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Alanis S, Blair MP, Kaufman LM, Bhat G, Shapiro MJ. Floating-Harbor syndrome with chorioretinal colobomas. Ophthalmic Genet 2024; 45:207-209. [PMID: 37722826 DOI: 10.1080/13816810.2023.2255895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND We present a case of a child with Floating-Harbor Syndrome (FHS) with bilateral chorioretinal coloboma (CC). To the best of our knowledge, this is the first case report of this association. Floating- Harbor syndrome is an extremely rare autosomal dominant genetic disorder with approximately 100 cases reported. It is characterized by a series of atypical features that include short stature with delayed bone age, low birth weight, skeletal anomalies, delayed speech development, and dysmorphic facial characteristics that typically portray a triangular face, deep-set eyes, long eyelashes, and prominent nose. MATERIALS AND METHODS Our patient was examined by a pediatric ophthalmologist for the time at age of 7. Visual acuity, optical coherence tomography (OCT) and Optos imaging were collected on every visit. The patient had whole genome sequencing ordered by a pediatric geneticist to confirm Floating-Harbor syndrome. RESULTS We present the patient's OCT and Optos images that illustrate the location of the patient's inferior chorioretinal coloboma in both eyes. The whole genome sequencing report collected revealed a heterozygous de novo pathogenic variant in the SRCAP gene, consistent with a Floating-Harbor syndrome diagnosis in the literature. DISCUSSION Both genetic and systemic findings are consistent with the diagnosis of Floating-Harbor syndrome in our patient. Rubenstein-Taybi and Floating-Harbor syndrome share a similarity in molecular and physical manifestations, but because of the prevalence in Rubenstein-Taybi diagnoses, it is a syndromic condition that includes coloboma and frequently associated with each other. Therefore, a retinal exam should become part of the standard protocol for those with FHS, as proper diagnosis, examination and treatment can prevent irreversible retinal damage.
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Affiliation(s)
| | - M P Blair
- Retina Consultants, Ltd, Des Plaines, Illinois, USA
| | - L M Kaufman
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - G Bhat
- University of Illinois Hospital Health & Science Center, Chicago, Illinois, USA
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Mohan PB, Nagaraju SP, Musunuri B, Rajpurohit S, Bhat G, Shetty S. Study of prevalence, risk factors for acute kidney injury, and mortality in liver cirrhosis patients. Ir J Med Sci 2024:10.1007/s11845-024-03663-z. [PMID: 38517600 DOI: 10.1007/s11845-024-03663-z] [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: 02/13/2024] [Accepted: 02/29/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION Acute kidney injury (AKI) occurs frequently in patients with end-stage liver disease and cirrhosis and is associated with increased short-term mortality. This study aims to study the prevalence and risk factors associated with AKI development and mortality in cirrhosis of liver patients. METHODOLOGY In the current prospective study, hospitalized patients with liver cirrhosis from October 2021 to March 2023 were recruited. Demographic, clinical, and laboratory data were collected, which included, the etiology of cirrhosis, comorbidities, severity of liver disease, and relevant biochemical parameters. The patient was followed up for 90 days to record the clinical outcome. The statistical software SPSS was utilized to conduct the analysis. RESULTS Of 364 liver cirrhosis patients, 25.2% (n, 92) had AKI and belonged to an average age of 51.54 ± 11.82 years. The majority of individuals in the study were males (90.4%), and alcohol (63.4%) was the most common etiology of liver cirrhosis. The present study showed that higher level of direct bilirubin (p = 0.011) and MELD score (p = 0.0001) were identified as significant risk factors for AKI development in patients with liver cirrhosis. Regarding mortality, the significant risk factors were the presence of AKI (p = 0.045) and MELD score (p = 0.025). Among AKI patients, 90-day mortality rates were higher in patients with acute tubular necrosis (p value = 0.010) and stage 3 AKI (p value = 0.001). CONCLUSION AKI is common in cirrhosis of liver patients. Elevated levels of direct bilirubin and MELD score emerged as significant factors associated with AKI development. Furthermore, AKI and MELD scores were identified as independent risk factors for mortality at both 30 and 90 days. Survival rates were influenced by both the type and stage of AKI; AKI stage 3 and ATN patients had significantly higher mortality rate. Early AKI detection and management are crucial for reducing mortality risk in liver cirrhosis patients.
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Affiliation(s)
- Pooja Basthi Mohan
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Shankar Prasad Nagaraju
- Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Balaji Musunuri
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Siddheesh Rajpurohit
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Ganesh Bhat
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Shiran Shetty
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
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Rajpurohit S, Musunuri B, Basthi Mohan P, Bhat G, Shetty S. Role of granulocyte colony stimulating factor in the treatment of cirrhosis of liver: a systematic review. J Int Med Res 2023; 51:3000605231207064. [PMID: 37946367 PMCID: PMC10637184 DOI: 10.1177/03000605231207064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/21/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE We performed a systematic review to analyze the benefits of and risk factors associated with granulocyte colony stimulating factor (GCSF) in patients with liver cirrhosis. METHODS PubMed, Scopus, and Embase were searched for randomized controlled trials and case-control studies that compared the use of GCSF with another treatment or control group. The Jadad and Newcastle-Ottawa scales were used to assess the risk of bias in the included studies. The primary outcome studied was mortality; and the secondary outcomes were the disease severity score, liver transplantation criteria, complications, CD34+ cell count, adverse events, and health-related quality of life (HRQOL). PROSPERO registration number CRD42023416014. RESULTS The initial search yielded 2,235 studies, of which seven studies of 670 patients with liver cirrhosis were included. Multiple cycles of GCSF significantly improved the survival rate, disease severity score, CD34+ cell count, and HRQOL; and significantly reduced the incidences of liver transplantation, ascites, infection, and hepatic encephalopathy. Fatigue and backache were the most commonly reported adverse events. CONCLUSION GCSF significantly improves the survival rate and disease severity scores, and reduces the incidence of complications in patients with liver cirrhosis. The administration of GCSF is likely to be effective in patients awaiting liver transplantation.
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Affiliation(s)
- Siddheesh Rajpurohit
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Balaji Musunuri
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Pooja Basthi Mohan
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Ganesh Bhat
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Shiran Shetty
- Department of Gastroenterology & Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
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Pemmada V, Shetty A, Nedunchezhian S, Bhat G. Antesternal colonic interposition. BMJ Case Rep 2023; 16:16/5/e254304. [PMID: 37147108 PMCID: PMC10163415 DOI: 10.1136/bcr-2022-254304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Affiliation(s)
- Vikas Pemmada
- Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Athish Shetty
- Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Suriya Nedunchezhian
- Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ganesh Bhat
- Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Basthi Mohan P, Rajpurohit S, Musunuri B, Bhat G, Lochan R, Shetty S. Exosomes in chronic liver disease. Clin Chim Acta 2023; 540:117215. [PMID: 36603656 DOI: 10.1016/j.cca.2022.117215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023]
Abstract
Chronic liver disease (CLD) is the major cause of mortality and morbidity, particularly in developing countries. Although there has been a significant advancement in the identification and treatment of liver diseases over time, clinical results are not satisfactory in advanced liver disease. Thus, it is crucial to develop certain technology for early detection, and curative therapies and to investigate the molecular mechanisms behind CLD's pathogenesis. The study of exosomes in CLD is a rapidly developing field. They are structurally membrane-derived nano vesicles released by various cells. In CLD, exosomes released from injured hepatic cells affect intercellular communication, creating a microenvironment conducive to the illness's development. They also carry liver cell-specific proteins and miRNAs, which can be used as diagnostic biomarkers and treatment targets for various liver diseases. End-stage liver disease can only be treated by a liver transplant, however, the low availability of compatible organs, high expenses of treatment, and surgical complications significantly lower patient survival rates. Early diagnosis and therapeutic intervention of CLD positively affect the likelihood of curative treatment and high patient survival rates. Considering the possibility that exosomes could be employed as tools for disease diagnostics and clinical intervention, The current study briefly summarizes the roles of exosomes and their cargo in diagnosing and treating liver diseases.
