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Tutelman PR, Moran C, Beattie SM, Khu M, Howlett M, Scheidl J, Boychuk A, Silveira K, Henning JW, Schulte FSM. Acceptability, feasibility and preliminary effects of an online group psychotherapy intervention for adolescents and young adults with cancer. Psychooncology 2024; 33:e6335. [PMID: 38526517 DOI: 10.1002/pon.6335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/23/2024] [Accepted: 03/14/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Adolescents and young adults (AYAs; ages 15-29 years) diagnosed with cancer are increasingly recognized as an oncology population with distinct psychosocial needs. However, few specialized psychosocial interventions for AYAs currently exist. This study reports on the development of a novel group-based psychotherapy intervention to address the psychosocial needs of AYAs. The objective was to evaluate the acceptability, feasibility, and preliminary effects of the intervention. METHODS The manualized group psychotherapy program is delivered virtually over an 8-week period by registered psychologists. Four groups (n = 5-11 AYAs per group) with a total of N = 33 participants (Mage = 20.97 years, SD = 3.68, range = 15-29 years, 76% women) were conducted. Recruitment and retention data assessed intervention feasibility. Patient-reported psychosocial outcomes were measured at baseline and immediately following the intervention to assess preliminary effects. Acceptability was assessed following the intervention using a self-report measure of participant satisfaction. RESULTS Overall, the completion rate of the intervention was 85% (n = 28). All participants "strongly agreed" (88%) or "agreed" (13%) that they were satisfied with the group. Meeting, sharing experiences, and expressing feelings with other AYAs were identified as the most helpful aspects. Participants reported significant improvements in emotional (p < 0.05) and functional (p < 0.01) quality of life from baseline to immediately post-intervention with medium effect sizes (d = 0.58-0.70). CONCLUSIONS Findings suggest that the intervention is feasible, acceptable, and shows promise for improving psychosocial outcomes for AYAs. Further research will refine the intervention and establish efficacy in a randomized trial.
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Affiliation(s)
- Perri R Tutelman
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Chelsea Moran
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
| | - Sara M Beattie
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Khu
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Melissa Howlett
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jessica Scheidl
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - April Boychuk
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Kristen Silveira
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Jan-Willem Henning
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Fiona S M Schulte
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
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Farah E, Carbonell C, Boyne DJ, Brenner DR, Henning JW, Moldaver D, Shokar S, Cheung WY. Treatment Patterns and Health Outcomes among Patients with HER2 IHC0/-Low Metastatic or Recurrent Breast Cancer. Cancers (Basel) 2024; 16:518. [PMID: 38339269 PMCID: PMC10854846 DOI: 10.3390/cancers16030518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Improved understanding of the biological heterogeneity of breast cancer (BC) has facilitated the development of more effective and personalized approaches to treatment. This study describes real-world evidence on treatment patterns and outcomes for a population-based cohort of patients with human epidermal growth factor receptor (HER2) IHC0 and -low BC with de novo or recurrent disease from Alberta, Canada. Patients 18+ years old diagnosed with HER2 IHC0/-low, de novo/recurrent BC from 2010 to 2019 were identified using Alberta's cancer registry. Analyses of these patients' existing electronic medical records and administrative claims data were conducted to examine patient characteristics, treatment patterns, and survival outcomes. A total of 3413 patients were included in the study, of which 72.10% initiated first line hormonal and non-hormonal systemic therapy. The 1-year overall survival (OS) was 81.09% [95% CI, 79.52-82.69]. Recurrent patients had a higher OS compared to de novo patients: 54.30 months [95% CI, 47.80-61.90] vs. 31.5 months [95% CI, 28.40-35.90], respectively. Median OS was 43.4 months [95% CI, 40.70-47.10] and 35.80 months [95% CI, 29.00-41.70] among patients with HER2-low and HER2 IHC0 cancer, respectively. The study results provide real-world evidence regarding the clinical outcomes of HER2 IHC0/-low and de novo/recurrent disease.
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Affiliation(s)
- Eliya Farah
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Chantelle Carbonell
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Devon J. Boyne
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Darren R. Brenner
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jan-Willem Henning
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | | | - Simran Shokar
- AstraZeneca Canada Inc., Mississauga, ON L4Y 1M4, Canada
| | - Winson Y. Cheung
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
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3
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Harper A, Maseja N, Parkinson R, Pakseresht M, McKillop S, Henning JW, Watson L, Cuthbert C, Cheung W, Fidler-Benaoudia MM. Symptom severity and trajectories among adolescent and young adult patients with cancer. JNCI Cancer Spectr 2023; 7:pkad049. [PMID: 37943323 PMCID: PMC10634503 DOI: 10.1093/jncics/pkad049] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/28/2023] [Accepted: 07/18/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Patients with cancer experience significant symptom burden. We investigated symptom severity in adolescents and young adults (18- to 39-year-olds) during the year following a cancer diagnosis and made comparisons with older adult (those older than 40 years of age) patients with cancer. METHODS All Albertan residents diagnosed with a first primary neoplasm at 18 years of age or older between April 1, 2018, and December 31, 2019, and who completed at least 1 electronic patient-reported outcome questionnaire were included. Symptom severity was assessed using the Edmonton Symptom Assessment System-revised. Descriptive statistics, multivariable logistic modeling, and mixed logistic regression modeling were used to describe symptom severity, identify risk factors, and assess symptom trajectories, respectively. RESULTS In total, 473 and 322 adolescents and young adults completed a patient-reported outcomes questionnaire at diagnosis and 1 year after diagnosis, respectively. Adolescent and young adult patients with cancer reported high levels of tiredness, poor well-being, and anxiety. Important risk factors included metastatic disease, female sex, treatment types received, and age at diagnosis. Symptom severity varied by clinical tumor group, with those diagnosed with sarcoma having the worst scores for all symptoms at diagnosis and patients with intrathoracic or endocrine tumors having the worst scores for all symptoms at 1 year after diagnosis. Statistically significant differences in symptom severity over the 1-year period were observed between adolescents and young adults and older adults-specifically, the odds of having moderate to severe symptoms were statistically significantly greater among adolescents and young adults with respect to pain, tiredness, nausea, depression, anxiety, and poor well-being (all P < .01). CONCLUSIONS A substantial proportion of adolescents and young adults experience moderate to severe symptoms during the year following diagnosis. Modifying existing supportive services and developing interventions based on the needs of adolescent and young adult patients with cancer could aid symptom control.
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Affiliation(s)
- Andrew Harper
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Nicole Maseja
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Reilly Parkinson
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Mohammadreza Pakseresht
- Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB, Canada
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Sarah McKillop
- Division of Hematology/Oncology, Stollery Children’s Hospital, Edmonton, AB, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jan-Willem Henning
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Linda Watson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Applied Research and Patient Experience, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Colleen Cuthbert
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Winson Cheung
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Miranda M Fidler-Benaoudia
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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4
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Henning JW, Brezden-Masley C, Gelmon K, Chia S, Shapera S, McInnis M, Rayson D, Asselah J. Managing the Risk of Lung Toxicity with Trastuzumab Deruxtecan (T-DXd): A Canadian Perspective. Curr Oncol 2023; 30:8019-8038. [PMID: 37754497 PMCID: PMC10529919 DOI: 10.3390/curroncol30090582] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/28/2023] Open
Abstract
Ongoing advances in precision cancer therapy have increased the number of molecularly targeted and immuno-oncology agents for a variety of cancers, many of which have been associated with a risk of pulmonary complications, among the most concerning being drug-induced interstitial lung disease/pneumonitis (DI-ILD). As the number of patients undergoing treatment with novel anticancer agents continues to grow, DI-ILD is expected to become an increasingly significant clinical challenge. Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate targeting human epidermal growth factor receptor 2 that is gaining widespread use in the metastatic breast cancer setting and is undergoing exploration for other oncologic indications. ILD/pneumonitis is an adverse event of special interest associated with T-DXd, which has potentially fatal consequences if left untreated and allowed to progress. When identified in the asymptomatic stage (grade 1), T-DXd-related ILD can be monitored and treated effectively with the possibility of treatment continuation. Delayed diagnosis and/or treatment, however, results in progression to grade 2 or higher toxicity and necessitates immediate and permanent discontinuation of this active agent. Strategies are, therefore, needed to optimize careful monitoring during treatment to ensure patient safety and optimize outcomes. Several guidance documents have been developed regarding strategies for the early identification and management of T-DXd-related ILD, although none have been within the context of the Canadian health care environment. A Canadian multidisciplinary steering committee was, therefore, convened to evaluate existing recommendations and adapt them for application in Canada. A multidisciplinary approach involving collaboration among medical oncologists, radiologists, respirologists, and allied health care professionals is needed to ensure the proactive identification and management of T-DXd-related ILD and DI-ILD associated with other agents with a similar toxicity profile.
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Affiliation(s)
| | | | - Karen Gelmon
- BC Cancer Agency, 600 10th Avenue West, Vancouver, BC V5Z 4E6, Canada; (K.G.); (S.C.)
| | - Stephen Chia
- BC Cancer Agency, 600 10th Avenue West, Vancouver, BC V5Z 4E6, Canada; (K.G.); (S.C.)
| | - Shane Shapera
- University Health Network, University of Toronto, Toronto General Hospital, 9N-971, 585 University Avenue, Toronto, ON M5G 2N2, Canada;
| | - Micheal McInnis
- Department of Medical Imaging, University of Toronto, 585 University Ave, Toronto, ON M5G 2N2, Canada;
| | - Daniel Rayson
- Department of Medical Oncology, Dalhousie University, QEII-Bethune Building, 1276 South Park Street, Halifax, NS B3H 2Y9, Canada;
| | - Jamil Asselah
- Cedars Cancer Centre, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC H4A 3J1, Canada;
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Henning JW, Boileau JF, Peck L, McFarlane T. Clinical Considerations for the Integration of Adjuvant Olaparib into Practice for Early Breast Cancer: A Canadian Perspective. Curr Oncol 2023; 30:7672-7691. [PMID: 37623037 PMCID: PMC10453371 DOI: 10.3390/curroncol30080556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023] Open
Abstract
With the recent Health Canada approval of olaparib for high-risk, HER2-negative early breast cancer, physicians are now facing the practical challenges of integrating olaparib into current management of triple-negative breast cancer (TNBC) and HR-positive, HER2-negative (HR+/HER2-) early breast cancer. This review provides perspectives on some of the challenges related to identification of olaparib candidates, with a focus on the latest guidance for germline BRCA testing and considerations regarding high-risk disease definitions. Updated treatment pathways are explored for both disease states, including other adjuvant treatment options such as pembrolizumab, capecitabine, and abemaciclib. Gaps in the current literature regarding the sequential or combined use of these adjuvant therapies are noted and future, potentially informative, studies are briefly examined.
