1
|
Lau BT, Almeda A, Schauer M, McNamara M, Bai X, Meng Q, Partha M, Grimes SM, Lee H, Heestand GM, Ji HP. Single-molecule methylation profiles of cell-free DNA in cancer with nanopore sequencing. Genome Med 2023; 15:33. [PMID: 37138315 PMCID: PMC10155347 DOI: 10.1186/s13073-023-01178-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/04/2023] [Indexed: 05/05/2023] Open
Abstract
Epigenetic characterization of cell-free DNA (cfDNA) is an emerging approach for detecting and characterizing diseases such as cancer. We developed a strategy using nanopore-based single-molecule sequencing to measure cfDNA methylomes. This approach generated up to 200 million reads for a single cfDNA sample from cancer patients, an order of magnitude improvement over existing nanopore sequencing methods. We developed a single-molecule classifier to determine whether individual reads originated from a tumor or immune cells. Leveraging methylomes of matched tumors and immune cells, we characterized cfDNA methylomes of cancer patients for longitudinal monitoring during treatment.
Collapse
Affiliation(s)
- Billy T Lau
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Alison Almeda
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Marie Schauer
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Madeline McNamara
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Xiangqi Bai
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Qingxi Meng
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Mira Partha
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Susan M Grimes
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - HoJoon Lee
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Gregory M Heestand
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
| | - Hanlee P Ji
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA.
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA.
| |
Collapse
|
2
|
Davaapil H, McNamara M, Granata A, Macrae RGC, Hirano M, Fitzek M, Aragon-Martin JA, Child A, Smith DM, Sinha S. A phenotypic screen of Marfan syndrome iPSC-derived vascular smooth muscle cells uncovers GSK3β as a new target. Stem Cell Reports 2023; 18:555-569. [PMID: 36669494 PMCID: PMC9968988 DOI: 10.1016/j.stemcr.2022.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
Marfan syndrome (MFS) is a rare connective tissue disorder caused by mutations in FBN1. Patients with MFS notably suffer from aortic aneurysm and dissection. Despite considerable effort, animal models have proven to be poorly predictive for therapeutic intervention in human aortic disease. Patient-derived induced pluripotent stem cells can be differentiated into vascular smooth muscle cells (VSMCs) and recapitulate major features of MFS. We have screened 1,022 small molecules in our in vitro model, exploiting the highly proteolytic nature of MFS VSMCs, and identified 36 effective compounds. Further analysis identified GSK3β as a recurring target in the compound screen. GSK3β inhibition/knockdown did not ameliorate the proliferation defect in MFS-VSMCs but improved MFS-VSMC proteolysis and apoptosis and partially rescued fibrillin-1 deposition. To conclude, we have identified GSK3β as a novel target for MFS, forming the foundation for future work in MFS and other aortic diseases.
Collapse
Affiliation(s)
- Hongorzul Davaapil
- Department of Medicine and Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 0AW, UK
| | - Madeline McNamara
- Department of Medicine and Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 0AW, UK
| | - Alessandra Granata
- Stroke Research Group, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Robyn G C Macrae
- Department of Medicine and Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 0AW, UK; Experimental Medicine and Immunotherapeutics, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Mei Hirano
- Department of Medicine and Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 0AW, UK
| | - Martina Fitzek
- Emerging Innovations, Discovery Sciences, R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - J A Aragon-Martin
- Department of Surgery and Cancer, Imperial College, Guy Scadding Building, London SW3 6LY, UK; The Marfan Trust, Guy Scadding Building, London SW3 6LY, UK
| | - Anne Child
- Department of Surgery and Cancer, Imperial College, Guy Scadding Building, London SW3 6LY, UK; The Marfan Trust, Guy Scadding Building, London SW3 6LY, UK
| | - David M Smith
- Emerging Innovations, Discovery Sciences, R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - Sanjay Sinha
- Department of Medicine and Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 0AW, UK.
| |
Collapse
|
3
|
Lamberson M, Radoncic V, King R, Dubuque A, Hobson S, Clouser R, Callas P, McNamara M. 299EMF Community Outreach for Patient Engagement: A Randomized Controlled Trial Using Implementation Framework. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
4
|
Almeda AF, Grimes SM, Lee H, Greer S, Shin G, McNamara M, Hooker AC, Arce MM, Kubit M, Schauer MC, Van Hummelen P, Ma C, Mills MA, Huang RJ, Hwang JH, Amieva MR, Han SS, Ford JM, Ji HP. The Gastric Cancer Registry: A Genomic Translational Resource for Multidisciplinary Research in Gastric Cancer. Cancer Epidemiol Biomarkers Prev 2022; 31:1693-1700. [PMID: 35771165 PMCID: PMC9813806 DOI: 10.1158/1055-9965.epi-22-0308] [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: 03/17/2022] [Revised: 05/10/2022] [Accepted: 06/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Gastric cancer is a leading cause of cancer morbidity and mortality. Developing information systems which integrate clinical and genomic data may accelerate discoveries to improve cancer prevention, detection, and treatment. To support translational research in gastric cancer, we developed the Gastric Cancer Registry (GCR), a North American repository of clinical and cancer genomics data. METHODS Participants self-enrolled online. Entry criteria into the GCR included the following: (i) diagnosis of gastric cancer, (ii) history of gastric cancer in a first- or second-degree relative, or (iii) known germline mutation in the gene CDH1. Participants provided demographic and clinical information through a detailed survey. Some participants provided specimens of saliva and tumor samples. Tumor samples underwent exome sequencing, whole-genome sequencing, and transcriptome sequencing. RESULTS From 2011 to 2021, 567 individuals registered and returned the clinical questionnaire. For this cohort 65% had a personal history of gastric cancer, 36% reported a family history of gastric cancer, and 14% had a germline CDH1 mutation. 89 patients with gastric cancer provided tumor samples. For the initial study, 41 tumors were sequenced using next-generation sequencing. The data was analyzed for cancer mutations, copy-number variations, gene expression, microbiome, neoantigens, immune infiltrates, and other features. We developed a searchable, web-based interface (the GCR Genome Explorer) to enable researchers' access to these datasets. CONCLUSIONS The GCR is a unique, North American gastric cancer registry which integrates clinical and genomic annotation. IMPACT Available for researchers through an open access, web-based explorer, the GCR Genome Explorer will accelerate collaborative gastric cancer research across the United States and world.
