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Van Treeck BJ, Olave MC, Watkins RD, Lu H, Moreira RK, Mounajjed T, Johnson MJ, Smith CY, Ilyas SI, Tran NH, Jenkins SM, Reed KA, Smoot R, Mahipal A, Allende D, Graham RP. Neoadjuvant therapy leads to objective response in intrahepatic cholangiocarcinoma. HPB (Oxford) 2024:S1365-182X(24)01259-0. [PMID: 38705793 DOI: 10.1016/j.hpb.2024.04.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Intrahepatic cholangiocarcinoma (iCCA) is the second most common hepatic malignancy and has a poor prognosis. Surgical resection is the standard of care for patients with resectable disease, representing 30-40% of cases. Increasingly, neoadjuvant systemic therapy is being utilized in patients due to high-risk anatomic or biologic considerations. However, data on the clinical effect of this approach are limited. We performed a cohort study to evaluate the effect of neoadjuvant therapy in patients with oncologically high-risk iCCA. METHODS iCCA patients (n = 181) between the years 2014-2020 were reviewed for clinical, histopathologic, treatment, and outcome-related data. Tumor regression grade was scored per CAP criteria for gastrointestinal carcinomas. RESULTS 47 iCCA patients received neoadjuvant therapy and 72 did not. Neoadjuvant treatment led to objective response and tumor regression by CAP score. After adjustment for age, clinical stage, and tumor size, the outcomes of patients who had neoadjuvant therapy followed by surgery were not significantly different from those patients who had surgery first. DISCUSSION In conclusion, neoadjuvant therapy in iCCA facilitated surgical care. The progression-free and overall survival for surgical patients with and without neoadjuvant therapy were not significantly different suggesting this approach needs further exploration as an effective treatment paradigm.
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Affiliation(s)
| | - Maria C Olave
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, USA
| | - Ryan D Watkins
- Mayo Clinic, Department of Surgery, Department of Biochemistry and Molecular Biology, Rochester, MN, USA
| | - Haiyan Lu
- Cleveland Clinic, Department of Pathology, Cleveland, OH, USA
| | - Roger K Moreira
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, USA
| | - Taofic Mounajjed
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, USA
| | - Michael J Johnson
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, USA
| | - Carin Y Smith
- Mayo Clinic, Department of Quantitative Health Sciences, Rochester, MN, USA
| | - Sumera I Ilyas
- Mayo Clinic, Division of Gastroenterology and Hepatology, Department of Immunology, Rochester, MN, USA
| | - Nguyen H Tran
- Mayo Clinic, Department of Oncology, Rochester, MN, USA
| | - Sarah M Jenkins
- Mayo Clinic, Department of Quantitative Health Sciences, Rochester, MN, USA
| | - Katelyn A Reed
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, USA
| | - Rory Smoot
- Mayo Clinic, Department of Surgery, Department of Biochemistry and Molecular Biology, Rochester, MN, USA
| | - Amit Mahipal
- Mayo Clinic, Department of Oncology, Rochester, MN, USA; University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland OH, USA
| | - Daniela Allende
- Cleveland Clinic, Department of Pathology, Cleveland, OH, USA
| | - Rondell P Graham
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, USA.
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Imperial R, Mosalem O, Majeed U, Tran NH, Borad MJ, Babiker H. Second-Line Treatment of Pancreatic Adenocarcinoma: Shedding Light on New Opportunities and Key Talking Points from Clinical Trials. Clin Exp Gastroenterol 2024; 17:121-134. [PMID: 38650920 PMCID: PMC11034511 DOI: 10.2147/ceg.s390655] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
Despite improvements in overall cancer mortality, deaths related to pancreatic cancer continue to rise. Following first-line treatment, second-line options are significantly limited. Classically, first-line treatment consisted of either gemcitabine or 5-fluorouracil based systemic chemotherapy. Upon progression of disease or recurrence, subsequent second-line treatment is still gemcitabine or 5-fluorouracil based chemotherapy, depending on what was used in the first line and the timing of progression or recurrence. A better understanding of the molecular underpinnings of pancreatic adenocarcinoma (PDAC) has led to new treatment strategies including specifically targeting the desmoplastic stroma, cytokine signaling and actionable mutations. Furthermore, efforts are also directed to enhance the immunogenicity profile of PDAC's well-established immunologically "cold" tumor microenvironment. More recently, the outstanding response rates of chimeric antigen receptor T (CAR-T) cells in hematologic malignancies, have led to clinical trials to evaluate the treatment modality in PDAC. In this review, we summarize recently presented clinical trials for metastatic pancreatic adenocarcinoma with novel treatment approaches in the second line and beyond.
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Affiliation(s)
- Robin Imperial
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Osama Mosalem
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Umair Majeed
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | | | - Mitesh J Borad
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Hani Babiker
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
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Nguyen MNH, Pandey SR, Dang TN, Huh EN, Tran NH, Saad W, Hong CS. Self-Organizing Democratized Learning: Toward Large-Scale Distributed Learning Systems. IEEE Trans Neural Netw Learn Syst 2023; 34:10698-10710. [PMID: 35536803 DOI: 10.1109/tnnls.2022.3170872] [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] [Indexed: 06/14/2023]
Abstract
Emerging cross-device artificial intelligence (AI) applications require a transition from conventional centralized learning systems toward large-scale distributed AI systems that can collaboratively perform complex learning tasks. In this regard, democratized learning (Dem-AI) lays out a holistic philosophy with underlying principles for building large-scale distributed and democratized machine learning systems. The outlined principles are meant to study a generalization in distributed learning systems that go beyond existing mechanisms such as federated learning (FL). Moreover, such learning systems rely on hierarchical self-organization of well-connected distributed learning agents who have limited and highly personalized data and can evolve and regulate themselves based on the underlying duality of specialized and generalized processes. Inspired by Dem-AI philosophy, a novel distributed learning approach is proposed in this article. The approach consists of a self-organizing hierarchical structuring mechanism based on agglomerative clustering, hierarchical generalization, and corresponding learning mechanism. Subsequently, hierarchical generalized learning problems in recursive forms are formulated and shown to be approximately solved using the solutions of distributed personalized learning problems and hierarchical update mechanisms. To that end, a distributed learning algorithm, namely DemLearn, is proposed. Extensive experiments on benchmark MNIST, Fashion-MNIST, FE-MNIST, and CIFAR-10 datasets show that the proposed algorithm demonstrates better results in the generalization performance of learning models in agents compared to the conventional FL algorithms. The detailed analysis provides useful observations to further handle both the generalization and specialization performance of the learning models in Dem-AI systems.
