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Reyhani A, Gimson E, Baker C, Kelly M, Maisey N, Meenan J, Subesinghe M, Hill M, Lagergren J, Gossage J, Zeki S, Dunn J, Davies A. Multiple staging investigations may not change management in patients with high-grade dysplasia or early esophageal adenocarcinoma. Dis Esophagus 2023; 36:doad020. [PMID: 37032121 DOI: 10.1093/dote/doad020] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 02/20/2023] [Indexed: 04/11/2023]
Abstract
The clinical value of multiple staging investigations for high-grade dysplasia or early adenocarcinoma of the esophagus is unclear. A single-center prospective cohort of patients treated for early esophageal cancer between 2000 and 2019 was analyzed. This coincided with a transition period from esophagectomy to endoscopic mucosal resection (EMR) as the treatment of choice. Patients were staged with computed tomography (CT), endoscopic ultrasound (EUS) and 2-deoxy-2-[18F]fluoro-d-glucose (FDG) positron emission tomography(PET)/CT. The aim of this study was to assess their accuracy and impact on clinical management. 297 patients with high-grade dysplasia or early adenocarcinoma were included (endoscopic therapy/EMR n = 184; esophagectomy n = 113 [of which a 'combined' group had surgery preceded by endoscopic therapy n = 23]). Staging accuracy was low (accurate staging EMR: CT 40.1%, EUS 29.6%, FDG-PET/CT 11.0%; Esophagectomy: CT 43.3%, EUS 59.7%, FDG-PET/CT 29.6%; Combined: CT 28.6%, EUS46.2%, FDG-PET/CT 30.0%). Staging inaccuracies across all groups that could have changed management by missing T2 disease were CT 12%, EUS 12% and FDG-PET/CT 1.6%. The sensitivity of all techniques for detecting nodal disease was low (CT 12.5%, EUS 12.5%, FDG-PET/CT0.0%). Overall, FDG-PET/CT and EUS changed decision-making in only 3.2% of patients with an early cancer on CT and low-risk histology. The accuracy of staging with EUS, CT and FDG-PET/CT in patients with high-grade dysplasia or early adenocarcinoma of the esophagus is low. EUS and FDG-PET/CT added relevant staging information over standard CT in very few cases, and therefore, these investigations should be used selectively. Factors predicting the need for esophagectomy are predominantly obtained from EMR histology rather than staging investigations.
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Affiliation(s)
- A Reyhani
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - E Gimson
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - C Baker
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
| | - M Kelly
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
| | - N Maisey
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
| | - J Meenan
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
| | - M Subesinghe
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - M Hill
- Department of Oncology, Maidstone & Tunbridge Wells, Maidstone and Tunbridge Wells, UK
| | - J Lagergren
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - J Gossage
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - S Zeki
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - J Dunn
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - A Davies
- Oesophagogastric research group, Guy's and St Thomas' Oesophago-gastric Centre, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Curnow B, Rich AF, Ireland J, Correa DC, Dunn J, Jenkins D, Carslake H, Ressel L. Histological evidence of superficial inflammation is associated with lower recurrence of equine sarcoids following surgical removal: A follow-up study of 106 tumours in 64 horses. Vet J 2023; 292:105953. [PMID: 36775186 DOI: 10.1016/j.tvjl.2023.105953] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
Although the equine sarcoid is the most common skin neoplasm in domesticated horses, histopathological characteristics have not previously been evaluated for association with recurrence. The aim of this retrospective cohort study was to investigate clinical and histopathological features of excised equine sarcoids and to evaluate their association with recurrence at the original surgical site and at new sites. Clinical records and excisional biopsies from 106 equine sarcoids from 64 horses referred to Leahurst Equine Hospital, University of Liverpool, between March 2010 and February 2015 were retrieved. Biopsies were re-evaluated histologically. Clinical data were obtained from hospital records, and owner-reported follow-up data were obtained by telephone questionnaire. Associations between clinical and histopathological features of sarcoids and their recurrence at the surgical site were determined using uni- and multivariable mixed effects logistic regression. Recurrence of sarcoids at the surgical site occurred in 30 horses (46.9%). Sarcoids developed at a distant site in 21 horses (32.8%). In the final mixed effects logistic regression model, only superficial inflammation was associated with reduced odds of recurrence at the surgical site (adjusted odds ratio, 0.32; 95% confidence intervals, 0.10-0.96; P = 0.04). This suggests that the inflammatory process may play a role in protecting horses against the recurrence of sarcoids.
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Affiliation(s)
- B Curnow
- Department of Equine Clinical Science, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK.
| | - A F Rich
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - J Ireland
- Department of Equine Clinical Science, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - D Cubillos Correa
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - J Dunn
- Department of Equine Clinical Science, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - D Jenkins
- Department of Equine Clinical Science, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - H Carslake
- Department of Equine Clinical Science, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
| | - L Ressel
- Department of Veterinary Anatomy, Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK
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Rischin D, Mehanna H, Young RJ, Bressel M, Dunn J, Corry J, Soni P, Fulton-Lieuw T, Iqbal G, Kenny L, Porceddu S, Wratten C, Robinson M, Solomon BJ. Prognostic stratification of HPV-associated oropharyngeal cancer based on CD103 + immune cell abundance in patients treated on TROG 12.01 and De-ESCALaTE randomized trials. Ann Oncol 2022; 33:804-813. [PMID: 35525376 DOI: 10.1016/j.annonc.2022.04.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/09/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND High CD103+ intratumoral immune cell (ITIC) abundance is associated with better prognosis in unselected patients with human papilloma virus-associated oropharyngeal squamous cell carcinoma (HPV-associated OPSCC) treated with cisplatin and radiotherapy (CIS/RT). Substituting cetuximab (CETUX) for CIS with RT in HPV-associated OPSCC resulted in inferior efficacy. Our aim was to determine whether quantification of CD103 ITIC could be used to identify a population of HPV-associated OPSCC with superior prognosis. PATIENTS AND METHODS We pooled data from the TROG 12.01 and De-ESCALaTE randomized trials that compared CETUX/70GyRT with CIS/70GyRT in low-risk HPV-associated OPSCC: American Joint Committee on Cancer 7 stage III (excluding T1-2N1) or stage IV (excluding N2b-c if smoking history >10 pack-years and/or distant metastases), including all patients with available tumor samples. The primary endpoint was failure-free survival (FFS) in patients receiving CETUX/RT comparing CD103+ ITIC high (≥30%) versus low (<30%). High and low CD103 were compared using Cox regression adjusting for age, stage and trial. RESULTS Tumor samples were available in 159/182 patients on TROG 12.01 and 145/334 on De-ESCALaTE. CD103+ ITIC abundance was high in 27% of patients. The median follow-up was 3.2 years. The 3-year FFS in patients treated with CETUX/RT was 93% [95% confidence interval (CI) 79% to 98%] in high CD103 and 74% (95% CI 63% to 81%) in low CD103 [adjusted hazard ratio = 0.22 (95% CI 0.12-0.41), P < 0.001]. The 3-year overall survival in patients treated with CETUX/RT was 100% in high CD103 and 86% (95% CI 76% to 92%) in low CD103, P < 0.001. In patients treated with CIS/RT, there was no significant difference in FFS. CONCLUSIONS CD103+ ITIC expression separates CETUX/RT-treated low-risk HPV-associated OPSCC into excellent and poor prognosis subgroups. The high CD103 population is a rational target for de-intensification trials.
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Affiliation(s)
- D Rischin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
| | - H Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - R J Young
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M Bressel
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - J Corry
- Genesiscare St Vincent's Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - P Soni
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - T Fulton-Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - G Iqbal
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - L Kenny
- Department of Radiation Oncology, Royal Brisbane & Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - S Porceddu
- Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia
| | - C Wratten
- Department of Radiation Oncology, Calvary Mater Hospital and University of Newcastle, Newcastle, Australia
| | - M Robinson
- Cellular Pathology, Newcastle upon Tyne Hospitals, Newcastle, UK
| | - B J Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
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Uyama T, Kelton DF, Winder CB, Dunn J, Goetz HM, LeBlanc SJ, McClure JT, Renaud DL. Colostrum management practices that improve the transfer of passive immunity in neonatal dairy calves: A scoping review. PLoS One 2022; 17:e0269824. [PMID: 35767544 PMCID: PMC9242493 DOI: 10.1371/journal.pone.0269824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/27/2022] [Indexed: 12/04/2022] Open
Abstract
The objective of this scoping review was to describe the literature on the characteristics and management practices of colostrum feeding and their associations with the level of transfer of passive immunity (TPI) in dairy calves. Observational and experimental studies were searched in 5 electronic databases and 3 conference proceedings. Two reviewers independently screened primary studies, either analytic observational or experimental studies written in English. Studies on dairy or dual-purpose calves with passive immunity analyzed by blood sampling between 1 to 9 days of age were included. All studies had to compare at least one colostrum intervention or risk factor and their association with passive immunity. Of the 3,675 initially identified studies, 256 were included in this synthesis. One hundred and ninety-five were controlled trials, 57 were cohort studies, and 4 were cross-sectional studies. The effect of colostral quantity at first feeding was investigated in 30 controlled studies including studies that were comparable to each other. The effect of colostral quality was explored in 24 controlled studies with inconsistent criteria used to define the quality. The effect of the timing of first feeding of colostrum was investigated in 21 controlled studies, where the timing of feeding ranged widely from immediately after birth to 60 h of age. Only 4 controlled studies evaluated the relationship between bacterial load in the colostrum and TPI in dairy calves. Of the 256 total studies, 222 assessed blood IgG concentration while 107 measured blood total protein concentration. We identified a gap in knowledge on the association between passive immunity in dairy calves and the bacterial load in colostrum, or the timing of harvesting colostrum from the dam. A possible quantitative synthesis could be conducted among the studies that evaluated colostral quantity at the first feeding in relation to TPI in dairy calves.
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Affiliation(s)
- T. Uyama
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- * E-mail:
| | - D. F. Kelton
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - C. B. Winder
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - J. Dunn
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - H. M. Goetz
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - S. J. LeBlanc
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - J. T. McClure
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - D. L. Renaud
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Levinger P, Dunn J, Panisset MG, Haines T, Dow B, Batchelor F, Biddle S, Duque G, Hill KD. The Effect of the ENJOY Seniors Exercise Park Physical Activity Program on Falls in Older People in the Community: A Prospective Pre-Post Study Design. J Nutr Health Aging 2022; 26:217-221. [PMID: 35297462 PMCID: PMC8727466 DOI: 10.1007/s12603-021-1724-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The ENJOY project (Exercise interveNtion outdoor proJect in the cOmmunitY for older people) is a community-based research project actively promoting physical activity engagement through the delivery of an exercise program using outdoor multimodal exercise equipment. This study investigated the impact of the physical activity program on falls in older people. METHOD This study was a multi-site prospective study with a pre-post intervention design and 12-month follow up. Eighty older people with increased falls risk underwent a 12-week supervised outdoors exercise program followed by a 6-month maintenance phase. The proportion of fallers and falls incidence were compared between the preceding and the prospective years. RESULTS A sample of 54 (age 72.4±7.3, 79.6% women) was available for the 12 months analysis (due to COVID19 lockdowns, data of 19 participants were excluded and 4 dropped out). Number of fallers (from 51.8% to 31.4%, p=0.03) and falls incidence (from 42 to 29 falls, p<0.01) were significantly reduced at the 12-months follow up. CONCLUSION The ENJOY Seniors Exercise Park program integrates outdoor multimodal exercise stations including specific exercises designed to challenge dynamic balance during functional daily movements. The outcomes provide preliminary evidence for the potential positive impact of the ENJOY Seniors Exercise Park in reducing falls for older people.