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Affiliation(s)
- Jan-Willem Henning
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Jean-François Boileau
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada;
| | - Larissa Peck
- Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
| | - Tom McFarlane
- Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada;
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6
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Heer E, Ruan Y, Boyne DJ, Jarada TN, Heng D, Henning JW, Morris DM, O'Sullivan DE, Cheung WY, Brenner DR. Impact of the COVID-19 pandemic on cancer diagnoses, stage and survival in Alberta. CMAJ 2023; 195:E804-E812. [PMID: 37308211 DOI: 10.1503/cmaj.221512] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is suspected to have affected cancer care and outcomes among patients in Canada. In this study, we evaluated the impact of the state of emergency period during the COVID-19 pandemic (Mar. 17 to June 15, 2020) on cancer diagnoses, stage at diagnosis and 1-year survival in Alberta. METHODS We included new diagnoses of the 10 most prevalent cancer types from Jan. 1, 2018, to Dec. 31, 2020. We followed patients up to Dec. 31, 2021. We used interrupted time series analysis to examine the impact of the first COVID-19-related state of emergency in Alberta on the number of cancer diagnoses. We used multivariable Cox regression to compare 1-year survival of the patients who received a diagnosis during 2020 after the state of emergency with those who received a diagnosis during 2018 and 2019. We also performed stage-specific analyses. RESULTS We observed significant reductions in diagnoses of breast cancer (incidence rate ratio [IRR] 0.67, 95% confidence interval [CI] 0.59-0.76), prostate cancer (IRR 0.64, 95% CI 0.56-0.73) and colorectal cancer (IRR 0.64, 95% CI 0.56- 0.74) and melanoma (IRR 0.57, 95% CI 0.47-0.69) during the state of emergency period compared with the period before it. These decreases largely occurred among early-stage rather than late-stage diagnoses. Patients who received a diagnosis of colorectal cancer, non-Hodgkin lymphoma and uterine cancer in 2020 had lower 1-year survival than those diagnosed in 2018; no other cancer sites had lower survival. INTERPRETATION The results from our analyses suggest that health care disruptions during the COVID-19 pandemic in Alberta considerably affected cancer outcomes. Given that the largest impact was observed among early-stage cancers and those with organized screening programs, additional system capacity may be needed to mitigate future impact.
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Affiliation(s)
- Emily Heer
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Yibing Ruan
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Devon J Boyne
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Tamer N Jarada
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Daniel Heng
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Jan-Willem Henning
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Donald M Morris
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Dylan E O'Sullivan
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Winson Y Cheung
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta
| | - Darren R Brenner
- Departments of Medicine (Heer), of Oncology (Boyne, Jarada, Heng, Henning, Morris, O'Sullivan, Cheung, Brenner) and of Community Health Sciences (Cheung, Brenner), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Ruan, O'Sullivan), Cancer Control AB, Alberta Health Services, Calgary, Alta.
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7
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Yang C, Brezden-Masley C, Joy AA, Sehdev S, Modi S, Simmons C, Henning JW. Targeting HER2-low in metastatic breast cancer: an evolving treatment paradigm. Ther Adv Med Oncol 2023; 15:17588359231175440. [PMID: 37323186 PMCID: PMC10262633 DOI: 10.1177/17588359231175440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/25/2023] [Indexed: 06/17/2023] Open
Abstract
The results of the Phase III DESTINY-Breast04 trial of trastuzumab deruxtecan (T-DXd) are leading to a shift in both the classification and treatment of human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer. In this trial, T-DXd was associated with a substantial survival benefit among patients with hormone receptor-positive and hormone receptor-negative disease and low expression of HER2, a biomarker previously considered unactionable in this treatment setting. Herein, we discuss the evolving therapeutic pathway for HER2-low disease, ongoing clinical trials, and the potential challenges and evidence gaps arising with treatment of this patient population.
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Affiliation(s)
- Charlie Yang
- Tom Baker Cancer Centre, University of Calgary, 1331 29 Street NW, Calgary, AB T2N 4N2, Canada
| | | | - Anil Abraham Joy
- Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
| | | | - Shanu Modi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine Simmons
- BC Cancer Agency – Vancouver Centre, University of British Columbia, Vancouver, BC, Canada
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8
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Jerzak KJ, Bouganim N, Brezden-Masley C, Edwards S, Gelmon K, Henning JW, Hilton JF, Sehdev S. HR+/HER2- Advanced Breast Cancer Treatment in the First-Line Setting: Expert Review. Curr Oncol 2023; 30:5425-5447. [PMID: 37366894 DOI: 10.3390/curroncol30060411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
The approval of CDK4/6 inhibitors has dramatically improved care for the treatment of HR+/HER2- advanced breast cancer, but navigating the rapidly-expanding treatment evidence base is challenging. In this narrative review, we provide best-practice recommendations for the first-line treatment of HR+/HER2- advanced breast cancer in Canada based on relevant literature, clinical guidelines, and our own clinical experience. Due to statistically significant improvements in overall survival and progression-free survival, ribociclib + aromatase inhibitor is our preferred first-line treatment for de novo advanced disease or relapse ≥12 months after completion of adjuvant endocrine therapy and ribociclib or abemaciclib + fulvestrant is our preferred first-line treatment for patients experiencing early relapse. Abemaciclib or palbociclib may be used when alternatives to ribociclib are needed, and endocrine therapy can be used alone in the case of contraindication to CDK4/6 inhibitors or limited life expectancy. Considerations for special populations-including frail and fit elderly patients, as well as those with visceral disease, brain metastases, and oligometastatic disease-are also explored. For monitoring, we recommend an approach across CDK4/6 inhibitors. For mutational testing, we recommend routinely performing ER/PR/HER2 testing to confirm the subtype of advanced disease at the time of progression and to consider ESR1 and PIK3CA testing for select patients. Where possible, engage a multidisciplinary care team to apply evidence in a patient-centric manner.
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Affiliation(s)
- Katarzyna J Jerzak
- Odette Cancer Centre, Sunnybrook Health Sciences, Toronto, ON M4N 3M5, Canada
| | - Nathaniel Bouganim
- Cedars Cancer Centre, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | | | - Scott Edwards
- Dr. H. Bliss Murphy Cancer Center, St. John's, NL A1B 3V6, Canada
| | - Karen Gelmon
- Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | | | - John F Hilton
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada
| | - Sandeep Sehdev
- The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada
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9
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Grover SA, Abbott L, Berman JN, Bourque G, Chan JA, Denburg AE, Deyell RJ, Fernandez CV, Hawkins C, Henning JW, Irwin MS, Jabado N, Jones SJ, Lange PF, Moorehead P, Moran MF, Morgenstern DA, Oberoi S, Palmer A, Rassekh SR, Senger DL, Shlien A, Sinnett D, Strahlendorf C, Sullivan PJ, Taylor MD, Vercauteren S, Villani A, Villeneuve S, Whitlock JA, Malkin D. Abstract 4509: A pan-Canadian precision oncology program for children, adolescents and young adults with hard-to-cure cancer: The PRecision Oncology For Young peopLE (PROFYLE) Program. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4509] [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: 04/07/2023]
Abstract
Abstract
Background: Over 4,300 children, adolescents, and young adults (CAYA) are diagnosed with cancer each year in Canada, 1/3 of whom have refractory/metastatic disease or will relapse. The PRecision Oncology For Young peopLE (PROFYLE) national, collaborative program, was created to provide equitable access to molecular profiling to identify novel targeted treatment options in a clinically relevant timeframe for all CAYA with hard-to-cure cancers in Canada.
Design: Building upon 3 pre-existing regional precision oncology programs, PROFYLE now includes >20 institutions and has united an interdisciplinary team of experts, leaders, research teams, end-users and advocates from across Canada. The program has 14 domain specific nodes that are unified by a shared governance structure, and has harmonized biobanking, genomics, bioinformatics and reporting procedures. PROFYLE includes genomic and transcriptomic sequencing of paired germline and cancer fresh/frozen samples, proteomic analysis, and cancer modelling. Inclusion criteria: ≤29y; treatment at a Canadian center; diagnosis of a hard-to-cure cancer. Profiling results are reviewed by multidisciplinary Molecular Tumor Boards. A report including a results/recommendations summary of actionable findings (therapeutic, diagnostic, prognostic, cancer predisposition), potential targeted therapy options including available clinical trials, clarification of diagnosis, and genetic counseling recommendations is provided to the treating oncologist.
Results: >1,000 CAYA are included from all of the provinces. Cancer diagnoses: 34% sarcoma, 16% leukemia/lymphoma, 16% CNS tumor, 11% neuroblastoma, 23% other. 17% of participants had a cancer-predisposing pathogenic/likely pathogenic germline variant, 45% had ≥1 potentially actionable somatic alteration, 22.6% had a therapeutically targetable somatic alteration. The most frequent classes of therapeutic alterations were RAS/MAPK (15%), cell cycle (14%), epigenetic (13%), RTK (12%), PI3K/AKT/mTOR (11%), DNA repair (9%), immune checkpoint (8%). Of clinicians who reported the utility of results, 55% indicated the findings were useful for clinical management.
Future Directions: Collaborations with other national and international initiatives and data from this interdisciplinary, multi-institutional research program will inform the development of a framework to innovatively link research, clinical and system considerations with Canadian values relevant to multi-omic profiling and drug access for CAYA. In addition, we believe that with a comprehensive molecular view of cancer, PROFYLE will transform our understanding of underlying disease mechanisms, facilitate and improve diagnostic and prognostic indicators, and identify new therapeutic strategies and targets for CAYA patients with cancer.