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Affiliation(s)
- Pooja Basthi Mohan
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Siddheesh Rajpurohit
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Balaji Musunuri
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ganesh Bhat
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajiv Lochan
- Lead Consultant- Liver transplant Surgeon, Manipal Hospital, Old Airport Road, Bangalore, and Adjunct Professor Manipal Academy of Higher Education, India
| | - Shiran Shetty
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Pemmada V, Bhat G, Bhat BK. Adult Hirschsprung's Disease. J Gastrointest Surg 2023; 27:1029-1031. [PMID: 36717467 DOI: 10.1007/s11605-022-05560-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 02/01/2023]
Affiliation(s)
- Vikas Pemmada
- Department of Gastroenterology, Kasturba Medical College & Hospital, MAHE, Manipal, 576104, Karnataka, India
| | - Ganesh Bhat
- Department of Gastroenterology, Kasturba Medical College & Hospital, MAHE, Manipal, 576104, Karnataka, India.
| | - Bharath Kumar Bhat
- Department of Surgical Gastroenterology, Kasturba Medical College & Hospital, MAHE, Manipal, Karnataka, India
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Bhat G, Shastry A. Development and validation of holding time (HoT), a novel tool to measure the control over ejaculation in males. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.540] [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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Sun S, Prelaj A, Baik C, Le X, Garassino M, Wollner M, Haura E, Piotrowska Z, Socinski M, Dreiling L, Bhat G, Lebel F, Cornelissen R. 26MO Efficacy and safety of poziotinib in treatment-naïve HER2 exon 20 insertion (ex20ins) mutated non-small cell lung cancer (NSCLC): ZENITH20-4. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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M S, Bhat G, Mulki SS, M SS, B D, M C. Antimicrobial Susceptibility Profile of Healthcare-Associated Methicillin Resistant Staphylococcus aureus with Special Reference to Vancomycin and Ceftaroline. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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R J, Bhat G. Mucinous Cystic Neoplasm of Mesentery: A Case Report. Cureus 2022; 14:e21482. [PMID: 35223262 PMCID: PMC8860678 DOI: 10.7759/cureus.21482] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Mucinous cystic neoplasms are very rare tumours. They may originate from ovaries, pancreas or other intra-abdominal sites but they rarely originate from the mesentery. They can be asymptomatic or present as an abdominal mass or abdominal pain. We present the case of a 28-year-old woman who presented with epigastric pain and cystic mass per abdomen with a diagnosis of mesenteric cyst made on further imaging studies. Subsequent excision and histopathological analysis demonstrated the cyst to be a mucinous tumour arising from the mesocolon. Mesenteric cyst must be considered as one of the differentials in abdominal cystic lesions.
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Musunuri B, Shetty S, Bhat G, Udupa K, Pai A. Profile of patients with hepatocellular carcinoma: An experience from a tertiary care center in India. Indian J Gastroenterol 2022; 41:127-134. [PMID: 35226292 PMCID: PMC9108108 DOI: 10.1007/s12664-021-01209-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The prevalence of hepatocellular carcinoma (HCC) is increasing worldwide and it is now the third most common cause of cancer-related death. HCC is becoming a major health burden with steadily increasing incidence globally. METHODS This is an observational study over a 3-year period in a tertiary care center in India. Three hundred and thirty-nine patients diagnosed to have HCC were included in this study. Patients' clinical, etiological, radiological and cytohistological data and therapy offered were recorded and analyzed. RESULTS Cirrhosis of the liver was seen in 73.2% of the patients. 16.8% of patients were asymptomatic at the time of presentation. Ascites (57.2%) and jaundice (22.4%) were the most common signs of hepatic decompensation. The most common etiology of HCC was cryptogenic/non-alcoholic fatty liver disease (NAFLD) in 51% of the patients, while hepatitis B and C were seen in 17.4% and 5.8% of the patients, respectively. Advanced and end-stage disease with Barcelona Clinic Liver Cancer (BCLC) stages C and D were seen in 62.4% of patients. 56.6% had Albumin-bilirubin (ALBI) score of 2, while 62.8% had Okuda stage II disease. High alpha-fetoprotein (AFP) levels (>400 ng/mL) were seen in 48.9% of patients. Macrovascular invasion and metastases were seen in 45.9% and 22.2% of the patients, respectively. 17.6% of patients had evidence of tumor thrombus. 14.5% of biopsy specimens showed associated steatosis/steatohepatitis along with confirmation of HCC. Only 26.6% of the cirrhotic HCC patients were diagnosed during surveillance. CONCLUSIONS HCC due to unknown cause/NAFLD appears to be overtaking hepatitis B as the commonest cause for HCC. Despite the advances in diagnostic methods and surveillance, most cases of HCC tend to be diagnosed at advanced stages.
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Affiliation(s)
- Balaji Musunuri
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576 104, India
| | - Shiran Shetty
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576 104, India
| | - Ganesh Bhat
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576 104, India
| | - Karthik Udupa
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576 104, India
| | - Ananth Pai
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576 104, India
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Rajpurohit S, Musunuri B, Basthi Mohan P, Lakshmi RV, Bhat G, Shetty S. Predictors for oesophageal candidiasis in patients with liver cirrhosis. Infez Med 2022; 31:79-85. [PMID: 36908388 PMCID: PMC9994834 DOI: 10.53854/liim-3101-11] [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: 10/04/2022] [Accepted: 01/09/2023] [Indexed: 03/07/2023]
Abstract
Background and aim Oesophageal candidiasis (OC) is one of the most common infections among patients with liver cirrhosis. The present study evaluates the potential predictors for OC among liver cirrhosis patients. Methodology This retrospective study was conducted in the tertiary care centre of coastal Karnataka from January 2016 to April 2022. Patients aged 18 and above with a confirmed diagnosis of liver cirrhosis were selected. Patients were equally divided into two groups, i.e., case and control, based on the presence and absence of OC. Results A total of 1513 patients with cirrhosis underwent upper gastrointestinal endoscopy. Of these, 50 (3.3%) were diagnosed with OC and taken into case group. An equal number of patients were selected in control group and matched for gender, age and etiology. Most participants were male (94%), with a mean age of 48.46±11.82 years. A lower serum creatinine value was noted among patients with OC. Binary logistic regression identified serum creatinine as an independent predictor for OC (OR: 7.65, 95% CI: 2.012-29.08; p-value: 0.003). The receiver operating characteristic curve for serum creatinine showed the highest significance with a cut-off of <0.86 mg/dL (AUC: 0.722). Conclusion Serum creatinine is the independent predictor for OC among liver cirrhosis patients. The possible mechanism is that cirrhosis is a catabolic state in which muscle protein breakdown exceeds synthesis, resulting in decreased muscle mass and low creatinine levels. However, more prospective studies are required to evaluate the role of sarcopenia with OC among liver cirrhosis patients.
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Affiliation(s)
- Siddheesh Rajpurohit
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Balaji Musunuri
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Pooja Basthi Mohan
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - R Vani Lakshmi
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ganesh Bhat
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shiran Shetty
- Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Mahajan A, Shetty A, Bhat BK, Bhat G. Calcified pseudocyst: an uncommon presentation of chronic pancreatitis. BMJ Case Rep 2021; 14:e243369. [PMID: 34593548 PMCID: PMC8487194 DOI: 10.1136/bcr-2021-243369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Pseudocysts are localised fluid collections, usually developing as a complication of acute or chronic pancreatitis. Pancreatic ductal or parenchymal calcifications are commonly seen in routine radiological imaging, but calcification of pseudocyst is extremely rare. Calcified pseudocysts have been reported in literature as case reports, but a calcified pseudocyst in the lesser sac, without underlying pancreatic calcification, has not been reported. We report a case of a pancreatic pseudocyst with a calcified wall, requiring surgical excision and histological examination confirming the diagnosis.