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Affiliation(s)
- P Levinger
- Professor Pazit Levinger, National Ageing Research Institute, PO Box 2127, Royal Melbourne Hospital, Victoria 3050 Australia, T +61 3 8387 2626 | F +61 3 9387 4030
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Vreugdenhil M, Fong C, Iqbal G, Roques T, Evans M, Palaniappan N, Yang H, O'Toole L, Sanghera P, Nutting C, Foran B, Sen M, Al Booz H, Fulton-Lieuw T, Dalby M, Dunn J, Hartley A, Mehanna H. Improvement in Dysphagia Outcomes Following Clinical Target Volume Reduction in the De-ESCALaTE Study. Clin Oncol (R Coll Radiol) 2021; 33:795-803. [PMID: 34340917 DOI: 10.1016/j.clon.2021.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/02/2021] [Accepted: 07/14/2021] [Indexed: 11/29/2022]
Abstract
AIMS The De-ESCALaTE study showed an overall survival advantage for the administration of synchronous cisplatin chemotherapy with radiotherapy in low-risk oropharyngeal cancer when compared with synchronous cetuximab. During the trial, a radiotherapy quality assurance protocol amendment permitted centres to swap from the original radiotherapy contouring protocol (incorporating the whole oropharynx into the high-dose clinical target volume (CTV); anatomical protocol) to a protocol that incorporated the gross tumour volume with a 10 mm margin into the CTV (volumetric protocol). The purpose of this study was to examine both toxicity and tumour control related to this protocol amendment. MATERIALS AND METHODS Overall survival and recurrence at 2 years were used to compare tumour control in the two contouring cohorts. For toxicity, the cohorts were compared by both the number of severe (grades 3-5) and all grades acute and late toxicities. In addition, quality of life and swallowing were compared using EORTC-C30 and MD Anderson Dysphagia Inventory, respectively. RESULTS Of 327 patients included in this study, 185 were contoured according to the anatomical protocol and 142 by the volumetric protocol. The two cohorts were well balanced, with the exception of significantly more patients in the anatomical cohort undergoing prophylactic feeding tube insertion (P < 0.001). With a minimum of 2 years of follow-up there was no significant difference in overall survival or recurrence between the two contouring protocols. Similarly, there was no significant difference in the rate of reported severe or all grades acute or late toxicity and no sustained significant difference in quality of life. However, there was a significant difference in favour of volumetric contouring in several domains of the MD Anderson Dysphagia Inventory questionnaire at 1 year, which persisted to 2 years in the dysphagia functional (P = 0.002), dysphagia physical (P = 0.009) and dysphagia overall function (P = 0.008) domains. CONCLUSION In the context of the unplanned post-hoc analysis of a randomised trial, measurable improvement in long-term dysphagia has been shown following a reduction in the CTV. Further reductions in the CTV should be subject to similar scrutiny within the confines of a prospective study.
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Affiliation(s)
- M Vreugdenhil
- Hall-Edwards Radiotherapy Research Group, Queen Elizabeth Hospital, Birmingham, UK
| | - C Fong
- Hall-Edwards Radiotherapy Research Group, Queen Elizabeth Hospital, Birmingham, UK
| | - G Iqbal
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - T Roques
- Norfolk and Norwich University Hospitals, Norwich, UK
| | - M Evans
- Velindre University NHS Trust, Cardiff, UK
| | | | - H Yang
- Addenbrooke's Hospital, Cambridge, UK
| | - L O'Toole
- Castle Hill Hospital, Cottingham, UK
| | - P Sanghera
- Hall-Edwards Radiotherapy Research Group, Queen Elizabeth Hospital, Birmingham, UK
| | | | - B Foran
- Weston Park Hospital, Sheffield, UK
| | - M Sen
- St James' Institute of Oncology, Leeds, UK
| | - H Al Booz
- Bristol Haematology and Oncology Centre, Bristol, UK
| | - T Fulton-Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - M Dalby
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - J Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - A Hartley
- Hall-Edwards Radiotherapy Research Group, Queen Elizabeth Hospital, Birmingham, UK.
| | - H Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
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Goetz HM, Winder CB, Costa JHC, Creutzinger KC, Uyama T, Kelton DF, Dunn J, Renaud DL. Characterizing the literature surrounding transportation of young dairy calves: A scoping review. J Dairy Sci 2021; 105:1555-1572. [PMID: 34802745 DOI: 10.3168/jds.2021-21211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/15/2021] [Indexed: 11/19/2022]
Abstract
Transportation is a stressful event for cattle, as it may involve various handling practices, commingling, deprivation of food and water, and fluctuating temperatures. Calves are particularly susceptible to these stressors because their physiological and immune systems are still developing. There has been no formal synthesis of the scientific literature evaluating the effect of transportation on young dairy calf health and performance; the aim of this scoping review is to describe and characterize this body of work. We targeted both descriptive and analytic studies examining transport of calves, including listing how the effect of transport has been evaluated. Eight databases were searched for relevant articles with eligible studies being primary research articles investigating transportation of calves of either sex who were younger than 60 d of age or weighed less than 100 kg. Two reviewers independently screened the title and abstracts of 6,859 articles with 361 potentially relevant articles screened at full text. Of these, 46 were relevant and had data extracted. Articles reporting study location were conducted in the United States (n = 5), Australia (n = 3), Japan (n = 3), and New Zealand (n = 3). Common transport-related variables evaluated included time in transit (n = 13), distance of transportation (n = 8), vehicle-related factors (n = 8), and age at time of transportation (n = 4). Outcome measures varied greatly, including blood parameters (n = 28), health assessments (n = 20), weight (n = 17), behavioral metrics (n = 14), mortality (n = 7), feed intake following transportation (n = 4), salivary cortisol concentrations (n = 3), morbidity (n = 3), and isolation of Salmonella Dublin in fecal samples (n = 2). Outcome parameters were measured during transport or ranged from immediately after to one year following transportation. As the transport-related risk factors and outcomes measured assessed varied widely between studies, future quantitative synthesis (e.g., meta-analysis) in this area may be limited. Several knowledge gaps were identified, including methods to prepare calves for transportation, such as improving nutrition, administering medication, or transporting calves at an older age or weight. Further research could also focus on consistent and clear reporting of key items related to study conduct and analysis, as well as the development of a core outcome set for calf transport studies.
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Affiliation(s)
- H M Goetz
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - C B Winder
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - J H C Costa
- Department of Animal and Food Sciences, University of Kentucky, Lexington 40508
| | - K C Creutzinger
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - T Uyama
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - D F Kelton
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - J Dunn
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada, N1G 2W1
| | - D L Renaud
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada, N1G 2W1.
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Hanemann CO, Dunn J, Akther Y, Ercolano E, Adams C, Banton M, Sharma V, Hilton D. OS08.5.A Proteomic analysis of meningioma. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.035] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Meningioma is the most common primary intracranial tumor. Although ~80% are benign some WHO grade I are clinically aggressive. Chemotherapies are ineffective and biomarkers for clinical management are lacking. Approximately 60% sporadic meningiomas harbor mutations in the NF2 gene andutations in TRAF7, KLF4, AKT1, SMO and PIK3CA have been identified in the majority NF2-positive tumors esp lower grade. However, the molecular mechanisms behind meningioma tumourigenesis is still unclear. We aim to identify novel biomarkers and therapeutic targets of meningioma by characterizing the proteomic landscape.
MATERIAL AND METHODS
We analysed grade I, II and III frozen meningioma specimens and three different mutational groups: AKT1/TRAF7, KLF4/TRAF7 and NF2 -/- using LC-MS/MS to analyse global proteins, enriched phosphoproteins and phosphopeptides. Differential expression and functional annotation of proteins was completed using Perseus, IPA® and DAVID. For mutational subtypes quantitative phosphoproteomics was performed using TMT 10plex labeling approach followed by motif analysis using motif-X algorithm. We validated differential expression of proteins and phosphoproteins by Western blot and immunohistochemistry.
RESULTS
We quantified 3888 proteins and 3074 phosphoproteins across all meningioma grades. Bioinformatics analysis revealed commonly upregulated (phospho)proteins to be enriched in Gene Ontology terms associated with RNA metabolism. Validation confirmed significant overexpression of proteins such as EGFR, CKAP4, the nuclear proto-oncogene SET, the splicing factor SF2/ASF as well as total and activated phosphorylated form of the NIMA-related kinase, NEK9, involved in mitotic progression. Hexokinase 2 was overexpressed in higher grades. For the mutation subtypes we have quantified 4162 proteins across all mutational meningioma subgroups. Analysis showed distinct proteomic profiles of mutational subgroups. Comparative analysis showed 10 proteins were commonly significantly upregulated among all mutational subtypes vs. normal meninges. 257 proteins were commonly significantly downregulated and enriched with molecular functions including aldehyde dehydrogenase and oxido-reductase. Mutational subtype-specific analysis identified 162 proteins significantly upregulated in AKT1/TRAF7 vs. remaining sample groups to be enriched in the oxidative phosphorylation pathway. 14 and 7 proteins were commonly significantly upregulated in KLF4/TRAF7 and NF2 -/- mutant meningioma subtypes respectively. Several of these up-regulated proteins including ANNEXIN-3, CRABP2, CLIC3 and Endoglin were verified via WB. Lastly, analyses of 6600 phosphosites predicted regulatory kinases
CONCLUSION
We show extensive proteomic and phospophoproteomics analysis of meningioma and suggest new therapeutic and biomarker candidates.
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Affiliation(s)
- C O Hanemann
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - J Dunn
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - Y Akther
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - E Ercolano
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - C Adams
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - M Banton
- School of Biomedical Sciences, University of Plymouth, Plymouth, United Kingdom
| | - V Sharma
- School of Biomedical Sciences, University of Plymouth, Plymouth, United Kingdom
| | - D Hilton
- Department of Histopathology, University Hospital Plymouth NHS Trust, Plymouth, United Kingdom
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Atherley A, Mumtaz S, Bickers K, Dunn J, Komath D. Application of NATROX® topical oxygen therapy in neck wounds after radiotherapy. Br J Oral Maxillofac Surg 2021; 59:722-723. [PMID: 33975764 PMCID: PMC7485454 DOI: 10.1016/j.bjoms.2020.09.002] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/03/2020] [Indexed: 10/27/2022]
Affiliation(s)
- A Atherley
- Department of Oral & Maxillofacial Surgery, Royal Free London NHS Foundation Trust, London.
| | - S Mumtaz
- Department of Oral & Maxillofacial Surgery, Royal Free London NHS Foundation Trust, London
| | - K Bickers
- Department of Oral & Maxillofacial Surgery, Royal Free London NHS Foundation Trust, London
| | - J Dunn
- Department of Oral & Maxillofacial Surgery, Royal Free London NHS Foundation Trust, London
| | - D Komath
- Department of Oral & Maxillofacial Surgery, Royal Free London NHS Foundation Trust, London
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11
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Earl HM, Hiller L, Dunn J, Macpherson I, Rea D, Hughes-Davies L, McAdam K, Hall P, Mansi J, Wheatley D, Abraham JE, Caldas C, Gasson S, O'Riordan E, Wilcox M, Miles D, Cameron DA, Wardley A. Optimising the Duration of Adjuvant Trastuzumab in Early Breast Cancer in the UK. Clin Oncol (R Coll Radiol) 2021; 33:15-19. [PMID: 32723485 PMCID: PMC7382576 DOI: 10.1016/j.clon.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/04/2020] [Accepted: 07/06/2020] [Indexed: 12/26/2022]
Affiliation(s)
- H M Earl
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; NIHR Cambridge Biomedical Research Centre, Cambridge, UK.