Citation Format: Stephanie A. Grover, Lesleigh Abbott, Jason N. Berman, Guillaume Bourque, Jennifer A. Chan, Avram E. Denburg, Rebecca J. Deyell, Conrad V. Fernandez, Cynthia Hawkins, Jan-Willem Henning, Meredith S. Irwin, Nada Jabado, Steven J. Jones, Philipp F. Lange, Paul Moorehead, Michael F. Moran, Daniel A. Morgenstern, Sapna Oberoi, Antonia Palmer, Shahrad R. Rassekh, Donna L. Senger, Adam Shlien, Daniel Sinnett, Caron Strahlendorf, Patrick J. Sullivan, Michael D. Taylor, Suzanne Vercauteren, Anita Villani, Stephanie Villeneuve, James A. Whitlock, David Malkin, on behalf of the PROFYLE Consortium. A pan-Canadian precision oncology program for children, adolescents and young adults with hard-to-cure cancer: The PRecision Oncology For Young peopLE (PROFYLE) Program. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4509.
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Affiliation(s)
| | - Lesleigh Abbott
- 2Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Jason N. Berman
- 2Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | | | | | | | | | | | | | | | - Nada Jabado
- 8McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Paul Moorehead
- 10Janeway Health and Rehabilitation Centre, St. John’s, Newfoundland and Labrador, Canada
| | | | | | - Sapna Oberoi
- 11CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Antonia Palmer
- 12Advocacy for Canadian Childhood Oncology Research Network (Ac2orn), Toronto, Ontario, Canada
| | | | - Donna L. Senger
- 13Lady Davis Institute of Medical Research and McGill University, Montreal, Quebec, Canada
| | - Adam Shlien
- 1The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daniel Sinnett
- 14Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | | | | | | | | | - Anita Villani
- 1The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - David Malkin
- 1The Hospital for Sick Children, Toronto, Ontario, Canada
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Hurvitz S, Hegg R, Chung WP, Im SA, Jacot W, Ganju V, Chiu JWY, Xu B, Hamilton E, Madhusudan S, Iwata H, Altintas S, Henning JW, Curigliano G, Pérez-García JM, Egorov A, Liu Y, Cathcart J, Ashfaque S, Cortés J. Abstract GS2-02: GS2-02 Trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: Updated survival results of the randomized, phase 3 study DESTINY-Breast03. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-gs2-02] [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: 03/06/2023]
Abstract
Abstract
Background: Trastuzumab deruxtecan (T-DXd) is approved in the United States and European Union for use in patients (pts) with HER2+ unresectable/metastatic breast cancer (mBC) after ≥1 prior anti–HER2 regimen(s). Approval was based on the randomized, multicenter, open-label, phase 3 DESTINY-Breast03 study (NCT03529110), in which T-DXd demonstrated statistically significant and clinically meaningful improvement in progression-free survival (PFS) compared with trastuzumab emtansine (T-DM1). At the primary interim analysis (data cutoff May 21, 2021), the risk of disease progression or death was reduced by 72% with T-DXd (P < 0.001; Cortes et al. N Engl J Med 2022). Overall survival (OS) data were immature for both treatment groups; although the prespecified cutoff for significance was not reached (NR), a trend toward benefit with T-DXd was observed. With further follow-up, we report results from the prespecified OS analysis of DESTINY-Breast03 (data cutoff July 25, 2022), including updated efficacy and safety.
Methods: Pts with HER2+ mBC previously treated with trastuzumab and a taxane in either the metastatic setting or (neo)adjuvant setting with progression within 6 mo of therapy, who could have received pertuzumab, were randomly assigned 1:1 to receive T-DXd 5.4 mg/kg every 3 weeks (Q3W) or T-DM1 3.6 mg/kg Q3W until disease progression. The primary endpoint was PFS by blinded independent central review (BICR). The key secondary endpoint was OS (80% powered at 2-sided significance level of 5%); other secondary endpoints included objective response rate (ORR), duration of response (DoR), PFS based on investigator assessment, and safety.
Results: 524 pts received either T-DXd (n = 261) or T-DM1 (n = 263). As of the updated data cutoff, median duration of study follow-up was 28.4 mo (range, 0.0-46.9 mo) for T-DXd and 26.5 mo (range, 0.0-45.0 mo) for T-DM1. Median treatment duration was 18.2 mo (range, 0.7-44.0 mo) for T DXd and 6.9 mo (range, 0.7-39.3 mo) for T-DM1. The risk of death was reduced by 36% (HR, 0.64; P = 0.0037) with T-DXd; median OS (mOS) was NR (95% CI, 40.5 mo-not evaluable [NE]), with 72 (27.6%) OS events, for T-DXd vs NR (95% CI, 34.0 mo-NE), with 97 (36.9%) OS events, for T-DM1. Landmark 12-mo OS rate was 94.1% (95% CI, 90.4-96.4) for T-DXd vs 86.0% (95% CI, 81.1-89.8) for T-DM1; 24-mo OS rate was 77.4% (95% CI, 71.7-82.1) for T-DXd vs 69.9% (95% CI, 63.7-75.2) for T-DM1. The P value for OS crossed the prespecified boundary (P = 0.013) and was statistically significant. mPFS by BICR was 28.8 mo (95% CI, 22.4-37.9 mo) with T-DXd, compared with 6.8 mo (95% CI, 5.6-8.2 mo) with T-DM1; HR, 0.33; nominal P < 0.000001. Key efficacy and safety results are shown in the table. Grade ≥3 treatment-emergent adverse events were experienced by 56.4% of T-DXd-treated pts and 51.7% of T DM1-treated pts. Drug-related interstitial lung disease/pneumonitis, as evaluated by an independent adjudication committee, was experienced by 39 pts (15.2%) in the T-DXd arm and 8 pts (3.1%) in the T DM1 arm; no adjudicated drug-related grade 4 or 5 events were observed in pts who received T-DXd.
Conclusions: Updated results confirm the superiority of T-DXd compared with T-DM1 for pts with HER2+ mBC previously treated with an anti-HER2 therapy, with highly clinically meaningful and statistically significant benefit in OS and PFS and a manageable safety profile with longer treatment duration.
Editorial Acknowledgment
Under the guidance of authors, assistance in medical writing and editorial support was provided by Laura Halvorson, PhD, and Rachel Hood, PhD, of ApotheCom, and was funded by Daiichi Sankyo.
Funding
This study was funded by Daiichi Sankyo and AstraZeneca.
Table. Summary of Efficacy Results for T-DXd and T-DM1
Citation Format: Sara Hurvitz, Roberto Hegg, Wei-Pang Chung, Seock-Ah Im, William Jacot, Vinod Ganju, Joanne Win Yang Chiu, Binghe Xu, Erika Hamilton, Srinivasan Madhusudan, Hiroji Iwata, Sevilay Altintas, Jan-Willem Henning, Giuseppe Curigliano, José Manuel Pérez-García, Anton Egorov, Yali Liu, Jillian Cathcart, Shahid Ashfaque, Javier Cortés. GS2-02 Trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: Updated survival results of the randomized, phase 3 study DESTINY-Breast03 [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr GS2-02.
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Affiliation(s)
- Sara Hurvitz
- 1University of California, Los Angeles, California
| | - Roberto Hegg
- 2Clinica de Pesquisas e Centro de Estudos em Oncologia Ginecologica e Mamaria Ltda, Sao Paolo, Brazil
| | - Wei-Pang Chung
- 3National Cheng Kung University Hospital, Tainan, Taiwan (Republic of China)
| | - Seock-Ah Im
- 4Seoul National University College of Medicine, Seoul, Korea, Republic of (South), Seoul, Republic of Korea
| | - William Jacot
- 5Institut du Cancer de Montpellier, Université de Montpellier, INSERM U1194, Paris, Montpellier, Languedoc-Roussillon, France
| | - Vinod Ganju
- 6PSEHOG (Peninsula & South Eastern Haematology and Oncology Group), Frankston, VIC, Australia
| | | | - Binghe Xu
- 8Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | | | | | - Hiroji Iwata
- 11Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | | | | | | | | | | | - Yali Liu
- 17Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | | | | | - Javier Cortés
- 20International Breast Cancer Center (IBCC), Pangaea Oncology, Quironsalud Group, Madrid and Barcelona, Spain & Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
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Hurvitz SA, Hegg R, Chung WP, Im SA, Jacot W, Ganju V, Chiu JWY, Xu B, Hamilton E, Madhusudan S, Iwata H, Altintas S, Henning JW, Curigliano G, Perez-Garcia JM, Kim SB, Petry V, Huang CS, Li W, Frenel JS, Antolin S, Yeo W, Bianchini G, Loi S, Tsurutani J, Egorov A, Liu Y, Cathcart J, Ashfaque S, Cortés J. Trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: updated results from DESTINY-Breast03, a randomised, open-label, phase 3 trial. Lancet 2023; 401:105-117. [PMID: 36495879 DOI: 10.1016/s0140-6736(22)02420-5] [Citation(s) in RCA: 135] [Impact Index Per Article: 135.0] [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: 11/02/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND An improvement in progression-free survival was shown with trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer in the progression-free survival interim analysis of the DESTINY-Breast03 trial. The aim of DESTINY-Breast03 was to compare the efficacy and safety of trastuzumab deruxtecan versus trastuzumab emtansine. METHODS This open-label, randomised, multicentre, phase 3 trial was done in 169 study centres in North America, Asia, Europe, Australia, and South America. Eligible patients were aged 18 or older, had HER2-positive unresectable or metastatic breast cancer previously treated with trastuzumab and a taxane, had an Eastern Cooperative Oncology Group performance status 0-1, and at least one measurable lesion per Response Evaluation Criteria in Solid Tumours version 1.1. Patients were randomly assigned (1:1) to receive trastuzumab deruxtecan 5·4 mg/kg or trastuzumab emtansine 3·6 mg/kg, both administered by intravenous infusion every 3 weeks. Randomisation was stratified by hormone receptor status, previous treatment with pertuzumab, and history of visceral disease, and was managed through an interactive web-based system. Within each stratum, balanced block randomisation was used with a block size of four. Patients and investigators were not masked to the treatment received. The primary endpoint was progression-free survival by blinded independent central review. The key secondary endpoint was overall survival and this prespecified second overall survival interim analysis reports updated overall survival, efficacy, and safety results. Efficacy analyses were performed using the full analysis set. Safety analyses included all randomly assigned patients who received at least one dose of study treatment. This study is registered with ClinicalTrials.gov, NCT03529110. FINDINGS Between July 20, 2018, and June 23, 2020, 699 patients were screened for eligibility, 524 of whom were enrolled and randomly assigned to receive trastuzumab deruxtecan (n=261) or trastuzumab emtansine (n=263). Median duration of study follow-up was 28·4 months (IQR 22·1-32·9) with trastuzumab deruxtecan and 26·5 months (14·5-31·3) with trastuzumab emtansine. Median progression-free survival by blinded independent central review was 28·8 months (95% CI 22·4-37·9) with trastuzumab deruxtecan and 6·8 months (5·6-8·2) with trastuzumab emtansine (hazard ratio [HR] 0·33 [95% CI 0·26-0·43]; nominal p<0·0001). Median overall survival was not reached (95% CI 40·5 months-not estimable), with 72 (28%) overall survival events, in the trastuzumab deruxtecan group and was not reached (34·0 months-not estimable), with 97 (37%) overall survival events, in the trastuzumab emtansine group (HR 0·64; 95% CI 0·47-0·87]; p=0·0037). The number of grade 3 or worse treatment-emergent adverse events was similar in patients who received trastuzumab deruxtecan versus trastuzumab emtansine (145 [56%] patients versus 135 [52%] patients). Adjudicated drug-related interstitial lung disease or pneumonitis occurred in 39 (15%) patients treated with trastuzumab deruxtecan and eight (3%) patients treated with trastuzumab emtansine, with no grade 4 or 5 events in either group. INTERPRETATION Trastuzumab deruxtecan showed a significant improvement in overall survival versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer, as well as the longest reported median progression-free survival, reaffirming trastuzumab deruxtecan as the standard of care in the second-line setting. A manageable safety profile of trastuzumab deruxtecan was confirmed with longer treatment duration. FUNDING Daiichi Sankyo and AstraZeneca.