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Aguillard DP, Albahri T, Allspach D, Anisenkov A, Badgley K, Baeßler S, Bailey I, Bailey L, Baranov VA, Barlas-Yucel E, Barrett T, Barzi E, Bedeschi F, Berz M, Bhattacharya M, Binney HP, Bloom P, Bono J, Bottalico E, Bowcock T, Braun S, Bressler M, Cantatore G, Carey RM, Casey BCK, Cauz D, Chakraborty R, Chapelain A, Chappa S, Charity S, Chen C, Cheng M, Chislett R, Chu Z, Chupp TE, Claessens C, Convery ME, Corrodi S, Cotrozzi L, Crnkovic JD, Dabagov S, Debevec PT, Di Falco S, Di Sciascio G, Drendel B, Driutti A, Duginov VN, Eads M, Edmonds A, Esquivel J, Farooq M, Fatemi R, Ferrari C, Fertl M, Fienberg AT, Fioretti A, Flay D, Foster SB, Friedsam H, Froemming NS, Gabbanini C, Gaines I, Galati MD, Ganguly S, Garcia A, George J, Gibbons LK, Gioiosa A, Giovanetti KL, Girotti P, Gohn W, Goodenough L, Gorringe T, Grange J, Grant S, Gray F, Haciomeroglu S, Halewood-Leagas T, Hampai D, Han F, Hempstead J, Hertzog DW, Hesketh G, Hess E, Hibbert A, Hodge Z, Hong KW, Hong R, Hu T, Hu Y, Iacovacci M, Incagli M, Kammel P, Kargiantoulakis M, Karuza M, Kaspar J, Kawall D, Kelton L, Keshavarzi A, Kessler DS, Khaw KS, Khechadoorian Z, Khomutov NV, Kiburg B, Kiburg M, Kim O, Kinnaird N, Kraegeloh E, Krylov VA, Kuchinskiy NA, Labe KR, LaBounty J, Lancaster M, Lee S, Li B, Li D, Li L, Logashenko I, Lorente Campos A, Lu Z, Lucà A, Lukicov G, Lusiani A, Lyon AL, MacCoy B, Madrak R, Makino K, Mastroianni S, Miller JP, Miozzi S, Mitra B, Morgan JP, Morse WM, Mott J, Nath A, Ng JK, Nguyen H, Oksuzian Y, Omarov Z, Osofsky R, Park S, Pauletta G, Piacentino GM, Pilato RN, Pitts KT, Plaster B, Počanić D, Pohlman N, Polly CC, Price J, Quinn B, Qureshi MUH, Ramachandran S, Ramberg E, Reimann R, Roberts BL, Rubin DL, Santi L, Schlesier C, Schreckenberger A, Semertzidis YK, Shemyakin D, Sorbara M, Stöckinger D, Stapleton J, Still D, Stoughton C, Stratakis D, Swanson HE, Sweetmore G, Sweigart DA, Syphers MJ, Tarazona DA, Teubner T, Tewsley-Booth AE, Tishchenko V, Tran NH, Turner W, Valetov E, Vasilkova D, Venanzoni G, Volnykh VP, Walton T, Weisskopf A, Welty-Rieger L, Winter P, Wu Y, Yu B, Yucel M, Zeng Y, Zhang C. Measurement of the Positive Muon Anomalous Magnetic Moment to 0.20 ppm. Phys Rev Lett 2023; 131:161802. [PMID: 37925710 DOI: 10.1103/physrevlett.131.161802] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/05/2023] [Indexed: 11/07/2023]
Abstract
We present a new measurement of the positive muon magnetic anomaly, a_{μ}≡(g_{μ}-2)/2, from the Fermilab Muon g-2 Experiment using data collected in 2019 and 2020. We have analyzed more than 4 times the number of positrons from muon decay than in our previous result from 2018 data. The systematic error is reduced by more than a factor of 2 due to better running conditions, a more stable beam, and improved knowledge of the magnetic field weighted by the muon distribution, ω[over ˜]_{p}^{'}, and of the anomalous precession frequency corrected for beam dynamics effects, ω_{a}. From the ratio ω_{a}/ω[over ˜]_{p}^{'}, together with precisely determined external parameters, we determine a_{μ}=116 592 057(25)×10^{-11} (0.21 ppm). Combining this result with our previous result from the 2018 data, we obtain a_{μ}(FNAL)=116 592 055(24)×10^{-11} (0.20 ppm). The new experimental world average is a_{μ}(exp)=116 592 059(22)×10^{-11} (0.19 ppm), which represents a factor of 2 improvement in precision.
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Affiliation(s)
| | - T Albahri
- University of Liverpool, Liverpool, United Kingdom
| | - D Allspach
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Anisenkov
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | - K Badgley
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Baeßler
- University of Virginia, Charlottesville, Virginia, USA
| | - I Bailey
- Lancaster University, Lancaster, United Kingdom
| | - L Bailey
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - V A Baranov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - E Barlas-Yucel
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - T Barrett
- Cornell University, Ithaca, New York, USA
| | - E Barzi
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - M Berz
- Michigan State University, East Lansing, Michigan, USA
| | - M Bhattacharya
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - H P Binney
- University of Washington, Seattle, Washington, USA
| | - P Bloom
- North Central College, Naperville, Illinois, USA
| | - J Bono
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - E Bottalico
- University of Liverpool, Liverpool, United Kingdom
| | - T Bowcock
- University of Liverpool, Liverpool, United Kingdom
| | - S Braun
- University of Washington, Seattle, Washington, USA
| | - M Bressler
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | | | - R M Carey
- Boston University, Boston, Massachusetts, USA
| | - B C K Casey
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Cauz
- Università di Udine, Udine, Italy
| | | | | | - S Chappa
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Charity
- University of Liverpool, Liverpool, United Kingdom
| | - C Chen
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - M Cheng
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - R Chislett
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - Z Chu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - T E Chupp
- University of Michigan, Ann Arbor, Michigan, USA
| | - C Claessens
- University of Washington, Seattle, Washington, USA
| | - M E Convery
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Corrodi
- Argonne National Laboratory, Lemont, Illinois, USA
| | | | - J D Crnkovic
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Dabagov
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | - P T Debevec
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | | | | | - B Drendel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - V N Duginov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - M Eads
- Northern Illinois University, DeKalb, Illinois, USA
| | - A Edmonds
- Boston University, Boston, Massachusetts, USA
| | - J Esquivel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Farooq
- University of Michigan, Ann Arbor, Michigan, USA
| | - R Fatemi
- University of Kentucky, Lexington, Kentucky, USA
| | | | - M Fertl
- Institute of Physics and Cluster of Excellence PRISMA+, Johannes Gutenberg University Mainz, Mainz, Germany
| | - A T Fienberg
- University of Washington, Seattle, Washington, USA
| | | | - D Flay
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - S B Foster
- Boston University, Boston, Massachusetts, USA
| | - H Friedsam
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | | | - I Gaines
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - S Ganguly
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Garcia
- University of Washington, Seattle, Washington, USA
| | - J George
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | | | - A Gioiosa
- Università del Molise, Campobasso, Italy
| | - K L Giovanetti
- Department of Physics and Astronomy, James Madison University, Harrisonburg, Virginia, USA
| | | | - W Gohn
- University of Kentucky, Lexington, Kentucky, USA
| | - L Goodenough
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - T Gorringe
- University of Kentucky, Lexington, Kentucky, USA
| | - J Grange
- University of Michigan, Ann Arbor, Michigan, USA
| | - S Grant
- Argonne National Laboratory, Lemont, Illinois, USA
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - F Gray
- Regis University, Denver, Colorado, USA
| | - S Haciomeroglu
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | | | - D Hampai
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | - F Han
- University of Kentucky, Lexington, Kentucky, USA
| | - J Hempstead
- University of Washington, Seattle, Washington, USA
| | - D W Hertzog
- University of Washington, Seattle, Washington, USA
| | - G Hesketh
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - E Hess
- INFN, Sezione di Pisa, Pisa, Italy
| | - A Hibbert
- University of Liverpool, Liverpool, United Kingdom
| | - Z Hodge
- University of Washington, Seattle, Washington, USA
| | - K W Hong
- University of Virginia, Charlottesville, Virginia, USA
| | - R Hong
- Argonne National Laboratory, Lemont, Illinois, USA
- University of Kentucky, Lexington, Kentucky, USA
| | - T Hu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Y Hu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | | | | | - P Kammel
- University of Washington, Seattle, Washington, USA
| | | | - M Karuza
- INFN, Sezione di Trieste, Trieste, Italy
| | - J Kaspar
- University of Washington, Seattle, Washington, USA
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - L Kelton
- University of Kentucky, Lexington, Kentucky, USA
| | - A Keshavarzi
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - D S Kessler
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - K S Khaw
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | | | - N V Khomutov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - B Kiburg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Kiburg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
- North Central College, Naperville, Illinois, USA
| | - O Kim
- University of Mississippi, University, Mississippi, USA
| | - N Kinnaird
- Boston University, Boston, Massachusetts, USA
| | - E Kraegeloh
- University of Michigan, Ann Arbor, Michigan, USA
| | - V A Krylov
- Joint Institute for Nuclear Research, Dubna, Russia
| | | | - K R Labe
- Cornell University, Ithaca, New York, USA
| | - J LaBounty
- University of Washington, Seattle, Washington, USA
| | - M Lancaster
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - S Lee
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - B Li
- Argonne National Laboratory, Lemont, Illinois, USA
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - D Li
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - L Li
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - I Logashenko
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | | | - Z Lu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - A Lucà
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - G Lukicov