| | - L Hiller
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - J Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - I Macpherson
- University of Glasgow, Institute of Cancer Sciences, Glasgow, UK
| | - D Rea
- Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - L Hughes-Davies
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - K McAdam
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Oncology, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK
| | - P Hall
- Edinburgh University Cancer Research Centre, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
| | - J Mansi
- Department of Medical Oncology, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust and King's College Medical School, London, UK
| | - D Wheatley
- Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - J E Abraham
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - C Caldas
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; NIHR Cambridge Biomedical Research Centre, Cambridge, UK; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - S Gasson
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - E O'Riordan
- Independent Cancer Patients' Voice, London, UK
| | - M Wilcox
- Independent Cancer Patients' Voice, London, UK
| | - D Miles
- Mount Vernon Cancer Centre, Northwood, UK
| | - D A Cameron
- Edinburgh University Cancer Research Centre, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
| | - A Wardley
- The NIHR Manchester Clinical Research Facility at The Christie, Manchester, UK; University of Manchester, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester, UK
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12
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Fong C, Mistry P, Roques T, Evans M, Yang H, O'Toole L, Sanghera P, Nutting C, Foran B, Sen M, Al Booz H, Fulton-Lieuw T, Dalby M, Dunn J, Hartley A, Mehanna H. OC-0573: Improvement in late dysphagia following clinical target volume reduction in the De-ESCALaTE study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00595-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Hummel K, Dunn J, Muldrew K, Gogia S, Kravitz E, Johnson E, Berra A, Stafford I, Martin I, Munson E. Mycoplasma Genitalium And Streptococcus Agalactiae Colonization In Pregnant Women: An Emerging Relationship. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
Mycoplasma genitalium has been identified as an emerging sexually transmitted infection (STI) causing cervicitis, pelvic inflammatory disease and other gynecologic pathology. The prevalence of M. genitalium in pregnant women has not been determined, nor has frequency of co-infection with Streptococcus agalactiae (GBS). Neonatal sepsis caused by GBS is associated with black race and young maternal age with approximately 10%-30% of pregnant women colonized. The aim of this retrospective study was to investigate the possible association between M. genitalium infection and colonization with GBS in a large cohort of pregnant women from a tertiary care center in Houston, Texas.
Methods
Remnant endocervical samples collected from pregnant women attending clinics at the Baylor College of Medicine between September 2019 and December 2019 were screened for M. genitalium by transcription mediated amplification (Hologic, Inc. Marlborough, MA). Demographic, STI co-infection [Human papillomavirus (types 16,18), Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and Herpes simplex virus], and GBS status data were recorded. Fisher’s exact test was performed for statistical analysis.
Results
719 total samples were collected and tested for M. genitalium. Of these, 41 (5.7%) were positive. The mean age of infected women was younger than noninfected women (24.9 vs. 28.1 years respectively p = 0.0004). More black women (34.2%) were infected with M. genitalium compared to white (14.6%) or other (51.2%) (p = 0.0003).
Rates of GBS colonization was significantly higher among women infected with M. genitalium compared to women who tested negative (58.3% vs. 16.1% respectively p = 0.002) and increased compared to national reported rates of GBS colonization. M. genitalium also showed a significant association with T. vaginalis (p=0.03), but no other STI co- infections studied.
Conclusion
Our data demonstrates that infection with M. genitalium may be associated with persistent GBS colonization. Further prospective studies are needed to further elucidate this relationship.
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Affiliation(s)
- K Hummel
- Pathology and Immunology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - J Dunn
- Pathology and Immunology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - K Muldrew
- Pathology and Immunology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - S Gogia
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - E Kravitz
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - E Johnson
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - A Berra
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - I Stafford
- Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, UNITED STATES
| | - I Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, CANADA
| | - E Munson
- Clinical Laboratory Sciences, Marquette University, Milwaukee, Wisconsin, UNITED STATES
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Starosolski Z, Admane P, Dunn J, Kaziny B, Huisman TAGM, Annapragada A. Design of 3D-Printed Nasopharyngeal Swabs for Children is Enabled by Radiologic Imaging. AJNR Am J Neuroradiol 2020; 41:2345-2347. [PMID: 32855191 DOI: 10.3174/ajnr.a6794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/22/2020] [Indexed: 11/07/2022]
Abstract
3D-printed nasopharyngeal swabs for COVID-19 molecular diagnostic testing address the national shortage of swabs. Swab designs for adult use were placed in the public domain in March 2020. Swabs for pediatric use, however, need to be smaller and more flexible to navigate delicate pediatric nasopharyngeal cavities. We describe a novel use of maxillofacial CT scans to aid in the design of pediatric nasopharyngeal swabs.
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Affiliation(s)
- Z Starosolski
- From the Edward B. Singleton Department of Radiology (Z.S., T.A.G.M.H., A.A.), Texas Children's Hospital, Feigin Center, Houston, Texas
| | - P Admane
- Department of Radiology (P.A.), Baylor College of Medicine, Houston, Texas
| | - J Dunn
- Medical Microbiology and Virology (J.D.), Texas Children's Hospital, Houston, Texas
| | - B Kaziny
- Department of Pediatrics (B.K.), Texas Children's Hospital, Houston, Texas
| | - T A G M Huisman
- From the Edward B. Singleton Department of Radiology (Z.S., T.A.G.M.H., A.A.), Texas Children's Hospital, Feigin Center, Houston, Texas
| | - A Annapragada
- From the Edward B. Singleton Department of Radiology (Z.S., T.A.G.M.H., A.A.), Texas Children's Hospital, Feigin Center, Houston, Texas
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15
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Conefrey C, Donovan JL, Stein RC, Paramasivan S, Marshall A, Bartlett J, Cameron D, Campbell A, Dunn J, Earl H, Hall P, Harmer V, Hughes-Davies L, Macpherson I, Makris A, Morgan A, Pinder S, Poole C, Rea D, Rooshenas L. Strategies to Improve Recruitment to a De-escalation Trial: A Mixed-Methods Study of the OPTIMA Prelim Trial in Early Breast Cancer. Clin Oncol (R Coll Radiol) 2020; 32:382-389. [PMID: 32089356 PMCID: PMC7246331 DOI: 10.1016/j.clon.2020.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/13/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022]
Abstract
AIMS De-escalation trials are challenging and sometimes may fail due to poor recruitment. The OPTIMA Prelim randomised controlled trial (ISRCTN42400492) randomised patients with early stage breast cancer to chemotherapy versus 'test-directed' chemotherapy, with a possible outcome of no chemotherapy, which could confer less treatment relative to routine practice. Despite encountering challenges, OPTIMA Prelim reached its recruitment target ahead of schedule. This study reports the root causes of recruitment challenges and the strategies used to successfully overcome them. MATERIALS AND METHODS A mixed-methods recruitment intervention (QuinteT Recruitment Intervention) was used to investigate the recruitment difficulties and feedback findings to inform interventions and optimise ongoing recruitment. Quantitative site-level recruitment data, audio-recorded recruitment appointments (n = 46), qualitative interviews (n = 22) with trialists/recruiting staff (oncologists/nurses) and patient-facing documentation were analysed using descriptive, thematic and conversation analyses. Findings were triangulated to inform a 'plan of action' to optimise recruitment. RESULTS Despite best intentions, oncologists' routine practices complicated recruitment. Discomfort about deviating from the usual practice of recommending chemotherapy according to tumour clinicopathological features meant that not all eligible patients were approached. Audio-recorded recruitment appointments revealed how routine practices undermined recruitment. A tendency to justify chemotherapy provision before presenting the randomised controlled trial and subtly indicating that chemotherapy would be more/less beneficial undermined equipoise and made it difficult for patients to engage with OPTIMA Prelim. To tackle these challenges, individual and group recruiter feedback focussed on communication issues and vignettes of eligible patients were discussed to address discomforts around approaching patients. 'Tips' documents concerning structuring discussions and conveying equipoise were disseminated across sites, together with revisions to the Patient Information Sheet. CONCLUSIONS This is the first study illuminating the tension between oncologists' routine practices and recruitment to de-escalation trials. Although time and resources are required, these challenges can be addressed through specific feedback and training as the trial is underway.
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Affiliation(s)
- C Conefrey
- Population Health Sciences, University of Bristol, Bristol, UK.
| | - J L Donovan
- Population Health Sciences, University of Bristol, Bristol, UK
| | - R C Stein
- National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London, UK
| | - S Paramasivan
- Population Health Sciences, University of Bristol, Bristol, UK
| | - A Marshall
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Bartlett
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - D Cameron
- The University of Edinburgh, Cancer Research UK Edinburgh Centre, Western General Hospital, EH4 University Cancer Centre, University of Edinburgh, Edinburgh, UK
| | - A Campbell
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Dunn
- Warwick Medical School, University of Warwick, Coventry, UK
| | - H Earl
- Oncology Centre, Addenbrooke's Hospital, Cambridge, UK
| | - P Hall
- The University of Edinburgh, Cancer Research UK Edinburgh Centre, Western General Hospital, EH4 University Cancer Centre, University of Edinburgh, Edinburgh, UK
| | - V Harmer
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | | | - I Macpherson
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Makris
- Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, UK
| | - A Morgan
- Independent Cancer Patients' Voice, London, UK
| | - S Pinder
- King's College London, Comprehensive Cancer Centre at Guy's Hospital, London, UK
| | - C Poole
- Arden Cancer Centre, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - D Rea
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - L Rooshenas
- Population Health Sciences, University of Bristol, Bristol, UK
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16
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McGowan CR, Wright T, Nitsch D, Lewer D, Brathwaite R, Scott J, Hope V, Ciccarone D, Dunn J, Gillmore J, Story A, Harris M. High prevalence of albuminuria amongst people who inject drugs: A cross-sectional study. Sci Rep 2020; 10:7059. [PMID: 32341462 PMCID: PMC7184598 DOI: 10.1038/s41598-020-63748-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/30/2020] [Indexed: 01/24/2023] Open
Abstract
Albuminuria is a key biomarker for cardiovascular disease and chronic kidney disease. Our study aimed to describe the prevalence of albuminuria amongst people who inject drugs in London and to test any potential associations with demographic characteristics, past diagnoses, and drug preparation and administration practices. We carried out a cross-sectional survey amongst people who use drugs in London. The main outcome measure was any albuminuria including both microalbuminuria and macroalbuminuria. Three-hundred and sixteen samples were tested by local laboratory services. Our study initially employed point-of-care testing methods but this resulted in a high number of false positives. Our findings suggest the prevalence of albuminuria amongst PWID is twice that of the general population at 19% (95%CI 15.3–24.0%). Risk factors associated with albuminuria were HIV (aOR 4.11 [95% CI 1.37–12.38]); followed by overuse of acidifier for dissolving brown heroin prior to injection (aOR 2.10 [95% CI 1.04–4.22]). Albuminuria is high amongst people who inject drugs compared to the general population suggesting the presence of increased cardiovascular and renal pathologies. This is the first study to demonstrate an association with acidifier overuse. Dehydration may be common amongst this population and may affect the diagnostic accuracy of point-of-care testing for albuminuria.
