karten J, Riegel A, Maduro L, Marrero M, Kamdar D, Frank D, Paul D, Teckie S, Seetharamu N, Ghaly M. Impact of Stereotactic Body Radiation Therapy on Assessment and Management for Older Adults with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gogineni E, Rana Z, Vempati P, Karten J, Sharma A, Taylor P, Pereira L, Gabalski E, Paul D, Seetharamu N, Teckie S, Ghaly M. Stereotactic Body Radiotherapy as Primary Treatment for Medically Unfit Patients with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1584] [Citation(s) in RCA: 2] [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: 11/30/2022]
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Khan U, Biran T, Ocean AJ, Popa EC, Ruggiero JT, Paul D, Garcia C, Carr-Locke D, Sharaiha R, Urata Y, Shah MA. Phase II study of a telomerase-specific oncolytic adenovirus (OBP-301, Telomelysin) in combination with pembrolizumab in gastric and gastroesophageal junction adenocarcinoma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps4145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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
TPS4145 Background: Although checkpoint inhibitors (CPIs) can produce durable responses in gastric cancer patients (pts) in the 3rd line setting, the response rate is only 10-15%. Therefore, there is a huge unmet need to enhance the response rate of CPIs to provide benefit to wide range of pts. A novel concept in immuno-oncology is the use of cancer specific oncolytic viral therapy. In addition to the specific killing of the tumor by the virus, these agents can induce an immunogenic cell death in the tumor to augment the immune activation driven by PD-1 inhibition. OBP-301 is an oncolytic adenovirus genetically modified to be able to selectively replicate in cancer cells by introducing human telomerase reverse transcriptase (hTERT) promoter. Results of a phase I study of OBP-301 in solid tumor pts demonstrated the safety and efficacy of intra-tumoral injection of OBP-301. A pre-clinical study of the combination of OBP-301 with anti-PD-1 antibody has also shown significant synergistic activity as well. Based on these encouraging pre-clinical and clinical data, we designed a phase II clinical trial to examine the safety and efficacy of combination of pembrolizumab and OBP-301 in the treatment of PD-L1 positive metastatic gastric/GEJ adenocarcinoma. Methods: This is a multicenter, non-randomized phase II trial of OBP-301 with pembrolizumab in metastatic gastric/GEJ adenocarcinoma that has progressed on at least 2 lines of prior therapy. Eligibility criteria include PD-L1 positive tumors as defined by a combined positive score, performance status ≤1, and good end organ function. The primary endpoints are to examine objective response rate and safety of OBP-301 with pembrolizumab. The secondary endpoints are to examine disease control rate, duration of response, overall survival and progression free survival. Correlative studies are planned to identify biomarkers for response to combination therapy by using multiparameter flowcytometry, single-cell transcriptional profiling and immunohistochemistry. All eligible pts will receive 1x1012Viral Particles/mL of OBP-301 administered every 2 weeks for total of 4 injections, injected directly into tumor via upper endoscopy. Every pt will also receive pembrolizumab 200 mg IV every 3 weeks for 2 years or until progression. Pts will be enrolled in a Simon two stage design, with 18 pts in the first stage. If 3 or more pts respond to the combination therapy, the study will move forward to stage 2, with 19 more pts enrolled. The study is currently enrolling pts.