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Affiliation(s)
- Abhishek Mahajan
- Gastroenterology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Athish Shetty
- Gastroenterology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bharath Kumar Bhat
- Surgical Gastroenterology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ganesh Bhat
- Gastroenterology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kumar U, Ramakant P, Singh K, Kumar A, Bhat G. Letter to the Editor: Development of a Rapid Intraoperative Point-of-Care Method Using Tissue Suspension to Differentiate Parathyroid Tissue: A Possible Substitute for Frozen Sections. World J Surg 2021; 45:3475. [PMID: 34392383 DOI: 10.1007/s00268-021-06284-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Upander Kumar
- Department of Endocrine Surgery, King George Medical University, Lucknow, India.
| | - Pooja Ramakant
- Department of Endocrine Surgery, King George Medical University, Lucknow, India
| | - Kulranjan Singh
- Department of Endocrine Surgery, King George Medical University, Lucknow, India
| | - Anand Kumar
- Department of Endocrine Surgery, King George Medical University, Lucknow, India
| | - Ganesh Bhat
- Department of Endocrine Surgery, King George Medical University, Lucknow, India
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Bhosale M, Sangle A, Bhat G, Dambal P. Transanal Small Bowel Evisceration in a 3-Year-Old Victim of Motor Vehicle Accident. J Indian Assoc Pediatr Surg 2021; 26:253-255. [PMID: 34385770 PMCID: PMC8323572 DOI: 10.4103/jiaps.jiaps_124_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/01/2020] [Accepted: 08/23/2020] [Indexed: 11/11/2022] Open
Abstract
Although motor vehicle accidents (MVAs) in children are common, pediatric rectal perforations secondary to MVAs leading to transanal evisceration of the small bowel are very rare. Herniation of bowel through breach in the rectal wall seen eviscerating through the anus is a surgical emergency requiring laparotomy and necessary surgical procedure. We report case of a 3-year-old boy, victim of run-over MVA accident, presenting with bilateral fracture shaft femur, fracture of the left humerus, and transanal small bowel evisceration. About 30–40 cm long, gangrenous, small bowel loop was hanging outside the anal canal. Two consecutive surgeries were performed to manage this unusual and complex case with an excellent outcome. This report is presented for an extremely rare presentation of MVA injury in a child.
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Affiliation(s)
- Minakshi Bhosale
- Department of Pediatric Surgery, B J Government Medical College, Pune, Maharashtra, India
| | - Ameya Sangle
- Department of Pediatric Surgery, B J Government Medical College, Pune, Maharashtra, India
| | - Ganesh Bhat
- Department of Pediatric Surgery, B J Government Medical College, Pune, Maharashtra, India
| | - Praveen Dambal
- Department of Pediatric Surgery, B J Government Medical College, Pune, Maharashtra, India
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Sacher A, Le X, Cornelissen R, Shum E, Suga J, Socinski M, Molina J, Haura E, Clarke J, Bhat G, Lebel F, Garassino M. 36MO Safety, tolerability and preliminary efficacy of poziotinib with twice daily strategy in EGFR/HER2 Exon 20 mutant non-small cell lung cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.01.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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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Mahajan A, Shetty A, Koteshwar P, Musunuri B, Shetty S, Bhat G. Complete Regression of Hepatocellular Carcinoma with Low Dose of Sorafenib. J Clin Exp Hepatol 2021; 11:756-757. [PMID: 34866855 PMCID: PMC8617530 DOI: 10.1016/j.jceh.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/11/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Abhishek Mahajan
- Department of Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India
| | - Athish Shetty
- Department of Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India
| | - Prakashini Koteshwar
- Department of Radiodiagnosis, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India
| | - Balaji Musunuri
- Department of Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India
| | - Shiran Shetty
- Department of Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India
| | - Ganesh Bhat
- Department of Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India
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Bhat G, Shetty A. Aspirin Use in Elderly for Primary Prevention of Cardiovascular Disease: Double Edged Sword? J R Coll Physicians Edinb 2020; 50:403-404. [DOI: 10.4997/jrcpe.2020.410] [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: 11/19/2022] Open
Affiliation(s)
- Ganesh Bhat
- Professor, Department of Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Athish Shetty
- Department of Gastroenterology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
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Bhat G, Jivraj N, Oza A, Dhani N, Lee Y, Madariaga A, Kasherman L, McMullen M, Liu S, Bowering V, Ferguson S, Croke J, Lheureux S. Proactive inter-professional program to manage malignant bowel obstruction (MBO) in women with advanced gynecological cancer: Improving quality of care, education and awareness of malignant bowel obstruction among patients and health care providers. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Madariaga A, Garg S, Oza A, Rouzbahman M, Dhani N, Bonilla L, Croke J, Laframboise S, Bhat G, Kasherman L, McMullen M, Liu S, Wang L, Bowering V, Lheureux S. Treatment and outcome of women with cervical mucinous carcinoma: 10 year experience from a single centre. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Madariaga A, Garg S, Oza A, Rouzbahman M, Dhani N, Bonilla L, Laframboise S, Croke J, Kasherman L, Liu S, Bhat G, McMullen M, Wang L, Bowering V, Lheureux S. Mucinous ovarian malignancies 10-year overview of treatment and outcome from a single centre. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Socinski M, Cornelissen R, Garassino M, Clarke J, Tchekmedyian N, Molina J, Goldman J, Bhat G, Lebel F, Le X. LBA60 ZENITH20, a multinational, multi-cohort phase II study of poziotinib in NSCLC patients with EGFR or HER2 exon 20 insertion mutations. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2293] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Smith S, Koech R, Nzorubara D, Otieno M, Wong L, Bhat G, van den Bogaart E, Thuranira M, Onchonga D, Rinke de Wit TF. Connected diagnostics: linking digital rapid diagnostic tests and mobile health wallets to diagnose and treat brucellosis in Samburu, Kenya. BMC Med Inform Decis Mak 2019; 19:139. [PMID: 31331394 PMCID: PMC6647279 DOI: 10.1186/s12911-019-0854-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/17/2018] [Accepted: 06/26/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite WHO guidelines for testing all suspected cases of malaria before initiating treatment, presumptive malaria treatment remains common practice among some clinicians and in certain low-resource settings the capacity for microscopic testing is limited. This can lead to misdiagnosis, resulting in increased morbidity due to lack of treatment for undetected conditions, increased healthcare costs, and potential for drug resistance. This is particularly an issue as multiple conditions share the similar etiologies to malaria, including brucellosis, a rare, under-detected zoonosis. Linking rapid diagnostic tests (RDTs) and digital test readers for the detection of febrile illnesses can mitigate this risk and improve case management of febrile illness. METHODS This technical advance study examines Connected Diagnostics, an approach that combines the use of point-of-care RDTs for malaria and brucellosis, digitally interpreted by a rapid diagnostic test reader (Deki Reader) and connected to mobile payment mechanisms to facilitate the diagnosis and treatment of febrile illness in nomadic populations in Samburu County, Kenya. Consenting febrile patients were tested with RDTs and patient diagnosis and risk information were uploaded to a cloud database via the Deki Reader. Patients with positive diagnoses were provided digital vouchers for transportation to the clinic and treatment via their health wallet on their mobile phones. RESULTS In total, 288 patients were tested during outreach visits, with 9% testing positive for brucellosis and 0.6% testing positive for malaria. All patients, regardless of diagnosis were provided with a mobile health wallet on their cellular phones to facilitate their transport to the clinic, and for patients testing positive for brucellosis or malaria, the wallet funded their treatment. The use of the Deki Reader in addition to quality diagnostics at point of care also facilitated geographic mapping of patient diagnoses in relation to key risk areas for brucellosis transmission. CONCLUSIONS This study demonstrates that the Connected Dx approach can be effective even when addressing a remote, nomadic population and a rare disease, indicating that this approach to diagnosing, treatment, and payment for healthcare costs is feasible and can be scaled to address more prevalent diseases and conditions in more populous contexts.
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Affiliation(s)
- S Smith
- PharmAccess Foundation, AHTC Tower 4C, Paasheuvelweg 25, 1105 BP, Amsterdam, The Netherlands.
| | - R Koech
- PharmAccess Foundation Kenya, New Rehema House, Rhamta Road, Westlands, Nairobi, Kenya
| | - D Nzorubara
- PharmAccess Foundation Kenya, New Rehema House, Rhamta Road, Westlands, Nairobi, Kenya
| | - M Otieno
- PharmAccess Foundation Kenya, New Rehema House, Rhamta Road, Westlands, Nairobi, Kenya
| | - L Wong
- Fio Corporation, 111 Queen Street East Suite 500, Toronto, Ontario, M5C 1S2, Canada
| | - G Bhat
- Fio Corporation, 111 Queen Street East Suite 500, Toronto, Ontario, M5C 1S2, Canada
| | - E van den Bogaart
- Mondial Diagnostics, Meibergdreef 39, 1105 AZ, Amsterdam, The Netherlands
| | - M Thuranira
- Samburu County Government, C77, P.O. Box 3 - 20600, Maralal, Samburu County, Kenya
| | - D Onchonga
- Samburu County Government, C77, P.O. Box 3 - 20600, Maralal, Samburu County, Kenya
| | - T F Rinke de Wit
- PharmAccess Foundation, AHTC Tower 4C, Paasheuvelweg 25, 1105 BP, Amsterdam, The Netherlands
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Bhat G, Shastry A. 012 Average Time to Orgasm (TitOr) in Females during Heterosexual Penovaginal Intercourse. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.469] [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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Bhat G, Potter D, Bharadwaj J, Khan N, Shabazz L, Tache J, Yang Z. Abstract OT2-07-04: A phase 1b study of poziotinib in combination with T-DM1 in women with advanced or metastatic HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-07-04] [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:Poziotinib represents a new class of irreversible quinazoline inhibitors of ErbB receptor tyrosine kinases that inhibit the proliferation of tumor cells in culture and in vivo by inhibiting HER-1 (EGFR), HER-2, HER-4. ErbB signaling plays important roles in the progression of HER2+ breast cancer. Poziotinib has promising clinical activity in breast cancer, and other solid tumors including lung, gastric, and colorectal cancers.