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Affiliation(s)
- C R McGowan
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. .,Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK.
| | - T Wright
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - D Nitsch
- Department of Non-communicable Disease Epidemiology, Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - D Lewer
- UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - R Brathwaite
- Department of Social Genetic & Developmental Psychiatry, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - J Scott
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - V Hope
- Public Health Institute, Liverpool John Moores University, 79 Tithebarn Street, Liverpool, L2 2ER, UK
| | - D Ciccarone
- University of California, San Francisco, Department of Family and Community Medicine, 500 Parnassus Avenue, San Francisco, CA, 94143, United States
| | - J Dunn
- Camden & Islington NHS Foundation Trust, 108 Hampstead Road, London, NW1 2LS, UK
| | - J Gillmore
- National Amyloidosis Centre, Centre for Amyloidosis & Acute Phase Proteins, Division of Medicine, University College London, Rowland Hill Street, London, NW3 2PF, UK
| | - A Story
- UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.,University College Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK
| | - M Harris
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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17
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Knight WRC, Yip C, Wulaningsih W, Jacques A, Griffin N, Zylstra J, Van Hemelrijck M, Maisey N, Gaya A, Baker CR, Kelly M, Gossage JA, Lagergren J, Landau D, Goh V, Davies AR, Ngan S, Qureshi A, Deere H, Green M, Chang F, Mahadeva U, Gill‐Barman B, George S, Dunn J, Zeki S, Meenan J, Hynes O, Tham G, Iezzi C. Prediction of a positive circumferential resection margin at surgery following neoadjuvant chemotherapy for adenocarcinoma of the oesophagus. BJS Open 2019; 3:767-776. [PMID: 31832583 PMCID: PMC6887675 DOI: 10.1002/bjs5.50211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/24/2019] [Indexed: 02/06/2023] Open
Abstract
Background A positive circumferential resection margin (CRM) has been associated with higher rates of locoregional recurrence and worse survival in oesophageal cancer. The aim of this study was to establish if clinicopathological and radiological variables might predict CRM positivity in patients who received neoadjuvant chemotherapy before surgery for oesophageal adenocarcinoma. Methods Multivariable analysis of clinicopathological and CT imaging characteristics considered potentially predictive of CRM was performed at initial staging and following neoadjuvant chemotherapy. Prediction models were constructed. The area under the curve (AUC) with 95% confidence intervals (c.i.) from 1000 bootstrapping was assessed. Results A total of 223 patients were included in the study. Poor differentiation (odds ratio (OR) 2·84, 95 per cent c.i. 1·39 to 6·01) and advanced clinical tumour status (T3-4) (OR 2·93, 1·03 to 9·48) were independently associated with an increased CRM risk at diagnosis. CT-assessed lack of response (stable or progressive disease) following chemotherapy independently corresponded with an increased risk of CRM positivity (OR 3·38, 1·43 to 8·50). Additional CT evidence of local invasion and higher CT tumour volume (14 cm3) improved the performance of a prediction model, including all the above parameters, with an AUC (c-index) of 0·76 (0·67 to 0·83). Variables associated with significantly higher rates of locoregional recurrence were pN status (P = 0·020), lymphovascular invasion (P = 0·007) and poor response to chemotherapy (Mandard score 4-5) (P = 0·006). CRM positivity was associated with a higher locoregional recurrence rate, but this was not statistically significant (P = 0·092). Conclusion The presence of advanced cT status, poor tumour differentiation, and CT-assessed lack of response to chemotherapy, higher tumour volume and local invasion can be used to identify patients at risk of a positive CRM following neoadjuvant chemotherapy.
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Affiliation(s)
- W. R. C. Knight
- Department of Surgery, Guy's and St Thomas' Oesophago‐Gastric Centre, King's College London
- School of Cancer and Pharmaceutical Sciences, King's College London
| | - C. Yip
- School of Biomedical Engineering and Imaging Sciences, King's College London
| | - W. Wulaningsih
- Cancer Epidemiology and Population Health Associated Research Group, King's College London
| | - A. Jacques
- Department of Radiology, Guy's and St Thomas' Hospital, London, UK
| | - N. Griffin
- Department of Radiology, Guy's and St Thomas' Hospital, London, UK
| | - J. Zylstra
- Department of Surgery, Guy's and St Thomas' Oesophago‐Gastric Centre, King's College London
| | - M. Van Hemelrijck
- Cancer Epidemiology and Population Health Associated Research Group, King's College London
| | - N. Maisey
- Department of Oncology, Guy's and St Thomas' Hospital, London, UK
| | - A. Gaya
- Department of Oncology, Guy's and St Thomas' Hospital, London, UK
| | - C. R. Baker
- Department of Surgery, Guy's and St Thomas' Oesophago‐Gastric Centre, King's College London
| | - M. Kelly
- Department of Surgery, Guy's and St Thomas' Oesophago‐Gastric Centre, King's College London
| | - J. A. Gossage
- Department of Surgery, Guy's and St Thomas' Oesophago‐Gastric Centre, King's College London
- School of Cancer and Pharmaceutical Sciences, King's College London
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - J. Lagergren
- Department of Surgery, Guy's and St Thomas' Oesophago‐Gastric Centre, King's College London
- School of Cancer and Pharmaceutical Sciences, King's College London
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - D. Landau
- Department of Oncology, Guy's and St Thomas' Hospital, London, UK
| | - V. Goh
- School of Biomedical Engineering and Imaging Sciences, King's College London
- Cancer Epidemiology and Population Health Associated Research Group, King's College London
| | - A. R. Davies
- Department of Surgery, Guy's and St Thomas' Oesophago‐Gastric Centre, King's College London
- School of Cancer and Pharmaceutical Sciences, King's College London
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Jones D, Mehanna H, Mistry P, Dalby M, Fulton-Lieuw T, Kong A, Dunn J, Gray A. Cisplatin reduces costs and provides more quality adjusted life years (QALYs) than cetuximab in chemoradiotherapy for patients with HPV-positive oropharyngeal cancer (HPV+OPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Hanemann CO, Ferluga S, Baiz D, Sharma V, Adams CL, Bassiri K, Dunn J, Ercolano E, Kurian K, Hilton DA. P09.07 Constitutive activation of the EGFR-STAT1 axis increases proliferation of meningioma tumour cells. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.139] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Meningiomas are the most frequent primary brain tumours of the central nervous system. The standard of treatment is (radio)surgery, but the lack of knowledge of their tumorigenesis contributes to delay the development of additional therapeutic options.
MATERIAL AND METHODS
We used a variety of differen model systems and cell biology techniques
RESULTS
We found STAT1 widely overexpressed in meningioma tumours and in patient-derived meningioma cells but not in the corresponding healthy controls. The protein showed a constitutive phosphorylation on both phosphosites (Y701 and S727), which was not dependent on the JAK/STAT pathway. STAT1 knocked down resulted in a significant reduction of cellular proliferation, showed as a decrease in Ki67-positive cells and Cyclin D1, and deactivation of AKT and ERK 1/2. By studying STAT1 binding partners we isolated a complex composed by STAT1, STAT2, PRMT5 and MEP50. As PRMT5 is known to interact with EGFR, we tested the tyrosine kinase and found that EGFR was constitutively active in meningioma and was responsible for the aberrant phosphorylation of STAT1 on both phosphosites. We tested different drugs inhibiting of EGFR phosphorylation, Canertinib was most effective. It caused a significant reduction in meningioma cells proliferation and a reduction of overall levels of Cyclin D1, phospho- AKT and phospho-ERK 1/2. Hence, STAT1 constitutive phosphorylation, initiated by EGFR activation, is responsible for inducing a positive feedback loop causing its own overexpression and consequently an increased proliferation of the tumour cells.
CONCLUSION
These findings underline a pivotal role of the EGFR and STAT1 axis in meningioma and provides the rationale for further studies aiming to identify novel and effective therapeutic options.
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Affiliation(s)
- C O Hanemann
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - S Ferluga
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - D Baiz
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - V Sharma
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - C L Adams
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - K Bassiri
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - J Dunn
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - E Ercolano
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - K Kurian
- Department of Neuropathology, Pathology Sciences, Southmead Hospital, Bristol, United Kingdom
| | - D A Hilton
- Cellular and Anatomical Pathology, Plymouth University Hospitals NHS Trust, Plymouth, United Kingdom
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20
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Penrose T, Dunn J, Sumner C, Scott E, Walshaw M, Ledson M. P467 Improving the transition of young people to an adult cystic fibrosis centre - the MDT approach. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30759-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Mehanna H, Robinson M, Hartley A, Kong A, Foran B, Fulton-Lieuw T, Dalby M, Mistry P, Sen M, O’Toole L, Dunn J. OC-011 New insights from the De-ESCALate HPV trial. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30177-x] [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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Pencharz D, Dunn J, Connor S, Siddiqui A, Sriskandan N, Thavaraj S, Jeannon JP, Oakley R, Lei M, Guerrero-Urbano T, Cook GJ, Szyszko TA. Palatine tonsil SUVmax on FDG PET-CT as a discriminator between benign and malignant tonsils in patients with and without head and neck squamous cell carcinoma of unknown primary. Clin Radiol 2019; 74:165.e17-165.e23. [PMID: 30454841 DOI: 10.1016/j.crad.2018.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/16/2018] [Indexed: 11/22/2022]
Abstract
AIM To analyse the maximum standardised uptake value (SUVmax) ratio between tonsils in patients with and without tonsillar carcinoma to determine useful diagnostic thresholds. MATERIALS AND METHODS Positron-emission tomography (PET)/computed tomography (CT) examinations of patients with suspected head and neck squamous cell carcinoma (SCC) and controls from April 2013 to September 2016 were reviewed retrospectively. Tonsillar SUVmax ratios (ipsilateral/contralateral for malignant tonsils, maximum/minimum for patients without [controls]) were calculated and used to construct a receiver operating characteristic (ROC) curve. RESULTS Twenty-five patients had tonsillar carcinoma (mean SUVmax ratio of 2, range 0.89-5.4) and 86 patients acted as controls (mean SUVmax ratio of 1.1, range 1-1.5). Using the ROC, the most accurate SUVmax ratio for identifying malignancy was >1.2 (77% sensitivity, 86% specificity). A potentially more clinically useful SUVmax ratio is ≥1.6 with 62% sensitivity and 100% specificity. CONCLUSION An SUVmax ratio between tonsils of ≥1.6 is highly suspicious for SCC and could be used to direct site of biopsy. Some malignant tonsils had normal FDG uptake; therefore, PET/CT should not be used to exclude tonsillar cancer. Minor asymmetrical uptake is frequently seen in non-malignant tonsils and does not necessarily require further investigation. Due to the single centre nature of this study and the recognised variation in SUV measurements between PET scans, other centres may need to develop their own cut-offs.
