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Doherty G, McLaughlin L, Hughes C, McConnell J, Bond R, McFadden S. A scoping review of educational programmes on artificial intelligence (AI) available to medical imaging staff. Radiography (Lond) 2024; 30:474-482. [PMID: 38217933 DOI: 10.1016/j.radi.2023.12.019] [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: 10/26/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Medical imaging is arguably the most technologically advanced field in healthcare, encompassing a range of technologies which continually evolve as computing power and human knowledge expand. Artificial Intelligence (AI) is the next frontier which medical imaging is pioneering. The rapid development and implementation of AI has the potential to revolutionise healthcare, however, to do so, staff must be competent and confident in its application, hence AI readiness is an important precursor to AI adoption. Research to ascertain the best way to deliver this AI-enabled healthcare training is in its infancy. The aim of this scoping review is to compare existing studies which investigate and evaluate the efficacy of AI educational interventions for medical imaging staff. METHODS Following the creation of a search strategy and keyword searches, screening was conducted to determine study eligibility. This consisted of a title and abstract scan, then subsequently a full-text review. Articles were included if they were empirical studies wherein an educational intervention on AI for medical imaging staff was created, delivered, and evaluated. RESULTS Of the initial 1309 records returned, n = 5 (∼0.4 %) of studies met the eligibility criteria of the review. The curricula and delivery in each of the five studies shared similar aims and a 'flipped classroom' delivery was the most utilised method. However, the depth of content covered in the curricula of each varied and measured outcomes differed greatly. CONCLUSION The findings of this review will provide insights into the evaluation of existing AI educational interventions, which will be valuable when planning AI education for healthcare staff. IMPLICATIONS FOR PRACTICE This review highlights the need for standardised and comprehensive AI training programs for imaging staff.
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Affiliation(s)
- G Doherty
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom.
| | - L McLaughlin
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
| | - C Hughes
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
| | - J McConnell
- Leeds Teaching Hospitals NHS Trust, United Kingdom
| | - R Bond
- Ulster University, School of Computing, Faculty of Computing, Engineering and the Built Environment, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
| | - S McFadden
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
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Spicer J, Basu B, Montes A, Banerji U, Kristeleit R, Miller R, Veal GJ, Corrigan CJ, Till SJ, Figini M, Canevari S, Barton C, Jones P, Mellor S, Carroll S, Selkirk C, Nintos G, Kwatra V, Funingana IG, Doherty G, Gould HJ, Pellizzari G, Nakamura M, Ilieva KM, Khiabany A, Stavraka C, Chauhan J, Gillett C, Pinder S, Bax HJ, Josephs DH, Karagiannis SN. Safety and anti-tumour activity of the IgE antibody MOv18 in patients with advanced solid tumours expressing folate receptor-alpha: a phase I trial. Nat Commun 2023; 14:4180. [PMID: 37491373 PMCID: PMC10368744 DOI: 10.1038/s41467-023-39679-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/22/2023] [Indexed: 07/27/2023] Open
Abstract
All antibodies approved for cancer therapy are monoclonal IgGs but the biology of IgE, supported by comparative preclinical data, offers the potential for enhanced effector cell potency. Here we report a Phase I dose escalation trial (NCT02546921) with the primary objective of exploring the safety and tolerability of MOv18 IgE, a chimeric first-in-class IgE antibody, in patients with tumours expressing the relevant antigen, folate receptor-alpha. The trial incorporated skin prick and basophil activation tests (BAT) to select patients at lowest risk of allergic toxicity. Secondary objectives were exploration of anti-tumour activity, recommended Phase II dose, and pharmacokinetics. Dose escalation ranged from 70 μg-12 mg. The most common toxicity of MOv18 IgE is transient urticaria. A single patient experienced anaphylaxis, likely explained by detection of circulating basophils at baseline that could be activated by MOv18 IgE. The BAT assay was used to avoid enrolling further patients with reactive basophils. The safety profile is tolerable and maximum tolerated dose has not been reached, with evidence of anti-tumour activity observed in a patient with ovarian cancer. These results demonstrate the potential of IgE therapy for cancer.
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Affiliation(s)
- James Spicer
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
| | - Bristi Basu
- Cambridge University Hospitals NHS Foundation Trust, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Ana Montes
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Udai Banerji
- Institute of Cancer Research and Royal Marsden Hospital NHS Foundation Trust, Sutton, UK
| | | | | | - Gareth J Veal
- Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
| | - Christopher J Corrigan
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Stephen J Till
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Mariangela Figini
- ANP2, Department of Advanced Diagnostics, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Claire Barton
- Centre for Drug Development, Cancer Research UK, London, UK
- Barton Oncology Ltd, Hertfordshire, UK
| | - Paul Jones
- Centre for Drug Development, Cancer Research UK, London, UK
- UCB Pharma Ltd., Slough, UK
| | - Sarah Mellor
- Centre for Drug Development, Cancer Research UK, London, UK
| | - Simon Carroll
- Centre for Drug Development, Cancer Research UK, London, UK
| | - Chris Selkirk
- Centre for Drug Development, Cancer Research UK, London, UK
| | - George Nintos
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Vineet Kwatra
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ionut-Gabriel Funingana
- Cambridge University Hospitals NHS Foundation Trust, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Gary Doherty
- Cambridge University Hospitals NHS Foundation Trust, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK
| | - Hannah J Gould
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
- Randall Centre for Cell and Molecular Biophysics, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Giulia Pellizzari
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Mano Nakamura
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Kristina M Ilieva
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Atousa Khiabany
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Chara Stavraka
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Jitesh Chauhan
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Cheryl Gillett
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Health Partners Cancer Biobank, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sarah Pinder
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Health Partners Cancer Biobank, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Heather J Bax
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Debra H Josephs
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Sophia N Karagiannis
- St. John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
- Breast Cancer Now Research Unit, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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Van Egeren D, Kohli K, Warner JL, Bedard PL, Riely G, Lepisto E, Schrag D, LeNoue-Newton M, Catalano P, Kehl KL, Michor F, Fiandalo M, Foti M, Khotskaya Y, Lee J, Peters N, Sweeney S, Abraham J, Brenton JD, Caldas C, Doherty G, Nimmervoll B, Pinilla K, Martin JE, Rueda OM, Sammut SJ, Silva D, Cao K, Heath AP, Li M, Lilly J, MacFarland S, Maris JM, Mason JL, Morgan AM, Resnick A, Welsh M, Zhu Y, Johnson B, Li Y, Sholl L, Beaudoin R, Biswas R, Cerami E, Cushing O, Dand D, Ducar M, Gusev A, Hahn WC, Haigis K, Hassett M, Janeway KA, Jänne P, Jawale A, Johnson J, Kehl KL, Kumari P, Laucks V, Lepisto E, Lindeman N, Lindsay J, Lueders A, Macconaill L, Manam M, Mazor T, Miller D, Newcomb A, Orechia J, Ovalle A, Postle A, Quinn D, Reardon B, Rollins B, Shivdasani P, Tramontano A, Van Allen E, Van Nostrand SC, Bell J, Datto MB, Green M, Hubbard C, McCall SJ, Mettu NB, Strickler JH, Andre F, Besse B, Deloger M, Dogan S, Italiano A, Loriot Y, Ludovic L, Michels S, Scoazec J, Tran-Dien A, Vassal G, Freeman CE, Hsiao SJ, Ingham M, Pang J, Rabadan R, Roman LC, Carvajal R, DuBois R, Arcila ME, Benayed R, Berger MF, Bhuiya M, Brannon AR, Brown S, Chakravarty D, Chu C, de Bruijn I, Galle J, Gao J, Gardos S, Gross B, Kundra R, Kung AL, Ladanyi M, Lavery JA, Li X, Lisman A, Mastrogiacomo B, McCarthy C, Nichols C, Ochoa A, Panageas KS, Philip J, Pillai S, Riely GJ, Rizvi H, Rudolph J, Sawyers CL, Schrag D, Schultz N, Schwartz J, Sheridan R, Solit D, Wang A, Wilson M, Zehir A, Zhang H, Zhao G, Ahmed L, Bedard PL, Bruce JP, Chow H, Cooke S, Del Rossi S, Felicen S, Hakgor S, Jagannathan P, Kamel-Reid S, Krishna G, Leighl N, Lu Z, Nguyen A, Oldfield L, Plagianakos D, Pugh TJ, Rizvi A, Sabatini P, Shah E, Singaravelan N, Siu L, Srivastava G, Stickle N, Stockley T, Tang M, Virtaenen C, Watt S, Yu C, Bernard B, Bifulco C, Cramer JL, Lee S, Piening B, Reynolds S, Slagel J, Tittel P, Urba W, VanCampen J, Weerasinghe R, Acebedo A, Guinney J, Guo X, Hunter-Zinck H, Yu T, Dang K, Anagnostou V, Baras A, Brahmer J, Gocke C, Scharpf RB, Tao J, Velculescu VE, Alexander S, Bailey N, Gold P, Bierkens M, de Graaf J, Hudeček J, Meijer GA, Monkhorst K, Samsom KG, Sanders J, Sonke G, ten Hoeve J, van de Velde T, van den Berg J, Voest E, Steinhardt G, Kadri S, Pankhuri W, Wang P, Segal J, Moung C, Espinosa-Mendez C, Martell HJ, Onodera C, Quintanar Alfaro A, Sweet-Cordero EA, Talevich E, Turski M, Van’t Veer L, Wren A, Aguilar S, Dienstmann R, Mancuso F, Nuciforo P, Tabernero J, Viaplana C, Vivancos A, Anderson I, Chaugai S, Coco J, Fabbri D, Johnson D, Jones L, Li X, Lovly C, Mishra S, Mittendorf K, Wen L, Yang YJ, Ye C, Holt M, LeNoue-Newton ML, Micheel CM, Park BH, Rubinstein SM, Stricker T, Wang L, Warner J, Guan M, Jin G, Liu L, Topaloglu U, Urtis C, Zhang W, D’Eletto M, Hutchison S, Longtine J, Walther Z. Genomic analysis of early-stage lung cancer reveals a role for TP53 mutations in distant metastasis. Sci Rep 2022; 12:19055. [PMID: 36351964 PMCID: PMC9646734 DOI: 10.1038/s41598-022-21448-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Patients with non-small cell lung cancer (NSCLC) who have distant metastases have a poor prognosis. To determine which genomic factors of the primary tumor are associated with metastasis, we analyzed data from 759 patients originally diagnosed with stage I-III NSCLC as part of the AACR Project GENIE Biopharma Collaborative consortium. We found that TP53 mutations were significantly associated with the development of new distant metastases. TP53 mutations were also more prevalent in patients with a history of smoking, suggesting that these patients may be at increased risk for distant metastasis. Our results suggest that additional investigation of the optimal management of patients with early-stage NSCLC harboring TP53 mutations at diagnosis is warranted in light of their higher likelihood of developing new distant metastases.