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | | | - A L Lyon
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - B MacCoy
- University of Washington, Seattle, Washington, USA
| | - R Madrak
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - K Makino
- Michigan State University, East Lansing, Michigan, USA
| | | | - J P Miller
- Boston University, Boston, Massachusetts, USA
| | - S Miozzi
- INFN, Sezione di Roma Tor Vergata, Rome, Italy
| | - B Mitra
- University of Mississippi, University, Mississippi, USA
| | - J P Morgan
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - W M Morse
- Brookhaven National Laboratory, Upton, New York, USA
| | - J Mott
- Boston University, Boston, Massachusetts, USA
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Nath
- INFN, Sezione di Napoli, Naples, Italy
| | - J K Ng
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - H Nguyen
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - Y Oksuzian
- Argonne National Laboratory, Lemont, Illinois, USA
| | - Z Omarov
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - R Osofsky
- University of Washington, Seattle, Washington, USA
| | - S Park
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | | | | | - R N Pilato
- University of Liverpool, Liverpool, United Kingdom
| | - K T Pitts
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - B Plaster
- University of Kentucky, Lexington, Kentucky, USA
| | - D Počanić
- University of Virginia, Charlottesville, Virginia, USA
| | - N Pohlman
- Northern Illinois University, DeKalb, Illinois, USA
| | - C C Polly
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - J Price
- University of Liverpool, Liverpool, United Kingdom
| | - B Quinn
- University of Mississippi, University, Mississippi, USA
| | - M U H Qureshi
- Institute of Physics and Cluster of Excellence PRISMA+, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - E Ramberg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - R Reimann
- Institute of Physics and Cluster of Excellence PRISMA+, Johannes Gutenberg University Mainz, Mainz, Germany
| | - B L Roberts
- Boston University, Boston, Massachusetts, USA
| | - D L Rubin
- Cornell University, Ithaca, New York, USA
| | - L Santi
- Università di Udine, Udine, Italy
| | - C Schlesier
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | | | - Y K Semertzidis
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - D Shemyakin
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | - M Sorbara
- INFN, Sezione di Roma Tor Vergata, Rome, Italy
| | - D Stöckinger
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, Dresden, Germany
| | - J Stapleton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Still
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - C Stoughton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Stratakis
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - H E Swanson
- University of Washington, Seattle, Washington, USA
| | - G Sweetmore
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | | | - M J Syphers
- Northern Illinois University, DeKalb, Illinois, USA
| | - D A Tarazona
- Cornell University, Ithaca, New York, USA
- Michigan State University, East Lansing, Michigan, USA
- University of Liverpool, Liverpool, United Kingdom
| | - T Teubner
- University of Liverpool, Liverpool, United Kingdom
| | - A E Tewsley-Booth
- University of Kentucky, Lexington, Kentucky, USA
- University of Michigan, Ann Arbor, Michigan, USA
| | - V Tishchenko
- Brookhaven National Laboratory, Upton, New York, USA
| | - N H Tran
- Boston University, Boston, Massachusetts, USA
| | - W Turner
- University of Liverpool, Liverpool, United Kingdom
| | - E Valetov
- Michigan State University, East Lansing, Michigan, USA
| | - D Vasilkova
- Department of Physics and Astronomy, University College London, London, United Kingdom
- University of Liverpool, Liverpool, United Kingdom
| | - G Venanzoni
- University of Liverpool, Liverpool, United Kingdom
| | - V P Volnykh
- Joint Institute for Nuclear Research, Dubna, Russia
| | - T Walton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Weisskopf
- Michigan State University, East Lansing, Michigan, USA
| | - L Welty-Rieger
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - P Winter
- Argonne National Laboratory, Lemont, Illinois, USA
| | - Y Wu
- Argonne National Laboratory, Lemont, Illinois, USA
| | - B Yu
- University of Mississippi, University, Mississippi, USA
| | - M Yucel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - Y Zeng
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - C Zhang
- University of Liverpool, Liverpool, United Kingdom
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5
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Palmer ME, Gile JJ, Storandt MH, Jin Z, Zemla TJ, Tran NH, Mahipal A. Outcomes of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib following Immunotherapy: A Real World Evidence Study. Cancers (Basel) 2023; 15:4867. [PMID: 37835561 PMCID: PMC10571707 DOI: 10.3390/cancers15194867] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/21/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Lenvatinib, a multikinase inhibitor, is an FDA-approved treatment for advanced hepatocellular carcinoma (HCC) in the first-line setting. Recent trial data have established atezolizumab plus bevacizumab as well as tremelimumab plus durvalumab as preferred first-line treatment options for advanced HCC. The role of lenvatinib following progression on immunotherapy in patients with advanced HCC remains unclear. METHODS We conducted a multicentric, retrospective analysis of patients with advanced HCC diagnosed between 2010 and 2021 at the Mayo Clinic in Minnesota, Arizona, and Florida who received immunotherapy followed by lenvatinib. Median overall survival and progression-free survival analyses were performed using the Kaplan-Meier method, and responses were determined using RECIST 1.1. Adverse events were determined using CTCAE v 4.0. RESULTS We identified 53 patients with advanced HCC who received lenvatinib following progression on immunotherapy. Forty five (85%) patients had a Child Pugh class A at diagnosis, while 30 (58%) patients were still Child Pugh A at time of lenvatinib initiation. Lenvatinib was administered as a second-line treatment in 85% of the patients. The median PFS was 3.7 months (95% CI: 3.2-6.6), and the median OS from the time of lenvatinib initiation was 12.8 months (95% CI: 6.7-19.5). In patients with Child Pugh class A, the median OS and PFS was 14 and 5.2 months, respectively. Race, gender, and Child Pugh class was associated with OS on multivariate analysis. DISCUSSION Our study, using real-world data, suggests that patients benefit from treatment with lenvatinib following progression on immunotherapy in advanced HCC. The optimal sequencing of therapy for patients with advanced HCC following progression on immunotherapy remains unknown, and these results need to be validated in a clinical trial.
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Affiliation(s)
- Mathias E. Palmer
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA; (M.E.P.); (M.H.S.)
| | - Jennifer J. Gile
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (J.J.G.); (Z.J.); (N.H.T.)
| | - Michael H. Storandt
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA; (M.E.P.); (M.H.S.)
| | - Zhaohui Jin
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (J.J.G.); (Z.J.); (N.H.T.)
| | - Tyler J. Zemla
- Department of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN 55905, USA;
| | - Nguyen H. Tran
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (J.J.G.); (Z.J.); (N.H.T.)
| | - Amit Mahipal
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA; (J.J.G.); (Z.J.); (N.H.T.)
- Department of Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
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6
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Leiting JL, Hernandez MC, Bergquist JR, Yonkus JA, Abdelrahman AM, Torbenson MS, Tran NH, Halfdanarson TR, Graham RP, Smoot RL, Truty MJ. Therapeutic Efficacy of Temsirolimus in a Patient-derived Model of Metastatic Fibrolamellar Hepatocellular Carcinoma. In Vivo 2023; 37:1940-1950. [PMID: 37652480 PMCID: PMC10500502 DOI: 10.21873/invivo.13290] [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: 04/23/2023] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare tumor presenting in younger patients without chronic liver disease. Up to 80-100% develop recurrent disease, necessitating additional surgery or systemic treatment. Systemic options and pre-clinical treatment studies are lacking. We previously described patient-derived xenograft (PDX) development, allowing for pre-clinical studies. Herein, we develop FLHCC PDX models and utilize these to define tumor characteristics and determine the efficacy of systemic agents. MATERIALS AND METHODS Primary and lymph node metastatic tumor tissues were obtained at the time of FLHCC resection in two patients. Tumor lysates were screened for protein upregulation. Cell lines were generated from metastatic and primary tumor tissue. The viability of the cell lines was assessed after treatment with temsirolimus, gemcitabine/oxaliplatin, and FOLFIRINOX. Two PDX models were developed from metastatic tissue. For in vivo studies, tumor-bearing mice were treated with temsirolimus, FOLFIRINOX, and Gemcitabine/oxaliplatin. RESULTS PDX models were successfully generated from metastatic FLHCC, which closely recapitulated the original tumor. Upregulation of mTOR was seen in metastatic tissue compared to primary tumors. Cell lines from metastatic tissue demonstrated significant sensitivity to temsirolimus. In vivo testing of PDX models demonstrated a significant response to single-agent temsirolimus with minimal toxicity. CONCLUSION Herein, we demonstrate the feasibility of developing PDX models that closely recapitulate FLHCC. Upregulation of mTOR was seen in metastatic tissue compared to primary tissue. The efficacy of mTOR inhibition with temsirolimus treatment suggests that the upregulation of the mTOR pathway may be a significant mechanism for growth in metastatic lesions and a potential target for therapeutics.