Study SPI-POZ-101, is being conducted to evaluate the safety and efficacy of the combination of daily poziotinib and T-DM1, HER2 antibody-drug-conjugate every three weeks in patients with HER2+ advanced or metastatic breast cancer.
Trial Objectives and Design: The primary objectives of the study are to determine the maximum tolerated dose (MTD) or maximum administered dose (MAD) of daily poziotinib plus T-DM1 (every 3 weeks) in women with advanced or metastatic HER2 positive breast cancer; and to evaluate the Objective Response Rate (ORR) in these patients.
The secondary objectives include disease control rate (DCR), progression-free-survival (PFS), safety and pharmacokinetics at the MTD/MAD dose level of poziotinib plus T-DM1.
In Part 1, the dose of poziotinib plus standard dose of T-DM1 (3.6 mg/kg IV) on Day 1 of each cycle will be determined using a “3+3” design with up to 3 escalating dose levels, 8, 10 and 12 mg with no DLT or to de-escalate to 6 mg with DLT observed in Cycle 1. Patients in current dose cohort, if not discontinued, will continue treatment until discontinuation of therapy.
In Part 2 of the study, approximately 10 patients will be treated at the MTD/MAD to confirm dose for safety of the combination and to evaluate preliminary efficacy.
Eligibility Criteria: The study will enroll female patients between 18 and 90 years with confirmed HER2 overexpression or gene-amplified tumor via immunohistochemistry [IHC] with IHC 3+ or IHC 2+ with confirmatory fluorescence in situ hybridization [FISH]+ or [ISH]+ and must have had at least 2 lines of anti-HER2 directed therapies either in the metastatic or early-stage disease setting. Patients must have adequate hematologic, hepatic, cardiac and renal functions and have at least one measurable lesion per RECIST 1.1 criteria. Exclusion criteria includes unstable CNS metastases or seizure disorder; anticancer chemotherapy, TKIs, biologics, immunotherapy, radiotherapy, or investigational treatment within 15 days; ≥ Grade 2 adverse events; known hypersensitivity to receptor tyrosine kinase inhibitors or any of the components of poziotinib tablets or T-DM1 IV solution.
Statistical Methods: Part 1 of the study will enroll 3 to 6 patients at each dose using 3+3 design. Part 2 will enroll 10 patients at the MTD/MAD. The efficacy analysis will be conducted using the Evaluable Population based on RECIST 1.1. The Clopper-Pearson 95% confidence interval will be estimated using exact method based on binomial distribution.
Target Accrual:Part 1: 6-18 patients Part 2: 10 patients
ClinicalTrials.gov Identifier: NCT03429101
Contact Information: Spectrum Pharmaceuticals. SPI-POZ-101@sppirx.com
Poziotinib is currently under clinical investigation and has not been approved for use in breast cancer.
Citation Format: Bhat G, Potter D, Bharadwaj J, Khan N, Shabazz L, Tache J, Yang Z. A phase 1b study of poziotinib in combination with T-DM1 in women with advanced or metastatic HER2-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-07-04.
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Affiliation(s)
- G Bhat
- Spectrum Pharmaceuticals, Irvine, CA; University of Minnesota, Minneapolis, MN; Pacific Cancer Medical Center, Anaheim, CA; Delta Hematology/Oncology Associates, Portsmouth, VA; BRCR Medical Center, Plantation, FL
| | - D Potter
- Spectrum Pharmaceuticals, Irvine, CA; University of Minnesota, Minneapolis, MN; Pacific Cancer Medical Center, Anaheim, CA; Delta Hematology/Oncology Associates, Portsmouth, VA; BRCR Medical Center, Plantation, FL
| | - J Bharadwaj
- Spectrum Pharmaceuticals, Irvine, CA; University of Minnesota, Minneapolis, MN; Pacific Cancer Medical Center, Anaheim, CA; Delta Hematology/Oncology Associates, Portsmouth, VA; BRCR Medical Center, Plantation, FL
| | - N Khan
- Spectrum Pharmaceuticals, Irvine, CA; University of Minnesota, Minneapolis, MN; Pacific Cancer Medical Center, Anaheim, CA; Delta Hematology/Oncology Associates, Portsmouth, VA; BRCR Medical Center, Plantation, FL
| | - L Shabazz
- Spectrum Pharmaceuticals, Irvine, CA; University of Minnesota, Minneapolis, MN; Pacific Cancer Medical Center, Anaheim, CA; Delta Hematology/Oncology Associates, Portsmouth, VA; BRCR Medical Center, Plantation, FL
| | - J Tache
- Spectrum Pharmaceuticals, Irvine, CA; University of Minnesota, Minneapolis, MN; Pacific Cancer Medical Center, Anaheim, CA; Delta Hematology/Oncology Associates, Portsmouth, VA; BRCR Medical Center, Plantation, FL
| | - Z Yang
- Spectrum Pharmaceuticals, Irvine, CA; University of Minnesota, Minneapolis, MN; Pacific Cancer Medical Center, Anaheim, CA; Delta Hematology/Oncology Associates, Portsmouth, VA; BRCR Medical Center, Plantation, FL
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Schwartzberg L, Bhat G, Mezei K, Lang I, Moon YW, Senviratne L, Chawla S, Cobb P, Yang Z. Abstract P1-13-05: Efficacy and safety of eflapegrastim confirmed in reducing severe neutropenia in breast cancer patients treated with myelosuppressive chemotherapy in the second Phase 3 randomized controlled multinational trial compared to pegfilgrastim (RECOVER trial). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-13-05] [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:
Eflapegrastim is a novel investigational biologic comprised of recombinant human G-CSF covalently linked to the human immunoglobulin G4FC fragment using proprietary LAPSCOVERY™ technology with potentially unique distribution to areas rich in FcRn receptors. RECOVER is the second Phase 3 study to investigate the non-inferiority (NI) of eflapegrastim to pegfilgrastim in patients receiving chemotherapy for breast cancer. The first Phase 3 study, ADVANCE, has demonstrated the non-inferiority of eflapegrastim comparing to pegfilgrastim in the duration of severe neutropenia (DSN) in breast cancer patients receiving docetaxel and cyclophosphamide (TC) and was previously published at ASCO 2018 meeting.
TrialDesign:
Patients with Stage I to Stage IIIA breast cancer from centers in the USA, Canada, Poland, Hungary, South Korea and India were treated on Day 1 of each of four 21-day cycles with adjuvant or neo-adjuvant TC. On Day 2 of each cycle, patients received a single subcutaneous dose of either eflapegrastim 13.2 mg/0.6 mL (equivalent to 3.6 mg G-CSF) or pegfilgrastim (6 mg) in a 1:1 ratio. Patients had CBCs drawn on Day 1 prior to chemotherapy and Days 4-15 daily or until recovery of neutropenia in Cycle 1. CBC was also collected on Days 1, 4, 7, 10 and 15 in Cycles 2-4. The primary endpoint was to demonstrate the non-inferiority of eflapegrastim comparing to pegfilgrastim as measured by the mean DSN in Cycle 1 with NI margin of <0.62 day.
Results:
In a total of 237 intent-to-treat patients (randomized to 118 eflapegrastim; 119 pegfilgrastim), median age was 59 years (range 29 to 88 years); mean (SD) DSN was 0.31 (0.688) days for eflapegrastim and 0.39 (0.949) days for pegfilgrastim, demonstrating the non-inferiority (95% CI of ΔDSN: [-0.292, 0.129]; p<0.0001). Non-inferiority of eflapegrastim for DSN was maintained across all 4 cycles. There were no statistically significant differences in secondary endpoints: time to ANC recovery, depth of ANC nadir and incidence of FN at Cycle 1. The common Grade 3/4 adverse events observed in≥5%of patients were similar across both arms and were mainly hematologic including neutropenia, lymphopenia, anemia and leukopenia. Grade 3/4 bone pain and febrile neutropenia rates were similar across both arms and were less than 5%.