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Affiliation(s)
- Uqba Khan
- Weill Cornell Medical College, New York, NY
| | | | | | - Elizabeta C. Popa
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY
| | | | - Doru Paul
- Weill Cornell Medical College, New York, NY
| | | | | | | | | | - Manish A. Shah
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY
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Tufano AM, Newman J, Gogineni E, Karten JL, Paul D, Ghaly M, Seetharamu N. Does systemic treatment add value to stereotactic body radiation therapy for locoregional control in head and neck squamous cell carcinoma patients? J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e17505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17505 Background: Stereotactic body radiotherapy (SBRT) has been shown to provide locoregional control in head and neck squamous cell carcinoma (HNSCC) patients (pts) who are not candidates for curative procedures due to poor performance status, comorbidities, or radiation dose limitations from prior treatment. The addition of chemotherapy (chemo) and/or cetuximab (CET) is hypothesized to improve outcomes compared to SBRT alone, but there is limited data on comparative effectiveness. We compared outcomes of pts treated with SBRT vs. SBRT + chemo and/or CET using retrospective observational data from our institution. Methods: We identified new and recurrent HNSCC pts treated with SBRT +/- systemic therapy from 2012 to 2018. Age, Charlson Comorbidity Index (CCI) and stage were recorded. Primary outcome was locoregional disease control rate based on Modified Response Evaluation Criteria in Solid Tumors on 3-month post-treatment imaging. Secondary outcome was overall survival (OS) at 1 year. Pts were divided into 4 groups: SBRT, SBRT+chemo, SBRT+CET, and SBRT+chemo+CET (cohorts A, B, C and D, respectively). Results: 90 pts with median age of 73 years and median follow-up of 11.5 months were included. 94.4% were stage III or IV, and 68.9% had recurrent disease. The most commonly utilized chemotherapy was carboplatin and paclitaxel. Cohorts A, B, C and D constituted 28.9%, 31.1%, 31.1% and 8.8% respectively. Groups were well matched except for pts in Cohort A being significantly older than those in Cohort B (74.9 vs. 68.4 years; p = 0.01). Average CCI estimated 10-year survival was 8.4%. There was a trend towards improved locoregional control at 3 months in Cohort B vs. A (57.1% vs. 34.6%, p = 0.09), and improved OS at 1 year (46.4% vs. 23.1%; p = 0.07). These trends were not observed in comparisons between other cohorts. Conclusions: Chemo + SBRT may improve disease control as well as 1 year OS in HNSCC pts who do not qualify for curative procedures. Given the younger age of pts receiving chemo, selection bias cannot be excluded. Prospective studies with larger patient cohorts are needed to further evaluate the benefits and toxicities of adding systemic treatment to SBRT in this population.
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Affiliation(s)
| | - James Newman
- Hofstra Northwell School of Medicine, Lake Success, NY
| | | | | | - Doru Paul
- Weill Cornell Medical College, New York, NY
| | - Maged Ghaly
- Hofstra Northwell School of Medicine, Lake Success, NY
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Wedret JJ, Tu TG, Paul D, Rousseau C, Bonta A, Bota RG. Interactions between antidepressants, sleep aids and selected breast cancer therapy. Ment Illn 2019; 11:8115. [PMID: 31281608 PMCID: PMC6589536 DOI: 10.4081/mi.2019.8115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Indexed: 11/23/2022] Open
Abstract
Depression and insomnia are very significant pathologies in cancer patients as they contribute to the patient’s overall cure and quality of life. Moreover, untreated depression and ongoing insomnia are associated with decreased immune responses and lower survival rates. With all disease states and especially with cancer, close attention to drug-drug interactions and the potential impact on the efficacy of therapy is paramount. One area of particular interest due to the lack of well-done clinical trials is drug-drug interaction(s) between antidepressants and cancer treatment. Pharmacokinetics of a certain drug allows for prediction of certain drug interactions based on chemical properties of the agents involved. If the agents depend on their metabolites for activity, active drug level will be decreased through this enzyme inhibition. In this paper, we looked at the cytochrome-P450 drug interactions between antidepressants and sleep aids with Selective Estrogen Receptor Modulators (SERM). Newer SERM metabolisms are less influenced by interactions with medications used to treat depression. However, tamoxifen metabolism could be severely altered by several antidepressants. This has direct consequences as patients on tamoxifen and antidepressant can have double the risk of relapse to cancer in two years. We discussed those interactions and made recommendations for clinical use.
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Affiliation(s)
| | - Thanh G Tu
- University of California San Francisco, San Francisco, CA, USA
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Wedret JJ, Tu TG, Paul D, Rousseau C, Bonta A, Bota RG. Interactions between antidepressants, sleep aids and selected breast cancer therapy. Ment Illn 2019. [DOI: 10.1108/mi.2019.8115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Depression and insomnia are very significant pathologies in cancer patients as they contribute to the patient's overall cure and quality of life. Moreover, untreated depression and ongoing insomnia are associated with decreased immune responses and lower survival rates. With all disease states and especially with cancer, close attention to drug-drug interactions and the potential impact on the efficacy of therapy is paramount. One area of particular interest due to the lack of well-done clinical trials is drug-drug interaction(s) between antidepressants and cancer treatment. Pharmacokinetics of a certain drug allows for prediction of certain drug interactions based on chemical properties of the agents involved. If the agents depend on their metabolites for activity, active drug level will be decreased through this enzyme inhibition. In this paper, we looked at the cytochrome-P450 drug interactions between antidepressants and sleep aids with Selective Estrogen Receptor Modulators (SERM). Newer SERM metabolisms are less influenced by interactions with medications used to treat depression. However, tamoxifen metabolism could be severely altered by several antidepressants. This has direct consequences as patients on tamoxifen and antidepressant can have double the risk of relapse to cancer in two years. We discussed those interactions and made recommendations for clinical use.