Collapse
Affiliation(s)
- Alison F. Almeda
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Susan M Grimes
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - HoJoon Lee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Stephanie Greer
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - GiWon Shin
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Madeline McNamara
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Anna C Hooker
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Maya M Arce
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Matthew Kubit
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Marie C Schauer
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Paul Van Hummelen
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Cindy Ma
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Meredith A. Mills
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Robert J. Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Joo Ha Hwang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Manuel R. Amieva
- Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Summer S Han
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - James M. Ford
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| | - Hanlee P. Ji
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, United States
| |
Collapse
|
5
|
Kerr-Wilson C, Kellison L, McNamara M. Management of Atypical Endometrial Hyperplasia with a Focus on Conservative Treatment. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
6
|
Broadbent R, Wheatley R, Stajer S, Jacobs T, Lamarca A, Hubner R, Valle J, Amir E, McNamara M. P-53 Prognostic factors for relapse in resected gastroenteropancreatic neuroendocrine neoplasms: A systematic review and meta-analysis. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
7
|
Edeline J, Lamarca A, McNamara M, Jacobs T, Hubner R, Palmer D, Johnson P, Guiu B, Valle J. P-229 Systematic review and pooled analysis of locoregional therapies in patients with intrahepatic cholangiocarcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
8
|
Collins PM, Elliott JA, Brennan MJ, McNamara M, O'Malley E, Barry K, Sweeney K, Malone C, Lowery A, McLaughlin R, Kerin MJ. O78: SARCOPENIA IN LOCALLY ADVANCED BREAST CANCER: PREVALENCE, AND IMPACT ON CLINICAL AND ONCOLOGIC OUTCOMES. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Sarcopenia in cancer may confer negative outcomes, but its prevalence and impact in the modern multimodal management of locally advanced breast cancer have not been systematically studied.
Method
Patients undergoing neoadjuvant therapy and surgery for locally advanced breast cancer between 2010 and 2015 were studied. Skeletal muscle index (SMI) and lean body mass (LBM) were determined. Sarcopenia was defined by computed tomography (CT) at L3 as SMI<38.5cm2/m2. Multivariable linear, logistic, and Cox regression analysis was undertaken to determine the independent impact of sarcopenia on clinical and oncologic outcome.
Result
258 patients were studied. Sarcopenia was present in 23.0%, 7.8% and 0.0% of patients with normal weight, overweight and obesity, respectively (P=0.001). Sarcopenia was not associated with baseline cT and cN stage, tumour grade, histologic type or receptor status. Patients with sarcopenia exhibited equivalent indices of neoadjuvant therapy response including ypT and ypN stage, pathologic complete response and Sataloff grade following surgical resection. Postoperatively, sarcopenia was not independently associated with comprehensive complications index (P=0.242), length of stay (P=0.716) or overall morbidity (P=0.365). However, on multivariable analysis, lower LBM independently predicted reduced invasive disease-free (P=0.049,HR0.93[95%CI0.87-1.00]) and overall (P=0.028,HR0.92[0.85-0.99]), but not disease-specific survival (P=0.070).
Conclusion
Consistent with a lack of association with baseline and post-treatment pathologic features, sarcopenia in locally advanced breast cancer is associated with reduced overall, but not disease-specific, survival. These data indicate that the prognostic impact of sarcopenia may be mediated by impaired performance status and increased non-cancer mortality.
Take-home message
Consistent with a lack of association with baseline and post-treatment pathologic features, sarcopenia in locally advanced breast cancer is associated with reduced overall, but not disease-specific, survival. These data indicate that the prognostic impact of sarcopenia may be mediated by impaired performance status and increased non-cancer mortality.
Collapse
Affiliation(s)
- PM Collins
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - JA Elliott
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - MJ Brennan
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - M McNamara
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - E O'Malley
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | | | - K Sweeney
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - C Malone
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - A Lowery
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
- Lambe Institute for Translational Research, National University of Ireland Galway, University Road, Galway, Ireland
| | - R McLaughlin
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - MJ Kerin
- Department of Breast Surgery, University Hospital Galway, Galway, Ireland
- Lambe Institute for Translational Research, National University of Ireland Galway, University Road, Galway, Ireland
| |
Collapse
|
9
|
Azizi A, Lamarca A, McNamara M, Valle J. PD-1 Systematic review and meta-analysis of the efficacy of chemotherapeutic regimens in advanced gallbladder cancer: Assessing current practice and treatment benefit. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
10
|
Pihlak R, Frizziero M, Mak S, Nuttall C, Lamarca A, Hubner R, Yorke J, Valle J, McNamara M. P-274 RELEVANT study: Patient and physician perspectives on clinically-meaningful outcomes in advanced pancreatic ductal adenocarcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
11
|
Malik A, Lamarca A, Siriwardena A, O'Reilly D, Deshpande R, Satyadas T, Sheen A, Jamdar S, McNamara M, Richard H, Valle J, De Liguori Carino N. The treatment of pancreatic ductal adenocarcinoma with curative intent: is age a barrier to adjuvant chemotherapy? Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
12
|
Marti FM, McGurk A, Alam N, Bhatt L, Braun M, Hubner R, Mansoor W, McBain C, McNamara M, Mullamitha S, Saunders M, Sheikh H, Thistlethwaite F, Valle J, Wilson G, Hasan J. 30-day mortality associated with systemic anti-cancer therapy (SACT) in gastrointestinal malignancies: The Christie experience. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
13
|
Berriochoa C, Balagamwala E, Reddy C, Stephans K, Leyrer C, Sohal D, Adelstein D, McNamara M, Juloori A, Raymond D, Murthy S, Raja S, Videtic G. The Role of Adjuvant Therapy for Patients With Early Esophageal Cancer Who Are Pathologically Upstaged Following Esophagectomy: An NCDB Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
14
|
Cordero F, Burnett O, McNamara M, Weber T, Zarzour J, Jang S, Barrett O, Kim R. Incidence of Mesorectal Nodal Metastasis in Vaginal and Cervical Cancer: Its Clinical Implication. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
15
|
Berriochoa C, Balagamwala E, Leyrer C, Reddy C, Videtic G, Sohal D, Adelstein D, McNamara M, Murthy S, Raymond D, Raja S, Stephans K. Definitive Radiation Therapy for Patients with Metastatic Esophageal Squamous Cell Carcinoma Improves Survival: An NCDB Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
16
|
Galdy S, Lamarca A, McNamara M, Hubner R, Cella C, Fazio N, Valle J. HER2/HER3 pathway in biliary tract cancers: A systematic review and meta-analysis. A novel therapeutic druggable target? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
Galdy S, Lamarca A, McNamara M, Hubner R, Cella C, Fazio N, Valle J. HER2/HER3 pathway in biliary tract cancers: a systematic review and meta-analysis. A novel therapeutic druggable target? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
18
|
McNamara M, Ernst I, Adlard RD. Using the Neptune project to benefit Australian aquatic animal health research. Dis Aquat Organ 2015; 115:1-8. [PMID: 26119294 DOI: 10.3354/dao02876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Diseases of aquatic animals have had, and continue to have, a significant impact on aquatic animal health. In Australia, where fisheries and aquaculture are important industries, aquatic species have been subject to serious disease outbreaks, including pilchard herpesvirus, the cause of one of the largest wild fish kills ever recorded. At the same time, there is a consensus that Australia's parasite fauna are largely unknown, and that aquatic animal health information is difficult to access. Managing aquatic animal diseases is challenging because they may be entirely new, their hosts may be new to aquaculture, and specialist expertise and basic diagnostic tools may be lacking or absent. The Neptune project was created in response to these challenges, and it aims to increase awareness of aquatic animal diseases, improve disease management, and promote communication between aquatic animal health professionals in Australia. The project consists of an online database, a digital microscopy platform containing a whole-slide image library, a community space, and online communications technology. The database contains aquatic animal health information from published papers, government reports, and other sources, while the library contains slides of key diseases both endemic and exotic to Australia. These assets make Neptune a powerful resource for researchers, students, and biosecurity officials.