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Affiliation(s)
- D Pencharz
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
| | - J Dunn
- King's College London and St Guy's and St Thomas' PET Centre, London, UK
| | - S Connor
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Siddiqui
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - N Sriskandan
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Thavaraj
- Head and Neck Pathology, King's College, London, UK
| | - J-P Jeannon
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R Oakley
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Lei
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - G J Cook
- King's College London and St Guy's and St Thomas' PET Centre, London, UK
| | - T A Szyszko
- King's College London and St Guy's and St Thomas' PET Centre, London, UK
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Navales R, Dunn J, Htoo J, Touchette K, Thaler R, Levesque C. 189 Efficiency of utilizing standardized ileal digestible Thr for whole body protein retention in pregnant gilts during early, mid and late gestation. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Navales
- South Dakota State University,Brookings, SD, United States
| | - J Dunn
- ADM Animal Nutrition,Decatur, IL, United States
| | - J Htoo
- Evonik Nutrition & Care GmbH, No.4, Rodenbacher Chaussee,63457, Hanau, Germany, Hanau-Wolfgang,Hessen, Germany
| | - K Touchette
- Ajinomoto North America,Itasca, IL, United States
| | - R Thaler
- South Dakota State University,Brookings, SD, United States
| | - C Levesque
- South Dakota State University,Brookings, SD, United States
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Kosmin M, Padhani A, Gogbashian A, Woolf D, Ah-See ML, Ostler P, Sutherland S, Miles D, Noble J, Marshall A, Dunn J, Makris A. Response evaluation of cancer therapeutics in metastatic breast cancer to the bone: A single arm phase II study of whole-body magnetic resonance imaging. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.311] [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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Crawford-Williams F, March S, Ireland M, Rowe A, Goodwin B, Chambers S, Aitken J, Dunn J. Geographical Variations in the Clinical Management of Colorectal Cancer in Australia: A Systematic Review. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.83400] [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
Background: Colorectal cancer (CRC) presents considerable health, economic, and societal burden, and Australia has one of the highest incidence rates of this disease. Over a third of the Australian population live in nonmetropolitan areas and research has shown that they experience a range of health disadvantages that result in a higher disease burden and lower life expectancy. One of the main contributors of poorer CRC outcomes in rural Australia may be limited access to treatment facilities and optimal care; however, the extent to which geographical disparities exist in CRC management has not been systematically explored. Aim: To understand the nature of geographical variations in the clinical management and treatment of CRC (including surgery, chemotherapy, and radiotherapy) in Australia, incorporating clinical reports as well as peer-reviewed literature. Methods: A systematic review of published and gray literature was conducted. Five databases (CINAHL, PubMed, Embase, ProQuest, and Informit) were searched for articles published in English from 1990 to 2018. Studies were included if they assessed differences in clinical management according to geographical location; focused on CRC patients; and were conducted in Australia. Included studies were critically appraised using a modified Newcastle-Ottawa Scale. PRISMA systematic review reporting methods were applied. Results: Only 17 articles met inclusion criteria. All were of high (53%) or moderate (47%) quality. The evidence available may suggest that patients in nonmetropolitan areas are more likely to experience delays in surgery and are less likely to receive chemotherapy for stage III colon cancer and adjuvant radiotherapy for rectal cancer. Conclusion: The present review found limited information on clinical management across geographic regions in Australia and the synthesis highlights significant issues both for data collection and reporting at the population level. Where geographical disparities exist, these may be due to a combination of patient and system factors reflective of location. Population-level data regarding clinical management and treatment of CRC needs to be routinely collected to better understand geographical variations and inform future guidelines and policy.
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Affiliation(s)
| | - S. March
- University of Southern Queensland, Springfield Central, Australia
| | - M. Ireland
- University of Southern Queensland, Springfield Central, Australia
| | - A. Rowe
- University of Southern Queensland, Springfield Central, Australia
| | - B. Goodwin
- University of Southern Queensland, Springfield Central, Australia
| | - S. Chambers
- Menzies Health Institute Queensland, Southport, Australia
| | - J. Aitken
- Cancer Council Queensland, Brisbane, Australia
| | - J. Dunn
- University of Southern Queensland, Springfield Central, Australia
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Ralph N, Chambers S, Pomery A, Dunn J. Developing a Nurse-Led Intervention for Men With Advanced Prostate Cancer: A Preimplementation Study. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.90300] [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
Background: Men with advanced prostate cancer can experience poor life quality and health outcomes compared with men with localized disease. Closely matching men's needs and identifying barriers and facilitators to implementation were critical first steps for ensuring the feasibility of our nurse-led telephone-based supportive care intervention for men with advanced prostate cancer. Aim: The aim of this study is to understand the context for implementing ProsCare from PCSNs, and in doing so, further develop the intervention and implementation strategy. Methods: A total of 30 Prostate Cancer Specialist Nurses (PCSNs) participated in 4 semistructured focus groups. Data were coded into the Consolidated Framework for Implementation Research (CFIR) to evaluate the ProsCare program content and guide the implementation and evaluation of this targeted program for men with advanced prostate cancer. Results: Participants validated ProsCare components of (1) decision support; (2) treatment education with self-management and skills training for symptom effects, including exercise prescription; (3) routine screening for psychological distress with referral; (4) psycho-education with tailored distress management strategies; and (5) communicating with health professionals. Data supported a revised treatment schedule and a comprehensive implementation plan including professional education and centralised administration. Conclusion: ProsCare is a valid supportive care nurse-led intervention. The CFIR framework is useful for the structured identification of implementation factors.
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Affiliation(s)
- N. Ralph
- University of Southern Queensland, Institute for Resilient Regions, Toowoomba, Australia
| | - S. Chambers
- Menzies Health Institute Queensland, Southport, Australia
| | - A. Pomery
- Prostate Cancer Foundation of Australia, Melbourne, Australia
| | - J. Dunn
- Institute for Resilient Regions, Springfield, Australia
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Crawford-Williams F, Goodwin B, March S, Ireland M, Chambers S, Aitken J, Dunn J. Challenges and Opportunities for Cancer Care in Regional Australia: The Health Professional´s Perspective. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.91700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Cancer specialists working in rural and regional Australia may experience unique difficulties when compared with their metropolitan counterparts, as they often have higher workloads, spend longer hours in clinical practice, and experience professional and social isolation. Previous research has identified accessibility and distance from services, a shortage of workforce, limited availability of specialists and allied health providers, suboptimal chemotherapy administration, and reduced availability of radiotherapy services as predictors of poorer outcomes in regional areas. Yet to date, limited research has focused on the perspective of the regional healthcare professionals. Aim: This study aimed to identify the factors which health professionals believe influence clinical care and outcomes for people with cancer in regional areas of Australia, to confirm existing barriers and identify any new insights specific to the health professional perspective. Methods: Semistructured interviews were conducted with regional oncology health professionals of varying backgrounds. Interview questions explored health professional´s perspectives on barriers to cancer care for patients, factors which influence clinical care, and access to support in regional areas. Data were interpreted using an inductive thematic analysis approach. Results: Two global themes were identified: rural culture and the health system. Within these global themes, health professionals discussed barriers to cancer care in regional areas, predominantly associated with travel, limited workforce, and poor communication within the health system. Participants also noted many positive aspects of cancer care in regional areas, including more personalised care for the patients and faster career progression for professionals. Conclusion: Despite recent innovations aimed at improving rural cancer care, including innovative models of care and increased infrastructure, regional health professionals still perceive many barriers to cancer care in regional Australia. These are predominantly associated with patient demographics, travel difficulties, and inadequate governance. However, there are also many notable benefits to receiving care in regional areas which have been absent from previous literature. These positive factors should be incorporated in efforts to enhance regional cancer care through the recruitment of health professionals to regional areas and development of regional community support networks. An understanding of the experiences of health professionals working in oncology settings in regional areas is a key step toward improving care and providing recommendations to health services and policymakers, particularly regarding recruitment and retention.
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Affiliation(s)
| | - B. Goodwin
- University of Southern Queensland, Springfield Central, Australia
| | - S. March
- University of Southern Queensland, Springfield Central, Australia
| | - M. Ireland
- University of Southern Queensland, Springfield Central, Australia
| | - S. Chambers
- Menzies Health Institute Queensland, Southport, Australia
| | - J. Aitken
- Cancer Council Queensland, Brisbane, Australia
| | - J. Dunn
- University of Southern Queensland, Springfield Central, Australia
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Hulme C, Hall P, Shinkins B, Chehadah F, McCabe C, Hiller L, Dunn J, Earl H. PERSEPHONE: 6 versus 12 months (m) of adjuvant trastuzumab in patients (pts) with HER2 positive (+) early breast cancer (EBC): Cost effectiveness analysis results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Goodwin B, March S, Ireland M, Crawford-Williams F, Manski D, Ford M, Dunn J. Geographic Variation in Compliance With FOBT Colorectal Cancer Screening Programs: The Role of Attitudes Toward Health and Help Seeking. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.77900] [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
Background: Utilization of health services is thought to vary between urban and nonurban residents. In Australia, colorectal cancer (CRC) patients in peri-urban and rural areas tend to be diagnosed at a more advanced stage than their urban counterparts and have poorer 5 year survival rates. Aim: In this study, we investigate the effect that attitudes toward health and health related help-seeking have on compliance with population CRC screening programs and whether this varied among varied locations. We also examined the rate of recipients complying with overall program guidelines as opposed to the commonly reported participation rates in mail-out screening programs. Methods: A cross-section of recipients (n=371) who reported receiving a mail-out fecal occult blood test (FOBT) as part of the National Bowel Cancer Screening Program (NBCSP) in Australia were surveyed in 2017 regarding compliance. Attitudinal constructs including fatalism, stoicism and consideration of future consequences known to impact health-related help seeking were also measured. Logistic regression models were tested to assess the attitudinal predictors of program compliance in urban, peri-urban and rural groups. Results: Program participation (% returning kits) was relatively even across geographical locations, however, compliance with overall screening guidelines (returning kit or engaging in suitable alternative) was significantly lower in peri-urban, compared with urban, areas. Higher levels of stoicism and lower levels of consideration for future consequences were associated with lower NBCSP compliance in rural and peri-urban, but not urban areas. Fatalism was not associated with NBCSP compliance. Conclusion: Attempts to increase compliance with mail-out CRC screening program guidelines need to consider the use of appropriately tailored interventions that reflect the different ways in which socio-cultural and psychological factors impact cancer screening practices in geographically diverse communities. Interventions to enhance compliance in nonurban areas should promote the consideration of one's future, and discourage stoic attitudes to health.
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Affiliation(s)
- B. Goodwin
- University of Southern Queensland, Institute for Resilient Regions, Springfield Central, Australia
| | - S. March
- University of Southern Queensland, Institute for Resilient Regions, Springfield Central, Australia
| | - M. Ireland
- University of Southern Queensland, Institute for Resilient Regions, Springfield Central, Australia
| | - F. Crawford-Williams
- University of Southern Queensland, Institute for Resilient Regions, Springfield Central, Australia
| | - D. Manski
- University of Southern Queensland, School of Psychology, Springfield Central, Australia
| | - M. Ford
- University of Southern Queensland, School of Psychology, Springfield Central, Australia
| | - J. Dunn
- University of Southern Queensland, Institute for Resilient Regions, Springfield Central, Australia
- Cancer Council Queensland, Cancer Research Centre, Brisbane, Australia
- Griffith University, School of Medicine, Mt. Gravatt, Australia
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Goodwin B, Ireland M, March S, Myers L, Crawford-Williams F, Chambers S, Aitken J, Dunn J. Strategies for Increasing Participation in Mail-out Colorectal Cancer Screening Programs. A Systematic Review and Meta-Analysis. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.74700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Population mail-out bowel screening programs are a convenient, cost-effective and sensitive method of detecting colorectal cancer (CRC). Despite increased survival rates associated with early detection of CRC, in many countries 50% or more of eligible individuals do not participate in such programs, resulting in a substantial amount of cancers progressing undetected and wasted public health resources. Aim: The current study aimed to systematically review all of the interventions that have been applied internationally to increase fecal occult blood test (FOBT) kit return, specifically in population mail-out programs, to make recommendations to policy makers and program organizers as to the most effective methods of increasing uptake. Method: Six electronic databases (PubMed, PsycINFO, Scopus, InformIT, CINAHL, and ProQuest Dissertations and Theses) were searched for articles published in English before 10th of March 2018. Studies were included if they reported the results of an intervention designed to increase the return of FOBT kits that had been mailed to individuals' homes. Results: PRISMA systematic review reporting methods were applied and each study was assessed using Cochrane's risk of bias tool. The quality of evidence was assessed using GRADE guidelines. The review identified 53 interventions from 30 published studies. Nine distinct intervention strategy types were identified and pooled risk ratios and confidence intervals were estimated for each intervention type. Four key effective intervention strategies were identified including telephone contact, GP endorsement, simplified test procedures, and advance notification with small to moderate effect sizes. Conclusions: Interventions that combine program-level changes incorporating the issue of advance notification and alternative screening tools with the involvement of primary health professionals through endorsement letters and telephone contact should lead to increases in kit return in mail-out CRC screening programs. Future research should examine the benefit of combining intervention strategies and tailoring to specific populations.