Conclusions:
Eflapegrastim, a novel long acting G-CSF demonstrated non-inferiority to pegfilgrastim in the reduction of DSN in breast cancer patients treated with TC and has validated the results from the first Phase 3 ADVANCE study. Eflapegrastim was safe and well-tolerated with a similar safety profile to pegfilgrastim.
Citation Format: Schwartzberg L, Bhat G, Mezei K, Lang I, Moon YW, Senviratne L, Chawla S, Cobb P, Yang Z. Efficacy and safety of eflapegrastim confirmed in reducing severe neutropenia in breast cancer patients treated with myelosuppressive chemotherapy in the second Phase 3 randomized controlled multinational trial compared to pegfilgrastim (RECOVER trial) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-05.
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Affiliation(s)
- L Schwartzberg
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - G Bhat
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - K Mezei
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - I Lang
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - YW Moon
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - L Senviratne
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - S Chawla
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - P Cobb
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
| | - Z Yang
- West Cancer Center, Germantown, TN; Spectrum Pharmaceuticals, Irvine, CA; Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz, Onkologiai Osztaly, Nyiregyhaza, Hungary; Orszagos Onkologiai Intezet, "B" Belgyogyaszati Onkologiai Osztaly, Budapest, Hungary; Cha Bundang Medical Center, Seongnam, Republic of Korea; Los Angeles Hematology and Oncology Medical Group, Los Angeles, CA; St Vincent Frontier Cancer Center, Billings, MT
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Ahmad K, Combs P, Munro J, Meehan K, Jennings K, Kabir C, Macaluso G, Pauwaa S, Bhat G, Tatooles A, Pappas P, Andrade A, Cotts W. Outcomes of Heart Transplant Recipients with LVAD Implantation as Destination Therapy versus Bridge to Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.900] [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: 10/17/2022] Open
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Yost G, Bhat G, Nagarkatte M, Bhan A, Kyi B, Asokan S, Pappas P, Tatooles A. Psoas Muscle Diameter in Patients Undergoing Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gopinathannair R, Dhawan R, Trivedi J, Roukoz H, Bhan A, Ahmed M, Bhat G, Cowger J, Slaughter M, Ravichandran A. 073_16794-J1 Cardiac Implantable Electrical Device related Procedures and Associated Complications in Continuous flow LVAD Recipients: A Multicenter Experience. JACC Clin Electrophysiol 2017. [DOI: 10.1016/j.jacep.2017.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Basu S, Barawkar DA, Ramdas V, Naykodi M, Shejul YD, Patel M, Thorat S, Panmand A, Kashinath K, Bonagiri R, Prasad V, Bhat G, Quraishi A, Chaudhary S, Magdum A, Meru AV, Ghosh I, Bhamidipati RK, Raje AA, Madgula VLM, De S, Rouduri SR, Palle VP, Chugh A, Hariharan N, Mookhtiar KA. Discovery of Potent and Selective A 2A Antagonists with Efficacy in Animal Models of Parkinson's Disease and Depression. ACS Med Chem Lett 2017; 8:835-840. [PMID: 28835798 DOI: 10.1021/acsmedchemlett.7b00175] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 04/22/2017] [Accepted: 07/05/2017] [Indexed: 12/15/2022] Open
Abstract
Adenosine A2A receptor (A2AAdoR) antagonism is a nondopaminergic approach to Parkinson's disease treatment that is under development. Earlier we had reported the therapeutic potential of 7-methoxy-4-morpholino-benzothiazole derivatives as A2AAdoR antagonists. We herein described a novel series of [1,2,4]triazolo[5,1-f]purin-2-one derivatives that displays functional antagonism of the A2A receptor with a high degree of selectivity over A1, A2B, and A3 receptors. Compounds from this new scaffold resulted in the discovery of highly potent, selective, stable, and moderate brain penetrating compound 33. Compound 33 endowed with satisfactory in vitro and in vivo pharmacokinetics properties. Compound 33 demonstrated robust oral efficacies in two commonly used models of Parkinson's disease (haloperidol-induced catalepsy and 6-OHDA lesioned rat models) and depression (TST and FST mice models).
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Affiliation(s)
- Sujay Basu
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Dinesh A. Barawkar
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Vidya Ramdas
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Minakshi Naykodi
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Yogesh D. Shejul
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Meena Patel
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Sachin Thorat
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Anil Panmand
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - K. Kashinath
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Rajesh Bonagiri
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Vandna Prasad
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Ganesh Bhat
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Azfar Quraishi
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Sumit Chaudhary
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Amol Magdum
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Ashwinkumar V. Meru
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Indraneel Ghosh
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Ravi K. Bhamidipati
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Amol A. Raje
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Vamsi L. M. Madgula
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Siddhartha De
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Sreekanth R. Rouduri
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Venkata P. Palle
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Anita Chugh
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Narayanan Hariharan
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Kasim A. Mookhtiar
- Advinus Therapeutics Ltd., Drug Discovery Facility, Quantum Towers, Plot-9,
Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
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Deshpande AM, Bhuniya D, De S, Dave B, Vyavahare VP, Kurhade SH, Kandalkar SR, Naik KP, Kobal BS, Kaduskar RD, Basu S, Jain V, Patil P, Chaturvedi Joshi S, Bhat G, Raje AA, Reddy S, Gundu J, Madgula V, Tambe S, Shitole P, Umrani D, Chugh A, Palle VP, Mookhtiar KA. Discovery of liver-directed glucokinase activator having anti-hyperglycemic effect without hypoglycemia. Eur J Med Chem 2017; 133:268-286. [DOI: 10.1016/j.ejmech.2017.03.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/09/2017] [Accepted: 03/22/2017] [Indexed: 01/18/2023]
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Milano C, Rogers J, Tatooles A, Bhat G, Slaughter M, Birks E, Mokadam N, Mahr C, Miller J, Jeevanandam V, Leadley K, Aaronson K, Pagani F. The Treatment of Patients with Advanced Heart Failure Ineligible for Cardiac Transplantation with the HeartWare Ventricular Assist Device: Results of the ENDURANCE Supplement Trial. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Coyle L, Yost G, Gallagher C, Graney N, Siemeck R, Bhat G, Tatooles A. Impatct of Morbid Obesity After Left Ventricular Assist Device Placement. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Yost G, Ibrahim K, Tatooles A, Bhat G. Longitudinal Neutrophil to Lymphocyte Ratio Assessment After Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Bhat G, Ali A, Yost G, Tatooles A. Right Atrial to Pulmonary Capillary Wedge Pressure Ratio as Predictor for Postoperative Outcomes in Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.954] [Citation(s) in RCA: 2] [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: 10/19/2022] Open
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Ahmed M, Trivedi J, Birks E, Slaughter M, Roukoz H, Bhan A, Bhat G, Cowger J, Ravichandran A, Gopinathannair R. Pre-Implant Digoxin Utilization and Impact on Survival in Left Ventricular Assist Device Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lathrop K, Lucas J, Vacirca JL, Bhat G, Choi MR, Naughton M. Abstract OT1-02-10: A phase 2 study of poziotinib in patients with HER2-positive metastatic breast cancer (MBC) who have received prior HER2 regimens for MBC. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-02-10] [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: Poziotinib is a novel, oral, quinazoline-based pan-HER inhibitor that irreversibly blocks signaling through the epidermal growth factor receptor (EGFR) family of tyrosine-kinase receptors, including EGFR (HER1/ErbB1/EGFR), HER2 (ErbB2), and HER4 (ErbB4), as well as HER receptor mutations. This, in turn, leads to inhibition of the proliferation of tumor cells that overexpress these receptors. It is well established that breast cancers are associated with a mutation in, or overexpression of, members of the EGFR receptor family. The primary objective of this Phase 2 study is to evaluate the Objective Response Rate (ORR) of poziotinib in patients with human epidermal growth factor receptor 2 (HER2)-positive MBC. The secondary efficacy variables are Progression-Free Survival (PFS), Disease Control Rate (DCR), Overall Survival (OS), and Time to Progression (TTP).