Collapse
Affiliation(s)
- M McNamara
- Natural Environments Program, Queensland Museum, South Brisbane, Queensland 4101, Australia
| | | | | |
Collapse
|
19
|
Rigby C, Lamarca A, McNamara M, OReilly D, Siriwardena A, Hubner R, Valle J. P-169 Adjuvant capecitabine: safe and tolerable option for adjuvant treatment in patients with resected pancreas and ampullary adenocarcinoma. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
20
|
Slagter A, McNamara M, Ryder D, Lamarca A, Hubner R, Mansoor W, OReilly D, Fulford P, Klumpen HJ, Valle J. P-123 Prognostic factors for disease relapse in patients with neuroendocrine tumours who underwent curative surgery. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
21
|
Hill S, McNamara M, Seals D, Kaplon R. Endothelial Cell Senescence with Age is Associated with Oxidative Stress‐Mediated Suppression of Endothelial Function in Healthy Adults. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.lb572] [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: 11/11/2022]
Affiliation(s)
- S Hill
- Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - M McNamara
- Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - D Seals
- Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - R Kaplon
- Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| |
Collapse
|
22
|
Mason M, McNamara M, Tieu M, Lwin Z, Millar BA, Menard C, Lapperiere N, Milosevic M, Mason W, Chung C. RT-19 * PROGNOSTIC VALUE OF EARLY CHANGES IN NEUTROPHIL AND LYMPHOCYTE MEASURES DURING CHEMORADIOTHERAPY FOR GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
23
|
Gregorio B, Beardsall M, Gallagher L, McNamara M, Tsang B. CASE ROUNDS: AN INTERDISCIPLINARY PATIENT QUALITY AND SAFETY INITIATIVE. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
24
|
Grunnet M, Christensen I, Lassen U, Jensen L, Lydolph M, Knox J, McNamara M, Jital M, Wasan H, Bridgewater J, Valle J, Mau-Sørensen M. Decline in CA19-9 During Chemotherapy Predicts Survival in Four Independent Cohorts of Patients with Inoperable Cholangiocarcinoma. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu164.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
25
|
McNamara M, Thornburg J, Semmens E, Ward T, Noonan C. Coarse particulate matter and airborne endotoxin within wood stove homes. Indoor Air 2013; 23:498-505. [PMID: 23551341 PMCID: PMC4556095 DOI: 10.1111/ina.12043] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 03/09/2013] [Indexed: 05/08/2023]
Abstract
Emissions from indoor biomass burning are a major public health concern in developing areas of the world. Less is known about indoor air quality, particularly airborne endotoxin, in homes burning biomass fuel in residential wood stoves in higher income countries. A filter-based sampler was used to evaluate wintertime indoor coarse particulate matter (PM₁₀₋₂.₅) and airborne endotoxin (EU/m³, EU/mg) concentrations in 50 homes using wood stoves as their primary source of heat in western Montana. We investigated number of residents, number of pets, dampness (humidity), and frequency of wood stove usage as potential predictors of indoor airborne endotoxin concentrations. Two 48-h sampling events per home revealed a mean winter PM₁₀₋₂.₅ concentration (± s.d.) of 12.9 (± 8.6) μg/m³, while PM₂.₅ concentrations averaged 32.3 (± 32.6) μg/m³. Endotoxin concentrations measured from PM₁₀₋₂.₅ filter samples were 9.2 (± 12.4) EU/m³ and 1010 (± 1524) EU/mg. PM₁₀₋₂.₅ and PM₂.₅ were significantly correlated in wood stove homes (r = 0.36, P < 0.05). The presence of pets in the homes was associated with PM₁₀₋₂.₅ but not with endotoxin concentrations. Importantly, none of the other measured home characteristics was a strong predictor of airborne endotoxin, including frequency of residential wood stove usage.
Collapse
Affiliation(s)
- M. McNamara
- Department of Biomedical and Pharmaceutical Sciences, Center for Environmental Health Sciences, University of Montana, Missoula, MT, USA
| | - J. Thornburg
- RTI International, Research Triangle Park, NC, USA
| | - E. Semmens
- Department of Biomedical and Pharmaceutical Sciences, Center for Environmental Health Sciences, University of Montana, Missoula, MT, USA
| | - T. Ward
- Department of Biomedical and Pharmaceutical Sciences, Center for Environmental Health Sciences, University of Montana, Missoula, MT, USA
| | - C. Noonan
- Department of Biomedical and Pharmaceutical Sciences, Center for Environmental Health Sciences, University of Montana, Missoula, MT, USA
| |
Collapse
|
26
|
McNamara M, Antun A, Kempton CL. The role of disease severity in influencing body mass index in people with haemophilia: a single-institutional cross-sectional study. Haemophilia 2013; 20:190-5. [PMID: 24118577 DOI: 10.1111/hae.12279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2013] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the effect of haemophilia disease severity and potential intermediaries on body mass index (BMI) in patients with haemophilia. A secondary analysis of a cross-sectional study of 88 adults with haemophilia was undertaken. On bivariate analysis, persons with severe haemophilia had 9.8% lower BMI (95% CI -17.1, -3.0) than persons with non-severe haemophilia. The effect of haemophilia severity on BMI varied significantly by human immunodeficiency virus (HIV) status. Among HIV-positive subjects, haemophilia severity was not associated with BMI (+5.0%, 95% CI -22.4, 41.9). Among HIV-negative subjects, severe haemophilia was associated with 15.1% lower BMI (95% CI, -23.6, -5.7). Older (>41 years) HIV-negative subjects with severe haemophilia had a BMI that was 24.8% lower (95% CI -39.1, -7.0) than those with non-severe haemophilia. No statistically significant association was detected between BMI and severe vs. non-severe haemophilia for younger HIV-negative subjects. Although joint disease, as measured by the World Federation of Hemophilia (WFH) joint score, did not influence the association between haemophilia disease severity and BMI, adjustment for the atrophy component of the WFH score reduced the association between haemophilia severity and BMI by 39.1-69.9%. This suggested that muscle atrophy mediated at least part of the relationship between haemophilia severity and BMI. Haemophilia disease severity is associated with BMI and appears to be mediated by muscle atrophy of surrounding joints. This association appears to be modified by HIV status and possibly age.