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Affiliation(s)
- Debra Van Egeren
- grid.65499.370000 0001 2106 9910Department of Data Science, Dana-Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Systems Biology, Harvard Medical School, Boston, MA USA ,grid.2515.30000 0004 0378 8438Stem Cell Program, Boston Children’s Hospital, Boston, MA USA ,grid.5386.8000000041936877XDepartment of Medicine, Weill Cornell Medicine, New York, NY USA
| | - Khushi Kohli
- grid.65499.370000 0001 2106 9910Department of Data Science, Dana-Farber Cancer Institute, Boston, MA USA
| | - Jeremy L. Warner
- grid.152326.10000 0001 2264 7217Department of Medicine, Vanderbilt University, Nashville, TN USA ,grid.152326.10000 0001 2264 7217Department of Biomedical Informatics, Vanderbilt University, Nashville, TN USA
| | - Philippe L. Bedard
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Gregory Riely
- grid.51462.340000 0001 2171 9952Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Eva Lepisto
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA ,grid.429426.f0000 0000 9350 5788Present Address: Multiple Myeloma Research Foundation, Norwalk, CT USA
| | - Deborah Schrag
- grid.51462.340000 0001 2171 9952Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Michele LeNoue-Newton
- grid.412807.80000 0004 1936 9916Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN USA
| | - Paul Catalano
- grid.65499.370000 0001 2106 9910Department of Data Science, Dana-Farber Cancer Institute, Boston, MA USA
| | - Kenneth L. Kehl
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA USA
| | - Franziska Michor
- grid.65499.370000 0001 2106 9910Department of Data Science, Dana-Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA USA ,grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA ,grid.65499.370000 0001 2106 9910The Center for Cancer Evolution, Dana-Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XThe Ludwig Center at Harvard, Boston, MA USA
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Quarrell TM, Millar Z, Doherty G, Jena R, Harris F. Treatment of Glioblastoma Multiforme at Progression or Recurrence: A Service Evaluation. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac200.097] [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: 11/13/2022] Open
Abstract
Abstract
AIMS
After initial treatment, glioblastoma multiforme (GBM) invariably reoccurs or progresses. When this happens, there is no established standard of care and treatment choice is made on a case-by-case basis. In our service, there is a multidisciplinary approach to progression, with oncologists and surgeons cooperating closely. This means that our cohort is ideal for studying treatment at progression.
METHOD
We performed a retrospective cohort service evaluation on patients diagnosed with isocitrate dehydrogenase wildtype GBM over a 4-year, 5-month period. We focused on patients who had received Stupp regimen treatment. Analysis was though a cox-proportional hazard model with multiple imputation analysis for missing data when appropriate.
RESULTS
The variable most strongly correlated with the treatment chosen at progression was patient performance status (Kruskal Wallis chi-squared = 22.804, p=0.00014). Some variables, such as age at progression or initial surgical management, were unexpectedly not correlated with the chosen treatment. Of the possible treatments at progression, only surgical management approached borderline significance for increasing survival relative to best supportive care (p=0.06). Performance status had at most a moderate, non-significant impact upon survival post-progression. The MGMT methylation status of the tumour emerged as a powerful predictor of survival post-progression (p=0.01).
CONCLUSION
A range of variables are correlated with which treatment is chosen at progression, but they do not always relate to the post-progression survival. Of all treatments, we can only demonstrate surgical management as having an impact upon survival, suggesting a more moderate effect of medical therapies relative to best supportive care.
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Affiliation(s)
| | | | - Gary Doherty
- Cambridge University Hospitals NHS Foundation Trust
| | - Rajesh Jena
- Cambridge University Hospitals NHS Foundation Trust
| | - Fiona Harris
- Cambridge University Hospitals NHS Foundation Trust
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O'Moráin N, Stack R, Doherty J, Tosetto M, Garcia Leon A, Mallon P, Doherty G. Faecal calprotectin as a potential biomarker of disease severity in SARS-CoV-2 infection. J Infect 2022; 85:436-480. [PMID: 35768051 PMCID: PMC9233623 DOI: 10.1016/j.jinf.2022.06.016] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/05/2022]
Affiliation(s)
- N O'Moráin
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland.
| | - R Stack
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland
| | - J Doherty
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland
| | - M Tosetto
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - A Garcia Leon
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, 4, Ireland
| | - P Mallon
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, 4, Ireland; Department of Infectious Disease, St. Vincent's University Hospital, Dublin, 4, Ireland
| | - G Doherty
- Centre for Colorectal Disease, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland; School of Medicine, University College Dublin, Dublin, 4, Ireland
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Gatfield E, Hughes J, Kumaran M, Doherty G, Daly M, Stancliffe M, Jephcott C, Wilson C, Smith S, Jadon R. P-226 Outcomes using induction chemotherapy followed by long-course chemoradiotherapy as total neoadjuvant therapy for locally advanced rectal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.316] [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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Corrie PG, Welsh SJ, Stewart GD, Doherty G, Vervier K, Neville A, Parkinson C, Fife K, Faust G, Jayaprakash KT, Geldart TR, Brown E, Wheater M, Nobes JP, Bruce D, Demiris N, Dalchau KM, Adams D, Robinson M, Lawley T. Identification of a microbiome signature predicting immune checkpoint inhibitor outcomes across multiple cancer types in the MITRE study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps2665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS2665 Background: The gut microbiome is implicated as a biomarker of response to immune checkpoint inhibitors (ICIs), based on preclinical mouse models and preliminary observations in limited patient series. Furthermore, early reports suggest faecal microbial transfer may have therapeutic potential, converting ICI non-responders to responders. So far, identification of specific responsible bacterial taxa has been inconsistent between published studies, which limits future application. By culturing and metagenomic sequencing of stool sample bacteria, our group has identified a unique microbiome signature, which appears to be predictive of response to ICIs across all key published series as well as our own melanoma patient series (Robinson M et al, J Immunother Cancer 2020;8(suppl 3):A404). Because the patient numbers in all published series remain low, we are now further exploring and validating this microbiome signature in a larger scale study across several different cancer types. Methods: MITRE (Microbiome Immunotherapy Toxicity and Response Evaluation) is a UK NIHR portfolio multi-centre prospective study funded jointly by Cancer Research UK and Microbiotica (NCT04107168). Up to 1800 patients receiving ICIs will be recruited over a 5-year period. In the first stage, 300 patients with advanced melanoma (cohort 1: anti-PD1 monotherapy, cohort 2: anti-PD1+anti-CTLA-4 combination), renal cancer (cohort 3: anti-PD(L)1+kinase inhibitor, cohort 4: anti-PD1+anti-CTLA-4 combination) and non-small cell lung cancer (cohort 5: anti-PD(L)1 monotherapy, cohort 6: anti-PD(L)1+chemotherapy+anti-angiogenic) are being recruited, 50 patients to each cohort. A cohort-specific, simulation-based power calculation will then be performed, guiding subsequent recruitment. Stool and blood are collected prior to treatment, at 3, 6 and 12 months, or disease progression (whichever is sooner), as well as after any grade >3 immune-related adverse events. Patients collect and freeze their own stool samples which are cultured and subjected to shotgun metagenomic sequencing. Plasma, whole blood, buffy coat, RNA and PBMCs are being stored, for correlative studies. Any tumour, or organ biopsies, taken prior to and during treatment are also being collected. Clinical data collection includes treatment, disease response (using RECIST criteria) and toxicity. The primary outcome measure is 1 year progression-free survival. Patients are also asked to invite a household member to be part of the study control group. Recruitment started in July 2020. The Covid-19 pandemic hindered recruitment last year, but the protocol was amended to incorporate a Covid-19 substudy (to document testing, infection and vaccination) and adapt processes for remote trial delivery as much as possible. As of February 2021, 7 sites have opened, 17 patients and 5 household controls have been recruited. Clinical trial information: NCT04107168.