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Affiliation(s)
| | | | | | | | | | | | - Nguyen H Tran
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, U.S.A
| | | | | | - Rory L Smoot
- Department of Surgery, Mayo Clinic, Rochester, MN, U.S.A
| | - Mark J Truty
- Department of Surgery, Mayo Clinic, Rochester, MN, U.S.A.;
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7
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Tran NH, Almodallal Y, Batheja M, Martin NA, Le-Rademacher J, Ridgeway JL, Sia IG, Jatoi A. Social determinants of health: a need for better data capture in Asian American patients with hepatocellular cancer. Support Care Cancer 2023; 31:543. [PMID: 37646853 DOI: 10.1007/s00520-023-08016-7] [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: 01/06/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Social determinants of health lead to better cancer care. This multi-site, single-institution study sought to capture data on social determinants of health data in Asian Americans with hepatocellular carcinoma; this group constitutes 60% of patients with this malignancy and are often undertreated or not treated at all. METHODS This study took advantage of an institutional initiative designed to capture and integrate social determinants of health data into the electronic medical record for all patients. Medical records of Asian Americans with hepatocellular cancer were reviewed to acquire data on housing instability, lack of transportation, financial concerns, and social isolation; a score of 1 indicated poor social determinants of health. RESULTS Of 112 adult Asian American patients with hepatocellular cancer, 22 (20%) were Southeast Asian, and 74 (67%) described English proficiency/preference. Total noncompletion per domain (no question answered within that domain) was observed in 90 patients (80%) for housing instability; 90 (80%) for lack of transportation; 92 (82%) for financial hardship; and 90 (80%) for social isolation. A score of 1 (highest risk) was observed in 1 patient (0.9%) for housing instability; 1 (0.9%) lack of transportation; no patient for financial hardship; and 1 (0.9%) for social isolation. Of note, institution-wide benchmark total noncompletion rates were 0.3%, 0.3%, 47%, and 39% for these respective domains. CONCLUSION High total noncompletion rates make social determinants of health data challenging to interpret and underscore the need for evidence-based guidelines on how best to capture such data in underserved patients.
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Affiliation(s)
- Nguyen H Tran
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Yahya Almodallal
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Mashal Batheja
- Division of Gastroenterology, Mayo Clinic, Phoenix, AZ, USA
| | - Nichole A Martin
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | | | - Irene G Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Aminah Jatoi
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
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8
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Storandt MH, Tran NH, Ehret CJ, Hanna M, Jochum J, Moynagh MR, Jatoi A. Gastrointestinal perforation after bevacizumab: a multi-site, single-institution study with a focus on survival. World J Surg Oncol 2023; 21:177. [PMID: 37291587 DOI: 10.1186/s12957-023-03058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Bevacizumab-induced gastrointestinal perforation is a rare but potentially devastating adverse event that has generated limited data on overall survival. Yet, such survival data are critical in guiding management. METHODS This multi-site, single-institution retrospective study focused on all cancer patients who had received bevacizumab and who had suffered a well-documented gastrointestinal perforation from January 1, 2004 through January 20, 2022.The main goal was to report survival outcomes; Kaplan Meier curves and Cox survival models were used for this purpose. RESULTS Eighty-nine patients are included in this report with a median age of 62 years (range 26-85). Colorectal cancer was the most common malignancy (n = 42). Thirty-nine patients underwent surgery for the perforation. Seventy-eight were deceased at the time of reporting with an overall median survival of all patients of 2.7 months (range 0-45 months), and 32 (36%) died within 30 days of perforation. In univariable survival analyses, no statistically significant associations were observed for age, gender, corticosteroid use, and time since last bevacizumab dose. However, surgically treated patients manifested a better survival (hazard ratio (HR) 0.49 (95% CI 0.31-0.78); p = 0.003). In multivariable analyses, surgery continued to be associated with improved survival (HR 0.47 (95% CI 0.29-0.74); p = 0.002), and corticosteroid use was associated with worse survival (HR 1.75 (95% CI 1.02-2.99); p = 0.04). CONCLUSION Although gastrointestinal perforation after bevacizumab should be managed on a case-by-case basis, these descriptive survival data can help inform patients, their families, and healthcare providers as challenging management decisions arise.
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Affiliation(s)
| | - Nguyen H Tran
- Department of Oncology, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Mina Hanna
- Department of Oncology, Mayo Clinic, 404 W. Fountain Street, Albert Lea, MN, 56007, USA
| | - Jacob Jochum
- Department of Oncology, 200 First Street SW, Rochester, MN, 55905, USA
| | - Michael R Moynagh
- Department of Radiology, 200 First Street SW, Rochester, MN, 55905, USA
| | - Aminah Jatoi
- Department of Oncology, 200 First Street SW, Rochester, MN, 55905, USA.
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9
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Tran NH, Larson JJ, Ou FS, Mahipal A, McCue SA, Graham RP, Fernandez-Zapico ME, Revzin A, Fonkoua LAK, Flickinger LM, Cleary SP, Bekaii-Saab TS, Borad MJ, McWilliams RR, Jatoi A, Ma WW. CLO23-030: MC200402-Single-Arm Phase 2 Study of the FGFR Inhibitor Futibatinib (Futi) in Combination With Pembrolizumab (Pem) in Patients With FGF19 Expressing Advanced or Metastatic Hepatocellular Carcinoma (aHCC). J Natl Compr Canc Netw 2023. [DOI: 10.6004/jnccn.2022.7121] [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: 04/03/2023]
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10
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Tran NH, Nguyen PL, Martin NA, Asiedu G, Le-Rademacher JG, Jatoi A. "It's Like You Stuck a Pin in It:" African American/Black Patients Describe Cutaneous Toxicity From Epidermal Growth Factor Receptor Inhibitors. Am J Hosp Palliat Care 2023; 40:337-340. [PMID: 35442101 PMCID: PMC11005108 DOI: 10.1177/10499091221092698] [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] [Indexed: 11/15/2022] Open
Abstract
Background: Epidermal growth factor receptor (EGFR) inhibitors cause cutaneous toxicity in over 90% of patients. Conceivably, healthcare providers could overlook such toxicity in African American/Black patients because of a darker complexion. This qualitative study sought to learn about such cutaneous signs and symptoms and, if present, to report them in patients' own words. Methods: Any patient who self-identified as African American/Black and who had been prescribed an EGFR inhibitor was eligible. The current report focuses on patients' responses to the following question, "What have you noticed since starting your cancer treatment (the EGFR inhibitor), any particular symptoms or reactions, positive or negative?" All interview data were audio-recorded, transcribed, and then independently coded and analyzed by two investigators. Results: Fifteen patients are the focus of this report, and all described cutaneous toxicity. Patients appeared troubled by the cosmetic aspect of these drug-induced skin changes, including their acneiform appearance, describing "little pimples with little, little pus in it." Notable were comments on hyperpigmentation, "I'm a black person but…. became darker." Furthermore, patients experienced physical symptoms: "it itches;" "it's like you stuck a pin in it;" "stinging;" and "burning;". Conclusion: Although cutaneous toxicity from EGFR inhibitors might be more difficult to visualize among darkly complected patients, the graphic descriptions offered in this qualitative study underscore the need for clinicians to heighten their awareness of such toxicity in African American/Black patients.
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Affiliation(s)
| | - Phuong L. Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Gladys Asiedu
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | | | - Aminah Jatoi
- Department of Oncology, Mayo Clinic, Rochester, MN, USA
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11
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Ahn JC, Tran NH, Yang JD. Systemic therapy in advanced hepatocellular carcinoma. Clin Mol Hepatol 2023; 29:516-519. [PMID: 36800697 PMCID: PMC10121316 DOI: 10.3350/cmh.2023.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Affiliation(s)
- Joseph C Ahn
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Nguyen H Tran
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Ju Dong Yang
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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12
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Gile J, Palmer ME, Storandt MH, Bekaii-Saab TS, Tran NH, Mahipal A. Outcome of receiving lenvatinib following immunotherapy in patients with advanced hepatocellular carcinoma. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.507] [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: 01/25/2023] Open
Abstract
507 Background: Lenvatinib, a multikinase inhibitor, is an FDA approved treatment for advanced hepatocellular carcinoma (HCC) in the first line setting. Atezolizumab and bevacizumab are considered new standard of care as first line therapy after results of the IMBrave 150 trial. Currently, we do not have data to suggest any second-line treatment after administration of immunotherapy. We describe the clinical outcomes in patients with advanced HCC who received lenvatinib following treatment with immunotherapy. Methods: We conducted a multicentric, retrospective analysis of patients with advanced HCC diagnosed between 2010 and 2021 at Mayo Clinic in Minnesota, Arizona, and Florida. The study was reviewed and approved by the intuitional review board. The primary outcomes were overall survival (OS) and progression free survival (PFS). Results: We identified 53 patients with advanced HCC who received lenvatinib following immunotherapy. Most patients (83%) were male. Median age at start of lenvatinib was 67 years old. Forty-two (79%) patients had a Child-Pugh score of A at diagnosis while 30 (58%) patients were still Child-Pugh A at time of lenvatinib initiation. Risk factors for HCC included Hep C (43%), alcohol use (34%), NASH (15%) and hepatitis B (7%). Forty-five (85%) patients received lenvatinib in the 2nd line and 8 (15%) patients received it as third line or later. At time of data extraction, 38 (72%) patients had died. Median PFS was 4 months (95% CI: 3 – 6) and median OS from time of lenvatinib initiation was 13 months (95% CI: 6 – 24). The most common adverse events of any grade included fatigue (53%), hypertension (37%), AST elevation (30%), anorexia (28%), bilirubin elevation (25%) and diarrhea (25%). Twenty-one (40%) patients experienced grade 3 or higher adverse events including hypertension (25%), confusion (6%), acute kidney injury (2%), hyperkalemia (2%), ALT elevation (2%), proteinuria (2%), arthralgia (2%), heart failure (2%), AST elevation (2%), bilirubin elevation (2%), palmar-plantar erythrodysesthesia (2%), oral mucositis (2%), weight loss (2%), hypothyroidism (2%), anorexia (2%), fatigue (2%) and diarrhea (2%). Seven patients stopped treatment due to adverse events: 1 for hypertension, 2 for confusion, 1 for heart failure, 2 for fatigue, and 1 for elevated bilirubin. Conclusions: The optimal sequencing of therapy for patients with advanced HCC following progression on immunotherapy remains unknown. We found that median OS was 13 months in patients who received lenvatinib after immunotherapy which is comparable to survival in other studies when used as first line therapy. Our experience demonstrates that patients may benefit from treatment with lenvatinib following initial progression on immunotherapy.