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Affiliation(s)
- Sara A Hurvitz
- Department of Medicine, Division of Hematology-Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
| | - Roberto Hegg
- Clinica de Pesquisas e Centro de Estudos em Oncologia Ginecologica e Mamaria Ltda, Sao Paolo, Brazil
| | - Wei-Pang Chung
- Department of Oncology, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Seock-Ah Im
- Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University, Seoul, South Korea
| | - William Jacot
- Institut du Cancer de Montpellier, Montpellier University, INSERM U1194, Montpellier, France
| | - Vinod Ganju
- Peninsula and South Eastern Haematology and Oncology Group, Frankston, VIC, Australia
| | - Joanne Wing Yan Chiu
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Binghe Xu
- Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Erika Hamilton
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, USA
| | - Srinivasan Madhusudan
- School of Medicine, University of Nottingham, Nottingham University Hospital, Nottingham, UK
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Sevilay Altintas
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
| | | | - Giuseppe Curigliano
- Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | - José Manuel Perez-Garcia
- International Breast Cancer Center, Pangaea Oncology, Quironsalud Group, Barcelona, Spain; Medica Scientia Innovation Research, Barcelona, Spain; Medica Scientia Innovation Research, Ridgewood, NJ, USA
| | - Sung-Bae Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Vanessa Petry
- ICESP-Instituto do Cancer do Estado de Sao Paulo Octavio Frias de Oliveria, Sao Paulo, Brazil
| | - Chiun-Sheng Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei Li
- The First Hospital of Jilin University, Changchun, China
| | | | - Silvia Antolin
- Complejo Hospitalario Universitario A Coruna, La Coruna, Spain
| | - Winnie Yeo
- Chinese University of Hong Kong, Ma Liu Shui, Hong Kong Special Administrative Region, China
| | | | - Sherene Loi
- Peter MacCallum Cancer, Melbourne, VIC, Australia
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University Hospital, Advanced Cancer Research Center, Showa University Hospital, Tokyo, Japan
| | | | - Yali Liu
- Daiichi Sankyo, Basking Ridge, NJ, USA
| | | | | | - Javier Cortés
- International Breast Cancer Center, Pangaea Oncology, Quironsalud Group, Barcelona, Spain; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
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Grover SA, Abbott L, Berman JN, Chan JA, Denburg AE, Deyell RJ, Fernandez CV, Hawkins C, Henning JW, Irwin MS, Jabado N, Jones SJ, Lange PF, Moran MF, Morgenstern DA, Palmer A, Rassekh SR, Senger DL, Shlien A, Sinnett D, Strahlendorf C, Sullivan PJ, Taylor MD, Vercauteren S, Villani A, Whitlock JA, Malkin D. Abstract 5224: The PRecision Oncology For Young peopLE (PROFYLE) Program: A national precision oncology program for children, adolescents and young adults with hard-to-cure cancer in Canada. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Over 4,300 children, adolescents, and young adults (CAYA) are diagnosed with cancer each year in Canada, 1/3 of whom have refractory/metastatic disease or will relapse. A national collaborative program, PRecision Oncology For Young peopLE (PROFYLE), was created with the goal to develop and implement a pipeline providing access to tumor molecular profiling to identify novel targeted treatment options in a clinically relevant timeframe for CAYA with hard-to-cure cancers.
Design: PROFYLE includes more than 20 institutions, building upon 3 pre-existing regional precision oncology programs (Personalized Oncogenomics (POG), SickKids Cancer Sequencing (KiCS), and Personalized Targeted Therapy in Refractory or Relapsed Cancer in Childhood (TRICEPS)). PROFYLE has united an interdisciplinary team of experts, leaders, research team, end-users and advocates from across Canada to form 14 domain specific nodes unified by a shared governance structure. PROFYLE includes genomic and transcriptomic sequencing of paired germline/cancer fresh/frozen samples. Inclusion criteria: ≤29y; treatment at a Canadian center; diagnosis of a hard-to-cure cancer. Profiling results are reviewed by multidisciplinary Molecular Tumor Boards. A report including a results/recommendations summary of actionable findings (therapeutic, diagnostic, prognostic, cancer predisposition), potential targeted therapy options including available clinical trials, clarification of diagnosis, and genetic counseling recommendations is provided to the treating oncologist.
Results: To date, >900 CAYA are enrolled. Cancer diagnoses: 36% sarcoma, 16% leukemia/lymphoma, 16% CNS tumor, 13% neuroblastoma, 19% other. At study entry, 44% of participants had not relapsed, 40% had 1 relapse, 9% 2 relapses, 4% 3+ relapses. 17% had a cancer-predisposing pathogenic/likely pathogenic germline variant, 40% had ≥1 potentially actionable somatic alteration, 9.7% had a therapeutically targetable somatic alteration. The most frequent classes of therapeutic alterations were cell cycle (15%), RAS/MAPK (14%), epigenetic (13%), RTK (12%), PI3K/AKT/mTOR (10%), DNA repair (9%), immune checkpoint (8%). Of clinicians who reported the utility of results, 56% indicated the findings were useful for clinical management.
Future Directions: With a comprehensive molecular view of cancer, PROFYLE will transform our understanding of underlying disease mechanisms, facilitate and improve diagnostic and prognostic indicators, and identify new therapeutic strategies and targets. Data from this interdisciplinary, multi-institutional research program will inform the development of a framework to innovatively link research, clinical and system considerations with Canadian values relevant to genomic profiling and drug access for CAYA in Canada.
Citation Format: Stephanie A. Grover, Lesleigh Abbott, Jason N. Berman, Jennifer A. Chan, Avram E. Denburg, Rebecca J. Deyell, Conrad V. Fernandez, Cynthia Hawkins, Jan-Willem Henning, Meredith S. Irwin, Nada Jabado, Steven J. Jones, Philipp F. Lange, Michael F. Moran, Daniel A. Morgenstern, Antonia Palmer, Shahrad R. Rassekh, Donna L. Senger, Adam Shlien, Daniel Sinnett, Caron Strahlendorf, Patrick J. Sullivan, Michael D. Taylor, Suzanne Vercauteren, Anita Villani, James A. Whitlock, David Malkin, on behalf of the Terry Fox PROFYLE Consortium. The PRecision Oncology For Young peopLE (PROFYLE) Program: A national precision oncology program for children, adolescents and young adults with hard-to-cure cancer in Canada [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5224.
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Affiliation(s)
| | - Lesleigh Abbott
- 2Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Jason N. Berman
- 2Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | | | | | | | | | | | | | - Nada Jabado
- 7McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | | | | | - Antonia Palmer
- 9Advocacy for Canadian Childhood Oncology Research Network (Ac2orn), Toronto, Ontario, Canada
| | | | - Donna L. Senger
- 10Lady Davis Institute of Medical Research and McGill University, Montreal, Quebec, Canada
| | - Adam Shlien
- 1The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daniel Sinnett
- 11Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | | | | | | | | | - Anita Villani
- 1The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - David Malkin
- 1The Hospital for Sick Children, Toronto, Ontario, Canada
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Simmons C, Rayson D, Joy AA, Henning JW, Lemieux J, McArthur H, Card PB, Dent R, Brezden-Masley C. Current and future landscape of targeted therapy in HER2-positive advanced breast cancer: redrawing the lines. Ther Adv Med Oncol 2022; 14:17588359211066677. [PMID: 35035535 PMCID: PMC8753087 DOI: 10.1177/17588359211066677] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/26/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Evidence to date supports continued human epidermal growth factor receptor 2 (HER2) suppression beyond progression on HER2-directed therapy for advanced HER2-positive breast cancer. Data from several phase II and III trials evaluating HER2-directed therapy following second-line T-DM1 have recently become available. METHODS We performed a systematic search of the published and presented literature to identify phase II and phase III trials assessing novel HER2-targeted agents as third-line therapy or beyond for HER2-positive advanced breast cancer using search terms 'breast cancer' AND 'HER2' AND 'advanced' AND ('phase II' OR 'phase III'). RESULTS Eight clinical trials reporting efficacy outcomes on third-line or greater HER2-directed therapy for HER2-positive advanced breast cancer were identified. In phase III trials, margetuximab and neratinib combinations demonstrated significant 1.3-month (hazard ratio, HR = 0.71, p < 0.001) and 0.1-month (HR = 0.76, p = 0.006) net improvements in median progression-free survival (PFS), respectively, with no significant improvements in overall survival (OS). Tucatinib added to trastuzumab and capecitabine demonstrated a significant 2.7-month improvement in median PFS (HR = 0.57, p < 0.00001) and a 5.5-month improvement in median OS (HR = 0.73, p = 0.004) in a randomized phase II trial, including significant clinical benefit for patients with brain metastases. Finally, trastuzumab-deruxtecan, zenocutuzumab, and poziotinib demonstrated benefit in phase II trials with the most robust overall response rate (62.0%) and median duration of response (18.2 months) observed for trastuzumab-deruxtecan among heavily pretreated patients. CONCLUSION Tucatinib plus trastuzumab and capecitabine significantly prolongs OS, and promising preliminary response outcomes for trastuzumab-deruxtecan suggest that sequencing of these regimens following second-line therapy is reasonable.