Collapse
Affiliation(s)
- M McNamara
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | |
Collapse
|
27
|
McNamara M, Lwin Z, Jiang H, Chung C, Millar B, Laperriere N, Mason W. Conditional Probability of Survival in Patients with Glioblastoma Multiforme in the Temozolomide Treatment Era. Ann Oncol 2012. [DOI: 10.1093/annonc/mds394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
28
|
Somlo G, Martel CL, Lau SK, Frankel P, Ruel C, Gu L, Hurria A, Chung C, Luu T, Morgan R, Leong L, Koczywas M, McNamara M, Russell CA, Kane SE. A phase I/II prospective, single arm trial of gefitinib, trastuzumab, and docetaxel in patients with stage IV HER-2 positive metastatic breast cancer. Breast Cancer Res Treat 2011; 131:899-906. [PMID: 22042372 DOI: 10.1007/s10549-011-1850-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 10/19/2011] [Indexed: 10/16/2022]
Abstract
Inhibition of the HER-2 pathway via the monoclonal antibody trastuzumab has had a major impact in treatment of HER-2 positive breast cancer, but de novo or acquired resistance may reduce its effectiveness. The known interplay between the epidermal growth factor receptor (EGFR) and HER-2 receptors and pathways creates a rationale for combined anti-EGFR and anti-HER-2 therapy in HER-2 positive metastatic breast cancer (MBC), and toxicities associated with the use of multiple chemotherapeutic agents together with biological therapies may also be reduced. We conducted a prospective, single arm, phase I/II trial to determine the efficacy and toxicity of the combination of trastuzumab with the EGFR inhibitor gefitinib and docetaxel, in patients with HER-2 positive MBC. The maximum tolerated dose (MTD) was determined in the phase I portion. The primary end point of the phase II portion was progression-free survival (PFS). Immunohistochemical analysis of biomarker expression of the PKA-related proteins cAMP response element-binding protein (CREB), phospho-CREB and DARPP-32 (dopamine and cAMP-regulated phosphoprotein of 32 kDa) plus t-DARPP (the truncated isoform of DARPP-32); PTEN; p-p70 S6K; and EGFR was conducted on tissue from metastatic sites. Nine patients were treated in the phase I portion of the study and 22 in the phase II portion. The MTD was gefitinib 250 mg on days 2-14, trastuzumab 6 mg/kg, and docetaxel 60 mg/m(2) every 21 days. For the 29 patients treated at the MTD, median PFS was 12.7 months, with complete and partial response rates of 18 and 46%, and a stable disease rate of 29%. No statistically significant correlation was found between response and expression of any biomarkers. We conclude that the combination of gefitinib, trastuzumab, and docetaxel is feasible and effective. Expression of the biomarkers examined did not predict outcome in this sample of HER-2 overexpressing metastatic breast cancer.
Collapse
Affiliation(s)
- G Somlo
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Duarte, California, 91010, USA,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Murphy R, Green S, Ritter G, Cohen L, Ryan D, Woods W, Rubira M, Cebon J, Davis ID, Sjolander A, Kypridis A, Kalnins H, McNamara M, Moloney MB, Ackland J, Cartwright G, Rood J, Dumsday G, Healey K, Maher D, Maraskovsky E, Chen YT, Hoffman EW, Old LJ, Scott AM. Recombinant NY‐ESO‐1 Cancer Antigen: Production and Purification under cGMP Conditions. Prep Biochem Biotechnol 2010; 35:119-34. [PMID: 15881594 DOI: 10.1081/pb-200054732] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The cancer-testis antigen, NY-ESO-1, has been engineered into a bacterial expression plasmid which incorporates a His6-tag. The plasmid was transfected into E. coli strain BL21 and Master and Working cell banks generated from this expression system. Three 15-litre fermentations were performed under cGMP (code of Good Manufacturing Practice) conditions and the crude NY-ESO-1 tagged protein isolated as solubilised inclusion bodies. A three-step cGMP chromatography process (immobilised metal affinity, anion exchange, and hydrophobic interaction) was utilised to purify the protein. The purified NY-ESO-1 is being used in early stage human cancer vaccine trials in Australia and the U.S.A.
Collapse
Affiliation(s)
- R Murphy
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Austin Hospital, Heidelberg, Australia.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Haas DM, Sabi F, McNamara M, Rivera-Alsina M. Comparing ambulatory spot urine protein/creatinine ratios and 24-h urine protein measurements in normal pregnancies. J Matern Fetal Neonatal Med 2009; 14:233-6. [PMID: 14738168 DOI: 10.1080/jmf.14.4.233.236] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine whether a single specimen protein/creatinine ratio correlated with a 24-h urine protein measurement in ambulatory women with normal pregnancies. METHODS A prospective cohort was evaluated of healthy women performing a 24-h urine collection and spot urine measurement for protein and creatinine in each trimester and the postpartum period. Data were analyzed to establish the correlation of values and the reliability of cut-off values. RESULTS Fifty-eight women were enrolled in the study. Thirty-three completed at least one measurement. Three (5.1%) developed pre-eclampsia. With the use of linear regression, the spot protein/creatinine ratio correlated with the 24-h protein measurement in the first trimester and postpartum periods only (p < 0.001 and p < 0.043, respectively). It did not correlate in the second or third trimester (p = 0.637 and p = 0.290, respectively). CONCLUSION In this population, the protein/creatinine ratio correlated only with the 24-h urine protein measurement in the first trimester and postpartum periods. In the periods of pregnancy where physiological changes are most prevalent, the ratio does not predict total urinary protein reliably.
Collapse
Affiliation(s)
- D M Haas
- Department of Obstetrics and Gynecology, Naval Medical Center, San Diego, California 92134-1005, USA
| | | | | | | |
Collapse
|
31
|
Abstract
e20691 Background:Febrile neutropenia (F/N) is a relatively common and serious side effect for oncology patients undergoing chemotherapy. Due to varying dosages and frequency of cytotoxic agents administered to oncology patients, the incidence and grade of neutropenia varies. The purpose of this study was to establish the frequency of febrile neutropenia in different chemotherapy regimens. Methods: Data was collected on 343 patients who underwent chemotherapy over a 9 month period. Regimens that caused at least one episode of febrile neutropenia in patients within that period were assessed in the study. A list of the patients on identified chemotherapy regimens during the time period was generated by the pharmacy department. Data on patients who had febrile neutropenia was obtained from their clinical notes. Clinical data was then obtained on all those patients. This information was then used to compare the frequency of febrile neutropenia in the included chemotherapy regimens. Results: 343 patients were included in this study. Of those, 41 patients developed febrile neutropenia within the 9 month period (11%); there were 49 cases of febrile neutropenia (14%) in total as some patients had more than one episode. Conclusions: Febrile neutropenia (FN) is a known potential side-effect from treatment with chemotherapy. This study highlights the rates of FN in patients treated within one centre. In patients being treated with specific chemotherapy regimens this study may guide the increased use of G-CSF and better outline the risk profile of such therapy to patients. [Table: see text] No significant financial relationships to disclose.