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Affiliation(s)
- Philippa Gail Corrie
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | | | - Gary Doherty
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | | | | | - Kate Fife
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Guy Faust
- Oncology Department, Leicester, United Kingdom
| | | | | | - Ewan Brown
- Western General Hospital, Edinburgh, United Kingdom
| | - Matthew Wheater
- University Hospital Southampton, Southampton, United Kingdom
| | | | - David Bruce
- Cambridge Cancer Trials Centre, Cambridge, United Kingdom
| | - Nikos Demiris
- Cambridge Cancer Trials Centre, Cambridge, United Kingdom
| | | | - David Adams
- Wellcome Sanger Institute, Cambridge, United Kingdom
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De Paula BHR, Doherty G. Results from a global survey of clinical cancer researchers on clinical trial design and conduct during the COVID-19 pandemic and beyond. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e13576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13576 Background: The COVID-19 pandemic has had profound detrimental consequences on cancer patient outcomes and clinical cancer research, with considerable adaptations made to both standard care and clinical research to optimise patient safety. Detailed perspectives of clinical researchers on such risk mitigation, and granular insight into which adaptions should persist long term, are required to inform future clinical trial design. Methods: We designed and performed an in depth, global survey (open between 04/22/20 and 06/10/2020) of cancer research professionals to assess the impact of the pandemic on clinical care and research, and how researchers prioritise and view clinical research methodologies. Results: 162 valid responses were received (58.7% oncologists, 14.8% research nurses; 69.1% working in academic centers) from six continents. There was significant heterogeneity in how the pandemic has affected healthcare workers, patients on standard of care or investigational trial treatments, and clinical trial recruitment. Our results detail how trial and non-trial patient care has altered in respondents’ centres and how respondents would prioritise specific trial designs while the pandemic continues. We show marked variance in the perceived value of specific trial protocol features and assessments (regardless of the pandemic). More respondents agreed than disagreed that trial eligibility criteria are too restrictive (48% agreed versus 28% disagreed), that screening assessments generally have unnecessary tests (51% versus 23%), that physical examination should only be performed when clinically indicated (43% versus 30%), that electronic patient outcomes/questionnaires are better at detecting adverse events that a consultation with a study doctor (33% versus 29%), that wearable technology/validated tools for patients to perform self-examination would provide more useful information than vital sign assessment in the study center (48% versus 13%), and that replacing routine in person visits with virtual visits would not significantly compromise patient safety (36% versus 28%). However, 65% of respondents indicated that fully virtual clinical trials (in the absence of reported clinically significant toxicities) would not be sufficiently safe (versus 15% who indicated that they would be). Conclusions: These detailed data provide further evidence of a significant adverse impact of the pandemic on cancer patient care and drug development, may help inform risk mitigation for studies in times of heightened infection risk, and aid with future clinical trial design.
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Affiliation(s)
| | - Gary Doherty
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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9
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Drewett LM, Pugh SA, Kieran R, Nair B, Attia H, Sabar MI, Milne I, Saunders S, Bragg J, Whitehorn D, Lay J, Rueda OM, Harris F, Welsh SJ, Doherty G, Basu B, Abraham J, Beddowes E, Corrie PG, O'Carrigan B. The impact of COVID-19 on clinical cancer care: An individual-patient level analysis. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1533 Background: At the outset of the COVID-19 pandemic, concerns for the safety of patients receiving anti-cancer treatment coupled with pressures on healthcare services prompted review of standard clinical care pathways in the UK. Revised consensus treatment guidelines were generated. Individual patient-level data regarding actual treatment modifications implemented in clinical practice are lacking. Methods: All anti-cancer treatment plans of patients with breast, lung, renal, hepatopancreatobiliary, CNS cancers and melanoma attending a single academic cancer centre in the UK between 16 March and 31 May 2020 were reviewed and any modifications to standard practice were documented. The effect of patient (age, ECOG performance status [PS], sex) and cancer (site, stage, treatment intent) characteristics on likelihood of treatment modifications were analysed using univariable and multivariable models. Results: Treatment plans for 925 patients were reviewed: median patient age was 63 (range 19-97); 66% were female; 73% were PS 0-1; 45% were on a curative pathway. Overall, 47% of all patients had one or more modifications made to their treatment plans: 53% of surgeries (primarily being delayed); 41% of radiotherapy (primarily reduced fractions delivered); 39% of systemic therapy prescriptions. 96-100% of all systemic therapy modifications resulted in treatment de-escalation, excluding endocrine therapy used as a bridge to defer primary breast cancer surgery. Biological therapy was predominantly interrupted (49%), immunotherapy was mostly omitted entirely (36%), and chemotherapy varied between interruptions (39%) or omissions (31%). Relative to the likelihood of modification to chemotherapy, surgery was significantly more likely to be modified (OR 1.69 95%CI 1.20-2.38). Chemotherapy, radiotherapy, biological therapy and immunotherapy were all modified to a similar degree. Multivariate analysis identified PS ≥2 (OR 1.79, 95% CI 1.18–2.75), but not patient age, as a predictor of treatment modification. Some tumour types were less likely to undergo any modification: stage 1-3 lung (OR 0.13, 95%CI 0.04-0.37), stage 4 lung (OR 0.26 95%CI 0.24–0.60) and stage 4 renal cancer (OR 0.22 95%CI 0.09-0.52). Conclusions: This single centre analysis demonstrated almost half of cancer patients had their treatment modified, the overwhelming majority resulting in treatment de-escalation. The impact of the treatment modifications on overall cancer patient outcomes remains to be determined.
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Affiliation(s)
- Lynsey M Drewett
- Department of Oncology, University of Cambridge and Cambridge Breast Cancer Research Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sian Alexandra Pugh
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Rosalind Kieran
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Binu Nair
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Hossameldin Attia
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Muhammad Iftikhar Sabar
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Isabel Milne
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sharon Saunders
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jennie Bragg
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Deborah Whitehorn
- Cambridge Breast Cancer Research Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jonathan Lay
- Cambridge Breast Cancer Research Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Oscar M Rueda
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
| | - Fiona Harris
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sarah Joanne Welsh
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Gary Doherty
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Bristi Basu
- Department of Oncology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jean Abraham
- Department of Oncology, University of Cambridge and NIHR Cambridge Biomedical Research Centre and Cambridge Breast Cancer Research Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Emma Beddowes
- Department of Oncology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Philippa Gail Corrie
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Brent O'Carrigan
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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10
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Jenkins L, Mills H, McCaughan J, Doherty G, Reid A, Bell J, Keown K. P043 A snapshot of respiratory microbiology results pre- and postcommencing Kaftrio®. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01070-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Will E, Magill N, Arnold R, Davies M, Doherty G, Fairhurst C, Roposch A, Lundy C, Norman-Taylor F. Preoperative botulinum neurotoxin A for children with bilateral cerebral palsy undergoing major hip surgery: a randomized double-blind placebo-controlled trial. Dev Med Child Neurol 2019; 61:1074-1079. [PMID: 30644541 DOI: 10.1111/dmcn.14145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2018] [Indexed: 11/28/2022]
Abstract
AIM To assess whether preoperative botulinum neurotoxin A (BoNT-A) affects pain after major hip surgery for children with bilateral cerebral palsy (CP). METHOD This was a randomized, parallel arms, placebo-contolled trial. Children with hypertonic CP aged 2 to 15 years awaiting bony hip surgery at a tertiary hospital were randomized to receive either BoNT-A or placebo injections into the muscles of the hip on a single occasion immediately before surgery. The primary outcome was the paediatric pain profile (PPP), which was assessed at baseline and weekly for 6 weeks. Treatment allocation was by minimization. Participants, clinicians, and outcome assessors were masked to group assignment. RESULTS Twenty-seven participants (17 males, 10 females; mean 8y 8mo [SD 3y 9mo], range 3y 4mo-15y 10mo) were allocated to BoNT-A and 27 participants (14 males, 13 females; mean 8y 11mo [SD 3y 5mo], range 4y 1mo-15y 2mo) to placebo. Mean (SD) PPP at 6 weeks for the BoNT-A group (n=24 followed up) was 10.96 (7.22) and for the placebo group (n=26) was 10.04 (8.54) (p=0.69; 95% confidence interval [CI] -4.82, 3.18). There were 16 serious adverse events in total during 6 months of follow-up (n=6 in BoNT-A group). INTERPRETATION Use of BoNT-A immediately before bony hip surgery for reducing postoperative pain for children with CP was not supported. WHAT THIS PAPER ADDS Botulinum neurotoxin A (BoNT-A) does not reduce postoperative pain following bony hip surgery. BoNT-A also does not affect postoperative quality of life.