Trial Design: This is a Phase 2, open-label, multicenter study to evaluate the efficacy, safety and tolerability of poziotinib in patients with HER2-positive MBC who have received at least 2 prior HER2- directed treatment regimens. Each treatment cycle is 21 days in duration. During each cycle, eligible patients receive 24 mg of poziotinib orally (as three 8-mg tablets) once daily for 14 days, followed by a 7 day treatment-free period.
Eligibility Criteria: Eligible patients are at least 18 years of age, have confirmed HER2 overexpression, adequate hematologic, renal and hepatic function, and have received at least 2 prior HER2-directed therapy regimens, including trastuzumab and trastuzumab emtansine (TDM-1). Patients are excluded if they have prior exposure to poziotinib, a history of congestive heart failure, left ventricular ejection fraction <50%, unable to take oral medications, or have conditions that cause malabsorption. A 30 day wash out period from previous chemotherapeutic or radiation therapies is required.
Statistical Methods: The purpose of this study is to evaluate the efficacy of poziotinib compared to the efficacy of other standard HER2-positive breast cancer treatments as reported in the literature. The ORR will be analyzed descriptively along with the 95% CI. The secondary efficacy variables will be analyzed descriptively.
Target Accrual: Approximately 70 patients. Enrollment began February 2016.
Contact Information: For more information or to refer a patient,
email: spi-poz-201@sppirx.com or fax: 1-949-398-9711.
Citation Format: Lathrop K, Lucas J, Vacirca JL, Bhat G, Choi MR, Naughton M. A phase 2 study of poziotinib in patients with HER2-positive metastatic breast cancer (MBC) who have received prior HER2 regimens for MBC [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-02-10.
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Affiliation(s)
- K Lathrop
- The University of Texas Health Science Center at San Antonio, San Antonio, TX; Marin Cancer Care, Greenbrae, CA; North Shore Hematology/Oncology, East Satauket, NY; Spectrum Pharmaceuticals, Irvine, CA; Washington University, St Louis, MO
| | - J Lucas
- The University of Texas Health Science Center at San Antonio, San Antonio, TX; Marin Cancer Care, Greenbrae, CA; North Shore Hematology/Oncology, East Satauket, NY; Spectrum Pharmaceuticals, Irvine, CA; Washington University, St Louis, MO
| | - JL Vacirca
- The University of Texas Health Science Center at San Antonio, San Antonio, TX; Marin Cancer Care, Greenbrae, CA; North Shore Hematology/Oncology, East Satauket, NY; Spectrum Pharmaceuticals, Irvine, CA; Washington University, St Louis, MO
| | - G Bhat
- The University of Texas Health Science Center at San Antonio, San Antonio, TX; Marin Cancer Care, Greenbrae, CA; North Shore Hematology/Oncology, East Satauket, NY; Spectrum Pharmaceuticals, Irvine, CA; Washington University, St Louis, MO
| | - MR Choi
- The University of Texas Health Science Center at San Antonio, San Antonio, TX; Marin Cancer Care, Greenbrae, CA; North Shore Hematology/Oncology, East Satauket, NY; Spectrum Pharmaceuticals, Irvine, CA; Washington University, St Louis, MO
| | - M Naughton
- The University of Texas Health Science Center at San Antonio, San Antonio, TX; Marin Cancer Care, Greenbrae, CA; North Shore Hematology/Oncology, East Satauket, NY; Spectrum Pharmaceuticals, Irvine, CA; Washington University, St Louis, MO
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Schwartzberg LS, Bharadwaj J, Peguero JA, Vacirca JL, Ibrahim EN, Bhat G, Choi MR, McGregor K, Agajanian R. Abstract OT1-01-11: Randomized phase 3 study of a novel, long-acting G-CSF (eflapegrastim) versus pegfilgrastim in the management of chemotherapy-induced neutropenia in early-stage breast cancer patients receiving docetaxel and cyclophosphamide (TC) (ADVANCE study). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-01-11] [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: Eflapegrastim is a distinct biologic that uses an innovative, proprietary long-acting protein/peptide discovery technology (LAPSCOVERY™). Eflapegrastim consists of a novel, modified recombinant human G-CSF conjugated to the Fc fragment of IgG4 via a polyethylene glycol linker to produce a new, longer-acting G-CSF with a potentially unique distribution to areas rich in Fc receptors including its site of action in the bone marrow. A successful dose-finding Phase 2 trial including a pegfilgrastim control arm established the dose for a Phase 3 non-inferiority trial.
Trial Design: This is a randomized, open-label, active-controlled, multinational, multicenter, Phase 3 study comparing the efficacy and safety of eflapegrastim to pegfilgrastim. Patients (n=580) will be randomized in a 1:1 ratio to receive either eflapegrastim (equivalent to 3.6 mg G-CSF) or pegfilgrastim (equivalent to 6.0 mg G-CSF) once per chemotherapy cycle (up to 4 cycles), approximately 24 hours after chemotherapy. The primary endpoint is to compare the efficacy of a single dose of eflapegrastim with pegfilgrastim in patients with ESBC receiving TC, as measured by the Duration of Severe Neutropenia (DSN) in Cycle 1. Key secondary objectives include Time to Absolute Neutrophil Count (ANC) Recovery in Cycle 1; Depth of ANC Nadir in Cycle 1; incidence of Febrile Neutropenia. Safety and pharmacokinetics will also be assessed.
Eligibility Criteria: This study is enrolling histologically confirmed ESBC patients who are: eligible to receive adjuvant or neoadjuvant TC chemotherapy; at least 18 years of age, with adequate hematologic, renal and hepatic function. Patients will be excluded if they have: active concurrent malignancy or life-threatening disease; a known sensitivity or previous reaction to E. coli derived products or any of the products to be administered during study participation; concurrent adjuvant cancer therapy; locally recurrent/metastatic or contralateral breast cancer; previous exposure to filgrastim, pegfilgrastim, or other G-CSF products in clinical development prior to the administration of study drug; bone marrow or hematopoietic stem cell transplant or radiation therapy prior to enrollment, or are pregnant or breast-feeding.
Statistical Methods: The goal of this study is to demonstrate non-inferiority. For the Primary Efficacy Analysis, the mean DSN in Cycle 1 will be compared between the eflapegrastim and pegfilgrastim treatment arms. A 2-sided 95% confidence interval (CI) of the difference between the mean DSN of the eflapegrastim arm and the mean DSN of the pegfilgrastim arm will be calculated using bootstrap resampling with treatment as the only stratification factor. For the Secondary Efficacy Analyses, the results will each be summarized by treatment arm and cycle. The two-sided 95% CI for the difference between the treatment arms will be calculated.
Target Accrual: Approximately 580 patients. Enrollment began January 2016.
Contact Information: Spectrum Pharmaceuticals. advance@sppirx.com.
Citation Format: Schwartzberg LS, Bharadwaj J, Peguero JA, Vacirca JL, Ibrahim EN, Bhat G, Choi MR, McGregor K, Agajanian R. Randomized phase 3 study of a novel, long-acting G-CSF (eflapegrastim) versus pegfilgrastim in the management of chemotherapy-induced neutropenia in early-stage breast cancer patients receiving docetaxel and cyclophosphamide (TC) (ADVANCE study) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-01-11.
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Affiliation(s)
- LS Schwartzberg
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - J Bharadwaj
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - JA Peguero
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - JL Vacirca
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - EN Ibrahim
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - G Bhat
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - MR Choi
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - K McGregor
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
| | - R Agajanian
- West Cancer Center, Memphis, TN; Oncology Consultants, Houston, TX; North Shore Hematology/Oncology Associates, East Setauket, NY; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; Samaritan Hematology and Oncology Associates, Corvallis, OR; The Oncology Institute of Hope and Innovation, Downey, CA; Pacific Cancer Medical Center, Anaheim, CA
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Basu S, Barawkar DA, Thorat S, Shejul YD, Patel M, Naykodi M, Jain V, Salve Y, Prasad V, Chaudhary S, Ghosh I, Bhat G, Quraishi A, Patil H, Ansari S, Menon S, Unadkat V, Thakare R, Seervi MS, Meru AV, De S, Bhamidipati RK, Rouduri SR, Palle VP, Chug A, Mookhtiar KA. Design, Synthesis of Novel, Potent, Selective, Orally Bioavailable Adenosine A 2A Receptor Antagonists and Their Biological Evaluation. J Med Chem 2017; 60:681-694. [PMID: 28055204 DOI: 10.1021/acs.jmedchem.6b01584] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Our initial structure-activity relationship studies on 7-methoxy-4-morpholino-benzothiazole derivatives featured by aryloxy-2-methylpropanamide moieties at the 2-position led to identification of compound 25 as a potent and selective A2A adenosine receptor (A2AAdoR) antagonist with reasonable ADME and pharmacokinetic properties. However, poor intrinsic solubility and low to moderate oral bioavailability made this series unsuitable for further development. Further optimization using structure-based drug design approach resulted in discovery of potent and selective adenosine A2A receptor antagonists bearing substituted 1-methylcyclohexyl-carboxamide groups at position 2 of the benzothiazole scaffold and endowed with better solubility and oral bioavailability. Compounds 41 and 49 demonstrated a number of positive attributes with respect to in vitro ADME properties. Both compounds displayed good pharmacokinetic properties with 63% and 61% oral bioavailability, respectively, in rat. Further, compound 49 displayed oral efficacy in 6-OHDA lesioned rat model of Parkinson diseases.