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Affiliation(s)
- Christine Simmons
- Medical Oncology, British Columbia Cancer
Agency – Vancouver Centre, University of British Columbia, 600 West 10th
Avenue, Vancouver, BC V5Z 4E6, Canada
| | - Daniel Rayson
- Queen Elizabeth II Health Sciences Centre,
Dalhousie University, Halifax, NS, Canada
| | - Anil Abraham Joy
- Cross Cancer Institute, University of Alberta,
Edmonton, AB, Canada
| | | | - Julie Lemieux
- Centre hospitalier universitaire de Québec,
Université Laval, Quebec, QC, Canada
| | | | - Paul B. Card
- Kaleidoscope Strategic, Inc., Toronto, ON,
Canada
| | - Rebecca Dent
- National Cancer Centre Singapore, Duke-NUS
Medical School, Singapore
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Diaz RL, Moss SJ, Amin KB, Harper AS, Henning JW, Logie N, Schulte F, McKillop SJ, Lang MJ, Fidler-Benaoudia MM. Data Resource Profile: The Alberta Adolescent and Young Adult Cancer Survivor Study. Int J Epidemiol 2021; 51:e55-e64. [PMID: 34635912 DOI: 10.1093/ije/dyab193] [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] [Received: 04/29/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ruth L Diaz
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Stephana J Moss
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Khalid B Amin
- Department of Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB, Canada
| | - Andrew S Harper
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Jan-Willem Henning
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Natalie Logie
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Fiona Schulte
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Sarah J McKillop
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Michael J Lang
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Miranda M Fidler-Benaoudia
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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15
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Hsu T, De Angelis F, Al-Asaaed S, Basi SK, Tomiak A, Grenier D, Hammad N, Henning JW, Berry S, Song X, Mukherjee SD. Ten ways to get a grip on designing and implementing a competency-based medical education training program. Can Med Educ J 2021; 12:e81-e87. [PMID: 33995724 PMCID: PMC8105576 DOI: 10.36834/cmej.70723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Globally there is a move to adopt competency-based medical education (CBME) at all levels of the medical training system. Implementation of a complex intervention such as CBME represents a marked paradigm shift involving multiple stakeholders. METHODS This article aims to share tips, based on review of the available literature and the authors' experiences, that may help educators implementing CBME to more easily navigate this major undertaking and avoid "black ice" pitfalls that educators may encounter. RESULTS Careful planning prior to, during and post implementation will help programs transition successfully to CBME. Involvement of key stakeholders, such as trainees, teaching faculty, residency training committee members, and the program administrator, prior to and throughout implementation of CBME is critical. Careful and selective choice of key design elements including Entrustable Professional Activities, assessments and appropriate use of direct observation will enhance successful uptake of CBME. Pilot testing may help engage faculty and learners and identify logistical issues that may hinder implementation. Academic advisors, use of curriculum maps, and identifying and leveraging local resources may help facilitate implementation. Planned evaluation of CBME is important to ensure choices made during the design and implementation of CBME result in the desired outcomes. CONCLUSION Although the transition to CBME is challenging, successful implementation can be facilitated by careful design and strategic planning.
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Affiliation(s)
- Tina Hsu
- Division of Medical Oncology, University of Ottawa, Ontario, Canada
| | - Flávia De Angelis
- University of Sherbrooke medical oncology program; Department of Medicine, Sherbrooke University, Quebec, Canada
| | - Sohaib Al-Asaaed
- Division of Medical Oncology, Memorial University of Newfoundland and Labrador, Newfoundland and Labrador, Canada
| | - Sanraj K Basi
- Department of Oncology, University of Alberta, Alberta, Canada
| | - Anna Tomiak
- Department of Oncology, Queen’s University, Ontario, Canada
| | - Debjani Grenier
- Section of Medical Oncology and Hematology, University of Manitoba, Manitoba, Canada
| | - Nazik Hammad
- Department of Oncology, Queen’s University, Ontario, Canada
| | | | - Scott Berry
- Department of Oncology, Queen’s University, Ontario, Canada
| | - Xinni Song
- Division of Medical Oncology, University of Ottawa, Ontario, Canada
| | - Som D Mukherjee
- Department of Oncology, McMaster University, Hamilton ON, Canada
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16
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Arora R, Kazemi G, Hsu T, Levine O, Basi SK, Henning JW, Sussman J, Mukherjee SD. Implementing changes to a residency program curriculum before competency-based medical education: a survey of Canadian medical oncology program directors. Curr Oncol 2020; 27:e614-e620. [PMID: 33380877 PMCID: PMC7755432 DOI: 10.3747/co.27.6659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Postgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature. Methods We surveyed Canadian medical oncology program directors on planned or newly implemented residency program changes in preparation for cbme. Results Prior to implementing cbme, all program directors changed at least 1 clinical rotation, most commonly making hematology/oncology (74%) entirely outpatient and eliminating radiation oncology (64%). Introductory rotations were altered to focus on common tumour sites, and later rotations were changed to increase learner autonomy. Most program directors planned to enhance resident learning with electronic teaching modules (79%), new training experiences (71%), and academic half-day changes (50%). Most program directors (64%) planned to change assessment methods to be entirely based on entrustable professional activities. All programs had developed a competence committee to review learner progress, and most (86%) had integrated academic coaches. Conclusions Transitioning to cbme led to major structural and curricular changes within medical oncology training programs. Identifying these commonly implemented changes could help other programs transition to cbme.
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Affiliation(s)
- R Arora
- Division of Medical Oncology, McMaster University, Hamilton
| | - G Kazemi
- Division of Medical Oncology, McMaster University, Hamilton
| | - T Hsu
- Division of Medical Oncology, University of Ottawa, Ottawa, ON
| | - O Levine
- Division of Medical Oncology, McMaster University, Hamilton
| | - S K Basi
- Division of Medical Oncology, University of Alberta, Edmonton
| | - J W Henning
- Division of Medical Oncology, University of Calgary, Calgary, AB
| | - J Sussman
- Division of Radiation Oncology, McMaster University, Hamilton, ON
| | - S D Mukherjee
- Division of Medical Oncology, McMaster University, Hamilton
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17
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Nadolski A, Vieira JD, Sobrin JA, Kofman AM, Ade PAR, Ahmed Z, Anderson AJ, Avva JS, Basu Thakur R, Bender AN, Benson BA, Bryant L, Carlstrom JE, Carter FW, Cecil TW, Chang CL, Cheshire JR, Chesmore GE, Cliche JF, Cukierman A, de Haan T, Dierickx M, Ding J, Dutcher D, Everett W, Farwick J, Ferguson KR, Florez L, Foster A, Fu J, Gallicchio J, Gambrel AE, Gardner RW, Groh JC, Guns S, Guyser R, Halverson NW, Harke-Hosemann AH, Harrington NL, Harris RJ, Henning JW, Holzapfel WL, Howe D, Huang N, Irwin KD, Jeong O, Jonas M, Jones A, Korman M, Kovac J, Kubik DL, Kuhlmann S, Kuo CL, Lee AT, Lowitz AE, McMahon J, Meier J, Meyer SS, Michalik D, Montgomery J, Natoli T, Nguyen H, Noble GI, Novosad V, Padin S, Pan Z, Paschos P, Pearson J, Posada CM, Quan W, Rahlin A, Riebel D, Ruhl JE, Sayre JT, Shirokoff E, Smecher G, Stark AA, Stephen J, Story KT, Suzuki A, Tandoi C, Thompson KL, Tucker C, Vanderlinde K, Wang G, Whitehorn N, Yefremenko V, Yoon KW, Young MR. Broadband, millimeter-wave antireflection coatings for large-format, cryogenic aluminum oxide optics. Appl Opt 2020; 59:3285-3295. [PMID: 32400613 DOI: 10.1364/ao.383921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/25/2020] [Indexed: 06/11/2023]
Abstract
We present two prescriptions for broadband ($ {\sim} 77 - 252\;{\rm GHz} $), millimeter-wave antireflection coatings for cryogenic, sintered polycrystalline aluminum oxide optics: one for large-format (700 mm diameter) planar and plano-convex elements, the other for densely packed arrays of quasi-optical elements-in our case, 5 mm diameter half-spheres (called "lenslets"). The coatings comprise three layers of commercially available, polytetrafluoroethylene-based, dielectric sheet material. The lenslet coating is molded to fit the 150 mm diameter arrays directly, while the large-diameter lenses are coated using a tiled approach. We review the fabrication processes for both prescriptions, then discuss laboratory measurements of their transmittance and reflectance. In addition, we present the inferred refractive indices and loss tangents for the coating materials and the aluminum oxide substrate. We find that at 150 GHz and 300 K the large-format coating sample achieves $ (97 \pm 2)\% $ transmittance, and the lenslet coating sample achieves $ (94 \pm 3)\% $ transmittance.
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18
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Deleemans JM, Chleilat F, Reimer RA, Henning JW, Baydoun M, Piedalue KA, McLennan A, Carlson LE. The chemo-gut study: investigating the long-term effects of chemotherapy on gut microbiota, metabolic, immune, psychological and cognitive parameters in young adult Cancer survivors; study protocol. BMC Cancer 2019; 19:1243. [PMID: 31870331 PMCID: PMC6927187 DOI: 10.1186/s12885-019-6473-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [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: 06/20/2019] [Accepted: 12/17/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The gut microbiota is an important modulator of immune, metabolic, psychological and cognitive mechanisms. Chemotherapy adversely affects the gut microbiota, inducing acute dysbiosis, and alters physiological and psychological function. Cancer among young adults has risen 38% in recent decades. Understanding chemotherapy's long-term effects on gut microbiota and psycho-physiological function is critical to improve survivors' physical and mental health, but remains unexamined. Restoration of the gut microbiota via targeted therapies (e.g. probiotics) could potentially prevent or reverse the psycho-physiological deficits often found in young survivors following chemotherapy, ultimately leading to reduced symptom burden and improved health. METHODS This longitudinal study investigates chemotherapy induced long-term gut dysbiosis, and associations between gut microbiota, and immune, metabolic, cognitive and psychological parameters using data collected at < 2 month (T1), 3-4 months (T2), and 5-6 months (T3) post-chemotherapy. Participants will be 18-39 year old blood or solid tumor cancer survivors (n = 50), and a healthy sibling, partner or friend as a control (n = 50). Gut microbiota composition will be measured from fecal samples using 16 s RNA sequencing. Psychological and cognitive patient reported outcome measures will include depression, anxiety, post-traumatic stress disorder symptoms, pain, fatigue, and social and cognitive function. Dual-energy X-ray Absorptiometry (DXA) will be used to measure fat and lean mass, and bone mineral concentration. Pro-inflammatory cytokines, C-reactive protein (CRP), lipopolysaccharide (LPS), serotonin, and brain derived neurotrophic factor (BDNF) will be measured in serum, and long-term cortisol will be assayed from hair. Regression and linear mixed model (LMM) analyses will examine associations across time points (T1 - T3), between groups, and covariates with gut microbiota, cognitive, psychological, and physiological parameters. CONCLUSION Knowing what bacterial species are depleted after chemotherapy, how long these effects last, and the physiological mechanisms that may drive psychological and cognitive issues among survivors will allow for targeted, integrative interventions to be developed, helping to prevent or reverse some of the late-effects of treatment that many young cancer survivors face. This protocol has been approved by the Health Research Ethics Board of Alberta Cancer Committee (ID: HREBA.CC-19-0018).