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Affiliation(s)
- B. Goodwin
- University of Southern Queensland, Springfield, Australia
| | - M. Ireland
- Institute for Resilient Regions, Springfield, Australia
| | - S. March
- University of Southern Queensland, Springfield, Australia
| | - L. Myers
- University of Southern Queensland, Springfield, Australia
| | | | - S. Chambers
- Cancer Council Queensland, Research Centre, Brisbane, Australia
- Menzies Health Institute Queensland, Southport, Australia
- Prostate Cancer Foundation of Australia, St. Leonards, Australia
| | - J. Aitken
- Cancer Council Queensland, Research Centre, Brisbane, Australia
- Queensland University of Technology, School of Public Health and Social Work, Brisbane, Australia
- Menzies Health Institute Queensland, Brisbane, Australia
| | - J. Dunn
- Cancer Council Queensland, Research Centre, Brisbane, Australia
- University of Southern Queensland, Institute for Resilient Regions, Springfield, Australia
- University of Queensland, School of Social Science, Brisbane, Australia
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Mehanna H, Kong A, Hartley A, Mistry P, Dalby M, Fulton-Lieuw T, Robinson M, Gray A, Foran B, Sen M, O'Toole L, Dyker K, Al Booz H, Moleron R, Brennan S, Aynsley E, Chan A, Srinivasan D, Buter J, Dunn J. Cetuximab versus cisplatin in patients with HPV-positive, low risk oropharyngeal cancer, receiving radical radiotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hanemann CO, Dunn J, Ferluga S, Sharma V, Futschik M, Hilton D, Adams C, Lasonder E. P02.09 Proteomic analysis of meningioma discovers new pathways and their activation including NEK9 and AKT. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C O Hanemann
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - J Dunn
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - S Ferluga
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - V Sharma
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - M Futschik
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - D Hilton
- University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | - C Adams
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
| | - E Lasonder
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom
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Metrebian N, Weaver T, Pilling S, Hellier J, Byford S, Shearer J, Mitcheson L, Astbury M, Bijral P, Bogdan N, Bowden-Jones O, Day E, Dunn J, Finch E, Forshall S, Glasper A, Morse G, Akhtar S, Bajaria J, Bennett C, Bishop E, Charles V, Davey C, Desai R, Goodfellow C, Haque F, Little N, McKechnie H, Morris J, Mosler F, Mutz J, Pauli R, Poovendran D, Slater E, Strang J. Positive reinforcement targeting abstinence in substance misuse (PRAISe): Study protocol for a Cluster RCT & process evaluation of contingency management. Contemp Clin Trials 2018; 71:124-132. [PMID: 29908336 DOI: 10.1016/j.cct.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/09/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 10/14/2022]
Abstract
There are approximately 256,000 heroin and other opiate users in England of whom 155,000 are in treatment for heroin (or opiate) addiction. The majority of people in treatment receive opiate substitution treatment (OST) (methadone and buprenorphine). However, OST suffers from high attrition and persistent heroin use even whilst in treatment. Contingency management (CM) is a psychological intervention based on the principles of operant conditioning. It is delivered as an adjunct to existing evidence based treatments to amplify patient benefit and involves the systematic application of positive reinforcement (financial or material incentives) to promote behaviours consistent with treatment goals. With an international evidence base for CM, NICE recommended that CM be implemented in UK drug treatment settings alongside OST to target attendance and the reduction of illicit drug use. While there was a growing evidence base for CM, there had been no examination of its delivery in UK NHS addiction services. The PRAISe trial evaluates the feasibility, acceptability, clinical and cost effectiveness of CM in UK addiction services. It is a cluster randomised controlled effectiveness trial of CM (praise and financial incentives) targeted at either abstinence from opiates or attendance at treatment sessions versus no CM among individuals receiving OST. The trial includes an economic evaluation which explores the relative costs and cost effectiveness of the two CM intervention strategies compared to TAU and an embedded process evaluation to identify contextual factors and causal mechanisms associated with variations in outcome. This study will inform UK drug treatment policy and practice. Trial registration ISRCTN 01591254.
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Affiliation(s)
- N Metrebian
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
| | - T Weaver
- Imperial College London, London, UK; Middlesex University, London, UK
| | - S Pilling
- University College London, London, UK
| | - J Hellier
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - S Byford
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - J Shearer
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - L Mitcheson
- South London and Maudsley NHS Foundation Trust, London, UK
| | - M Astbury
- Dudley & Walsall Mental Health Partnership Trust, Dudley, UK
| | - P Bijral
- Change, Grow, Live Charity, Management Offices, London, UK
| | - N Bogdan
- South Essex Partnership NHS Foundation Trust, Essex, UK
| | - O Bowden-Jones
- Central and North West London NHS Foundation Trust, London, UK
| | - E Day
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - J Dunn
- Camden & Islington NHS Foundation Trust, London, UK
| | - E Finch
- South London and Maudsley NHS Foundation Trust, London, UK
| | - S Forshall
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - A Glasper
- Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - G Morse
- Turning Point Charity, London, UK
| | - S Akhtar
- Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - J Bajaria
- South Essex Partnership NHS Foundation Trust, Essex, UK
| | - C Bennett
- Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - E Bishop
- University College London, London, UK
| | - V Charles
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - C Davey
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - R Desai
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | | | - F Haque
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - N Little
- University College London, London, UK
| | | | - J Morris
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - F Mosler
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - J Mutz
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - R Pauli
- Birmingham & Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | | | - E Slater
- South Essex Partnership NHS Foundation Trust, Essex, UK
| | - J Strang
- King's College London, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
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Dunn J, Hanemann O, Ferluga S, Lasonder E, Sharma V, Hilton D, Adams C, Futschik M. PO-522 Global proteome and phosphoprotein profiling of meningiomas reveals novel potential therapeutic targets and biomarkers. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.1023] [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: 11/03/2022] Open
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Sipley J, Stassi D, Dunn J, Goldman E. Analysis of bacteriophage T7 gene 10A and frameshifted 10B proteins. Gene Expr 2018; 1:127-36. [PMID: 1820210 PMCID: PMC5952207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Bacteriophage T7 capsid protein 10B has previously been proposed to arise by a translational frameshift near the 3' end of the capsid gene 10A coding sequence, adding an additional 53 amino acid residues to the carboxyl-terminal end of the protein. Here we show by peptide mapping experiments as well as by direct partial sequence analysis of an overlapping "junction" peptide, that 10B is in fact related to 10A by a -1 switch in reading frame in a narrow region near the carboxy terminus of 10A. Peptide mapping experiments demonstrate that 10A and 10B have the same amino terminus as well as virtually identical methionine-labeled peptide maps. However, the predicted unique carboxyl-terminal peptide from 10B was also identified. An overlapping peptide was isolated from 10B which spans the junction region in which the proposed translational frameshift is thought to occur. Partial sequencing of this junction peptide confirms a -1 frameshift within the last few codons of 10A.
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Affiliation(s)
- J Sipley
- Department of Microbiology and Molecular Genetics, University of Medicine and Dentistry of New Jersey, Newark 07103
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Harris M, Brathwaite R, McGowan CR, Ciccarone D, Gilchrist G, McCusker M, O'Brien K, Dunn J, Scott J, Hope V. 'Care and Prevent': rationale for investigating skin and soft tissue infections and AA amyloidosis among people who inject drugs in London. Harm Reduct J 2018; 15:23. [PMID: 29739408 PMCID: PMC5941602 DOI: 10.1186/s12954-018-0233-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/02/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Skin and soft tissue infections (SSTIs) are a leading cause of morbidity and mortality among people who inject drugs (PWID). International data indicate up to one third of PWID have experienced an SSTI within the past month. Complications include sepsis, endocarditis and amyloid A (AA) amyloidosis. AA amyloidosis is a serious sequela of chronic SSTI among PWID. Though there is a paucity of literature reporting on AA amyloidosis among PWID, what has been published suggests there is likely a causal relationship between AA amyloidosis and injecting-related SSTI. If left untreated, AA amyloidosis can lead to renal failure; premature mortality among diagnosed PWID is high. Early intervention may reverse disease. Despite the high societal and individual burden of SSTI among PWID, empirical evidence on the barriers and facilitators to injecting-related SSTI prevention and care or the feasibility and acceptability of AA amyloidosis screening and treatment referral are limited. This study aims to fill these gaps and assess the prevalence of AA amyloidosis among PWID. METHODS Care and Prevent is a UK National Institute for Health Research-funded mixed-methods study. In five phases (P1-P5), we aim to assess the evidence for AA amyloidosis among PWID (P1); assess the feasibility of AA amyloidosis screening, diagnostic and treatment referral among PWID in London (P2); investigate the barriers and facilitators to AA amyloidosis care (P3); explore SSTI protection and risk (P4); and co-create harm reduction resources with the affected community (P5). This paper describes the conceptual framework, methodological design and proposed analysis for the mixed-methods multi-phase study. RESULTS We are implementing the Care and Prevent protocol in London. The systematic review component of the study has been completed and published. Care and Prevent will generate an estimate of AA amyloidosis prevalence among community recruited PWID in London, with implications for the development of screening recommendations and intervention implementation. We aim to recruit 400 PWID from drug treatment services in London, UK. CONCLUSIONS Care and Prevent is the first study to assess screening feasibility and the prevalence of positive proteinuria, as a marker for AA amyloidosis, among PWID accessing drug treatment services. AA amyloidosis is a serious, yet under-recognised condition for which early intervention is available but not employed.