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Affiliation(s)
| | | | | | | | | | - Amit Mahipal
- University Hospital Seidman Cancer Center, Cleveland, OH
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13
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Palmer ME, Storandt MH, Gile J, Zemla TJ, Bekaii-Saab TS, Jin Z, Tran NH, Mahipal A. Multisite institutional study of efficacy and safety of cabozantinib following immunotherapy in patients with advanced hepatocellular carcinoma. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.559] [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: 01/26/2023] Open
Abstract
559 Background: Cabozantinib, a multikanase inhibitor, is approved by the Food and Drug Administration (FDA) for treatment of advanced stage hepatocellular carcinoma (HCC) following progression on sorafenib. The CELESTIAL study which demonstrated benefit from cabozantinib following sorafenib included only patients with Child Pugh class A liver function. Recently, bevacizumab plus atezolizumab has replaced sorafenib as the first line treatment for HCC. It is unclear whether there is benefit from using Cabozantinib following progression on immunotherapy as CELESTIAL trial included very few patients who received prior immunotherapy. We describe the outcomes of individuals with advanced stage HCC treated with Cabozantinib following progression on immunotherapy. Methods: This was a multicenter, retrospective analysis of patients with advanced HCC diagnosed between 2010-2021 at Mayo Clinic Arizona, Florida, and Minnesota. Progression free survival (PFS) and median overall survival analysis were performed using Kaplan-Meier method. Results: We identified a total of 26 patients with advanced stage HCC who received cabozantinib following progression on immunotherapy. The median age of patients was 61 years (range, 39 – 81) and the majority were male (85%). Eighteen (72%) patients had Child Pugh A at initiation of cabozantinib therapy. Four (15%) patients received cabozantinib as second line therapy, the rest received it as third line or later. PFS on cabozantinib was 2.1 months (95% CI: 1.3 – 3.9) and median overall survival from time of cabozantinib initiation was 7.7 months (95% CI: 5.3 – 14.9). PFS was shorter with Child Pugh Class B, 1.3 months (95% CI: 0.9 – NE) compared to those with Child Pugh Class A, 2.1 months (95% CI: 1.5 – 4); although this difference was not significant (p=0.55). Common adverse events included fatigue (50%), anorexia (35%), aspartate aminotransferase (AST) elevation (35%), and diarrhea (31%); 7 (26%) patients experienced Grade 3 or greater adverse events including hypertension, diarrhea, anorexia, and bowel obstruction. Two patients discontinued cabozantinib due to side effects including one for uncontrolled blood pressure elevations and the other due to fatigue. Conclusions: The optimal sequencing of therapy for patients with advanced HCC following progression on immunotherapy is unknown. Treatment with cabozantinib may improve clinical outcomes following progression on immunotherapy with similar adverse event profile. This study included patients with Child Pugh class B liver disease (28%) and heavily pretreated population and demonstrated mPFS and mOS similar to other work examining outcomes of cabozantinib in real world setting after progression on sorafenib. Further studies to determine optimal treatment sequencing for this patient population are needed.
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Affiliation(s)
| | | | | | - Tyler J. Zemla
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN
| | | | | | | | - Amit Mahipal
- University Hospital Seidman Cancer Center, Cleveland, OH
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Tran NH, Almodallal Y, Batheja M, Martin N, Le-Rademacher J, Ridgeway J, Sia IG, Jatoi A. Social Determinants of Health: A Need for Evidence-Based Guidelines on How to Capture Data on Underserved Patients. Res Sq 2023:rs.3.rs-2451501. [PMID: 36711509 PMCID: PMC9882670 DOI: 10.21203/rs.3.rs-2451501/v1] [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] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background . Social determinants of health lead to better cancer care. This multi-site, single-institution study sought to capture data on social determinants of health data in Asian Americans with hepatocellular carcinoma; this group constitutes 60% of patients with this malignancy and are often undertreated or not treated at all. Methods . This study took advantage of an institutional initiative designed to capture and integrate social determinants of health data into the electronic medical record for all patients. Medical records of Asian Americans with hepatocellular cancer were reviewed to acquire data on housing instability, lack of transportation, financial concerns, and social isolation; a score of 1 indicated poor social determinants of health. Results . Of 112 adult Asian American patients with hepatocellular cancer, 22 (20%) were Southeast Asian, and 74 (67%) described English proficiency. A score of 1 (highest risk) was observed in 1 patient (0.9%) for housing instability; 1 (0.9%) lack of transportation; no patient for financial hardship; and 1 (0.9%) for social isolation. However â€" and importantly -- total noncompletion per domain (no question answered within that domain) was observed in 90 patients (80%) for housing instability; 90 (80%) for lack of transportation; 92 (82%) for financial hardship; and 90 (80%) for social isolation. Of note, institution-wide benchmark total noncompletion rates were 0.3%, 0.3%, 47%, and 39% for these respective domains. Conclusion . High total noncompletion rates make social determinants of health data challenging to interpret and underscore the need for evidence-based guidelines on how best to capture such data in underserved patients.
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Dinh CT, Vu TT, Tran NH, Dao MN, Zhang H. A New Look and Convergence Rate of Federated Multitask Learning With Laplacian Regularization. IEEE Trans Neural Netw Learn Syst 2022; PP:1-11. [PMID: 37015617 DOI: 10.1109/tnnls.2022.3224252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Non-independent and identically distributed (non-IID) data distribution among clients is considered as the key factor that degrades the performance of federated learning (FL). Several approaches to handle non-IID data, such as personalized FL and federated multitask learning (FMTL), are of great interest to research communities. In this work, first, we formulate the FMTL problem using Laplacian regularization to explicitly leverage the relationships among the models of clients for multitask learning. Then, we introduce a new view of the FMTL problem, which, for the first time, shows that the formulated FMTL problem can be used for conventional FL and personalized FL. We also propose two algorithms and decentrali-zed () to solve the formulated FMTL problem in communication-centralized and decentralized schemes, respectively. Theoretically, we prove that the convergence rates of both algorithms achieve linear speedup for strongly convex and sublinear speedup of order 1/2 for nonconvex objectives. Experimentally, we show that our algorithms outperform the conventional algorithm FedAvg, FedProx, SCAFFOLD, and AFL in FL settings, MOCHA in FMTL settings, as well as pFedMe and Per-FedAvg in personalized FL settings.
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Storandt MH, Gile JJ, Palmer ME, Zemla TJ, Ahn DH, Bekaii-Saab TS, Jin Z, Tran NH, Mahipal A. Cabozantinib Following Immunotherapy in Patients with Advanced Hepatocellular Carcinoma. Cancers (Basel) 2022; 14:cancers14215173. [PMID: 36358592 PMCID: PMC9657200 DOI: 10.3390/cancers14215173] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Cabozantinib, a multikinase inhibitor, is approved by the Food and Drug Administration (FDA) for the treatment of advanced hepatocellular carcinoma (HCC) following progression on sorafenib. Recently, atezolizumab plus bevacizumab has been approved in the first line setting for advanced HCC and has become the new standard of care. Whether cabozantinib improves outcomes following progression on immunotherapy remains unknown. We describe the clinical outcomes following treatment with immunotherapy in patients with advanced HCC who received cabozantinib. (2) Methods: We conducted a multicentric, retrospective analysis of patients with advanced HCC diagnosed between 2010-2021 at Mayo Clinic in Minnesota, Arizona, and Florida who received cabozantinib. Median overall survival and progression free survival analyses were performed using the Kaplan-Meier method. Adverse events were determined using Common Terminology Criteria for Adverse Events (CTCAE). (3). Results: We identified 26 patients with advanced HCC who received cabozantinib following progression on immunotherapy. Median progression free survival on cabozantinib therapy was 2.1 months (95% CI: 1.3-3.9) and median overall survival from time of cabozantinib initiation was 7.7 months (95% CI: 5.3-14.9). (4) Conclusion: The optimal sequencing of therapy for patients with advanced HCC following progression on immunotherapy remains unknown. Our study demonstrates that patients may benefit from treatment with cabozantinib following progression on immunotherapy.