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Affiliation(s)
- Julie M. Deleemans
- Cumming School of Medicine, Division of Medical Science, University of Calgary, Calgary, Canada
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Faye Chleilat
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Raylene A. Reimer
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, Calgary, Canada
| | | | - Mohamad Baydoun
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Katherine-Ann Piedalue
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Andrew McLennan
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Linda E. Carlson
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
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19
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Raghunathan S, Patil S, Baxter E, Benson BA, Bleem LE, Crawford TM, Holder GP, McClintock T, Reichardt CL, Varga TN, Whitehorn N, Ade PAR, Allam S, Anderson AJ, Austermann JE, Avila S, Avva JS, Bacon D, Beall JA, Bender AN, Bianchini F, Bocquet S, Brooks D, Burke DL, Carlstrom JE, Carretero J, Castander FJ, Chang CL, Chiang HC, Citron R, Costanzi M, Crites AT, da Costa LN, Desai S, Diehl HT, Dietrich JP, Dobbs MA, Doel P, Everett S, Evrard AE, Feng C, Flaugher B, Fosalba P, Frieman J, Gallicchio J, García-Bellido J, Gaztanaga E, George EM, Giannantonio T, Gilbert A, Gruendl RA, Gschwend J, Gupta N, Gutierrez G, de Haan T, Halverson NW, Harrington N, Henning JW, Hilton GC, Hollowood DL, Holzapfel WL, Honscheid K, Hrubes JD, Huang N, Hubmayr J, Irwin KD, Jeltema T, Kind MC, Knox L, Kuropatkin N, Lahav O, Lee AT, Li D, Lima M, Lowitz A, Maia MAG, Marshall JL, McMahon JJ, Melchior P, Menanteau F, Meyer SS, Miquel R, Mocanu LM, Mohr JJ, Montgomery J, Moran CC, Nadolski A, Natoli T, Nibarger JP, Noble G, Novosad V, Ogando RLC, Padin S, Plazas AA, Pryke C, Rapetti D, Romer AK, Roodman A, Rosell AC, Rozo E, Ruhl JE, Rykoff ES, Saliwanchik BR, Sanchez E, Sayre JT, Scarpine V, Schaffer KK, Schubnell M, Serrano S, Sevilla-Noarbe I, Sievers C, Smecher G, Smith M, Soares-Santos M, Stark AA, Story KT, Suchyta E, Swanson MEC, Tarle G, Tucker C, Vanderlinde K, Veach T, De Vicente J, Vieira JD, Vikram V, Wang G, Wu WLK, Yefremenko V, Zhang Y. Detection of CMB-Cluster Lensing using Polarization Data from SPTpol. Phys Rev Lett 2019; 123:181301. [PMID: 31763885 DOI: 10.1103/physrevlett.123.181301] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Indexed: 06/10/2023]
Abstract
We report the first detection of gravitational lensing due to galaxy clusters using only the polarization of the cosmic microwave background (CMB). The lensing signal is obtained using a new estimator that extracts the lensing dipole signature from stacked images formed by rotating the cluster-centered Stokes QU map cutouts along the direction of the locally measured background CMB polarization gradient. Using data from the SPTpol 500 deg^{2} survey at the locations of roughly 18 000 clusters with richness λ≥10 from the Dark Energy Survey (DES) Year-3 full galaxy cluster catalog, we detect lensing at 4.8σ. The mean stacked mass of the selected sample is found to be (1.43±0.40)×10^{14}M_{⊙} which is in good agreement with optical weak lensing based estimates using DES data and CMB-lensing based estimates using SPTpol temperature data. This measurement is a key first step for cluster cosmology with future low-noise CMB surveys, like CMB-S4, for which CMB polarization will be the primary channel for cluster lensing measurements.
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Affiliation(s)
- S Raghunathan
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - S Patil
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - E Baxter
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - B A Benson
- Fermi National Accelerator Laboratory, MS209, P.O. Box 500, Batavia, Illinois 60510, USA
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - L E Bleem
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
| | - T M Crawford
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - G P Holder
- Astronomy Department, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, Illinois 61801, USA
- Department of Physics, University of Illinois Urbana-Champaign, 1110 W. Green Street, Urbana, Illinois 61801, USA
- Canadian Institute for Advanced Research, CIFAR Program in Gravity and the Extreme Universe, Toronto, Ontario M5G 1Z8, Canada
| | - T McClintock
- Department of Physics, University of Arizona, Tucson, Arizona 85721, USA
| | - C L Reichardt
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - T N Varga
- Max Planck Institute for Extraterrestrial Physics, Giessenbachstrasse, Garching 85748, Germany
- Universitäts-Sternwarte, Fakultät für Physik, LudwigMaximilians Universität München, Scheinerstr. 1, München 81679, Germany
| | - N Whitehorn
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - P A R Ade
- Cardiff University, Cardiff CF10 3XQ, United Kingdom
| | - S Allam
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
| | - A J Anderson
- Fermi National Accelerator Laboratory, MS209, P.O. Box 500, Batavia, Illinois 60510, USA
| | - J E Austermann
- NIST Quantum Devices Group, 325 Broadway Mailcode 817.03, Boulder, Colorado 80305, USA
| | - S Avila
- Instituto de Fisica Teorica UAM/CSIC, Universidad Autonoma de Madrid, 28049 Madrid, Spain
| | - J S Avva
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - D Bacon
- Institute of Cosmology & Gravitation, University of Portsmouth, Dennis Sciama Building, Burnaby Road, Portsmouth PO1 3FX, United Kingdom
| | - J A Beall
- NIST Quantum Devices Group, 325 Broadway Mailcode 817.03, Boulder, Colorado 80305, USA
| | - A N Bender
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
| | - F Bianchini
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - S Bocquet
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
- Faculty of Physics, Ludwig-Maximilians-Universität, Scheinerstr. 1, Munich 81679, Germany
| | - D Brooks
- Department of Physics & Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - D L Burke
- Kavli Institute for Particle Astrophysics & Cosmology, P. O. Box 2450, Stanford University, Stanford, California 94305, USA
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J E Carlstrom
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
- Department of Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Enrico Fermi Institute, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - J Carretero
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) 08193, Spain
| | - F J Castander
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona 08034, Spain
- Institute of Space Sciences (ICE, CSIC), Campus UAB, Carrer de Can Magrans, s/n, Barcelona 08193, Spain
| | - C L Chang
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
| | - H C Chiang
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, Scottsville 3209, South Africa
| | - R Citron
- University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - M Costanzi
- Universitäts-Sternwarte, Fakultät für Physik, Ludwig-Maximilians Universität München, Scheinerstr. 1, München 81679, Germany
| | - A T Crites
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- California Institute of Technology, MS 249-17, 1216 E. California Blvd., Pasadena, California 91125, USA
| | - L N da Costa
- Laboratório Interinstitucional de e-Astronomia-LIneA, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
- Observatório Nacional, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
| | - S Desai
- Department of Physics, IIT Hyderabad, Kandi, Telangana 502285, India
| | - H T Diehl
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
| | - J P Dietrich
- Excellence Cluster Origins, Boltzmannstr. 2, Garching 85748, Germany
- Faculty of Physics, Ludwig-Maximilians-Universität, Scheinerstr. 1, Munich 81679, Germany
| | - M A Dobbs
- Canadian Institute for Advanced Research, CIFAR Program in Gravity and the Extreme Universe, Toronto, Ontario M5G 1Z8, Canada
- Department of Physics, McGill University, 3600 Rue University, Montreal, Quebec H3A 2T8, Canada
| | - P Doel
- Department of Physics & Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - S Everett
- Santa Cruz Institute for Particle Physics, Santa Cruz, California 95064, USA
| | - A E Evrard
- Department of Astronomy, University of Michigan, Ann Arbor, Michigan 48109, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - C Feng
- Astronomy Department, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, Illinois 61801, USA
- Department of Physics, University of Illinois Urbana-Champaign, 1110 W. Green Street, Urbana, Illinois 61801, USA
| | - B Flaugher
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
| | - P Fosalba
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona 08034, Spain
- Institute of Space Sciences (ICE, CSIC), Campus UAB, Carrer de Can Magrans, s/n, Barcelona 08193, Spain
| | - J Frieman
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
- Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - J Gallicchio
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Harvey Mudd College, 301 Platt Blvd., Claremont, California 91711, USA
| | - J García-Bellido
- Instituto de Fisica Teorica UAM/CSIC, Universidad Autonoma de Madrid, 28049 Madrid, Spain
| | - E Gaztanaga
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona 08034, Spain
- Institute of Space Sciences (ICE, CSIC), Campus UAB, Carrer de Can Magrans, s/n, Barcelona 08193, Spain
| | - E M George
- Department of Physics, University of California, Berkeley, California 94720, USA
- European Southern Observatory, Karl-Schwarzschild-Str. 2, Garching bei München 85748, Germany
| | - T Giannantonio
- Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
- Kavli Institute for Cosmology, University of Cambridge, Madingley Road, Cambridge CB3 0HA, United Kingdom
| | - A Gilbert
- Department of Physics, McGill University, 3600 Rue University, Montreal, Quebec H3A 2T8, Canada
| | - R A Gruendl
- Department of Astronomy, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, Illinois 61801, USA
- National Center for Supercomputing Applications, 1205 West Clark St., Urbana, Illinois 61801, USA
| | - J Gschwend
- Laboratório Interinstitucional de e-Astronomia-LIneA, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
- Observatório Nacional, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
| | - N Gupta
- School of Physics, University of Melbourne, Parkville VIC 3010, Australia
| | - G Gutierrez
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
| | - T de Haan
- Department of Physics, University of California, Berkeley, California 94720, USA
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N W Halverson
- Department of Astrophysical and Planetary Sciences, University of Colorado, Boulder, Colorado 80309, USA
- Department of Physics, University of Colorado, Boulder, Colorado 80309, USA
| | - N Harrington
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J W Henning
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
| | - G C Hilton
- NIST Quantum Devices Group, 325 Broadway Mailcode 817.03, Boulder, Colorado 80305, USA
| | - D L Hollowood
- Santa Cruz Institute for Particle Physics, Santa Cruz, California 95064, USA
| | - W L Holzapfel
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - K Honscheid
- Center for Cosmology and Astro-Particle Physics, The Ohio State University, Columbus, Ohio 43210, USA
- Department of Physics, The Ohio State University, Columbus, Ohio 43210, USA
| | - J D Hrubes
- University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - N Huang
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J Hubmayr