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Affiliation(s)
| | - Nicholas Magill
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | | | | | - Gary Doherty
- Royal Belfast Hospital for Sick Children, Belfast, UK
| | | | - Andreas Roposch
- Institute of Child Health, University College London, London, UK
| | - Claire Lundy
- Royal Belfast Hospital for Sick Children, Belfast, UK
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12
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Sahami S, Wildenberg ME, Koens L, Doherty G, Martin S, D'Haens GRAM, Cullen G, Bemelman WA, Winter D, Buskens CJ. Appendectomy for Therapy-Refractory Ulcerative Colitis Results in Pathological Improvement of Colonic Inflammation: Short-Term Results of the PASSION Study. J Crohns Colitis 2019; 13:165-171. [PMID: 30285094 DOI: 10.1093/ecco-jcc/jjy127] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The objective of this study was to examine the modulating effect of an appendectomy on the disease course of therapy-refractory ulcerative colitis [UC] patients, and to analyse appendiceal pathological characteristics predictive of pathological response. METHODS Patients with therapy-refractory UC, and referred for proctocolectomy, were invited to undergo laparoscopic appendectomy first. The primary end points were clinical response after 3 and 12 months. Secondary end points were endoscopic remission, failure, and pathologic response. Appendiceal specimens, and pre- and post-operative biopsies were histologically graded according to the validated Geboes score. RESULTS Thirty patients [53% male] with a median age of 40 (interquartile range [IQR], 33-47) underwent appendectomy, with a median preoperative total Mayo score of 9 [IQR, 8-11]. After 12 months, 9 patients [30%] had lasting clinical response, of whom 5 [17%] were in endoscopic remission. Pathological evaluation was possible in 28 patients. After a median of 13.0 weeks [range 7-51], pathological response was seen in 13 patients [46%], with a median decrease of 2 points [range 1-3]. Appendiceal inflammation was highly predictive of pathological response when compared with no inflammation or extensive ulcerations [85% vs 20%, p = 0.001]. CONCLUSIONS Appendectomy was effective in one-third of therapy-refractory UC patients, with a substantial proportion of patients demonstrating complete endoscopic remission after 1 year. Pathological response was seen in almost 50% of patients and was related to active inflammation in the appendix, limited disease, and shorter disease duration. These early results suggest that there is a UC patient group that may benefit from appendectomy.
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Affiliation(s)
- S Sahami
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.,Department of Gastroenterology & Hepatology, Academic Medical Center, Amsterdam, The Netherlands
| | - M E Wildenberg
- Department of Gastroenterology & Hepatology, Academic Medical Center, Amsterdam, The Netherlands.,Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands
| | - L Koens
- Department of Pathology, Academic Medical Centre, Amsterdam, The Netherlands
| | - G Doherty
- Department of Gastroenterology and Hepatology, St. Vincent's Hospital, Dublin, Ireland
| | - S Martin
- Department of Gastroenterology and Hepatology, St. Vincent's Hospital, Dublin, Ireland
| | - G R A M D'Haens
- Department of Gastroenterology & Hepatology, Academic Medical Center, Amsterdam, The Netherlands
| | - G Cullen
- Department of Gastroenterology and Hepatology, St. Vincent's Hospital, Dublin, Ireland
| | - W A Bemelman
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - D Winter
- Department of Surgery, St. Vincent's Hospital, Dublin, Ireland
| | - C J Buskens
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
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13
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Gatfield E, Cleary S, Doherty G, Smith S. Identifying and preventing delays in the fast-track discharge process. Eur J Surg Oncol 2017. [DOI: 10.1016/j.ejso.2017.10.131] [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] Open
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14
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Doherty G, Bennett K, Jephcott C, Ford H, Wilson C. Neoadjuvant chemotherapy prior to chemoradiation and surgery for rectal cancer: Tolerability, pathological and survival outcomes for a high risk cohort. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Doherty G, Lynskey D, Matakidou A, Fife K, Eisen T. A novel strategy for axitinib dosing in the treatment of metastatic renal cell carcinoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
464 Background: The AXIS trial established axitinib as an effective second line treatment for patients with metastatic renal cell carcinoma (mRCC). The dosing schedule of axitinib in this trial begins at 5mg twice daily, with escalation of individual doses to 7mg and 10mg after consecutive 2 week intervals if tolerated. We observed significant drug-related toxicity using this dosing strategy, particularly after dose escalations, while clinical responses were often observed at the starting dose. We therefore switched to a pragmatic strategy where dose escalations were made only after disease progression or where a rapid response was deemed clinically pertinent. Methods: We performed a retrospective review of electronic health records and radiology of all patients with mRCC treated with axitinib for greater than 2 weeks at Addenbrooke’s Hospital, Cambridge, UK (a tertiary referral center), over a 40 month period to determine the clinical and radiological effects of dose escalations made according to the above strategy. Results: 42 patients fitting these criteria were identified; of these, 29 had at least one dose escalation event (DEE). A total of 58 DEEs were identified, with a median of 2 per patient, and the objective radiological consequences of 50 of these could be determined. The disease control rate (partial response or stable disease) after the first DEE instituted for disease progression was similar to that after the second DEE (68.8% versus 70%). 56% of all DEEs, and 62.5% of DEEs made as a result of disease progression, resulted in disease control. The median overall survival from the commencement of axitinib for all dose-escalated patients was 19.9 months, and 6.7 months for non-dose-escalated patients. The median survival for dose-escalated patients with a higher than median time on a prior tyrosine kinase inhibitor has not been reached at the time of data cut-off. The mean dose (for all patients) at 90 days after starting axitinib was 5.92 mg. Conclusions: These data suggest that dose escalation of axitinib after disease progression may be an effective dosing strategy for patients with mRCC, and may reduce toxicity through lower drug exposure. Our survival data compares favourably to the AXIS trial in a real practice population.
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Affiliation(s)
- Gary Doherty
- University of Cambridge, Cambridge, United Kingdom
| | - Deirdre Lynskey
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Kate Fife
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Tim Eisen
- University of Cambridge, Cambridge, United Kingdom
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16
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Boulos S, Shamash J, Wong HH, Rudman SM, Doherty G, Ansell W, Berney D, Reinius M, Wilson P, Shephard L, Mazhar D. Liver metastases in germ cell tumors. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
403 Background: Metastatic germ cell tumour (GCT) to the liver is considered rare and usually caries adverse outcomes. We aimed to determine the outcome of patients with metastatic GCT to the liver. Methods: We identified retrospectively 36 patients with metastatic germ cell tumour to the liver between the years 2001 and 2015, from which 34 were non-seminomatous germ cell tumours (NSGCT) and two seminomas. 35 patients had other sites of metastases including lungs, bones and brain. Elevated tumour markers were seen in the vast majority of patients (97.2%). 15 patients received treatment with dose intense regime including actinomycin-D, high-dose methotrexate, etoposide and cisplatin (GAMEC) every 14 days, 20 patients received the standard protocol of bleomycin, etoposide and cisplatin (BEP) every 21 days and one patient received POMB/ACE chemotherapy. 20 patients had an induction cycle of cisplatin, vincristine and bleomycin (Baby-BOP) prior to initial treatment. Results: 12 patients had radiological complete response (CR) and 19 patients had radiological partial response (PR) in the liver, with five patients having a CR in all sites with negative markers. Five patients underwent liver resection with no viable tumour seen. Three patients that underwent liver resection also had retroperitoneal lymph node dissection (RPLND) the histology from which was viable seminoma in one case, mature teratoma in one case and necrosis in the final patient.16 patients had marker negative PR, 10 patients had marker positive PR and 5 patients had a marker negative CR. 15 patients eventually relapsed and 10 died with only one liver relapse. Median Overall survival for patients that received BEP was 35.38 months (not reached for GAMEC) (p = 0.0147). The median progression free survival (PFS) for the BEP group was 24.45 months (not reached for GAMEC) (p = 0.22) and the 2-years PFS for the GAMEC and BEP groups were 73% and 55% respectively. Conclusions: Within this cohort, liver metastasis from germ-cell tumour had a good response to chemotherapy, with progression occurring mainly in extra-hepatic sites. There was also a suggestion that dose dense GAMEC regime may offer superior efficacy compared with BEP.These results also question the role of liver metastectomy after initial response to chemotherapy.