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Affiliation(s)
| | | | | | - Tyler J. Zemla
- Department of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN 55905, USA
| | - Daniel H. Ahn
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | | | - Zhaohui Jin
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Nguyen H. Tran
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Amit Mahipal
- Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Oncology, University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH 44106, USA
- Correspondence: ; Tel.: +1-216-844-3951; Fax: +1-216-844-5234
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Tran NH, Muñoz S, Thompson S, Hallemeier CL, Bruix J. Hepatocellular carcinoma downstaging for liver transplantation in the era of systemic combined therapy with anti-VEGF/TKI and immunotherapy. Hepatology 2022; 76:1203-1218. [PMID: 35765265 DOI: 10.1002/hep.32613] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/08/2022]
Abstract
Hepatocellular carcinoma remains a global health challenge affecting close to 1 million cases yearly. Liver transplantation provides the best long-term outcomes for those meeting strict criteria. Efforts have been made to expand these criteria, whereas others have attempted downstaging approaches. Although locoregional approaches to downstaging are appealing and have demonstrated efficacy, limitations and challenges exists including poor imaging modality to assess response and appropriate endpoints along the process. Recent advances in systemic treatments including immune checkpoint inhibitors alone or in combination with tyrosine kinase inhibitors have prompted the discussion regarding their role for downstaging disease prior to transplantation. Here, we provide a review of prior locoregional approaches for downstaging, new systemic agents and their role for downstaging, and finally, key and critical considerations of the assessment, endpoints, and optimal designs in clinical trials to address this key question.
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Affiliation(s)
- Nguyen H Tran
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sergio Muñoz
- BCLC Group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spain
| | - Scott Thompson
- Division of Vascular and Interventional Radiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Christopher L Hallemeier
- Division of Radiation Oncology, Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jordi Bruix
- BCLC Group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spain
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18
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Abdelrahman AM, Goenka AH, Alva-Ruiz R, Yonkus JA, Leiting JL, Graham RP, Merrell KW, Thiels CA, Hallemeier CL, Warner SG, Haddock MG, Grotz TE, Tran NH, Smoot RL, Ma WW, Cleary SP, McWilliams RR, Nagorney DM, Halfdanarson TR, Kendrick ML, Truty MJ. FDG-PET Predicts Neoadjuvant Therapy Response and Survival in Borderline Resectable/Locally Advanced Pancreatic Adenocarcinoma. J Natl Compr Canc Netw 2022; 20:1023-1032.e3. [PMID: 36075389 DOI: 10.6004/jnccn.2022.7041] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/03/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Neoadjuvant therapy (NAT) is used in borderline resectable/locally advanced (BR/LA) pancreatic ductal adenocarcinoma (PDAC). Anatomic imaging (CT/MRI) poorly predicts response, and biochemical (CA 19-9) markers are not useful (nonsecretors/nonelevated) in many patients. Pathologic response highly predicts survival post-NAT, but is only known postoperatively. Because metabolic imaging (FDG-PET) reveals primary tumor viability, this study aimed to evaluate our experience with preoperative FDG-PET in patients with BR/LA PDAC in predicting NAT response and survival. METHODS We reviewed all patients with resected BR/LA PDAC who underwent NAT with FDG-PET within 60 days of resection. Pre- and post-NAT metabolic (FDG-PET) and biochemical (CA 19-9) responses were dichotomized in addition to pathologic responses. We compared post-NAT metabolic and biochemical responses as preoperative predictors of pathologic responses and recurrence-free survival (RFS) and overall survival (OS). RESULTS We identified 202 eligible patients. Post-NAT, 58% of patients had optimization of CA 19-9 levels. Major metabolic and pathologic responses were present in 51% and 38% of patients, respectively. Median RFS and OS times were 21 and 48.7 months, respectively. Metabolic response was superior to biochemical response in predicting pathologic response (area under the curve, 0.86 vs 0.75; P<.001). Metabolic response was the only univariate preoperative predictor of OS (odds ratio, 0.25; 95% CI, 0.13-0.40), and was highly correlated (P=.001) with pathologic response as opposed to biochemical response alone. After multivariate adjustment, metabolic response was the single largest independent preoperative predictor (P<.001) for pathologic response (odds ratio, 43.2; 95% CI, 16.9-153.2), RFS (hazard ratio, 0.37; 95% CI, 0.2-0.6), and OS (hazard ratio, 0.21; 95% CI, 0.1-0.4). CONCLUSIONS Among patients with post-NAT resected BR/LA PDAC, FDG-PET highly predicts pathologic response and survival, superior to biochemical responses alone. Given the poor ability of anatomic imaging or biochemical markers to assess NAT responses in these patients, FDG-PET is a preoperative metric of NAT efficacy, thereby allowing potential therapeutic alterations and surgical treatment decisions. We suggest that FDG-PET should be an adjunct and recommended modality during the NAT phase of care for these patients.
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Affiliation(s)
| | - Ajit H Goenka
- Division of Nuclear Medicine Radiology, Department of Radiology
| | - Roberto Alva-Ruiz
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
| | - Jennifer A Yonkus
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
| | | | - Rondell P Graham
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology
| | | | | | | | - Susanne G Warner
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
| | | | - Travis E Grotz
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
| | - Nguyen H Tran
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - Rory L Smoot
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
| | - Wen Wee Ma
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - Sean P Cleary
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
| | - Robert R McWilliams
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - David M Nagorney
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
| | | | | | - Mark J Truty
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery
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19
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Ma WW, Ou FS, Li JJ, Tran NH, Babiker HM, Revzin A, Dong H, Nelson GD, Ness A, Schuster CE, Jia J, Bekaii-Saab TS. ACCRU-GI-2008: A phase II randomized study of atezolizumab (Atezo) plus a multi-kinase inhibitor (MKI) versus MKI alone in patients with unresectable advanced hepatocellular carcinoma (aHCC) who previously received atezolizumab plus bevacizumab (Bev). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps4170] [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
TPS4170 Background: IMbrave150 is the first study demonstrating the benefit of anti-PDL1 in the frontline treatment of aHCC, and established Atezo/Bev as a new 1st line standard for aHCC. There is currently limited evidence to guide subsequent therapy for aHCC patients progressing on Atezo/Bev. ACCRU-GI-2008 is designed to determine the benefit of continuing Atezo into 2nd line and the safety of Atezo plus a MKI in patients with aHCC who previously received Atezo/Bev. The study is being conducted across 12 centers in the United States (ClincalTrials.gov#: NCT05168163). Methods: This study utilizes a 2:1 randomized phase II design where eligible patients will receive either Atezo/MKI (experimental arm) or MKI alone (control). Patients will be stratified according to the MKI choice (cabozantinib or lenvatinib, per physician’s decision), etiology of HCC (viral vs. non-viral) and alpha-fetoprotein level ( < 400 vs. > = 400 ng/mL). The major eligibility criteria are histological/cytological diagnosis or clinical diagnosis of HCC per the AASLD or WASL 2018 guidelines, has advanced disease not amendable to curative treatment, previously received and progressed on Atezo/Bev, has received only 1 previous line of systemic therapy (2nd line only), ECOG PS 0-1, Child Pugh Class A, adequate organ reserves and RECIST v1.1 measurable disease; previous MKI for advanced disease is excluded. The primary endpoints are overall survival (OS) and progression free survival (PFS). A total sample size of 122, with 89 PFS events, we will have 80% power to detect an improvement in median PFS from 4 to 7 months, assuming a one-sided significance level of 0.05. With approximately 84 deaths, we will have 80% power to detect an improvement in median OS from 10 to 18 months, assuming a one-sided significance level of 0.05. The overall one-sided significance level, for the study, is 0.1. An OS interim analysis will be conducted at 89 PFS events. Secondary endpoints include objective response, duration of response, and adverse events. Archival tumor and serial blood samples will be collected to evaluate for potential prediction biomarkers and mechanisms of sensitivity/resistance. Baseline and on-treatment tumor biopsy specimens will also be collected from the initial 10 patients of each arm. The study is approved by the ethics committee and enrollment to the study will be underway by Q2/3 2022. Clinical trial information: NCT05168163.