- NIST Quantum Devices Group, 325 Broadway Mailcode 817.03, Boulder, Colorado 80305, USA
| | - K D Irwin
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
- Deptartment of Physics, Stanford University, 382 Via Pueblo Mall, Stanford, California 94305, USA
| | - T Jeltema
- Santa Cruz Institute for Particle Physics, Santa Cruz, California 95064, USA
| | - M Carrasco Kind
- Department of Astronomy, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, Illinois 61801, USA
- National Center for Supercomputing Applications, 1205 West Clark St., Urbana, Illinois 61801, USA
| | - L Knox
- Department of Physics, University of California, One Shields Avenue, Davis, California 95616, USA
| | - N Kuropatkin
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
| | - O Lahav
- Department of Physics & Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - A T Lee
- Department of Physics, University of California, Berkeley, California 94720, USA
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - D Li
- NIST Quantum Devices Group, 325 Broadway Mailcode 817.03, Boulder, Colorado 80305, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - M Lima
- Laboratório Interinstitucional de e-Astronomia-LIneA, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
- Departamento de Física Matemática, Instituto de Física, Universidade de São Paulo, CP 66318, São Paulo, SP 05314-970, Brazil
| | - A Lowitz
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - M A G Maia
- Laboratório Interinstitucional de e-Astronomia-LIneA, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
- Observatório Nacional, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
| | - J L Marshall
- George P. and Cynthia Woods Mitchell Institute for Fundamental Physics and Astronomy, and Department of Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - J J McMahon
- Department of Physics, University of Michigan, 450 Church Street, Ann Arbor, Michigan 48109, USA
| | - P Melchior
- Department of Astrophysical Sciences, Princeton University, Peyton Hall, Princeton, New Jersey 08544, USA
| | - F Menanteau
- Department of Astronomy, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, Illinois 61801, USA
- National Center for Supercomputing Applications, 1205 West Clark St., Urbana, Illinois 61801, USA
| | - S S Meyer
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Enrico Fermi Institute, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - R Miquel
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) 08193, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona E-08010, Spain
| | - L M Mocanu
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - J J Mohr
- Max Planck Institute for Extraterrestrial Physics, Giessenbachstrasse, Garching 85748, Germany
- Excellence Cluster Origins, Boltzmannstr. 2, Garching 85748, Germany
- Faculty of Physics, Ludwig-Maximilians-Universität, Scheinerstr. 1, Munich 81679, Germany
| | - J Montgomery
- Department of Physics, McGill University, 3600 Rue University, Montreal, Quebec H3A 2T8, Canada
| | - C Corbett Moran
- TAPIR, Walter Burke Institute for Theoretical Physics, California Institute of Technology, 1200 E California Blvd, Pasadena, California 91125, USA
| | - A Nadolski
- Astronomy Department, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, Illinois 61801, USA
- Department of Physics, University of Illinois Urbana-Champaign, 1110 W. Green Street, Urbana, Illinois 61801, USA
| | - T Natoli
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, 50 St George St, Toronto, Ontario M5S 3H4, Canada
| | - J P Nibarger
- NIST Quantum Devices Group, 325 Broadway Mailcode 817.03, Boulder, Colorado 80305, USA
| | - G Noble
- Department of Physics, McGill University, 3600 Rue University, Montreal, Quebec H3A 2T8, Canada
| | - V Novosad
- Materials Sciences Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
| | - R L C Ogando
- Laboratório Interinstitucional de e-Astronomia-LIneA, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
- Observatório Nacional, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
| | - S Padin
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- California Institute of Technology, MS 249-17, 1216 E. California Blvd., Pasadena, California 91125, USA
| | - A A Plazas
- Department of Astrophysical Sciences, Princeton University, Peyton Hall, Princeton, New Jersey 08544, USA
| | - C Pryke
- School of Physics and Astronomy, University of Minnesota, 116 Church Street S.E. Minneapolis, Minneapolis 55455, USA
| | - D Rapetti
- Department of Astrophysical and Planetary Sciences, University of Colorado, Boulder, Colorado 80309, USA
- NASA Postdoctoral Program Senior Fellow, NASA Ames Research Center, Moffett Field, California 94035, USA
| | - A K Romer
- Department of Physics and Astronomy, Pevensey Building, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - A Roodman
- Kavli Institute for Particle Astrophysics & Cosmology, P. O. Box 2450, Stanford University, Stanford, California 94305, USA
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A Carnero Rosell
- Laboratório Interinstitucional de e-Astronomia-LIneA, Rua Gal. José Cristino 77, Rio de Janeiro, RJ 20921-400, Brazil
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid 28040, Spain
| | - E Rozo
- Department of Physics, University of Arizona, Tucson, Arizona 85721, USA
| | - J E Ruhl
- Physics Department, Center for Education and Research in Cosmology and Astrophysics, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - E S Rykoff
- Kavli Institute for Particle Astrophysics & Cosmology, P. O. Box 2450, Stanford University, Stanford, California 94305, USA
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B R Saliwanchik
- Physics Department, Center for Education and Research in Cosmology and Astrophysics, Case Western Reserve University, Cleveland, Ohio 44106, USA
- Department of Physics, Yale University, P.O. Box 208120, New Haven, Connecticut 06520-8120, USA
| | - E Sanchez
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid 28040, Spain
| | - J T Sayre
- Department of Astrophysical and Planetary Sciences, University of Colorado, Boulder, Colorado 80309, USA
- Department of Physics, University of Colorado, Boulder, Colorado 80309, USA
| | - V Scarpine
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
| | - K K Schaffer
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Enrico Fermi Institute, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
- Liberal Arts Department, School of the Art Institute of Chicago, 112 S Michigan Ave, Chicago, Illinois 60603, USA
| | - M Schubnell
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - S Serrano
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona 08034, Spain
- Institute of Space Sciences (ICE, CSIC), Campus UAB, Carrer de Can Magrans, s/n, Barcelona 08193, Spain
| | - I Sevilla-Noarbe
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid 28040, Spain
| | - C Sievers
- University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - G Smecher
- Department of Physics, McGill University, 3600 Rue University, Montreal, Quebec H3A 2T8, Canada
- Three-Speed Logic, Inc., Vancouver, British Columbia V6A 2J8, Canada
| | - M Smith
- School of Physics and Astronomy, University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - M Soares-Santos
- Brandeis University, Physics Department, 415 South Street, Waltham Massachusetts 02453, USA
| | - A A Stark
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, Massachusetts 02138, USA
| | - K T Story
- Deptartment of Physics, Stanford University, 382 Via Pueblo Mall, Stanford, California 94305, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94305, USA
| | - E Suchyta
- Computer Science and Mathematics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M E C Swanson
- National Center for Supercomputing Applications, 1205 West Clark St., Urbana, Illinois 61801, USA
| | - G Tarle
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - C Tucker
- Cardiff University, Cardiff CF10 3XQ, United Kingdom
| | - K Vanderlinde
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, 50 St George St, Toronto, Ontario M5S 3H4, Canada
- Department of Astronomy and Astrophysics, University of Toronto, 50 St George St, Toronto, Ontario M5S 3H4, Canada
| | - T Veach
- Department of Astronomy, University of Maryland College Park, Maryland 20742, USA
| | - J De Vicente
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid 28040, Spain
| | - J D Vieira
- Astronomy Department, University of Illinois at Urbana-Champaign, 1002 W. Green Street, Urbana, Illinois 61801, USA
- Department of Physics, University of Illinois Urbana-Champaign, 1110 W. Green Street, Urbana, Illinois 61801, USA
| | - V Vikram
- Argonne National Laboratory, 9700 South Cass Avenue, Lemont, Illinois 60439, USA
| | - G Wang
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
| | - W L K Wu
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, Illinois 60637, USA
| | - V Yefremenko
- High Energy Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439, USA
| | - Y Zhang
- Fermi National Accelerator Laboratory, P. O. Box 500, Batavia, Illinois 60510, USA
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Chia SKL, Henning JW, Warner E, Song X, Joy AA, Califaretti N, Desbiens C, Zarate JP, Haftchenary S, Perri SR, Morin GB. Leeomic: A comprehensive proteomic analysis towards discovery of predictive patterns of protein expression to ribociclib sensitivity and resistance—A compLEEment-1 Canadian correlative sub-study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps3170] [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
TPS3170 Background: Despite developments in the treatment of advanced hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) breast cancer, primary or acquired resistance eventually occurs in all cases and there is still very limited understanding of the mechanisms of resistance to therapy. LEEOMIC is a sub-study of the main CompLEEment-1 ( N = 3255 patients enrolled, CLEE011A2404 v03) trial, an open-label, phase 3b study evaluating ribociclib + letrozole as first-line therapy in an expanded advanced breast cancer patient population which recruited over 250 Canadian patients. The purpose of this Canadian correlative sample collection study is to explore the mechanisms of response and resistance to ribociclib in combination with letrozole through proteomic and ctDNA analysis. Methods: The British Columbia Cancer Research Centre team developed a novel and optimized MS/MS platform called SP3-Clinical Tissue Proteomics (SP3-CTP) to perform in-depth proteome profiling ( > 8,000 proteins) from formalin fixed paraffin embedded (FFPE) material (10-micron section). SP3-CTP analysis of the proteome of the study patients who did not achieve clinical benefit (primary resistance: progression within 3 months of treatment) will be compared to the proteome of the sub-group of prolonged responders (time to progression of 22 months or more) in order to identify biomarkers that can predict response or de-novo resistance to therapy. Archival tumor biopsies (primary or metastatic) collected from the study will be submitted for proteomic analysis to identify proteomic expression levels that may serve as predictor of response. It is anticipated that over 150 samples will be collected. If available, blood samples taken at time of progression or end of treatment will also be analyzed for ctDNA for genetic profiling and to study if there is any correlation between genetic mutations and response or resistance to therapy. Currently, both tissue and blood samples are being collected and no analysis has been conducted thus far. Clinical trial information: NCT03613220.