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Affiliation(s)
- Suliman Boulos
- Addenbrookes Cambridge University Hospital, Cambridge, United Kingdom
| | | | - Han Hsi Wong
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Gary Doherty
- University of Cambridge, Cambridge, United Kingdom
| | - Wendy Ansell
- St Bartholomew's Hospital, London, United Kingdom
| | | | - Marika Reinius
- Addenbrookes Cambridge University Hospital, Cambridge, United Kingdom
| | - Peter Wilson
- St Bartholomew's Hospital, London, United Kingdom
| | - Linda Shephard
- Guy's and St. Thomas' University Hospital, London, United Kingdom
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17
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Clowry J, Sheridan J, Healy R, Deady S, Keegan D, Byrne K, Cullen G, Mulcahy H, Comber H, Parnell A, Doherty G, Lally A. Increased non-melanoma skin cancer risk in young patients with inflammatory bowel disease on immunomodulatory therapy: a retrospective single-centre cohort study. J Eur Acad Dermatol Venereol 2017; 31:978-985. [DOI: 10.1111/jdv.14105] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 12/14/2016] [Indexed: 02/06/2023]
Affiliation(s)
- J. Clowry
- Department of Dermatology; St Vincent's University Hospital; Dublin 4 Ireland
| | - J. Sheridan
- Department of Gastroenterology; St Vincent's University Hospital; Dublin 4 Ireland
| | - R. Healy
- School of Mathematics and Statistics; University College Dublin; Dublin 4 Ireland
| | - S. Deady
- National Cancer Registry of Ireland; Cork Ireland
| | - D. Keegan
- Department of Gastroenterology; St Vincent's University Hospital; Dublin 4 Ireland
| | - K. Byrne
- Department of Gastroenterology; St Vincent's University Hospital; Dublin 4 Ireland
| | - G. Cullen
- Department of Gastroenterology; St Vincent's University Hospital; Dublin 4 Ireland
| | - H. Mulcahy
- Department of Gastroenterology; St Vincent's University Hospital; Dublin 4 Ireland
| | - H. Comber
- National Cancer Registry of Ireland; Cork Ireland
| | - A.C. Parnell
- School of Mathematics and Statistics; University College Dublin; Dublin 4 Ireland
| | - G. Doherty
- Department of Gastroenterology; St Vincent's University Hospital; Dublin 4 Ireland
| | - A. Lally
- Department of Dermatology; St Vincent's University Hospital; Dublin 4 Ireland
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18
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Yip K, Conibear J, Woolf D, Tarver K, Willis B, Hall S, Sun F, Kuhan H, Lambourne B, Piskilidis P, Kussaibati R, Martin L, Satar NA, Gray C, Khan A, Doherty G, Prewett S, Smith M, Dancey G, Patterson D, Rimmer Y, Hollingdale A, Ingle C, Tasigiannopoulos Z, Aslam S, Waite K, Polychronis A, Ghafoor Q, Baijal S, Newsom-Davis T, Shah R, Forster M, Mulatero C, Greystoke A, Postmus P, Blackhall F, Gilligan D. 62: A retrospective multicentre audit of outcome among patients with anaplastic lymphoma kinase (ALK) gene rearrangement positive non-small cell lung cancer (NSCLC) who have been treated with crizotinib in England. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30112-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Hartery K, O'Reilly S, Houlihan D, Doherty G, Mulcahy H, Cullen G, Sheridan J. Letter: vedolizumab for the management of inflammatory bowel disease in patients after liver transplantation for primary sclerosing cholangitis. Aliment Pharmacol Ther 2017; 45:376-378. [PMID: 27933688 DOI: 10.1111/apt.13861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- K Hartery
- Department of Gastroenterology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - S O'Reilly
- Department of Gastroenterology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - D Houlihan
- School of Medicine, University College Dublin, Dublin, Ireland.,National Liver Unit, St. Vincent's University Hospital, Dublin, Ireland
| | - G Doherty
- Department of Gastroenterology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - H Mulcahy
- Department of Gastroenterology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - G Cullen
- Department of Gastroenterology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - J Sheridan
- Department of Gastroenterology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
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20
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Elliott L, Sheahan K, Doherty G, Fennelly D, Ryan E. The colorectal cancer (CRC) tumour microenvironment recruits and polarises two distinct populations of myeloid cells with unique regulatory profiles. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw393.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Alston CL, Howard C, Oláhová M, Hardy SA, He L, Murray PG, O'Sullivan S, Doherty G, Shield JPH, Hargreaves IP, Monavari AA, Knerr I, McCarthy P, Morris AAM, Thorburn DR, Prokisch H, Clayton PE, McFarland R, Hughes J, Crushell E, Taylor RW. A recurrent mitochondrial p.Trp22Arg NDUFB3 variant causes a distinctive facial appearance, short stature and a mild biochemical and clinical phenotype. J Med Genet 2016; 53:634-41. [PMID: 27091925 PMCID: PMC5013090 DOI: 10.1136/jmedgenet-2015-103576] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 03/27/2016] [Indexed: 11/05/2022]
Abstract
Background Isolated Complex I deficiency is the most common paediatric mitochondrial disease presentation, associated with poor prognosis and high mortality. Complex I comprises 44 structural subunits with at least 10 ancillary proteins; mutations in 29 of these have so far been associated with mitochondrial disease but there are limited genotype-phenotype correlations to guide clinicians to the correct genetic diagnosis. Methods Patients were analysed by whole-exome sequencing, targeted capture or candidate gene sequencing. Clinical phenotyping of affected individuals was performed. Results We identified a cohort of 10 patients from 8 families (7 families are of unrelated Irish ancestry) all of whom have short stature (<9th centile) and similar facial features including a prominent forehead, smooth philtrum and deep-set eyes associated with a recurrent homozygous c.64T>C, p.Trp22Arg NDUFB3 variant. Two sibs presented with primary short stature without obvious metabolic dysfunction. Analysis of skeletal muscle from three patients confirmed a defect in Complex I assembly. Conclusions Our report highlights that the long-term prognosis related to the p.Trp22Arg NDUFB3 mutation can be good, even for some patients presenting in acute metabolic crisis with evidence of an isolated Complex I deficiency in muscle. Recognition of the distinctive facial features—particularly when associated with markers of mitochondrial dysfunction and/or Irish ancestry—should suggest screening for the p.Trp22Arg NDUFB3 mutation to establish a genetic diagnosis, circumventing the requirement of muscle biopsy to direct genetic investigations.
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Affiliation(s)
- Charlotte L Alston
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Caoimhe Howard
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Monika Oláhová
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Steven A Hardy
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Langping He
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Philip G Murray
- Centre for Paediatrics and Child Health, Institute of Human Development, Faculty of Medical & Human Sciences, University of Manchester, & Manchester Academic Health Science Centre, Manchester, UK
| | - Siobhan O'Sullivan
- Department of Metabolic Paediatrics, Royal Hospital for Sick Children, Belfast, UK
| | - Gary Doherty
- Department of Metabolic Paediatrics, Royal Hospital for Sick Children, Belfast, UK
| | - Julian P H Shield
- University of Bristol and Bristol Royal Hospital for Children, Bristol, UK
| | - Iain P Hargreaves
- Neurometabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - Ardeshir A Monavari
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Ina Knerr
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Peter McCarthy
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Andrew A M Morris
- Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - David R Thorburn
- Department of Paediatrics, The Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Parkville, Australia
| | - Holger Prokisch
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Peter E Clayton
- Centre for Paediatrics and Child Health, Institute of Human Development, Faculty of Medical & Human Sciences, University of Manchester, & Manchester Academic Health Science Centre, Manchester, UK
| | - Robert McFarland
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Joanne Hughes
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Ellen Crushell
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Robert W Taylor
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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Richards D, Timulak L, Vigano N, O’Brien E, Doherty G, Sharry J, Hayes C. A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IntroductionInternet-delivered treatments for depression have proved successful, with supported programs offering the potential for improved adherence and outcomes. Internet interventions are particularly interesting in the context of increasing access to interventions, and delivering interventions population-wide.ObjectiveInvestigate the potential feasibility and effectiveness of an online intervention for depression in the community.AimsEstablish the effectiveness of a supported online delivered cognitive behavioural intervention for symptoms of depression in adults in the community.MethodsThe study was a randomized controlled trial of an 8-module internet-delivered cognitive behavioral therapy (iCBT) program for adults with depressive symptoms (n = 96) compared to a waiting-list control group (n = 92). Participants received weekly support from a trained supporter. The primary outcome was depressive symptoms as measured by the Beck Depression Inventory (BDI-II). The program was made available nationwide from an established and recognized charity for depression.ResultsFor the treatment group, post-treatment effect sizes reported were large for the primary outcome measure (d = 0.91). The between-group effects were moderate to large and statistically significant for the primary outcomes (d = 0.50) favoring the treatment group. Gains were maintained at 6-month follow-up.ConclusionThe study has demonstrated the efficacy of the online delivered space from depression treatment. Participants demonstrated reliable and statistically significant changes in symptoms from pre- to post-intervention. The study supports a model for delivering online depression interventions population-wide using trained supporters.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Richards D, Timulak L, O'Brien E, Hayes C, Vigano N, Sharry J, Doherty G. A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression. Behav Res Ther 2015; 75:20-31. [DOI: 10.1016/j.brat.2015.10.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 09/19/2015] [Accepted: 10/16/2015] [Indexed: 10/22/2022]
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Lavelle A, Lennon G, O'Sullivan O, Docherty N, Balfe A, Maguire A, Mulcahy HE, Doherty G, O'Donoghue D, Hyland J, Ross RP, Coffey JC, Sheahan K, Cotter PD, Shanahan F, Winter DC, O'Connell PR. Spatial variation of the colonic microbiota in patients with ulcerative colitis and control volunteers. Gut 2015; 64:1553-61. [PMID: 25596182 PMCID: PMC4602252 DOI: 10.1136/gutjnl-2014-307873] [Citation(s) in RCA: 179] [Impact Index Per Article: 19.9] [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: 06/17/2014] [Accepted: 10/19/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The relevance of spatial composition in the microbial changes associated with UC is unclear. We coupled luminal brush samples, mucosal biopsies and laser capture microdissection with deep sequencing of the gut microbiota to develop an integrated spatial assessment of the microbial community in controls and UC. DESIGN A total of 98 samples were sequenced to a mean depth of 31,642 reads from nine individuals, four control volunteers undergoing routine colonoscopy and five patients undergoing surgical colectomy for medically-refractory UC. Samples were retrieved at four colorectal locations, incorporating the luminal microbiota, mucus gel layer and whole mucosal biopsies. RESULTS Interpersonal variability accounted for approximately half of the total variance. Surprisingly, within individuals, asymmetric Eigenvector map analysis demonstrated differentiation between the luminal and mucus gel microbiota, in both controls and UC, with no differentiation between colorectal regions. At a taxonomic level, differentiation was evident between both cohorts, as well as between the luminal and mucosal compartments, with a small group of taxa uniquely discriminating the luminal and mucosal microbiota in colitis. There was no correlation between regional inflammation and a breakdown in this spatial differentiation or bacterial diversity. CONCLUSIONS Our study demonstrates a conserved spatial structure to the colonic microbiota, differentiating the luminal and mucosal communities, within the context of marked interpersonal variability. While elements of this structure overlap between UC and control volunteers, there are differences between the two groups, both in terms of the overall taxonomic composition and how spatial structure is ascribable to distinct taxa.