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Taylor R, Valabhji J, Aveyard P, Paul D. Prevention and reversal of Type 2 diabetes: highlights from a symposium at the 2019 Diabetes UK Annual Professional Conference. Diabet Med 2019; 36:359-365. [PMID: 30597609 DOI: 10.1111/dme.13892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 11/26/2022]
Abstract
AIM This symposium covers the gamut of Type 2 diabetes prevention, reversing established Type 2 diabetes, population-level delivery of weight loss programmes and personal insights into achieving and retaining substantial weight loss. RESULTS The NHS Diabetes Prevention Programme was launched in 2016 and rates of referral and attendance have both exceeded expectations. By March 2018, mean weight loss for completers (those attending more than 60% of sessions) was 3.2 kg reflecting considerable health benefits. Established Type 2 diabetes is now known to be a reversible condition in the early years, and the underlying mechanism is the removal of the excess fat from within liver and pancreas in these susceptible individuals. The Diabetes Remission Clinical Trial has shown that around half of a primary care population of people with Type 2 diabetes of less than 6 years' duration can be returned to non-diabetic blood glucose control which lasts at least 12 months. This raises the question of population-level intervention to achieve weight loss. The success of some mass weight loss programmes requires to be recognized. Reframing mass provision of weight loss support should be a vital part of our clinical strategy to prevent and treat Type 2 diabetes. However, the current obesogenic environment is a reality in which individuals must live. A personal account of achieving substantial and maintaining substantial weight loss provides an invaluable insight into practical problems encountered. All health professionals dealing with weight control should assimilate and reflect upon this understanding. CONCLUSIONS Effective prevention and long term reversal of Type 2 diabetes is feasible. The impact upon the individual must be considered during delivery of advice and support.
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Affiliation(s)
- R Taylor
- Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK
| | - J Valabhji
- Imperial College Healthcare NHS Trust and NHS England, Skipton House, London, UK
| | - P Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Khan S, Bal H, Khan ID, Paul D. PREVALENCE OF GESTATIONAL DIABETES MELLITUS IN AN URBAN INDIAN COHORT USING DIABETES IN PREGNANCY STUDY GROUP IN INDIA (DIPSI) CRITERIA – VALIDATING ONE-STEP APPROACH. IJMMR 2019. [DOI: 10.11603/ijmmr.2413-6077.2018.2.9317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. India is the “World’s Diabetes capital”, with half the diabetic population being women. Early detection of glucose intolerance during pregnancy offers a timely opportunity for screening, management and prevention of gestational diabetes mellitus (GDM) and prevents fetal complications.
Objective. The study assessed the prevalence of GDM in an Indian cohort using the Diabetes in Pregnancy Study group of India (DIPSI) criteria.
Methods. 200 pregnant women underwent two-phase testing with non-fasting 75-gram glucose challenge under Diabetes in Pregnancy Study group of India (DIPSI) criteria at <20 weeks and between 24-28 weeks period of gestation. A 3-hour 100-gm oral glucose tolerance test (OGTT) was used for confirmation. Repeat testing was done for women negative during the first-phase.
Results. Mean age was 24.26±3.75 years with 52.5% multigravidas. Mean Body Mass Index (BMI) was 20.7±3.07 kg/m2. The prevalence of GDM in study cohort was found to be 15.5% using the DIPSI criteria while the prevalence of GDM after 100 g OGTT was 13.0%. GDM was mostly seen to occur in women of 26-30-year age group. Statistically significant associations for age and GDM, and BMI and GDM were evidenced.
Conclusions. Maternal age of ≥25 years should be adopted as a risk factor for the development of GDM. The DIPSI criteria offer a cost-effective and an evidence-based protocol for a single-step definitive glucose test for both screening and diagnosis of pregnant patients belonging to any socio-economic strata; furthering its implementation for public health obstetrics.