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Affiliation(s)
| | | | - Ellen Warner
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Xinni Song
- The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
| | - Anil A. Joy
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
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Turner B, Alghamdi M, Henning JW, Kurien E, Morris D, Bouchard-Fortier A, Schiller D, Puloski S, Monument M, Itani D, Mack LA. Surgical excision versus observation as initial management of desmoid tumors: A population based study. Eur J Surg Oncol 2018; 45:699-703. [PMID: 30420189 DOI: 10.1016/j.ejso.2018.09.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022] Open
Abstract
SYNOPSIS Desmoid tumors can be safely managed with watchful waiting, including either observation alone or tamoxifen/NSAIDs. Surgery at first presentation can be associated with significant treatment burden. BACKGROUND Immediate surgery was historically recommended for desmoid tumors. Recently, watchful waiting, (tamoxifen/NSAIDs or observation alone), has been advocated. METHODS All diagnoses of desmoid tumor within the Alberta Cancer Registry from August 2004 to September 2015 were identified. Patients with FAP were excluded. Demographics, tumor characteristics and treatment and outcome data were collected. Outcomes were compared between immediate surgery and watchful waiting. The effect of abdominal wall site on progression and recurrence and the effect of microscopic margin on recurrence were assessed with Fisher's exact test. RESULTS We identified 111 non-FAP patients. Median follow-up was 35 months from diagnosis. 74% were female. Mean age was 42. Fifty (45%) underwent watchful waiting, of whom 21(42%) progressed, with median PFS of 10 months. Fifty-three (48%) underwent resection at presentation, of whom 8 (15%) recurred, with median disease-free survival of 22 months. Abdominal wall lesions were equally represented in both groups, and equally likely to progress on watchful waiting (50% vs 39%, p = 0.53), but there was a trend toward decreased recurrence after surgery. (5% vs 23%, p = 0.08). Microscopic margin had no effect on recurrence (14% of margin negative vs 20% of margin positive, p = 1.0). CONCLUSIONS Watchful waiting was successful in 58% of patients, and a further 28% only required one aggressive treatment thereafter, for a total of 86%. Surgery had a favorable recurrence rate (15%), but some recurrences were associated with significant treatment burden. Treatment should be tailored to individual patients in a multidisciplinary setting. A trial of observation appears warranted in most patients. Recurrence rate was not affected by positive margins.
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Affiliation(s)
- Benjamin Turner
- Head and Neck Oncologic Surgery & Microvascular Fellowship, 2nd Floor, Faculty Clinics Building University of Florida, Jacksonville 653-1 West 8th Street, Jacksonville, FL, 32209, United States.
| | - Mohamed Alghamdi
- Division of Medical Oncology, University of Calgary, Calgary, AB, Canada; Department of Medical Oncology, King Saud University, Riyadh, Saudi Arabia
| | - Jan-Willem Henning
- Division of Medical Oncology, University of Calgary, Calgary, AB, Canada
| | - Elizabeth Kurien
- Division of Radiation Oncology, University of Calgary, Calgary, AB, Canada
| | - Don Morris
- Division of Medical Oncology, University of Calgary, Calgary, AB, Canada
| | | | - Daniel Schiller
- Department of Surgery, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Shannon Puloski
- Division of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada
| | - Michael Monument
- Division of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada
| | - Doha Itani
- Department of Pathology, University of Calgary, Calgary, AB, Canada
| | - Lloyd A Mack
- Department of Surgery, University of Calgary, Calgary, AB, Canada
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Califaretti N, Bouganim N, Dent SF, Doyle C, Henning JW, Sampalis JS, Perri SR, Chia SKL. Treat ER +ight: Treatment of Canadian postmenopausal women with ER + HER2 - advanced breast cancer in the real-world setting with hormone therapy ± targeted therapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.tps614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Nathaniel Bouganim
- Department of Medical Oncology, McGill University Health Center, Montreal, QC, Canada
| | | | - Catherine Doyle
- Deschênes-Fabia Breast Cancer Center, CHU de Québec, Quebec, QC, Canada
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Hanson D, Hoover S, Crites A, Ade PAR, Aird KA, Austermann JE, Beall JA, Bender AN, Benson BA, Bleem LE, Bock JJ, Carlstrom JE, Chang CL, Chiang HC, Cho HM, Conley A, Crawford TM, de Haan T, Dobbs MA, Everett W, Gallicchio J, Gao J, George EM, Halverson NW, Harrington N, Henning JW, Hilton GC, Holder GP, Holzapfel WL, Hrubes JD, Huang N, Hubmayr J, Irwin KD, Keisler R, Knox L, Lee AT, Leitch E, Li D, Liang C, Luong-Van D, Marsden G, McMahon JJ, Mehl J, Meyer SS, Mocanu L, Montroy TE, Natoli T, Nibarger JP, Novosad V, Padin S, Pryke C, Reichardt CL, Ruhl JE, Saliwanchik BR, Sayre JT, Schaffer KK, Schulz B, Smecher G, Stark AA, Story KT, Tucker C, Vanderlinde K, Vieira JD, Viero MP, Wang G, Yefremenko V, Zahn O, Zemcov M. Detection of B-mode polarization in the cosmic microwave background with data from the South Pole Telescope. Phys Rev Lett 2013; 111:141301. [PMID: 24138230 DOI: 10.1103/physrevlett.111.141301] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Indexed: 06/02/2023]
Abstract
Gravitational lensing of the cosmic microwave background generates a curl pattern in the observed polarization. This "B-mode" signal provides a measure of the projected mass distribution over the entire observable Universe and also acts as a contaminant for the measurement of primordial gravity-wave signals. In this Letter we present the first detection of gravitational lensing B modes, using first-season data from the polarization-sensitive receiver on the South Pole Telescope (SPTpol). We construct a template for the lensing B-mode signal by combining E-mode polarization measured by SPTpol with estimates of the lensing potential from a Herschel-SPIRE map of the cosmic infrared background. We compare this template to the B modes measured directly by SPTpol, finding a nonzero correlation at 7.7σ significance. The correlation has an amplitude and scale dependence consistent with theoretical expectations, is robust with respect to analysis choices, and constitutes the first measurement of a powerful cosmological observable.
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Affiliation(s)
- D Hanson
- Department of Physics, McGill University, Montreal, Quebec H3A 2T8, Canada
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Vijay A, Duan Q, Henning JW, Duggan P, Daly A, Shafey M, Bahlis NJ, Stewart DA. High dose salvage therapy with dose intensive cyclophosphamide, etoposide and cisplatin may increase transplant rates for relapsed/refractory aggressive non-Hodgkin lymphoma. Leuk Lymphoma 2013; 54:2620-6. [DOI: 10.3109/10428194.2013.783211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Henning JW, Duan Q, Bahlis NJ, Daly A, Duggan P, Shafey M, Stewart DA. Dose-intensive cyclophosphamide, etoposide, cisplatin reinduction for relapsed/refractory aggressive non-Hodgkin lymphoma (r/r-aNHL). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.6548] [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
6548 Background: Approximately 2/3 r/r-aNHL patients (pts) respond to salvage R-ICE or R-DHAP, 1/2 proceed to autologous stem cell transplantation (ASCT), and 1/3 achieve 3 year (yr) progression-free survival (PFS); however, PFS is only 20% if prior Rituximab, time to progression (TTP)<1yr, or age-adjusted International Prognostic Index (aaIPI)=2-3 [JCO 2010;28: 4184-90]. Since 1995, we re-induced poor prognosis r/r-aNHL with dose-intensive Cyclophosphamide 5.25g/m2, Etoposide 1.05g/m2 and Cisplatin 105mg/m2 (DICEP), G-CSF days (d) 14-19, and apheresis d19,20, or 21. Rituximab was added d0,7 after 2006. Methods: We retrospectively analyzed 113 consecutive transplant eligible r/r-aNHL pts [diffuse large B-cell=95, transformed=9, peripheral T-cell=6, other=3] who received one cycle of DICEP (n=93) or R-DICEP (n=20) from 1995-2009. Patient characteristics included: median age=49yr (22-69); primary refractory=68; TTP<1yr=85; elevated LDH=60; ECOG 2-4=42; aaIPI 2-3=59; bulk>10cm=26. Results: Of 113 pts, 77% responded to DICEP and 90% (102) proceeded to ASCT. The median CD34+ cells collected was 19x106/kg (0.3-142). Early treatment-related mortality (TRM) occurred in 3 pts (2.7%), and 4 others developed late second cancers (MDS/AML=2). With 94 months median follow-up (26-194), 5 and 10yr OS rates for all 113pts are 48% and 41%, and PFS rates are 42% and 37%, respectively. 5 year PFS rates for ASCT vs no-ASCT are 46% vs 9%, for relapse aaIPI=0-1 vs aaIPI=2-3 are 53.3% vs 32.1% (p=0.01), and for TTP>1yr vs <1yr are 63.9% vs 35.2% (p=0.009). Other predictors of inferior PFS in univariate analysis were elevated LDH, ECOG 2-4, no response to DICEP; however, PFS for 27 pts who failed prior Rituximab-chemotherapy (56%) was similar to other 86 pts (38%) (logrank p=0.09). Predictors of PFS and OS in multivariate analysis include: TTP<1yr, elevated LDH, bulk, no response to DICEP. Conclusions: (R)DICEP is an effective re-induction regimen for r/r-aNHL, leading to excellent stem cell mobilization and a high chance of proceeding to ASCT. Long-term PFS and OS rates compare favourably to reports of other re-induction regimens, and a prospective multicentre trial is warranted.
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Affiliation(s)
| | - Qiuli Duan
- Tom Baker Cancer Centre, Calgary, AB, Canada
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