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Affiliation(s)
- A Lavelle
- University College Dublin, School of Medicine and Medical Science, Dublin, Ireland,Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - G Lennon
- University College Dublin, School of Medicine and Medical Science, Dublin, Ireland,Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - O O'Sullivan
- Teagasc, Food Research Centre, Moorepark, Fermoy, County Cork, Ireland
| | - N Docherty
- Department of Physiology, Trinity College Dublin, Dublin, Ireland
| | - A Balfe
- University College Dublin, School of Medicine and Medical Science, Dublin, Ireland
| | - A Maguire
- Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - H E Mulcahy
- Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - G Doherty
- Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - D O'Donoghue
- Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - J Hyland
- Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - R P Ross
- Teagasc, Food Research Centre, Moorepark, Fermoy, County Cork, Ireland,Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
| | - J C Coffey
- 4i Centre for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - K Sheahan
- Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - P D Cotter
- Teagasc, Food Research Centre, Moorepark, Fermoy, County Cork, Ireland,Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
| | - F Shanahan
- Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
| | - D C Winter
- University College Dublin, School of Medicine and Medical Science, Dublin, Ireland,Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
| | - P R O'Connell
- University College Dublin, School of Medicine and Medical Science, Dublin, Ireland,Centre for Colorectal Disease, Saint Vincent's University Hospital, Dublin, Ireland
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Caiazza F, Power R, Elliott L, Tosetto M, Nolan B, Doherty G, Ryan E. 2020 Modulation of colorectal cancer tumorigenesis by KHSRP through the tumor microenvironment. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30943-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rahier JF, Magro F, Abreu C, Armuzzi A, Ben-Horin S, Chowers Y, Cottone M, de Ridder L, Doherty G, Ehehalt R, Esteve M, Katsanos K, Lees CW, Macmahon E, Moreels T, Reinisch W, Tilg H, Tremblay L, Veereman-Wauters G, Viget N, Yazdanpanah Y, Eliakim R, Colombel JF. Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis 2014; 8:443-68. [PMID: 24613021 DOI: 10.1016/j.crohns.2013.12.013] [Citation(s) in RCA: 688] [Impact Index Per Article: 68.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 12/18/2013] [Indexed: 02/06/2023]
Affiliation(s)
- J F Rahier
- Department of Gastroenterology, CHU Dinant-Godinne, Avenue G. Therasse 1, 5530 Yvoir, Belgium.
| | - F Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal; Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal; Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal
| | - C Abreu
- Department of Infectious Diseases, Hospital São João, Porto, Portugal
| | - A Armuzzi
- IBD Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
| | - S Ben-Horin
- Department of Gastroenterology, Sheba Medical Center, Tel-hashomer, 52961 Ramat-Gan, Israel
| | - Y Chowers
- Department of Gastroenterology, Rambam Health Care Campus, Haalia, 31096 Haifa, Israel
| | - M Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Italy
| | - L de Ridder
- Pediatric gastroenterologist, Sophia Children's Hospital, 3000 CB Rotterdam, The Netherlands
| | - G Doherty
- Centre for Colorectal Disease, St. Vincent's University Hospital and School of Medicine and Medical Science, University College Dublin, Ireland
| | - R Ehehalt
- Gastroenterology Outpatient Clinic, 69121 Heidelberg, Germany
| | - M Esteve
- Hospital Universitari Mutua de Terrassa, University of Barcelona, Catalonia, Centro de Investigación Biomédica en Red en el Área Temática de Enfermedades Hepáticas y Digestivas, Spain
| | - K Katsanos
- Division of Gastroenterology, University Hospital of Ioannina, Medical School of Ioannina, Greece
| | - C W Lees
- Gastrointestinal Unit, Western General Hospital, EH4 2XU Edinburgh, United Kingdom
| | - E Macmahon
- Department of Infectious Diseases, Guy's & St. Thomas' NHS, Foundation Trust, London SE1 7EH, United Kingdom
| | - T Moreels
- Department of Gastroenterology, Antwerp University Hospital, 2650 Edegem, Belgium
| | - W Reinisch
- Division Internal Medicine III, Dept. Gastroenterology and Hepatology Medical University Vienna, A-1090 Vienna, Austria; Department of Internal Medicine, McMaster University, Ontario, Canada
| | - H Tilg
- Department of Internal Medicine I, Division of Gastroenterology, Endocrinology and Metabolism, Medical University Innsbruck, Austria
| | - L Tremblay
- Department of Pharmacy, Centre Hospitalier de l'Université de Montréal, H2X 3J4 Montreal, Canada
| | - G Veereman-Wauters
- Pediatric Gastroenterology and Nutrition UZBrussels, Free University Brussels, Belgium
| | - N Viget
- Service Universitaire des Maladies infectieuses et du voyageur Centre hospitalier de Tourcoing, 59208 Tourcoing cedex, France
| | - Y Yazdanpanah
- Service des Maladies Infectieuses et tropicales, Hopital Bichat Claude Bernard, 75877 Paris, France
| | - R Eliakim
- Department of Gastroenterology and Hepatology, Sheba Medical Center, 52621 Tel Hashomer, Israel
| | - J F Colombel
- Henry D. Janowitz Division of Gastroenterology, Icahn Medical School at Mount Sinai, New York 10029, USA
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Hutton F, Kildea S, Griffin D, Spink J, Doherty G, Hunter A. First report of potato tuber necrotic ringspot disease associated with PVY recombinant strains in Ireland. ACTA ACUST UNITED AC 2013. [DOI: 10.5197/j.2044-0588.2013.028.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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]
Affiliation(s)
- F. Hutton
- TeagascCrops Research CentreOak ParkCarlowIreland
| | - S. Kildea
- TeagascCrops Research CentreOak ParkCarlowIreland
| | - D. Griffin
- TeagascCrops Research CentreOak ParkCarlowIreland
| | - J. Spink
- TeagascCrops Research CentreOak ParkCarlowIreland
| | - G. Doherty
- Department of AgricultureFood and the MarineTops Potato CentreRaphoeCounty DonegalIreland
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Doherty G, Vincent A, Cox A. RASH DECISIONS–DERMATOLOGICAL MANIFESTATIONS PRECEDING A PROGRESSIVE NEUROLOGICAL SYNDROME. J Neurol Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306573.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Oliphant R, Balsitis M, Doherty G, Felsenstein I. Ileocolic intussusception secondary to a type II low-grade appendiceal mucinous neoplasm. Colorectal Dis 2013; 15:e200-1. [PMID: 23351140 DOI: 10.1111/codi.12146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Accepted: 11/15/2012] [Indexed: 02/08/2023]
Affiliation(s)
- R Oliphant
- Department of Surgery, University Hospital Crosshouse, Kilmarnock, UK.