Collapse
Affiliation(s)
- K. Chohan
- Beaumont Hospital Cancer Centre, Dublin, Ireland
| | - D. Lai
- Beaumont Hospital Cancer Centre, Dublin, Ireland
| | - M. McNamara
- Beaumont Hospital Cancer Centre, Dublin, Ireland
| | - L. Grogan
- Beaumont Hospital Cancer Centre, Dublin, Ireland
| | | |
Collapse
|
32
|
Chung VM, Ruel C, Cristea M, Luu TH, Leong L, McNamara M, Martel C, Lim D, Twardowski P, Morgan RJ. Randomized pilot trial of oral cyclophosphamide versus oral cyclophosphamide with celecoxib for recurrent or persistent epithelial ovarian, fallopian tube or primary peritoneal cancer: preliminary data. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
33
|
Herring A, McNamara M, Ortiz P. 294: Emergency Medicine and Surveillance of Emerging Populations: The Case of Migrant Ngwabe in Costa Rica. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
Reynolds CP, Frgala T, Tsao-Wei DD, Groshen S, Morgan R, McNamara M, Scudder S, Zwiebel JA, Lenz HJ, Garcia AA. High plasma levels of fenretinide (4-HPR) were associated with improved outcome in a phase II study of recurrent ovarian cancer: A study by the California Cancer Consortium. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5555] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5555 Background: 4-HPR is a synthetic retinoid with dose-dependent cytotoxicity in vitro for ovarian cancer cell lines, especially at concentrations > 10 μM. We previously reported preliminary results of a phase II trial (Garcia et al, Proc ASCO 2004: a5056) that showed encouraging stabilization of disease. Methods: 4-HPR capsules were given orally (900 mg/m2/bid for 7 days every 21-days) to women with recurrent ovarian cancer. Steady-state plasma concentrations of 4-HPR were determined by HPLC. Patients were required to have uni-dimensionally measurable disease, 0–2 chemotherapy regimens for recurrent disease, and performance status 0–2. The primary endpoint was response rate by RECIST criteria; secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: 31 patients were enrolled to the first stage; 28 patients were evaluable for response, with a median of 3 prior chemotherapy regimens (range: 1–3); 24 patients were evaluable for pharmacokinetics. A total of 172 4-HPR treatment cycles were given. Eleven patients experienced at least one grade 3 toxicity and one patient had grade 4 fatigue. No objective responses were observed, leading to study closure. Best response was stable disease in 13 patients (42%) with a median duration of 7.9 months (2.1–25.8 months). 4-HPR steady-state plasma levels ranged from 3.1–12.5 μM. PFS at 6 months was 26% (± 0.08 SE), 42 % (± 0.14 SE) for patients with 4-HPR plasma levels = 9 μM (n=12), and 17% (± 0.11 SE) for plasma levels < 9 μM (n=12). OS with plasma levels = 9 μM was significantly higher than for those with 4-HPR levels < 9 μM (66% vs. 13% at 18 months, adjusted p-value = 0.016). Conclusions: 4-HPR may provide clinical benefit to patients with recurrent ovarian cancer who obtain high 4-HPR plasma levels. Trials in ovarian cancer of 4-HPR focused on progression-free survival as an endpoint are justified using formulations with improved bioavailability. Supported by N01-CM-62209. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- C. P. Reynolds
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - T. Frgala
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - D. D. Tsao-Wei
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - S. Groshen
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - R. Morgan
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - M. McNamara
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - S. Scudder
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - J. A. Zwiebel
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - H. J. Lenz
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| | - A. A. Garcia
- Children’s Hospital of Los Angeles, Los Angeles, CA; Univ of Southern Calif Keck School of Medicine, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Univ of California Davis School of Medicine, Sacramento, CA; National Cancer Institute, Bethesda, MD; Premiere Oncology, Santa Monica, CA
| |
Collapse
|
35
|
Somlo G, Koczywas M, Luu T, McNamara M, Bedell V, Slovak ML, Wilczynski S, Morgan R, Russell C, Frankel P. The combination of the HER2 antibody trastuzumab, the EGFR tyrosine kinase inhibitor gefitinib, and docetaxel as first-line therapy in patients with HER2 overexpressing stage IV breast carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1057 Background: Interference with both HER2 and epidermal growth factor (EGFR) dependent pathways may improve therapeutic efficacy of docetaxel (doc) in pts with HER2 overexpressing (+) BC. Methods: Patients (pts) without prior chemotherapy (Rx) exposure for stage IV HER-2 + BC were enrolled. Prior hormonal or adjuvant Rx inclusive of taxane or trastuzumab (tras) were allowed. A left ventricular ejection fraction of > 45% and ECOG performance status of ≥ 2 were required. Pts were to receive doc 75 m2, tras every 3 weeks, and gefitinib (gef) 250 mg daily. BC samples from 12 pts were analyzed by FISH for HER2 and EGFR amplification (amp), and topoisomerase II (topo II) amp or loss. IHC was to be performed to examine p-Src, p-STAT3, Ki67 and survivin expression. Results: The median age was 49 (range, 34–67) and ECOG performance status 0.5 (0–1). The first 9 patients received gef 250 mg daily; 2 pts received dox 75 mg/m2 and developed grade 3 febrile neutropenia (neu), hence, additional pts received doc at 60 mg/m2: 3 more episodes of grade 3 neu were seen. Gef was held due to grade 3 dermatitis (2 pts) and diarrhea (2 pts). Pts received a median of 6 cycles (3–10). Gef schedule then was changed, and was prescribed on days 2–14, only. Three of the next 9 pts experienced grades 3 or 4 neu, and we observed 3 cases of grade 3 gastrointestinal toxicities; pts were able to receive 11 + (range; 5–25+) cycles on this schedule (p<0.04). There were 4 complete (CR)and 6 partial R (23 % CR, 59 % overall R), and 3 pts had stable disease (SD; all R and SD confirmed); 3 pts progressed at 4, 4, and 5 mos, 1 pt was inevaluable. The median time to progression is 12 + mos. Samples from 3 pts revealed topo II amplification and one pt sample showed loss of one topo II allele; none were amplified for EGFR. Outcome will be correlated with IHC defined signal trasduction status and proliferation rates. Conclusions: The combination of doc, tras, and short course of gef is feasible, with encouraging R and SD rates and time to progression. Further exploration of simultaneous blockage of multiple signal transduction pathways is indicated in combination with chemoRx. Supported by NCI CA33572 and by a grant from AstraZeneca. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- G. Somlo
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - M. Koczywas
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - T. Luu
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - M. McNamara
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - V. Bedell
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - M. L. Slovak
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - S. Wilczynski
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - R. Morgan
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - C. Russell
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| | - P. Frankel
- City of Hope National Medical Center, Duarte, CA; University of Southern California, Los Angeles, CA
| |
Collapse
|
36
|
Luu TH, Leong L, Morgan R, McNamara M, Lim D, Portnow J, Frankel P, Aparicio A, Chew H, Gandara DR, Somlo G. Vorinostat (suberoylanilide hydroxamic acid) as salvage therapy in metastatic breast cancer (MBC): A California Cancer Consortium phase II study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11502 Background: MBC patients (pts) have a median survival of 27 mo. Vorinostat is a small molecule inhibitor of histone deacetylase that exerts its targeted action during post-translational acetylation of core nucleosomal histones, affecting chromatin structure, thereby regulating genes implicated in cell survival, proliferation, differentiation, and apoptosis. The primary end point was to evaluate the response rate. Secondary endpoints included: time to progression, overall survival, toxicity, and assessment of biologic correlates. Method: From 6/05 to 3/06, we enrolled 14 pts with measurable MBC. Response and progression were evaluated using RECIST criteria. Two pts had no, 5 pts had one, and 7 pts had two prior regimens. Median age was 60.5 years (37- 89). Six were ER/PR positive, four were Her2neu overexpressers. Sites of metastatic disease included brain (1), liver, lungs, and bone (5), pelvic and chest wall (1), liver and bone (2), distant lymph nodes (3), pleura and bone (1). Pts received Vorinostat 200mg oral twice daily for 14 of 21 days per cycle. Tumor measurements were performed after every 2 cycles. Biopsies (pre and on-treatment) were collected from 6 of 14 pts. Results: The mean cycles delivered was 5 (range: 1–18). Four pts had SD for a median of >8.7 mo (4–13 mo); 1 pt with ER/PR/Her2neu negative tumor who received no prior treatment for MBC to mediastinal nodes and chest wall continues to receive treatment having completed cycle 18 with stable disease for >11.4 mo. The median duration on treatment for all pts is 3.2 mo (1–12 mo). Toxicities included gr 3 fatigue (1), gr 2–3 diarrhea (3), gr 2–3 nausea (2), gr 2 mucositis(1), gr 4 lymphopenia (1), gr 2–3 lymphopenia (6). Correlative studies of pre- and on-treatment tumor samples will be presented describing gene expression profiling using custom Agilent oligonucleotide microarrays optimized for analysis of RNA isolated from formalin fixed paraffin embedded tissues (FFPET). Conclusion: In this trial Vorinostat demonstrated disease stabilization rate in 4/14 (29%) pts by intention to treat analysis. With ease of administration, further investigation in combination with other agents is warranted. (NCI-NO1-CM- 62209) No significant financial relationships to disclose.