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Affiliation(s)
- Sujay Basu
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Dinesh A Barawkar
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Sachin Thorat
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Yogesh D Shejul
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Meena Patel
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Minakshi Naykodi
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Vaibhav Jain
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Yogesh Salve
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Vandna Prasad
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Sumit Chaudhary
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Indraneel Ghosh
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Ganesh Bhat
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Azfar Quraishi
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Harish Patil
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Shariq Ansari
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Suraj Menon
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Vishal Unadkat
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Rhishikesh Thakare
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Madhav S Seervi
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Ashwinkumar V Meru
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Siddhartha De
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Ravi K Bhamidipati
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Sreekanth R Rouduri
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Venkata P Palle
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Anita Chug
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
| | - Kasim A Mookhtiar
- Drug Discovery Facility, Advinus Therapeutics Ltd. , Quantum Towers, Plot-9, Phase-I, Rajiv Gandhi Infotech Park, Hinjawadi, Pune 411 057, India
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Mohamedali B, Yost G, Doukky R, Bhat G. Mean Arterial Pressure to Central Venous Pressure Ratio - A Novel Marker for Right Ventricular Failure after Left Ventricular Assist Device Placement. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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41
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Yost G, Bhat G, Mahoney E, Tatooles A. Reduced Anxiety and Depression in Patients with Advanced Heart Failure after Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.069] [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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Zalawadiya S, Cotts W, Bhat G, Lindenfeld J. Extra-Corporeal Membrane Support as Bridge to Transplant - An Outcome Analysis of United Network for Organ Sharing Registry. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Schwartzberg L, Vacirca JL, Hager SJ, Adoo CS, Ibrahim EN, Bhat G, Choi MR, Allen LF, Tedesco KL, Agajanian R. Abstract OT3-02-13: Randomized phase 3 study of a novel, long-acting G-CSF (SPI-2012) versus pegfilgrastim in the management of chemotherapy-induced neutropenia in early-stage breast cancer patients receiving docetaxel and cyclophosphamide (TC) (ADVANCE study). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot3-02-13] [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: SPI-2012 is a distinct biologic that uses the innovative, proprietary long-acting protein/peptide discovery technology (LAPSCOVERY™) to enhance the activity of G-CSF. SPI-2012 consists of a novel, modified recombinant human G-CSF conjugated to the Fc fragment of IgG4 via a polyethylene glycol linker to produce a new, more potent, longer-acting G-CSF with a potentially unique distribution to areas rich in Fc receptors. The primary endpoint of this Phase 3 study is to compare the efficacy of a single dose of SPI-2012 with pegfilgrastim in patients with early-stage breast cancer (ESBC) receiving TC chemotherapy, as measured by the Duration of Severe Neutropenia (DSN) in Cycle 1. Key secondary objectives include the comparison of SPI-2012 with pegfilgrastim during Cycle 1 in: Time to Absolute Neutrophil Count (ANC) Recovery; Depth of ANC Nadir and Incidence of Febrile Neutropenia. Safety and pharmacokinetics will also be assessed.
Trial Design: This is a randomized, open-label, active-controlled, multicenter study comparing the efficacy and safety of SPI-2012 to pegfilgrastim. Patients (n=506) will be randomized in a 1:1 ratio to receive either SPI-2012 (equivalent to 3.6 mg G-CSF) or pegfilgrastim (equivalent to 6.0 mg G-CSF) once per chemotherapy cycle (up to 4 cycles), approximately 24 hrs after chemotherapy.
Eligibility Criteria: This study will enroll histologically confirmed ESBC patients who are eligible to receive adjuvant or neoadjuvant TC chemotherapy and at least 18 years of age, with adequate hematologic, renal and hepatic function. Patients will be excluded if they have active concurrent malignancy or life-threatening disease; a known sensitivity or previous reaction to E. coli derived products or any of the products to be administered during study participation; concurrent adjuvant cancer therapy; locally recurrent/metastatic or contralateral breast cancer; previous exposure to filgrastim, pegfilgrastim, or other G-CSF products in clinical development prior to the administration of study drug; bone marrow or hematopoietic stem cell transplant or radiation therapy prior to enrollment or are pregnant or breast-feeding.
Statistical Methods: The goal of the study is to demonstrate non-inferiority of SPI-2012 to pegfilgrastim. For the Primary Efficacy Analysis, the mean DSN in Cycle 1 will be compared between the SPI-2012 and pegfilgrastim treatment arms. A 2-sided 95% confidence interval (CI) of the difference between the mean DSN of the SPI-2012 arm and the mean DSN of the pegfilgrastim arm will be calculated using bootstrap resampling with treatment as the only stratification factor. For the Secondary Efficacy Analyses, the results will each be summarized by treatment arm and Cycle. The two-sided 95% CI for the difference between the treatment arms will be calculated.
Target Accrual: Approximately 506 pts.
Citation Format: Schwartzberg L, Vacirca JL, Hager SJ, Adoo CS, Ibrahim EN, Bhat G, Choi MR, Allen LF, Tedesco KL, Agajanian R. Randomized phase 3 study of a novel, long-acting G-CSF (SPI-2012) versus pegfilgrastim in the management of chemotherapy-induced neutropenia in early-stage breast cancer patients receiving docetaxel and cyclophosphamide (TC) (ADVANCE study). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT3-02-13.
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Affiliation(s)
- L Schwartzberg
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - JL Vacirca
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - SJ Hager
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - CS Adoo
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - EN Ibrahim
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - G Bhat
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - MR Choi
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - LF Allen
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - KL Tedesco
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
| | - R Agajanian
- The West Clinic, Memphis, TN; North Shore Hematology/Oncology Associates, East Setauket, NY; California Cancer Associates for Research and Excellence, Fresno, CA; Arizona Center for Cancer Care, Glendale, AZ; Beaver Medical Group, Highland, CA; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation, Downey, CA
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Vacirca JL, Chan A, Mezei K, Adoo CS, Papai Z, McGregor K, Okera M, Horvath Z, Landherr L, Hanslik J, Hager SJ, Ibrahim EN, Ghazal H, Rostom M, Bhat G, Choi MR, Allen LF, Tedesco KL, Agajanian R, Lang I. Abstract P1-10-05: Randomized phase 2, open-label, dose-ranging study of a novel, long-acting G-CSF (SPI-2012) or pegfilgrastim for the management of neutropenia in patients with breast cancer (BC) treated with (Neo) adjuvant chemotherapy with docetaxel + cyclophosphamide (TC). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-10-05] [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: SPI-2012 is a distinct biologic that uses the innovative proprietary long-acting protein/peptide discovery technology (LAPSCOVERY™) to enhance the activity of G-CSF. SPI-2012 consists of a novel, modified recombinant human G-CSF conjugated to the Fc fragment of IgG4 via a polyethylene glycol linker to produce a new, more potent, longer-acting G-CSF with a potentially unique distribution to areas rich in Fc receptors. To assess the effect of SPI-2012 in supporting patients with breast cancer receiving myelosuppressive chemotherapy with TC, we conducted a randomized Phase 2 study of 3 SPI-2012 doses versus pegfilgrastim.
Methods: This was an open-label, global, multicenter, dose-ranging study designed to compare the safety and efficacy of SPI-2012 relative to a fixed, standard dose of pegfilgrastim as a concurrent active control. The study included 4 treatment arms: 3 dose levels of SPI-2012 (45 μg/kg, 135 μg/kg, and 270 μg/kg) vs pegfilgrastim (6 mg,). The primary objective of the study was the Duration of Severe Neutropenia (DSN) during Cycle 1 in patients with BC who received adjuvant or neoadjuvant TC chemotherapy.