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Vempati P, Halthore A, Teckie S, Antone J, Zhang H, Marrero M, Cohen J, Beadle K, Frank D, Paul D, Ghaly M. Long Term Follow-Up from a Phase I/II Trial Utilizing a Dose-Escalated Stereotactic Radiosurgery (SRS) Boost for Unfavorable Locally Advanced Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1102] [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: 10/28/2022]
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Preeshagul IR, Sullivan KM, Paul D, Maki RG, Seetharamu N. A comparison of three clinical factors as predictive markers for response to immunotherapy in non-small cell lung cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21158] [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: 11/20/2022] Open
Affiliation(s)
| | | | | | - Robert G. Maki
- Monter Cancer Center, Northwell Health and Cold Spring Harbor Laboratory, Lake Success, NY
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Holstead R, Vege A, Barnaby KM, Paul D, Savona SR, Goncalves PH, Frank DK, Kamdar D, Pereira L, Fantasia J, Ghaly M, Pollack JM, Teckie S, Seetharamu N. Should surveillance guidelines be different based on Human Papilloma Virus (HPV) status? Patterns of failure and second primary cancers (SPM) in patients (pts) with oropharyngeal squamous cell cancer (OPSCC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18059] [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: 11/20/2022] Open
Affiliation(s)
- Ryan Holstead
- Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY
| | - Anusha Vege
- Hofstra Northwell School of Medicine at Forest Hills, Forest Hills, NY
| | - Keara M. Barnaby
- Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY
| | | | | | | | | | | | | | - John Fantasia
- Hofstra North Shore-LIJ School of Medicine, Hempstead, NY
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Preeshagul IR, Sullivan KM, Paul D, Seetharamu N. The utilization of pre-treatment neutrophil to lymphocyte ratio as a predictive marker for response to nivolumab therapy in non small cell lung cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20634] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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
e20634 Background:The tumor immune environment is integral in lung cancer progression. Cancer cells attract neutrophils through chemokine signaling pathyways into the tumor stroma. Neutrophils promote angiogenesis, metastasis and inhibit apoptosis whereas lymphocytes assist with tumor defense. Increased peritumoral neutrophil-to-lymphocyte ratio (NLR) has been shown to mediate T cell anergy and tumor immune evasion. In solid tumor pre-clinical models, elevated blood NLR correlates with increased tumor neutrophil infiltration and decreased CD3(+) T-cell infiltration. Immunotherapy is a promising anticancer strategy in Non-Small Cell Lung Cancer (NSCLC). We hypothesized that peripheral blood NLR could serve as a predictive marker for clinical benefit (CB) from this intervention. Methods:A single institution retrospective analysis of 81 patients with NSCLC treated with Nivolumab from July 2015 to November 2016. Each patient’s NLR was calculated prior to starting Nivolumab. A cut-off of 5 categorized NLR as high or low based on prior studies. The presence or absence of CB (objective response or stable disease per RECIST 1.1) after at least 3 months of therapy was determined. Descriptive statistics were utilized to summarize the data. Fischer exact test was used to compare proportions and student t test to compare means. Results:79 patients were included. 54 (68%) had low NLR and 25 (31.6%) had high NLR. 44 patients (81.48%) in the low NLR group and 7 (28%) in the high NLR group experienced CB (28%) at 3 months. This difference was statistically significant (P = 0.0001). The mean time to progression(TTP) for the low NLR population was 5.53 months, as compared to 2.39 months in the high NLR group( p = 0.0001) (95% confidence interval 1.59 to 4.55).The mean TTP in the CB cohort was 6.42 months in the low NLR group and 4.43 months in the high NLR group (p = 0.0052 ) (95% CI 0.61 to 3.39). Conclusions:The immune response to cancer is lymphocyte dependent. In our study, the majority of patients with low NLR experienced CB from Nivolumab whereas most of the patients with elevated NLR did not. NLR as a predictive biomarker should be further investigated in large prospective studies.
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Affiliation(s)
| | | | - Doru Paul
- North Shore Long Island Jewish Health System Cancer Institute, Lake Success, NY
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Zhang I, Gill G, Marrero M, Sharma A, Riegel A, Paul D, Knisely J, Teckie S, Ghaly M. EP-1071: Organ-sparing SBRT in reirradiation of head and neck cancer: efficacy, toxicity, and quality of life. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31507-4] [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: 11/28/2022]
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