Collapse
Affiliation(s)
- T. H. Luu
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - L. Leong
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - R. Morgan
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - M. McNamara
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - D. Lim
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - J. Portnow
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - P. Frankel
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - A. Aparicio
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - H. Chew
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - D. R. Gandara
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| | - G. Somlo
- City of Hope National Medical Center, Duarte, CA; USC/Norris Cancer Center, Los Angeles, CA; UC Davis Cancer Center, Sacramento, CA
| |
Collapse
|
37
|
Kabrhel C, Matts C, McNamara M, Katz J. The Introduction of a Rapid Elisa D-Dimer Increases Emergency Department Testing with No Effect on the Diagnosis of Pulmonary Embolism. Ann Emerg Med 2005. [DOI: 10.1016/j.annemergmed.2005.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
38
|
Luu TH, Twardowski P, Leong L, Lim D, Morgan R, McNamara M, Portnow J, Ruel C, Shibata S, Synold T, Doroshow J. Phase I trial of oral etoposide in combination with celecoxib in patients with advanced malignancies. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3201] [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)
- T. H. Luu
- City of Hope Natl Medcl Ctr, Duarte, CA
| | | | - L. Leong
- City of Hope Natl Medcl Ctr, Duarte, CA
| | - D. Lim
- City of Hope Natl Medcl Ctr, Duarte, CA
| | - R. Morgan
- City of Hope Natl Medcl Ctr, Duarte, CA
| | | | | | - C. Ruel
- City of Hope Natl Medcl Ctr, Duarte, CA
| | | | - T. Synold
- City of Hope Natl Medcl Ctr, Duarte, CA
| | | |
Collapse
|
39
|
Takimoto C, Syed S, McNamara M, Doroshow J, Pezzulli S, Eastham E, Bernareggi A, Dupont J. 504 Phase I study of CT-2106 (polyglutamate camptothecin) in patients with advanced malignancies. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80512-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
40
|
Springett GM, Takimoto C, McNamara M, Doroshow JH, Syed S, Eastham E, Spriggs D, Pezzulli S, Michelson G, Dupont J. Phase I study of CT-2106 (polyglutamate camptothecin) in patients with advanced malignancies. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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)
- G. M. Springett
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - C. Takimoto
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - M. McNamara
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - J. H. Doroshow
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - S. Syed
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - E. Eastham
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - D. Spriggs
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - S. Pezzulli
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - G. Michelson
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| | - J. Dupont
- Memorial Sloan-Kettering, New York, NY; Cancer Therapy & Research Center, San Antonio, TX; City of Hope Medical Center, Pasadena, CA; City of Hope Medical Center, Duarte, CA; Cell Therapeutics, Inc, Seattle, WA
| |
Collapse
|
41
|
Garcia AA, Morgan R, McNamara M, Scudder S, Tsao-Wei D, Groshen S, Frgala T, Kim Y, Reynolds CP. Phase II trial of fenretinide (4-HPR) in recurrent ovarian and primary peritoneal carcinoma: A California Cancer Consortium trial. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. A. Garcia
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - R. Morgan
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - M. McNamara
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - S. Scudder
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - D. Tsao-Wei
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - S. Groshen
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - T. Frgala
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - Y. Kim
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| | - C. P. Reynolds
- University of Southern California, Los Angeles, CA; City of Hope, Duarte, CA; University of California-Davis, Davis, CA
| |
Collapse
|
42
|
Somlo G, Simpson JF, Frankel P, Chow W, Leong L, Margolin K, Morgan R, Raschko J, Shibata S, Forman S, Kogut N, McNamara M, Molina A, Somlo E, Doroshow JH. Predictors of long-term outcome following high-dose chemotherapy in high-risk primary breast cancer. Br J Cancer 2002; 87:281-8. [PMID: 12177795 PMCID: PMC2364229 DOI: 10.1038/sj.bjc.6600450] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2002] [Revised: 04/24/2002] [Accepted: 05/12/2002] [Indexed: 11/23/2022] Open
Abstract
We report on a predictive model of long-term outcome in 114 high-risk breast cancer patients treated with high-dose chemotherapy between 1989 and 1994. Paraffin-blocks from 90 of the 114 primaries were assessed for the presence of five risk factors: grade, mitotic index, protein expression of p53, HER2/neu, and oestrogen/progesterone receptor status; we could analyse the effect of risk factors in 84 of these 90 tumours. Seven-year relapse-free and overall survival was 58% (95% confidence interval 44-74%) and 82% (95% confidence interval 71-94%) vs 33% (95% confidence interval 21-52%) and 41% (95% confidence interval 28-60%) for patients whose primary tumours displayed > or =3 risk factors vs patients with < or =2 risk factors. For the entire group of 168 high-risk breast cancer patients, inflammatory stage IIIB disease and involved post-mastectomy margins were associated with decreased relapse-free survival and overall survival; patients treated with non-doxorubicin containing standard adjuvant therapy experienced worse overall survival (RR, 2.08; 95% confidence interval 1.04 to 4.16; P=0.04), while adjuvant tamoxifen improved overall survival (RR, 0.65; 95% confidence interval 0.41-1.01; P=0.054). Future trial designs and patient selection for studies specific for high-risk breast cancer patients should include appropriate prognostic models. Validation of such models could come from recently completed randomised, prospective trials.