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Affiliation(s)
- M Harris
- Department of Public Health, Environments, and Society London, School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - R Brathwaite
- Department of Public Health, Environments, and Society London, School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Catherine R McGowan
- Department of Public Health, Environments, and Society London, School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.,Humanitarian Public Health Technical Unit, Save the Children UK, London, UK
| | - D Ciccarone
- Family and Community Medicine, University of California San Francisco, San Franciso, CA, 94143, USA
| | - G Gilchrist
- Institute of Psychiatry, Psychology and Neuroscience, National Addiction Centre, King's College London, 4 Windsor Walk, London, SE5 8BB, UK
| | - M McCusker
- Lambeth Service Users Forum, Lorraine Hewitt House, Brighton Terrace, London, SW9 8DG, UK
| | - K O'Brien
- Camden Drug Services, The Margarete Centre, 108 Hampstead Road, London, NW1 2LS, UK
| | - J Dunn
- Camden Drug Services, The Margarete Centre, 108 Hampstead Road, London, NW1 2LS, UK
| | - J Scott
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - V Hope
- Public Health Institute, Liverpool John Moores University, 79 Tithebarn Street, Liverpool, L2 2ER, UK
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Charlesworth A, O'Sullivan S, Ferreira C, Barbaso I, LeCouteur J, Barrett S, Sayer V, Dunn J, Westcott E, Datta V, McCarthy M. The clinical and financial outcomes of initiating a home fluid and electrolyte (HFE) service at Guy's and St. Thomas' NHS Foundation Trust. Clin Nutr ESPEN 2017. [DOI: 10.1016/j.clnesp.2017.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
BACKGROUND People with gastroparesis who develop treatment-resistant (refractory) disease pose a difficult challenge, especially in the setting of end-stage renal disease (ESRD) or post pancreas transplant. Aprepitant (a neurokinin-receptor antagonist) is licensed for the short-term treatment of chemotherapy-induced nausea. There is lack of information on its long-term efficacy and safety in people with diabetic gastroparesis. CASE REPORT Case 1 was 73-year-old man with Type 2 diabetes of 25 years' duration and ESRD requiring dialysis. He was referred to our unit as his severe symptoms of gastroparesis had failed to respond to multiple medications and resulted in frequent hospital admissions. Aprepitant, which can be used in ESRD, resulted in significant improvement in his symptoms of nausea and vomiting within weeks, and he remained on this long term (18 months) with continued benefits and had no further gastroparesis-related hospital admissions. Case 2 was a 44-year-old man with Type 1 diabetes of 41 years' duration with a history of severe hypoglycaemic events that required a pancreas transplant. Despite normoglycaemia, his symptoms of gastroparesis persisted and failed to respond to multiple medications and frequent botulinum toxin injections. He was commenced on aprepitant with significant improvement in symptoms and has remained on treatment for 12 months with sustained benefits. CONCLUSION We describe two cases in which long-term aprepitant treatment proved effective in alleviating severe symptoms of gastroparesis that had failed to respond to conventional first-line medical treatments. Our cases highlight the need for novel treatments for managing refractory diabetic gastroparesis.
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Affiliation(s)
| | - J Dunn
- Guy's and St Thomas NHS Foundation Trust, London, UK
| | - S Thomas
- Guy's and St Thomas NHS Foundation Trust, London, UK
| | - J Karalliedde
- Guy's and St Thomas NHS Foundation Trust, London, UK
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Ali HR, Dariush A, Thomas J, Provenzano E, Dunn J, Hiller L, Vallier AL, Abraham J, Piper T, Bartlett JMS, Cameron DA, Hayward L, Brenton JD, Pharoah PDP, Irwin MJ, Walton NA, Earl HM, Caldas C. Lymphocyte density determined by computational pathology validated as a predictor of response to neoadjuvant chemotherapy in breast cancer: secondary analysis of the ARTemis trial. Ann Oncol 2017; 28:1832-1835. [PMID: 28525534 PMCID: PMC5834010 DOI: 10.1093/annonc/mdx266] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND We have previously shown lymphocyte density, measured using computational pathology, is associated with pathological complete response (pCR) in breast cancer. The clinical validity of this finding in independent studies, among patients receiving different chemotherapy, is unknown. PATIENTS AND METHODS The ARTemis trial randomly assigned 800 women with early stage breast cancer between May 2009 and January 2013 to three cycles of docetaxel, followed by three cycles of fluorouracil, epirubicin and cyclophosphamide once every 21 days with or without four cycles of bevacizumab. The primary endpoint was pCR (absence of invasive cancer in the breast and lymph nodes). We quantified lymphocyte density within haematoxylin and eosin (H&E) whole slide images using our previously described computational pathology approach: for every detected lymphocyte the average distance to the nearest 50 lymphocytes was calculated and the density derived from this statistic. We analyzed both pre-treatment biopsies and post-treatment surgical samples of the tumour bed. RESULTS Of the 781 patients originally included in the primary endpoint analysis of the trial, 609 (78%) were included for baseline lymphocyte density analyses and a subset of 383 (49% of 781) for analyses of change in lymphocyte density. The main reason for loss of patients was the availability of digitized whole slide images. Pre-treatment lymphocyte density modelled as a continuous variable was associated with pCR on univariate analysis (odds ratio [OR], 2.92; 95% CI, 1.78-4.85; P < 0.001) and after adjustment for clinical covariates (OR, 2.13; 95% CI, 1.24-3.67; P = 0.006). Increased pre- to post-treatment lymphocyte density showed an independent inverse association with pCR (adjusted OR, 0.1; 95% CI, 0.033-0.31; P < 0.001). CONCLUSIONS Lymphocyte density in pre-treatment biopsies was validated as an independent predictor of pCR in breast cancer. Computational pathology is emerging as a viable and objective means of identifying predictive biomarkers for cancer patients. CLINICALTRIALS.GOV NCT01093235.
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Affiliation(s)
- H. R. Ali
- Li Ka Shing Centre, Cancer Research UK Cambridge Institute
- Department of Pathology
| | - A. Dariush
- Institute of Astronomy, University of Cambridge, Cambridge
| | - J. Thomas
- Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
| | - E. Provenzano
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge
- Department of Histopathology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge
- Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - J. Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - L. Hiller
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - A.-L. Vallier
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge
- Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - J. Abraham
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge
- Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - T. Piper
- Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
| | - J. M. S. Bartlett
- Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
- Ontario Institute for Cancer Research, Toronto, Canada
| | - D. A. Cameron
- Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
| | - L. Hayward
- Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
| | - J. D. Brenton
- Li Ka Shing Centre, Cancer Research UK Cambridge Institute
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge
- Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - P. D. P. Pharoah
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge
- Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - M. J. Irwin
- Institute of Astronomy, University of Cambridge, Cambridge
| | - N. A. Walton
- Institute of Astronomy, University of Cambridge, Cambridge
| | - H. M. Earl
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge
- Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - C. Caldas
- Li Ka Shing Centre, Cancer Research UK Cambridge Institute
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge
- Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
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Ferluga S, Baiz D, Dunn J, Hilton DA, Bassiri K, Sharma V, Adams C, Lasonder E, Hanemann C. P12.08 Proteome and phosphoproteome analysis identifies STAT1 as a novel target in different grade meningiomas. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.366] [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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Dunn J, Casey C, Sandoe D, Hyde MK, Cheron-Sauer MC, Lowe A, Oliffe JL, Chambers SK. Advocacy, support and survivorship in prostate cancer. Eur J Cancer Care (Engl) 2017; 27:e12644. [PMID: 28145020 PMCID: PMC5900936 DOI: 10.1111/ecc.12644] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 10/20/2016] [Accepted: 12/05/2016] [Indexed: 11/30/2022]
Abstract
Across Australia, prostate cancer support groups (PCSG) have emerged to fill a gap in psychosocial care for men and their families. However, an understanding of the triggers and influencers of the PCSG movement is absent. We interviewed 21 SG leaders (19 PC survivors, two partners), of whom six also attended a focus group, about motivations, experiences, past and future challenges in founding and leading PCSGs. Thematic analysis identified four global themes: illness experience; enacting a supportive response; forming a national collective and challenges. Leaders described men's feelings of isolation and neglect by the health system as the impetus for PCSGs to form and give/receive mutual help. Negotiating health care systems was an early challenge. National affiliation enabled leaders to build a united voice in the health system and establish a group identity and collective voice. Affiliation was supported by a symbiotic relationship with tensions between independence, affiliation and governance. Future challenges were group sustainability and inclusiveness. Study findings describe how a grassroots PCSG movement arose consistent with an embodied health movement perspective. Health care organisations who seek to leverage these community resources need to be cognisant of SG values and purpose if they are to negotiate effective partnerships that maximise mutual benefit.
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Affiliation(s)
- J Dunn
- Cancer Council Queensland, Fortitude Valley, Qld, Australia.,Institute for Resilient Regions, University of Southern Queensland, Darling Heights, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,School of Social Science, The University of Queensland, St Lucia, Qld, Australia
| | - C Casey
- Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - D Sandoe
- Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - M K Hyde
- Cancer Council Queensland, Fortitude Valley, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - M-C Cheron-Sauer
- Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - A Lowe
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - J L Oliffe
- University of British Columbia, Vancouver, BC, Canada
| | - S K Chambers
- Cancer Council Queensland, Fortitude Valley, Qld, Australia.,Institute for Resilient Regions, University of Southern Queensland, Darling Heights, Qld, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
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42
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Hartley A, Fong C, Sanghera P, Wong W, McConkey C, Rahman J, Nutting C, Al-Booz H, Robinson M, Junor E, Rizwanullah M, Dunn J, Mehanna H. Radiation Therapy Variation in the Randomized Phase 3 Positron Emission Tomography Neck Study. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Two hundred thirty-one spectators at a Cricket match in Brisbane, Australia, were interviewed and observed to determine their sun protective behaviors, and these behaviors were compared to the temperature and amount of cloud cover at the time of the study. People tended to protect themselves from the sun when there was less cloud cover and temperatures were higher.
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Affiliation(s)
- J Dunn
- Community Services, Queensland Cancer Fund, Spring Hill, Queensland, Australia
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44
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Ferluga S, Dunn J, Lasonder E, Sharma V, Hilton D, Adams C, Hanemann C. Proteome and phosphoproteome analysis of stratified meningiomas. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61626-x] [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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Bell GM, Anderson AE, Diboll J, Reece R, Eltherington O, Harry RA, Fouweather T, MacDonald C, Chadwick T, McColl E, Dunn J, Dickinson AM, Hilkens CMU, Isaacs JD. Autologous tolerogenic dendritic cells for rheumatoid and inflammatory arthritis. Ann Rheum Dis 2016; 76:227-234. [PMID: 27117700 PMCID: PMC5264217 DOI: 10.1136/annrheumdis-2015-208456] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [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: 08/24/2015] [Revised: 02/29/2016] [Accepted: 03/24/2016] [Indexed: 11/28/2022]
Abstract
Objectives To assess the safety of intra-articular (IA) autologous tolerogenic dendritic cells (tolDC) in patients with inflammatory arthritis and an inflamed knee; to assess the feasibility and acceptability of the approach and to assess potential effects on local and systemic disease activities. Methods An unblinded, randomised, controlled, dose escalation Phase I trial. TolDC were differentiated from CD14+ monocytes and loaded with autologous synovial fluid as a source of autoantigens. Cohorts of three participants received 1×106, 3×106 or 10×106 tolDC arthroscopically following saline irrigation of an inflamed (target) knee. Control participants received saline irrigation only. Primary outcome was flare of disease in the target knee within 5 days of treatment. Feasibility was assessed by successful tolDC manufacture and acceptability via patient questionnaire. Potential effects on disease activity were assessed by arthroscopic synovitis score, disease activity score (DAS)28 and Health Assessment Questionnaire (HAQ). Immunomodulatory effects were sought in peripheral blood. Results There were no target knee flares within 5 days of treatment. At day 14, arthroscopic synovitis was present in all participants except for one who received 10×106 tolDC; a further participant in this cohort declined day 14 arthroscopy because symptoms had remitted; both remained stable throughout 91 days of observation. There were no trends in DAS28 or HAQ score or consistent immunomodulatory effects in peripheral blood. 9 of 10 manufactured products met quality control release criteria; acceptability of the protocol by participants was high. Conclusion IA tolDC therapy appears safe, feasible and acceptable. Knee symptoms stabilised in two patients who received 10×106 tolDC but no systemic clinical or immunomodulatory effects were detectable. Trial registration number NCT01352858.