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Affiliation(s)
- Wen Wee Ma
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
| | - Fang-Shu Ou
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Jenny Jing Li
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
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20
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Liddell SS, Chakrabarti S, Wintheiser GA, Zemla TJ, Shi Q, Tella SH, Jin Z, Wookey VB, Hassan H, Tran NH, Borad MJ, Mahipal A. Tumor Mutational Burden Is a Potential Predictive Biomarker for Response to Immune Checkpoint Inhibitors in Patients With Advanced Biliary Tract Cancer. JCO Precis Oncol 2022; 6:e2200003. [PMID: 35772047 DOI: 10.1200/po.22.00003] [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
PURPOSE Patients with advanced biliary tract cancers (BTCs) have a dismal prognosis. This multisite, single-institution study analyzed the efficacy and safety of immune checkpoint inhibitors (ICIs) in patients with advanced BTC. MATERIALS AND METHODS The prospectively maintained institutional database was searched for patients with advanced BTC. Electronic medical records of the patients with advanced BTC treated with an ICI that included programmed death-1 or programmed death-ligand 1 blockers were retrospectively reviewed to obtain data on patient characteristics, tumor characteristics including molecular biomarkers, detailed treatment, response characteristics, survival, and toxicities. The analysis included overall response rate, survival, and correlation between survival and molecular biomarkers. RESULTS The institutional database query identified 47 patients with advanced BTC who received at least one dose of an ICI; 11 (24%) patients in the first-line setting and the rest of the patients had refractory disease. The median age of the cohort was 62 years, and 51% were female. The overall response rate was 10.6%, with a disease control rate of 53.2%. The median progression-free survival (PFS) and overall survival were 3.6 months and 6.9 months, respectively. Biomarker analysis revealed improved PFS in patients with tumor mutational burden > 5 mutations per megabase (median PFS: 6.4 v 2.2 months; P = .0027). No unexpected adverse events were observed. CONCLUSION ICIs are well tolerated and have modest antitumor activity in patients with advanced BTC. The study result supports the exploration of tumor mutational burden as a potential predictive biomarker for response to ICIs in patients with advanced BTC.
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Affiliation(s)
| | - Sakti Chakrabarti
- Department of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI
| | | | - Tyler J Zemla
- Department of Biostatistics, Mayo Clinic, Rochester, MN
| | - Qian Shi
- Department of Biostatistics, Mayo Clinic, Rochester, MN
| | | | - Zhaohui Jin
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
| | | | - Hind Hassan
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
| | - Nguyen H Tran
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
| | | | - Amit Mahipal
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
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21
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Thompson SM, Suman G, Torbenson MS, Chen ZE, Jondal DE, Patra A, Ehman EC, Andrews JC, Fleming CJ, Welch BT, Kurup AN, Roberts LR, Watt KD, Truty MJ, Cleary SP, Smoot RL, Heimbach JK, Tran NH, Mahipal A, Yin J, Zemla T, Wang C, Fogarty Z, Jacobson M, Kemp BJ, Venkatesh SK, Johnson GB, Woodrum DA, Goenka AH. PSMA as a Theranostic Target in Hepatocellular Carcinoma: Immunohistochemistry and 68 Ga-PSMA-11 PET Using Cyclotron-Produced 68 Ga. Hepatol Commun 2022; 6:1172-1185. [PMID: 34783177 PMCID: PMC9035563 DOI: 10.1002/hep4.1861] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 02/05/2023] Open
Abstract
Prostate-specific membrane antigen (PSMA) is a validated target for molecular diagnostics and targeted radionuclide therapy. Our purpose was to evaluate PSMA expression in hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), and hepatic adenoma (HCA); investigate the genetic pathways in HCC associated with PSMA expression; and evaluate HCC detection rate with 68 Ga-PSMA-11 positron emission tomography (PET). In phase 1, PSMA immunohistochemistry (IHC) on HCC (n = 148), CCA (n = 111), and HCA (n = 78) was scored. In a subset (n = 30), messenger RNA (mRNA) data from the Cancer Genome Atlas HCC RNA sequencing were correlated with PSMA expression. In phase 2, 68 Ga-PSMA-11 PET was prospectively performed in patients with treatment-naïve HCC on a digital PET scanner using cyclotron-produced 68 Ga. Uptake was graded qualitatively and semi-quantitatively using standard metrics. On IHC, PSMA expression was significantly higher in HCC compared with CCA and HCA (P < 0.0001); 91% of HCCs (n = 134) expressed PSMA, which principally localized to tumor-associated neovasculature. Higher tumor grade was associated with PSMA expression (P = 0.012) but there was no association with tumor size (P = 0.14), fibrosis (P = 0.35), cirrhosis (P = 0.74), hepatitis B virus (P = 0.31), or hepatitis C virus (P = 0.15). Overall survival tended to be longer in patients without versus with PSMA expression (median overall survival: 4.2 vs. 1.9 years; P = 0.273). FGF14 (fibroblast growth factor 14) mRNA expression correlated positively (rho = 0.70; P = 1.70 × 10-5 ) and MAD1L1 (Mitotic spindle assembly checkpoint protein MAD1) correlated negatively with PSMA expression (rho = -0.753; P = 1.58 × 10-6 ). Of the 190 patients who met the eligibility criteria, 31 patients with 39 HCC lesions completed PET; 64% (n = 25) lesions had pronounced 68 Ga-PSMA-11 standardized uptake value: SUVmax (median [range] 9.2 [4.9-28.4]), SUVmean 4.7 (2.4-12.7), and tumor-to-liver background ratio 2 (1.1-11). Conclusion: Ex vivo expression of PSMA in neovasculature of HCC translates to marked tumor avidity on 68 Ga-PSMA-11 PET, which suggests that PSMA has the potential as a theranostic target in patients with HCC.
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Affiliation(s)
| | - Garima Suman
- Department of RadiologyMayo ClinicRochesterMNUSA
| | | | - Zong‐Ming E. Chen
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMNUSA
| | | | | | | | | | | | | | | | - Lewis R. Roberts
- Division of Gastroenterology and HepatologyMayo ClinicRochesterMNUSA
| | - Kymberly D. Watt
- Division of Gastroenterology and HepatologyMayo ClinicRochesterMNUSA
| | - Mark J. Truty
- Division of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMNUSA
| | - Sean P. Cleary
- Division of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMNUSA
| | - Rory L. Smoot
- Division of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMNUSA
| | | | | | - Amit Mahipal
- Division of Medical OncologyMayo ClinicRochesterMNUSA
| | - Jun Yin
- Division of Biostatistics and InformaticsMayo ClinicRochesterMNUSA
| | - Tyler Zemla
- Division of Biostatistics and InformaticsMayo ClinicRochesterMNUSA
| | - Chen Wang
- Division of Computational BiologyMayo ClinicRochesterMNUSA
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22
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Gile J, Jatoi A, Wee Ma W, Borad M, Tran NH. Reply to A. Rizzo et al. JCO Precis Oncol 2022; 6:e2200061. [PMID: 35294225 DOI: 10.1200/po.22.00061] [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)
- Jennifer Gile
- Jennifer Gile, MD, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Amina Jatoi, MD, and Wen Wee Ma, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN; Mitesh Borad, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ; and Nguyen H. Tran, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Amina Jatoi
- Jennifer Gile, MD, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Amina Jatoi, MD, and Wen Wee Ma, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN; Mitesh Borad, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ; and Nguyen H. Tran, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Wen Wee Ma
- Jennifer Gile, MD, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Amina Jatoi, MD, and Wen Wee Ma, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN; Mitesh Borad, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ; and Nguyen H. Tran, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Mitesh Borad
- Jennifer Gile, MD, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Amina Jatoi, MD, and Wen Wee Ma, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN; Mitesh Borad, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ; and Nguyen H. Tran, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Nguyen H Tran
- Jennifer Gile, MD, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Amina Jatoi, MD, and Wen Wee Ma, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN; Mitesh Borad, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ; and Nguyen H. Tran, MD, Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
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23
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Soderberg LC, Wookey V, Mitchell JL, Jochum JA, Tran NH, Halfdanarson TR, Hubbard JM, Graham RP, Mathis KL, Mahipal A, Jin Z. Clinical outcomes of neoadjuvant treatment strategies in localized mismatch repair-deficient rectal cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.4_suppl.192] [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