Collapse
Affiliation(s)
- G Somlo
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, 1500 E Duarte Road, Duarte, California, CA 91010-3000, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Morgan RJ, Doroshow JH, Leong L, Schriber J, Shibata S, Forman S, Hamasaki V, Margolin K, Somlo G, Alvarnas J, McNamara M, Longmate J, Raschko J, Chow W, Vasilev S, McGonigle K, Yen Y. Phase II trial of high-dose intravenous doxorubicin, etoposide, and cyclophosphamide with autologous stem cell support in patients with residual or responding recurrent ovarian cancer. Bone Marrow Transplant 2001; 28:859-63. [PMID: 11781646 DOI: 10.1038/sj.bmt.1703243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 05/11/2001] [Accepted: 08/09/2001] [Indexed: 11/09/2022]
Abstract
This study was performed in order to evaluate the toxicities, progression-free and overall survival of patients with responsive residual or recurrent ovarian cancer treated with high-dose chemotherapy. Twenty-seven patients were treated. Doxorubicin, 165 mg/m(2) over 96 h (days -12 to -8), etoposide 700 mg/m(2) every day x3 (days -6 to -4), and cyclophosphamide 4.2 g/m(2) on d -3 was followed by stem cells and granulocyte colony-stimulating factor. The median days of granulocyte count <500/microl was 14 (range 10-42) and platelets <20,000/microl was 13 (range 2-80). Median numbers of red cell and platelet transfusions were 15 (5-16) and 14 (4-103). Toxicity included mucositis requiring narcotic analgesia in all patients. Asymptomatic decreases in ejection fraction to values <50% were observed in four patients. No clinical congestive heart failure was observed. One death due to sepsis was observed. Median progression-free survival is 7.5 months (1.0-56 months); five patients remain alive, two of whom remain progression-free at 19.5 and 24.5 months post transplant. Median overall survival is 14.0 months (1-68 months). We conclude that high-dose anthracyclines may be safely administered to ovarian cancer patients. The short overall and progression-free survivals observed in our population suggest that this combination is not optimal.
Collapse
Affiliation(s)
- R J Morgan
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Morgan RJ, Synold T, Carr BI, Doroshow JH, Womack EP, Shibata S, Somlo G, Raschko J, Leong L, McNamara M, Chow W, Tetef M, Margolin K, Akman S, Longmate J. Continuous infusion prochlorperazine: pharmacokinetics, antiemetic efficacy, and feasibility of high-dose therapy. Cancer Chemother Pharmacol 2001; 47:327-32. [PMID: 11345649 DOI: 10.1007/s002800000232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of these sequential phase I studies was to evaluate the antiemetic efficacy and pharmacokinetics of high-dose continuous infusion prochlorperazine. METHODS A total of 52 patients with advanced cancer were treated in two sequential phase I studies utilizing high-dose prochlorperazine. In study 1, designed to investigate the antiemetic effects of dose-intensive prochlorperazine, various cisplatin-based multiagent chemotherapeutic regimens were administered in combination with escalating doses of prochlorperazine. In study 2, a fixed dose of cisplatin (60 mg/m2) was administered over 24 h as a continuous intravenous infusion in combination with infusional high-dose prochlorperazine. Antiemetic efficacy in the first trial was assessed in terms of the number of episodes of nausea, retching, and/or emesis during the 24 h following cisplatin administration. The pharmacokinetics of high-dose prochlorperazine were evaluated in eight patients treated in study 2 at the two dose levels below those at which dose-limiting toxicity was noted. RESULTS The maximally tolerated dose of prochlorperazine in combination with cisplatin (60 mg/m2 administered as a continuous infusion over 24 h) was 24 mg/h. The dose-limiting toxicity was grade 4 agitation and confusion noted in one patient treated at 26 mg/h. This patient died 3 days following cessation of chemotherapy due to the toxicity of the regimen in combination with the debilitating pulmonary effects of the disease. The mean end of infusion prochlorperazine level at the 24 mg/h dose level was 1.1 microM, a concentration previously reported to be consistent with the reversal of the multidrug resistance phenotype. Two partial responses were observed in study 2. CONCLUSIONS We conclude that the antiemetic efficacy of high-dose infusional prochlorperazine does not appear to be improved over more convenient bolus administration. However, prochlorperazine levels consistent with those required in vitro for drug resistance reversal are attainable within the dose range having a tolerable toxicity profile.
Collapse
Affiliation(s)
- R J Morgan
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA 91010, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Rivera-Alsina ME, Rivera CC, Rollene N, Kirby RS, Ayres A, McNamara M. Voluntary screening program for HIV in pregnancy. Cost effectiveness. J Reprod Med 2001; 46:243-8. [PMID: 11304866] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
OBJECTIVE To determine the effectiveness of a voluntary human immunodeficiency virus (HIV) screening program in pregnancy. STUDY DESIGN Using a business decision theory analysis model, we estimated the outcomes and costs of the two possible decisions by our patients (test/no test). Patients with a positive HIV screen would undergo evaluation and possible prophylactic antiviral therapy. The model was utilized to evaluate the Naval Medical Center San Diego Program from 1995-1997. RESULTS Prevalence of HIV in active duty Navy personnel during the years evaluated were 1995, 0.024%; 1996, 0.028%; and 1997, 0.022%. Patients screened for HIV during these years were 1995, 3,874; 1996, 3,924; and 1997, 4,127 (n = 11,925). Incidence of HIV seroprevalence in patients screened during the study period was zero. The number of patients declining HIV screening was: 1995, 10; 1996, 8; and 1997, 5. During the same period, reported HIV seroprevalence among pregnant patients in the United States was 1.5/1,000. CONCLUSION HIV seroprevalence in our pregnant population (zero) was lower than expected, considering the national pregnancy prevalence and Navy prevalence. The expected number of cases of positive HIV screens was 17.8. The cost of the program for the study period was $103,748. The cost of care for one positive neonate ranges between $100,000 and $200,000.
Collapse
Affiliation(s)
- M E Rivera-Alsina
- Department of Obstetrics and Gynecology, Naval Medical Center, San Diego, California, USA
| | | | | | | | | | | |
Collapse
|
46
|
Chang PY, Bjornstad K A, Chang E, McNamara M, Barcellos-Hoff MH, Lin SP, Aragon G, Polansky JR, Lui GM, Blakely EA. Particle irradiation induces FGF2 expression in normal human lens cells. Radiat Res 2000; 154:477-84. [PMID: 11025644 DOI: 10.1667/0033-7587(2000)154[0477:piifei]2.0.co;2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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] [Indexed: 11/03/2022]
Abstract
Particle Irradiation Induces FGF2 Expression in Normal Human Lens Cells. Particle radiations, including both proton and helium-ion beams, have been used to successfully treat choroidal melanoma, but with the complication of radiation-induced cataract. We have investigated a role for radiation-induced changes in the expression of basic fibroblast growth factor (FGF2) gene expression as part of the mechanism(s) underlying lens cell injury associated with cataract. Normal human lens epithelial (HLE) cells were cultured in vitro on extracellular matrix (ECM) originated from bovine corneal endothelial cells. This study reports evidence for rapid but transient induction of FGF2 transcripts, an increase of between 5- and 8-fold, within 0.5 h after exposure to particle radiation, followed by another wave of increased transcription at 2-3 h postirradiation. Immunofluorescence results confirm the enhanced levels of FGF2 protein rapidly after exposure to protons or helium ions, followed by another wave of increased activity unique to helium at 6 h postirradiation. This second wave of increased immunoreactivity was not observed in the proton-irradiated samples. Total FGF2 protein analysis after helium-ion exposures shows induced expression of three FGF2 isoforms, with an increase of up to 2-fold in the 18-kDa low-molecular-weight species. Studies of the effects of protons on individual FGF2 protein isoforms are in progress. Several mechanisms involving a role for FGF2 in radiation-induced cataract are discussed.