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Affiliation(s)
- G M Bell
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - A E Anderson
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - J Diboll
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - R Reece
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - O Eltherington
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - R A Harry
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - T Fouweather
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - C MacDonald
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - T Chadwick
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - E McColl
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Clinical Trials Unit, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - J Dunn
- Haematological Sciences, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - A M Dickinson
- Haematological Sciences, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - C M U Hilkens
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - John D Isaacs
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
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Rea D, Francis A, Poole C, Brookes C, Stein R, Bartlett J, Dunn J, Canney P, Sutton R, Daoud R, Hallissey M, Achuthan R, Grant M, Babrah J, Smith S, Fraser J, Desai A, Al Dubaisi M, Patel A, Bristol J, Chandrasekharan S, Prest C, Jewkes A. Abstract PD2-02: NEO-EXCEL phase III neoadjuvant trial of pre-operative exemestane or letrozole +/- celecoxib in the treatment of ER positive postmenopausal early breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-pd2-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
COX2 has been implicated in breast tumorigenesis, tumour proliferation & invasion. The role of COX2 in carcinogenesis is thought to be related to its abilities to increase production of prostaglandins, convert pro-carcinogens to carcinogens, inhibit apoptosis, promote angiogenesis, modulate inflammation & immune function & increase tumour cell invasiveness. COX2 inhibition may synergise with aromatase inhibition in controlling endocrine responsive breast cancer. The COX2 product prostaglandin E2 (PGE2) & cytokines such as interleukin-6 (IL6) can up regulate aromatase expression suggesting that aromatase inhibition may be more effective in combination with a COX2 inhibitor. There may be additional COX2 mediated anticancer activity. The hypothesis addressed is that activity of aromatase inhibitors(AI) as neoadjuvant endocrine therapy for early breast cancer may be enhanced by the addition of a COX2 inhibitor.
TRIAL OBJECTIVES
To determine whether the activity of AIs as neo-adjuvant endocrine therapy for ER positive breast cancer in postmenopausal women may be enhanced by the addition of the selective COX2 inhibitor celecoxib.
TRIAL DESIGN
Prospective phase III multicentre randomised trial. Patients were randomised to receive 16 weeks of exemestane 25 mg daily or letrozole 2.5 mg daily (open label) and celecoxib 400 mg twice daily or matched placebo (double blinded). Translational research tumour samples were collected before, during & after therapy.
KEY ELIGIBILITY CRITERIA
Post menopausal, ER positive, invasive cancer, 2cms or greater with calipers & visible on USS.
PRIMARY OUTCOME MEASURE
Objective clinical response to neoadjuvant treatment by RECIST criteria.
RESULTS
Primary Outcome; Response to treatment has been calculated for 266 patients (Table 1). Response rate was 73% in the celecoxib arm & 55% in the placebo arm (p=0.0022). The response rates 4 arm comparison are shown in Table 2. After adjustment for AI effect the significant difference in response rates remained (p=0.0023); the difference in response rates was greater in the exemestane treated group (29%) compared to the letrozole group (7%) although heterogeneity between AI arms was statistically non-significant (p=0.06).
Table 1 Primary Outcome Results: response ratesOUTCOMEPLACEBO N (%)CELECOXIB N (%)TOTAL N (%)X2statisticP-valueRESPONSE73(55)97(73%)170 (64%)9.38820.0022NO RESPONSE60 (45%)36 (27%)96 (36%) TOTAL133133266
Table 2: Response Rates 4 Arm Comparison EXEMESTANELETROZOLERESPONSEPLACEBO n(%)CELECOXIB n(%)TOTAL n(%)PLACEBO n(%)CELECOXIB n(%)TOTAL n(%)RESPONSE33 (49)52(78)85(63)40(61)45(68)85(64)NO RESPONSE34(51)15(22)49(37)26(39)21(32)47(36)TOTAL67671346666132
Secondary outcome; There was an USS response rate of 42% v 37% for celecoxib & placebo arms respectively (p=0.2513)
CONCLUSION
The addition of the COX2 inhibitor celecoxib to an AI significantly & substantially increased the clinical response from 55% to 73%. Effect on tumour size assessed with USS is less marked with a non-significant increase in responses from 37% to 42%.
This work was supported by CRUK: CRUK/06/005 and Pfizer.
Citation Format: Rea D, Francis A, Poole C, Brookes C, Stein R, Bartlett J, Dunn J, Canney P, Sutton R, Daoud R, Hallissey M, Achuthan R, Grant M, Babrah J, Smith S, Fraser J, Desai A, Al Dubaisi M, Patel A, Bristol J, Chandrasekharan S, Prest C, Jewkes A. NEO-EXCEL phase III neoadjuvant trial of pre-operative exemestane or letrozole +/- celecoxib in the treatment of ER positive postmenopausal early breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD2-02.
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Affiliation(s)
- D Rea
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - A Francis
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - C Poole
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - C Brookes
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - R Stein
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - J Bartlett
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - J Dunn
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - P Canney
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - R Sutton
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - R Daoud
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - M Hallissey
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - R Achuthan
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - M Grant
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - J Babrah
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - S Smith
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - J Fraser
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - A Desai
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - M Al Dubaisi
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - A Patel
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - J Bristol
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - S Chandrasekharan
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - C Prest
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
| | - A Jewkes
- On behalf of All the NEO-EXCEL Investigators University Hospital Birmingham, Birmingham, West Midlands, United Kingdom; University Hospital, Coventry, Coventry, West Midlands, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University of Warwick, Coventry, West Midlands, United Kingdom; Good Hope Hospital, Sutton Coldfield, West Midlands, United Kingdom; Royal United Hospital, Bath, Somerset, United Kingdom; Frimley Park Hospital, Camberley, Surrey, United Kingdom; St James's University Hospital, Leeds, West Yorkshire, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; City Hospital, Birmingham, West Midlands, United Kingdom; Broomfield Hospital, Chelmsford, Essex, United Kingdom; Princess Royal University Hospital, Orpington, Kent, United Kingdom; Barnet Hospital, Barnet, Hertfordshire, United Kingdom; St Margaret's Hospita
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McCaul J, Sutton D, Shaw R, Mehanna H, Hislop S, McMahon J, Dunn J. LIHNCS (Lugol's Iodine in Head and Neck Cancer Surgery) a UK multicentre prospective randomised controlled trial. Report of primary and secondary outcome measures. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.699] [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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Hyde MK, Chambers SK, Shum D, Ip D, Dunn J. Psycho-oncology assessment in Chinese populations: a systematic review of quality of life and psychosocial measures. Eur J Cancer Care (Engl) 2015; 25:691-718. [PMID: 26292029 DOI: 10.1111/ecc.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2015] [Indexed: 11/26/2022]
Abstract
This systematic review describes psychosocial and quality of life (QOL) measures used in psycho-oncology research with cancer patients and caregivers in China. Medline and PsycINFO databases were searched (1980-2014). Studies reviewed met the following criteria: English language; peer-reviewed; sampled Chinese cancer patients/caregivers; developed, validated or assessed psychometric properties of psychosocial or QOL outcome measures; and reported validation data. The review examined characteristics of measures and participants, translation and cultural adaptation processes and psychometric properties of the measures. Ninety five studies met review criteria. Common characteristics of studies reviewed were they: assessed primarily QOL measures, sampled patients with breast, colorectal, or head and neck cancer, and validated existing measures (>80%) originating in North America or Europe. Few studies reported difficulties translating measures. Regarding psychometric properties of the measures >50% of studies reported subscale reliabilities <α = 0.70, <50% reported test-retest reliability, and <30% reported divergent validity. Few reported sensitivity, specificity or responsiveness. Improved accuracy and transparency of reporting for translation, cultural adaptation and psychometric testing of psychosocial measures is needed. Developing support structures for translating and validating psychosocial measures would enable this and ensure Chinese psycho-oncology clinical practice and research keeps pace with international focus on patient reported outcome measures and data management.
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Affiliation(s)
- M K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, WA, Australia.,Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - D Shum
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - D Ip
- The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - J Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,School of Social Science, The University of Queensland, St Lucia, Qld, Australia
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Ali HR, Glont SE, Blows FM, Provenzano E, Dawson SJ, Liu B, Hiller L, Dunn J, Poole CJ, Bowden S, Earl HM, Pharoah PDP, Caldas C. PD-L1 protein expression in breast cancer is rare, enriched in basal-like tumours and associated with infiltrating lymphocytes. Ann Oncol 2015; 26:1488-93. [PMID: 25897014 DOI: 10.1093/annonc/mdv192] [Citation(s) in RCA: 209] [Impact Index Per Article: 23.2] [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: 03/23/2015] [Accepted: 04/13/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Expression of programmed death ligand 1 (PD-L1) in solid tumours has been shown to predict whether patients are likely to respond to anti-PD-L1 therapies. To estimate the therapeutic potential of PD-L1 inhibition in breast cancer, we evaluated the prevalence and significance of PD-L1 protein expression in a large collection of breast tumours. PATIENTS AND METHODS Correlations between CD274 (PD-L1) copy number, transcript and protein levels were evaluated in tumours from 418 patients recruited to the METABRIC genomic study. Immunohistochemistry was used to detect PD-L1 protein in breast tumours in tissue microarrays from 5763 patients recruited to the SEARCH population-based study (N = 4079) and the NEAT randomised, controlled trial (N = 1684). RESULTS PD-L1 protein data was available for 3916 of the possible 5763 tumours from the SEARCH and NEAT studies. PD-L1 expression by immune cells was observed in 6% (235/3916) of tumours and expression by tumour cells was observed in just 1.7% (66/3916). PD-L1 was most frequently expressed in basal-like tumours. This was observed both where tumours were subtyped by combined copy number and expression profiling [39% (17/44) of IntClust 10 i.e. basal-like tumours were PD-L1 immune cell positive; P < 0.001] and where a surrogate IHC-based classifier was used [19% (56/302) of basal-like tumours were PD-L1 immune cell positive; P < 0.001]. Moreover, CD274 (PD-L1) amplification was observed in five tumours of which four were IntClust 10. Expression of PD-L1 by either tumour cells or infiltrating immune cells was positively correlated with infiltration by both cytotoxic and regulatory T cells (P < 0.001). There was a nominally significant association between PD-L1 and improved disease-specific survival (hazard ratio 0.53, 95% confidence interval 0.26-1.07; P = 0.08) in ER-negative disease. CONCLUSIONS Expression of PD-L1 is rare in breast cancer, markedly enriched in basal-like tumours and is correlated with infiltrating lymphocytes. PD-L1 inhibition may benefit the 19% of patients with basal-like tumours in which the protein is expressed. NEAT CLINICALTRIALSGOV NCT00003577.
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Affiliation(s)
- H R Ali
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge Department of Pathology, University of Cambridge, Cambridge
| | - S-E Glont
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge
| | - F M Blows
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge
| | - E Provenzano
- Department of Histopathology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - S-J Dawson
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - B Liu
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge
| | - L Hiller
- Warwick Clinical Trials Unit, University of Warwick, Coventry
| | - J Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry
| | - C J Poole
- Warwick Clinical Trials Unit, University of Warwick, Coventry
| | - S Bowden
- Cancer Research UK Clinical Trials Unit, Institute for Cancer Studies, The University of Birmingham, Edgbaston, Birmingham
| | - H M Earl
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
| | - P D P Pharoah
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge Strangeways Research Laboratory, University of Cambridge, Cambridge, UK
| | - C Caldas
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
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Glendenning J, Barrington S, Tovey H, Parikh J, Dunn J, Tutt A. Repeatability evaluation of PET/CT imaging using [18F]fluorothymidine (FLT) and [18F]fluorodeoxyglucose (FDG) in primary triple negative breast cancer (TNBC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv119.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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