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Kavanagh DO, Carter MC, Keegan D, Doherty G, Smith MJ, Hyland JMP, Mulcahy H, Sheahan K, O' Connell PR, O' Donoghue DP, Winter DC. Management of colorectal cancer in patients with inflammatory bowel disease. Tech Coloproctol 2013; 18:23-8. [PMID: 23407916 DOI: 10.1007/s10151-013-0981-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 01/21/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND This study evaluated the clinicopathological features and survival rates of patients with inflammatory bowel disease who developed colorectal cancer (CRC). METHODS A retrospective review was performed on a prospectively maintained institutional database (1981-2011) to identify patients with inflammatory bowel disease who developed CRC. Clinicopathological parameters, management and outcomes were analysed. RESULTS A total of 2,843 patients with inflammatory bowel disease were identified. One thousand six hundred and forty-two had ulcerative colitis (UC) and 1,201 had Crohn's disease (CD). Following exclusion criteria, there were 29 patients with biopsy-proven colorectal carcinoma, 22 of whom had UC and 7 had CD. Twenty-six patients had a preoperative diagnosis of malignancy/dysplasia; 16 of these were diagnosed at surveillance endoscopy. Nodal/distant metastasis was identified at presentation in 47 and 71 % of the UC and CD group, respectively. Operative morbidity for UC and CD was 33 and 17 %, respectively. Despite the less favourable operative outcomes following surgery management of UC-related CRC, overall 5-year survival was significantly better in the UC group compared to the CD group (41 vs. 29 %; p = 0.04) reflecting the difference in stage at presentation between the two groups. CONCLUSIONS Patients who undergo surgery for UC-related CRC have less favourable short-term outcomes but present at a less advanced stage and have a more favourable long-term prognosis than similar patients with CRC and CD.
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Affiliation(s)
- D O Kavanagh
- Center for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland,
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McDermott E, Keegan D, Hall B, Mhuruchu EN, Murphy S, Doherty G, O'Donoghue D, Mulcahy H. Mycophenolate mofetil following intolerance or failure of thiopurine therapy in inflammatory bowel diseases. Aliment Pharmacol Ther 2011; 34:1040-2. [PMID: 21933214 DOI: 10.1111/j.1365-2036.2011.04825.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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McNicholas S, Andrews C, Boland K, Shields M, Doherty G, Murray F, Smyth E, Humphreys H, Fitzpatrick F. P06.05 A point prevalence study of healthcare-associated infection in patients with delayed discharge in an acute tertiary referral hospital. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Yousef S, Benden C, Frischer T, Westall G, Goldfarb S, Ballman M, Aurora P, Doherty G, Boyer D, Visner G. 201: Lung Transplantation in Children after Hematopoietic Stem-Cell Transplantation. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.212] [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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Doherty G, Bush A. Diagnosing respiratory problems in young children. Practitioner 2007; 251:20, 22-5. [PMID: 17882893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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Doherty G. Sobering message. Interview by Lynne Pearce. Nurs Stand 2006; 20:20-1. [PMID: 16786920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
As Northern Ireland's first alcohol liaison nurse, Gary Doherty has dramatically reduced the number of hospital admissions where misuse was an issue. His work has won him the RCN's 2006 Northern Ireland Nurse of the Year Award.
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Forrest M, Sun SY, Hajdu R, Bergstrom J, Card D, Doherty G, Hale J, Keohane C, Meyers C, Milligan J, Mills S, Nomura N, Rosen H, Rosenbach M, Shei GJ, Singer II, Tian M, West S, White V, Xie J, Proia RL, Mandala S. Immune cell regulation and cardiovascular effects of sphingosine 1-phosphate receptor agonists in rodents are mediated via distinct receptor subtypes. J Pharmacol Exp Ther 2004; 309:758-68. [PMID: 14747617 DOI: 10.1124/jpet.103.062828] [Citation(s) in RCA: 282] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sphingosine 1-phosphate (S1P) is a bioactive lysolipid with pleiotropic functions mediated through a family of G protein-coupled receptors, S1P(1,2,3,4,5). Physiological effects of S1P receptor agonists include regulation of cardiovascular function and immunosuppression via redistribution of lymphocytes from blood to secondary lymphoid organs. The phosphorylated metabolite of the immunosuppressant agent FTY720 (2-amino-2-(2-[4-octylphenyl]ethyl)-1,3-propanediol) and other phosphonate analogs with differential receptor selectivity were investigated. No significant species differences in compound potency or rank order of activity on receptors cloned from human, murine, and rat sources were observed. All synthetic analogs were high-affinity agonists on S1P(1), with IC(50) values for ligand binding between 0.3 and 14 nM. The correlation between S1P(1) receptor activation and the ED(50) for lymphocyte reduction was highly significant (p < 0.001) and lower for the other receptors. In contrast to S1P(1)-mediated effects on lymphocyte recirculation, three lines of evidence link S1P(3) receptor activity with acute toxicity and cardiovascular regulation: compound potency on S1P(3) correlated with toxicity and bradycardia; the shift in potency of phosphorylated-FTY720 for inducing lymphopenia versus bradycardia and hypertension was consistent with affinity for S1P(1) relative to S1P(3); and toxicity, bradycardia, and hypertension were absent in S1P(3)(-/-) mice. Blood pressure effects of agonists in anesthetized rats were complex, whereas hypertension was the predominant effect in conscious rats and mice. Immunolocalization of S1P(3) in rodent heart revealed abundant expression on myocytes and perivascular smooth muscle cells consistent with regulation of bradycardia and hypertension, whereas S1P(1) expression was restricted to the vascular endothelium.
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Affiliation(s)
- M Forrest
- Merck Research Laboratories, Department of Immunology and Rheumatology, Rahway, NJ 07065, USA
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Doherty G, Bali S, Casey F. Fetal hydrops due to supraventricular tachycardia--successful outcome in a difficult case. Ir Med J 2003; 96:52-3. [PMID: 12674156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- G Doherty
- Department of Child Health, Institute of Clinical Science, Queen's University Belfast.
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Johnson LR, Doherty G, Lairmore T, Moley JF, Brunt LM, Koenig J, Scott MG. Evaluation of the performance and clinical impact of a rapid intraoperative parathyroid hormone assay in conjunction with preoperative imaging and concise parathyroidectomy. Clin Chem 2001; 47:919-25. [PMID: 11325897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND (99m)Tc-sestamibi scans and rapid, intraoperative intact parathyroid hormone (PTH) assays allow preoperative identification of diseased glands and intraoperative confirmation of diseased gland removal, respectively. Use of these two new technologies may facilitate simpler, more concise surgery, shorter hospital stays, and decreased costs for frozen-section analysis. One major drawback to this new strategy has been the high cost of rapid point-of-care PTH assays. METHODS We performed rapid PTH assays with the DPC Turbo PTH assay on the DPC IMMULITE automated analyzer. The number of intraoperative frozen sections, type of anesthesia, surgical approach, length of hospital stay, and pre- and postoperative calcium values were compared between a group of 49 patients undergoing parathyroidectomy where the intraoperative PTH assay was used in conjunction with preoperative imaging, and a historical control group of 55 patients before the use of these two technologies in our institution. RESULTS Comparison of the Turbo PTH assay to the standard IMMULITE PTH assay gave the following: y = 1.08 x - 4.36 (r = 0.97; n = 48). For the 49 patients, the median turnaround time for each intraoperative PTH determination was 19 min (range, 14-40 min). The median decrease in PTH values from baseline was 88% (range, 33-99%). Thirty-seven patients required two PTH determinations, 7 required three, 4 had four, and 1 required five determinations. The average laboratory cost for the rapid intraoperative PTH assays was < $100 per patient (range, $55 to $113). Compared with the control group, the experimental group had significantly fewer frozen sections (1.4 vs 2.5; P < 0.0001), shorter hospital stays (17 discharged on the day of surgery vs none discharged on the day of surgery; P < 0.0001), greater use of local anesthesia (33% vs 0%; P < 0.001), and more unilateral, rather than bilateral neck explorations (65% vs 0%; P < 0.001). CONCLUSIONS The combination of intraoperative Turbo PTH assay and preoperative (99m)Tc-sestamibi scans can lead to significant decreases in laboratory and surgical pathology costs, hospital stays, and exposure to general anesthesia by facilitating concise parathyroidectomy surgery.