Collapse
Affiliation(s)
- P Y Chang
- SRI International, Menlo Park, California 94025, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Morgan RJ, Braly P, Leong L, Shibata S, Margolin K, Somlo G, McNamara M, Longmate J, Schinke S, Raschko J, Nagasawa S, Kogut N, Najera L, Johnson D, Doroshow JH. Phase II trial of combination intraperitoneal cisplatin and 5-fluorouracil in previously treated patients with advanced ovarian cancer: long-term follow-up. Gynecol Oncol 2000; 77:433-8. [PMID: 10831355 DOI: 10.1006/gyno.2000.5793] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [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] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This trial was performed to determine the response rate and progression-free and overall survivals of patients with advanced recurrent ovarian cancer who were treated with intraperitoneal cisplatin and 5-fluorouracil. METHODS Twenty-four patients with ovarian cancer were entered on this trial and treated with intraperitoneal (ip) cisplatin (DDP) and ip 5-fluorouracil, every 3 weeks for eight cycles. Following iv hydration, the cisplatin and 5-fluorouracil were administered through an ip catheter in 2 liters of 0.9% normal saline with a 4-h dwell. RESULTS All patients were evaluable for progression-free and overall survival and toxicity analysis, and 22 patients for response. The median age was 59 (range, 35-71); initial disease status included 9 patients with residual disease following chemotherapy prior to entry on this study; 5 patients had progressed, and 10 patients had recurrent disease more than 6 months following initial chemotherapy. Of the 9 patients with residual disease, 1 complete response and 3 partial responses were observed; of 10 patients with recurrent disease, 1 complete and 1 partial response were observed for an overall response rate of 27%. No objective responses were seen in the 7 patients who were platinum-refractory on protocol entry. The median progression-free and overall survivals are 7.0 (range, 0.5-137) and 15.5 (range, 3-147) months, respectively. Toxicity included hypomagnesemia, vomiting, abdominal pain, and mild anemia. Only one patient required a dosage adjustment of cisplatin for a serum creatinine elevation >2.0 mg/dl. CONCLUSIONS We conclude that the combination of ip cisplatin and 5-FU is an effective regimen for patients with residual or relapsed epithelial ovarian cancer with survival durations, response rates, and toxicity profiles that compare favorably with those of other second-line ovarian cancer regimens. Patients who are primarily platinum-refractory are unlikely to benefit from these agents administered into the peritoneal cavity.
Collapse
Affiliation(s)
- R J Morgan
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, California 91010, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Gómez-Isla T, Growdon WB, McNamara M, Newell K, Gómez-Tortosa E, Hedley-Whyte ET, Hyman BT. Clinicopathologic correlates in temporal cortex in dementia with Lewy bodies. Neurology 1999; 53:2003-9. [PMID: 10599772 DOI: 10.1212/wnl.53.9.2003] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [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] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To address the relationship between dementia and neuropathologic findings in dementia with Lewy bodies (DLB) in comparison with AD. METHODS We evaluated the clinical presentation of autopsy-confirmed DLB in comparison with AD according to new Consortium on DLB criteria and compared the two conditions using quantitative neuropathologic techniques. This clinicopathologic series included 81 individuals with AD, 20 with DLB (7 "pure" DLB and 13 "DLB/AD"), and 33 controls. We counted number of LB, neurons, senile plaques (SP), and neurofibrillary tangles (NFT) in a high order association cortex, the superior temporal sulcus (STS), using stereologic counting techniques. RESULTS The sensitivity and specificity of Consortium on DLB clinical criteria in this series for dementia, hallucinations, and parkinsonism are 53% and 83%, respectively, at the patient's initial visit and 90% and 68%, respectively, if data from all clinic visits are considered. In pathologically confirmed DLB brains, LB formation in an association cortical area does not significantly correlate with duration of illness, neuronal loss, or concomitant AD-type pathology. Unlike AD, there is no significant neuronal loss in the STS of DLB brains unless there is concomitant AD pathology (neuritic SP and NFT). CONCLUSIONS The evaluation of new Consortium on DLB criteria in this series highlights their utility and applicability in clinicopathologic studies but suggests that sensitivity and specificity, especially at the time of the first clinical evaluation, are modest. The lack of a relationship of LB formation to the amount of Alzheimer-type changes in this series suggests that DLB is a distinct pathology rather than a variant of AD.
Collapse
Affiliation(s)
- T Gómez-Isla
- Neurology Service, Massachusetts General Hospital, Boston, USA
| | | | | | | | | | | | | |
Collapse
|
49
|
Morgan RJ, Braly P, Cecchi G, Leong L, Shibata S, Margolin K, Somlo G, McNamara M, Longmate J, Schinke S, Raschko J, Nagasawa S, Kogut N, Parker P, Stein A, Cho J, Smith E, Coluzzi P, Najera L, Johnson D, Womack E, Doroshow JH. Phase II trial of intraperitoneal cisplatin with intravenous doxorubicin and cyclophosphamide in previously untreated patients with advanced ovarian cancer-long-term follow-up. Gynecol Oncol 1999; 75:419-26. [PMID: 10600300 DOI: 10.1006/gyno.1999.5613] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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] [Indexed: 11/22/2022]
Abstract
Forty-three patients with ovarian cancer were entered on this trial and treated with intravenous (iv) cyclophosphamide (C) and doxorubicin (A), and intraperitoneal (ip) cisplatin (DDP), every 21 days for eight cycles. Following iv hydration, the cisplatin was administered through an intraperitoneal catheter in 2 L of 0.9% normal saline with a 4-h dwell. All patients are evaluable for overall and progression-free survival with a median follow-up of 70 months (range: 3-162 months); 39 patients are evaluable for response. All complete responses were surgically confirmed. The median age was 59 (range 28-82 years); 3 patients were stage IC, 5 were IIC, 14 patients were stage III (optimally debulked), 14 patients were stage III (suboptimally debulked), and 7 patients were stage IV. Two patients had received prior alkylator therapy. Six of 8 patients with Stage IC or II remain without evidence of disease at a mean of 12 years following chemotherapy. Of 14 optimally debulked stage III patients, there were 7 complete responses, 3 partial responses, 1 patient with stable disease, and 3 inevaluable patients. Of 14 suboptimally debulked stage III patients there were 4 complete responses, 4 partial responses, 3 with stable disease, 2 progressions on treatment, and 1 inevaluable patient. Five-year progression-free and overall survivals for stage III optimally debulked patients are 21 and 64%, respectively. At 10 years, progression-free and overall survivals for this group are 21 and 29%, respectively. Toxicity included neutropenia (complicated by sepsis in 2 patients), infrequent thrombocytopenia, and mild anemia. Three patients developed transient serum creatinine elevations >2.0 mg/dl; however, decreased creatinine clearance was noted in 93/258 (36%) of evaluable courses which required a cisplatin dose reduction per protocol. Controllable hypomagnesemia, nausea, and emesis were also observed. We conclude that the combination of iv CA and ip DDP is an effective regimen with long-term progression-free and overall survivals that compare favorably with those of other published studies of intravenous or intraperitoneal chemotherapy. This report is unusual in terms of the prolonged follow-up for all patients enrolled. These long-term results lend further support to recently published trials documenting the efficacy of intraperitoneal chemotherapy for patients with this disease.
Collapse
Affiliation(s)
- R J Morgan
- Department of Gynecologic Oncology, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, California 91010, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
|