Results: A total of 147 evaluable patients were enrolled. Patient and tumor characteristics were comparable across all 4 treatment arms. Mean age was 58.2 years (range 32 to 77 years); most patients were <65 years (68%), female (98%) and white (95%). The study met its primary endpoint with DSN in patients treated in the 135 µg/kg and 270 µg/kg SPI-2012 treatment arms in Cycle 1 showing non-inferiority to the DSN in patients treated with pegfilgrastim (p=0.002 and p<0.001, respectively). In addition, superiority was demonstrated in patients treated with 270 µg/kg SPI-2012 compared to pegfilgrastim (p=0.023). Non-inferiority in DSN was also observed in Cycles 2 to 4 in both the 135 µg/kg and 270 µg/kg SPI-2012 treatment arms compared to pegfilgrastim.
Duration of Severe Neutropenia in Cycle 1 of TC chemotherapy by Treatment Arm 45 μg/kg SPI-2012 (N=39) 135 μg/kg SPI-2012 (N=36) 270 μg/kg SPI-2012 (N=36)Pegfilgrastim (N=36)DSN Mean (SD)(days)1.03 (1.5)0.44 (1.3)0.03 (0.2)0.31 (0.8)Difference with pegfilgrastim0.720.14-0.28NANon-inferiority p-value0.2960.002<0.001NASuperiority p-value0.0060.5280.023NASD=Standard Deviation; NA=Not Applicable
The common treatment-emergent adverse events observed in ≥20% of patients were similar across all 4 study arms with similar or lower incidence in the SPI-2012 treatment arms, and included fatigue, nausea, alopecia, diarrhea, and bone pain.
Conclusions: All doses of SPI-2012 administered in this Phase 2 study were well tolerated, and no new or significant dose-related toxicities were observed. Most reported adverse events were mild and similar to those previously reported in clinical trials with filgrastim and pegfilgrastim in patients receiving myelosuppressive chemotherapy. In Cycle 1, the 135 µg/kg dose of SPI-2012 was non-inferior compared to pegfilgrastim, and the 270 µg/kg dose was superior in terms of DSN. Additional efficacy and safety data for SPI-2012 will be collected in planned Phase 3 clinical trials.
Citation Format: Vacirca JL, Chan A, Mezei K, Adoo CS, Papai Z, McGregor K, Okera M, Horvath Z, Landherr L, Hanslik J, Hager SJ, Ibrahim EN, Ghazal H, Rostom M, Bhat G, Choi MR, Allen LF, Tedesco KL, Agajanian R, Lang I. Randomized phase 2, open-label, dose-ranging study of a novel, long-acting G-CSF (SPI-2012) or pegfilgrastim for the management of neutropenia in patients with breast cancer (BC) treated with (Neo) adjuvant chemotherapy with docetaxel + cyclophosphamide (TC). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-05.
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Affiliation(s)
- JL Vacirca
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - A Chan
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - K Mezei
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - CS Adoo
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - Z Papai
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - K McGregor
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - M Okera
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - Z Horvath
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - L Landherr
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - J Hanslik
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - SJ Hager
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - EN Ibrahim
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - H Ghazal
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - M Rostom
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - G Bhat
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - MR Choi
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - LF Allen
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - KL Tedesco
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - R Agajanian
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
| | - I Lang
- North Shore Hematology/Oncology, East Setaukut, NY; Breast Cancer Research Centre WA and Curtin University, Perth, Western Australia, Australia; Szabolcs Szatmar Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary; Arizona Center for Cancer Care, Glendale, AZ; State Health Center, Budapest, Hungary; Samaritan Hematology and Oncology Associates, Corvalis, OR; Adelaide Cancer Centre, Kurralta Park, South Australia, Australia; University of Debrecen, Oncology Clinic, Debrecen, Hungary; Uzsoki Hospital, Center of Oncoradiology, Budapest, Hungary; Szpital Rejonowy Dzienny Oddzial Chemioterapii, Racibórz, Poland; California Cancer Associates for Research and Excellence, Fresno, CA; Beaver Medical Group, Highland, CA; Hazard ARH Regional Medical Center, Hazard, KY; Cancer Center of Adjara Autonomous Republic, Batumi, Georgia; Spectrum Pharmaceuticals, Irvine, CA; New York Oncology Hematology (US Oncology/McKesson Specialty Health), Albany, NY; The Oncology Institute of Hope and Innovation,
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Veni EJK, Bhat G, Shalini SM, Kumar P, Chakrapani M, Baliga S. Community-Acquired Methicillin Resistant Staphylococcus aureus Bacteremia: Case Series. ACTA ACUST UNITED AC 2015; 13:77-9. [DOI: 10.3126/kumj.v13i1.13759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Community-acquired methicillin resistant Staphylococcus aureus (MRSA) usually causes skin and soft tissue infections. However, community-acquired methicillin resistant S.aureus has been identified as a causative agent of many invasive infections like necrotizing fasciitis, pneumonia and bacteremia. Risk factors such as immunodeficiency and skin and soft tissue infections have been identified for acquiring bacteremia. We present four cases of bacteremia caused by community-acquired methicillin resistant S.aureus, risk factors and outcome.Kathmandu University Medical Journal Vol.13(1) 2015; 77-79
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Pagani F, Milano C, Tatooles A, Bhat G, Slaughter M, Birks E, Boyce S, Najjar S, Jeevanandam V, Anderson A, Gregoric I, Delgado R, Leadley K, Aaronson K, Rogers J. HeartWare HVAD for the Treatment of Patients With Advanced Heart Failure Ineligible for Cardiac Transplantation: Results of the ENDURANCE Destination Therapy Trial. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Yost G, Gregory M, Bhat G. Handgrip Strength Is a Predictor for Length of Stay in Patients Implanted With Left Ventricular Assist Devices. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Coyle L, Milkevitch K, Adair R, Tatooles A, Bhat G. Functional Outcomes of Left Ventricular Assist Device Patients Receiving Inpatient Rehabilitation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Mohamedali B, Yost G, Bhat G. Pre-Implant Glomerular Filtration Rate (GFR) as a Predictor of Adverse Outcomes Post Left Ventricular Assist Device Placement. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Shivakumar BM, Rotti H, Vasudevan TG, Balakrishnan A, Chakrabarty S, Bhat G, Rao L, Pai CG, Satyamoorthy K. Copy number variations are progressively associated with the pathogenesis of colorectal cancer in ulcerative colitis. World J Gastroenterol 2015; 21:616-622. [PMID: 25605985 PMCID: PMC4296023 DOI: 10.3748/wjg.v21.i2.616] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/10/2014] [Accepted: 07/22/2014] [Indexed: 02/07/2023] Open
Abstract
AIM: To evaluate the association of known copy number variations (CNVs) in ulcerative colitis (UC) progressing to colorectal cancer.
METHODS: Microsatellite instability analysis using the National Cancer Institute’s panel of markers, and CNV association studies using Agilent 2 × 105 k arrays were done in tissue samples from four patient groups with UC: those at low risk (LR) or high risk of developing colorectal cancer, those with premalignant dysplastic lesions, and those with colitis-associated colorectal cancer (CAC). DNA from tissue samples of these groups were independently hybridized on arrays and analyzed. The data obtained were further subjected to downstream bioinformatics enrichment analysis to examine the correlation with CAC progression.
RESULTS: Microarray analysis highlighted a progressive increase in the total number of CNVs [LR (n = 178) vs CAC (n = 958), 5.3-fold], gains and losses [LR (n = 37 and 141) vs CAC (n = 495 and 463), 13.4- and 3.3-fold, respectively], size [LR (964.2 kb) vs CAC (10540 kb), 10.9-fold] and the number of genes in such regions [LR (n = 119) vs CAC (n = 455), 3.8-fold]. Chromosome-wise analysis of CNVs also showed an increase in the number of CNVs across each chromosome. There were 38 genes common to all four groups in the study; 13 of these were common to cancer genes from the Genetic Disease Association dataset. The gene set enrichment analysis and ontology analysis highlighted many cancer-associated genes. All the samples in the different groups were microsatellite stable.
CONCLUSION: Increasing numbers of CNVs are associated with the progression of UC to CAC, and warrant further detailed exploration.
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