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Affiliation(s)
- L R Johnson
- Washington University School of Medicine, Department of Pathology and Immunology, Barnes-Jewish Hospital, St. Louis, MO 63110, USA
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Abstract
The MDR-3-encoded P-glycoprotein (Pgp) is highly expressed in liver and is thought to function as a hepatic transporter of phospholipids into bile. However its role, if any, in other tissues remains undefined. Although transfection experiments have indicated that it may be unable to confer drug resistance, there is evidence that it may be involved in drug resistance in certain B-cell leukaemias. To date, most work on clinical samples has been performed at the mRNA level; limited work has been performed using polyclonal antibodies raised to MDR-3 and mdr-2 (the murine equivalent of MDR-3). We have generated a new monoclonal antibody, termed 6/1G, which specifically recognises the human MDR-3 gene-encoded product. Antibody 6/1G was produced by in vitro immunisation of spleen cells from BALB/c mice with a synthetic 12-amino acid peptide. Cells from MDR-3 transgenic mice showed consistent membranous staining with antibody 6/1G. Immunoblotting with 6/1G identified a band at 170 kDa on lysates of MDR-3 transgenic cells. Preliminary results with a range of B-cell leukaemias suggest that MDR-3 Pgp positivity may be a marker for a more malignant phenotype in B-CLL. Antibody 6/1G may be useful in defining a role for MDR-3 in malignancy and drug resistance, as well as in certain liver diseases such as progressive familial intracholeostasis.
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Affiliation(s)
- A Larkin
- National Cell and Tissue Culture Centre, Bioresearch Ireland, Dublin City University, Glasnevin, Dublin, Ireland.
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Wiedenmann B, Jensen RT, Mignon M, Modlin CI, Skogseid B, Doherty G, Oberg K. Preoperative diagnosis and surgical management of neuroendocrine gastroenteropancreatic tumors: general recommendations by a consensus workshop. World J Surg 1998; 22:309-18. [PMID: 9494425 DOI: 10.1007/s002689900387] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In 1996 a consensus workshop on the preoperative diagnosis and surgical treatment of neuroendocrine tumor disease took place in Berlin. Although there was a consensus on the diagnosis and surgical treatment by world experts in neuroendocrine surgery in some areas, it became clear that certain management policies vary among centers. In large part, diverging policies reflect a lack of controlled studies. This paper summarizes the various opinions brought forward during this conference and emphasizes consensus approaches for the diagnosis and therapy of neuroendocrine neoplasms.
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Affiliation(s)
- B Wiedenmann
- Freie Universität Berlin, Universitätsklinikum Benjamin Franklin, Abteilung Innere Medizin/Gastroenterologie und Infektiologie, Germany
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Moran E, Larkin A, Doherty G, Kelehan P, Kennedy S, Clynes M. A new mdr-1 encoded P-170 specific monoclonal antibody: (6/1C) on paraffin wax embedded tissue without pretreatment of sections. J Clin Pathol 1997; 50:465-71. [PMID: 9378810 PMCID: PMC499970 DOI: 10.1136/jcp.50.6.465] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS The generation and characterisation of a monoclonal antibody that specifically recognises the mdr-1 encoded protein, P-glycoprotein (P-170), on routinely processed formalin fixed, paraffin wax embedded tissue sections. METHODS The monoclonal antibody, designated 6/1C, was produced following a combination of in vivo and in vitro immunisation regimens in Balb/c mice with a synthetic 12 amino acid peptide that corresponds to amino acids 21-32 (believed to be intracellularly located) of P-170 and has insignificant homology with the mdr-3 encoded P-170. Antibody 6/1C was characterised by western blotting and immunocytochemistry on cytospins of paired multidrug resistant or sensitive cell lines, including mdr-1 and mdr-3 transfected cells, and by immunohistochemistry on normal and malignant formalin fixed paraffin wax embedded tissue sections. RESULTS Antibody 6/1C showed a single band at 170 kDa on western blots of multidrug resistant cell lysates and mdr-1 transfected cell lysates that was absent on similar preparations of drug sensitive cells and mdr-3 transfected cells. Immunocytochemical studies on cytospins of multidrug resistant cells and mdr-1 transfected cells revealed strong inner plasma membrane/cytoplasmic staining. Staining was negligible on drug sensitive cells and cells transfected with the mdr-3 gene. Immunohistochemical studies on formalin fixed, paraffin wax embedded normal adult kidney, liver, and breast tissue and a range of fetal tissues exhibited staining patterns of a variety of secretory surfaces consistent with documented mdr-1 specific staining. Specific staining of malignant cells in similarly treated sections of breast tumours was seen also with antibody 6/1C. Staining on paraffin wax embedded tissue with this antibody did not require any pretreatment of tissue sections. CONCLUSIONS This new monoclonal antibody, chosen for its specificity with the mdr-1 encoded P-170 and its reactivity on routinely fixed paraffin wax embedded tissue samples without pretreatment, appears to be useful for the investigation of P-170 in archival material. It is especially useful for retrospective studies on pretreatment and post-treatment tissue sections, and could help establish when and how rapidly mdr-1 associated drug resistance develops during chemotherapeutic regimens. Immunohistochemical assessment of P-170 expression in many cancers has potential for diagnostic purposes and may influence the choice of chemotherapeutic drugs used in the treatment of refractory tumours.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/analysis
- ATP Binding Cassette Transporter, Subfamily B, Member 1/immunology
- Animals
- Antibodies, Monoclonal
- Antibody Specificity
- Blotting, Western
- Breast Neoplasms/chemistry
- Carcinoma, Ductal, Breast/chemistry
- Female
- Humans
- Immunohistochemistry
- Mice
- Mice, Inbred BALB C
- Paraffin Embedding
- Tumor Cells, Cultured
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Affiliation(s)
- E Moran
- National Cell and Tissue Culture Centre, BioResearch Ireland, Dublin City University, Ireland
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Cleary I, Doherty G, Moran E, Clynes M. The multidrug-resistant human lung tumour cell line, DLKP-A10, expresses novel drug accumulation and sequestration systems. Biochem Pharmacol 1997; 53:1493-502. [PMID: 9260877 DOI: 10.1016/s0006-2952(97)00003-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Drug accumulation studies with the anticancer agents adriamycin and vincristine were carried out on the MDR variant of the human lung cell lines DLKP, DLKP-A10 which overexpresses the MDR associated P-glycoprotein efflux pump. Reduced cellular accumulation of both agents was observed in the resistant variant. The subsequent addition of verapamil and cyclosporin A resulted in partial restoration of cellular accumulation of both drugs in the DLKP-A10 resistant variant while complete restoration of cellular drug levels was observed in the SKMES-1/ADR cell line. These results suggested that the accumulation defect observed in the SKMES-1/ADR cell line was P-glycoprotein mediated and that accordingly, the cells exhibited characteristics consistent with the classical MDR phenotype. In contrast, while P-glycoprotein also appears to mediate a reduction in cellular drug accumulation in the DLKP-A10 cells, an alternative transport mechanism may also be present. No significant increase in the expression of either the MRP or LRP transport proteins was observed in the resistant cells. Metabolic inhibition by antimycin A (but not sodium azide or 2-deoxy-D-glucose) resulted in complete restoration of drug accumulation suggesting the presence of an alternative energy dependent transport mechanism. Fluorescent microscopy studies indicated different cellular localisation of the drug within the parental and resistant cells despite equivalent intracellular concentrations. These studies also revealed the presence of an ATP-dependent, vesicular sequestration mechanism which may be involved in the reduction of nuclear adriamycin accumulation in the DLKP-A10 cell line. This was indicated by observation of the disruption of cytoplasmic vesicles by antimycin A and also inhibition of cytoplasmic drug sequestration by the carboxylic ionophores, monensin and nigericin, accompanied by increased adriamycin accumulation and redistribution of the drug from the cytoplasm to the nucleus.
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Affiliation(s)
- I Cleary
- National Cell and Tissue Culture Centre, Dublin City University, Glasnevin, Dublin, Ireland
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Abstract
Two experiments are reported which demonstrate the development of co-ordinated description languages in two groups of communicators playing Garrod and Anderson's (1987) maze game. The experiments contrast language co-ordination between speakers who always interact with the same partner (isolated pairs) as compared with speakers who interact with different partners drawn from the same community. Whereas the isolated pairs show higher degrees of inter-speaker convergence than the community pairs at the start of the experiment, the situation reverses by the time they have all played six or more games. The results are discussed at two levels: (1) in terms of Lewis's formal theory of conventions, and (2) in relation to a language processing model which abides by the "output/input co-ordination" principle proposed in Garrod and Anderson (1987).
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Affiliation(s)
- S Garrod
- Department of Psychology, University of Glasgow, UK
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Doherty G. [Suffering and guilt]. Infirm Can 1979; 21:24. [PMID: 259573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Doherty G. The patient in pain: handling the guilt feelings. Can Nurse 1979; 75:31. [PMID: 252929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
Twenty-eight test-anxious Ss received either "cue-controlled relaxation therapy," an inert placebo treatment, or no treatment. Once before and twice after the experimental treatment period each S responded to three test-anxiety scales and to one measure of public-speaking anxiety. Once after the treatment, Ss rated the credibility of the procedure to which they had been exposed. Pre- and posttreatment scores on the measure of (untreated) speech anxiety and posttreatment ratings of credibility both showed that the cued relaxation and placebo procedures exerted equivalent experimental demand for improvement. Scores on all three test-anxiety measures showed that, under these conditions of equivalent demand,the placebo procedure reduced self-reports of test anxiety at least as much as did cue-controlled relaxation. Implications are discussed.
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