192 Background: Rectal cancer treatment paradigm has been evolving over time. Historically, for locally advanced rectal cancer, standard therapy (ST) consisted of neoadjuvant chemoradiation followed by surgery and adjuvant chemotherapy. Recently, total neoadjuvant treatment (TNT) approach that delivers both neoadjuvant chemotherapy (CAPOX or FOLFOX) and chemoradiation (or radiation only) prior to surgery is increasingly being utilized. The prognostic and predictive values of mismatch repair deficient (dMMR) in rectal cancer is not well characterized. Most dMMR patients receive the same treatment as MMR proficient (pMMR) patients although there is limited data that dMMR rectal cancer patients may not have the same level of benefits from neoadjuvant treatment. This retrospective study aims to evaluate the clinicopathological/molecular characteristics, disease response, and clinical outcomes in dMMR localized rectal cancer patients. Methods: A retrospective analysis was conducted on consecutive adult patients with a diagnosis of dMMR rectal cancer who were treated at Mayo Clinic between January 2000 to September 2021. Patients who presented with concurrent primary non-colorectal malignancies were excluded. The distributions of demographics, clinicopathological features, biomarkers, and outcome data were collected. Survival was assessed using Kaplan-Meier curves and Cox models were stratified by treatment arms to determine significance of treatment strategies. Results: Forty-one patients were identified with a median age of 45.3 years. Thirty (73.2%) pts were male. The most common MMR were loss of MSH2 and MSH6 (12/42; 29.3%) followed by loss of MLH1 and PMS2 (10/42; 24.4%) and solitary loss of MSH2 (4/42; 9.8%). The treatment, pathological response, and clinical outcomes are listed in table. With a median follow up of 101 months, only 6 patients (14.3%) died and median overall survival was not reached. Conclusions: Our findings showed dMMR localized rectal cancer responded to both ST and TNT with good clinical outcomes.[Table: see text]
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24
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Tran NH. Shifting Epidemiology of Hepatocellular Carcinoma in Far Eastern and Southeast Asian Patients: Explanations and Implications. Curr Oncol Rep 2022; 24:187-193. [DOI: 10.1007/s11912-021-01160-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 01/02/2023]
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25
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Torbenson M, McCabe CE, O’Brien DR, Yin J, Bainter T, Tran NH, Yasir S, Chen ZE, Dhanasekaran R, Ahn KS, Roberts LR, Wang C. Morphological heterogeneity in beta-catenin-mutated hepatocellular carcinomas: implications for tumor molecular classification. Hum Pathol 2022; 119:15-27. [PMID: 34592239 PMCID: PMC9258524 DOI: 10.1016/j.humpath.2021.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 01/03/2023]
Abstract
Beta-catenin (CTNNB1) is commonly mutated in hepatocellular carcinoma (HCC). CTNNB1-mutated HCC has important clinical correlates, such as being immune cold and less likely to respond to immune checkpoint inhibitor therapies. It remains unclear, however, if they are a morphologically homogenous group of tumors. To better understand the association between the morphology, CTNNB1 mutations, and other molecular features, a detailed study of 338 The Cancer Genome Atlas cases was performed. A characteristic histological morphology was strongly associated with CTNNB1 mutations but was present in only 58% of CTNNB1-mutated HCCs. Tumors with APC mutations tended to have the classic morphology; those with AXIN mutations did not. Pseudoglands are a key feature of the classic morphology, and they were associated with CTNNB1 mutations, male gender, specific CTNNB1 mutation site, and lack of TP53 mutations. Differential gene expression analysis stratified by the presence/absence of pseudoglands identified 60 differentially expressed genes (FDR <5%); clustering according to these differentially expressed genes revealed three groups of tumors, one with pseudoglands and a strong association with genes regulated by Wnt signaling; within this group, TP53 mutations were associated with a loss of the typical morphology of CTNNB1-mutated HCCs. When stratified by gender, further differential gene expression showed Wnt-regulated genes were associated with pseudoglands in men but not women. These findings indicate HCC with CTNNB1 mutations are morphologically heterogeneous, with gene penetrance for morphology dependent in part on gender, specific CTNNB1 mutations, and co-occurring TP53 mutations. This heterogeneity has important implications for the classification of HCC.
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Affiliation(s)
- Michael Torbenson
- Mayo Clinic Department of Pathology and Laboratory Medicine, United States,Corresponding author. Department of Pathology and Laboratory Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA. (M. Torbenson)
| | - Chantal E. McCabe
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Daniel R. O’Brien
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Jun Yin
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States
| | - Tiffany Bainter
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States
| | - Nguyen H. Tran
- Department of Oncology, Mayo Clinic, Rochester, MN, United States
| | - Saba Yasir
- Mayo Clinic Department of Pathology and Laboratory Medicine, United States
| | - Zongming Eric Chen
- Mayo Clinic Department of Pathology and Laboratory Medicine, United States
| | - Renu Dhanasekaran
- Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA, United States
| | - Keun Soo Ahn
- Department of Surgery, Keimyung University School of Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Lewis R. Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
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26
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Affiliation(s)
- Nguyen H Tran
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
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27
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Munir MS, Tran NH, Saad W, Hong CS. Multi-Agent Meta-Reinforcement Learning for Self-Powered and Sustainable Edge Computing Systems. IEEE Trans Netw Serv Manage 2021. [DOI: 10.1109/tnsm.2021.3057960] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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28
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Munir MS, Abedin SF, Tran NH, Han Z, Huh EN, Hong CS. Risk-Aware Energy Scheduling for Edge Computing With Microgrid: A Multi-Agent Deep Reinforcement Learning Approach. IEEE Trans Netw Serv Manage 2021. [DOI: 10.1109/tnsm.2021.3049381] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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29
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Li JJ, Zhu M, Kashyap PC, Chia N, Tran NH, McWilliams RR, Bekaii-Saab TS, Ma WW. The role of microbiome in pancreatic cancer. Cancer Metastasis Rev 2021; 40:777-789. [PMID: 34455517 PMCID: PMC8402962 DOI: 10.1007/s10555-021-09982-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
Recent studies of the human microbiome have offered new insights into how the microbiome can impact cancer development and treatment. Specifically, in pancreatic ductal adenocarcinoma (PDAC), the microbiota has been shown to modulate PDAC risk, contribute to tumorigenesis, impact the tumor microenvironment, and alter treatment response. These findings provide rationale for further investigations into leveraging the microbiome to develop new strategies to diagnose and treat PDAC patients. There is growing evidence that microbiome analyses have the potential to become easily performed, non-invasive diagnostic, prognostic, and predictive biomarkers in pancreatic cancer. More excitingly, there is now emerging interest in developing interventions based on the modulation of microbiota. Fecal microbiota transplantation, probiotics, dietary changes, and antibiotics are all potential strategies to augment the efficacy of current therapeutics and reduce toxicities. While there are still challenges to overcome, this is a rapidly growing field that holds promise for translation into clinical practice and provides a new approach to improving patient outcomes.
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Affiliation(s)
- Jenny Jing Li
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
| | - Mojun Zhu
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
| | - Purna C Kashyap
- Microbiome Program, Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nicholas Chia
- Microbiome Program, Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nguyen H Tran
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
| | - Robert R McWilliams
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
| | - Tanios S Bekaii-Saab
- Division of Hematology/Oncology, Mayo Clinic, 2779 E. Mayo Boulevard, Phoenix, AZ, USA
| | - Wen Wee Ma
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
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Abstract
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. Its incidence is rising faster than any other cancer in the United States and it remains one of the leading causes of cancer-related deaths worldwide. While advances in massive parallel sequencing and integration of 'omics information have transformed the field of oncology, tissue access is often limited in HCC and a single biopsy is poorly representative of the known genetic heterogeneity of tumours. Liquid biopsy has emerged as a promising strategy for analysing circulating tumour components including circulating tumour DNA. Cell-free DNA and tumour DNA are derived from necrotic, apoptotic and living eukaryotic cells. The profiling of genetic and epigenetic alterations in circulating cell-free DNA has potential clinical applications including early disease detection, prediction of treatment response and prognostication in real time. Novel biomarker candidates for disease detection and monitoring are under study. Of these, methylation analyses of circulating tumour DNA have shown promising performance for early HCC detection in at-risk patients. Assessments of assay performance in longitudinal validation cohorts are ongoing. Implementation of liquid biopsy for HCC will likely improve upon the current surveillance strategy. This review summarises the most recent developments on the role and utility of circulating cell-free DNA in the detection and management of HCC.
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Affiliation(s)
- Nguyen H Tran
- Department of Oncology, Mayo Clinic, Rochester, Minnesota, United States
| | - John Kisiel
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
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Gile JJ, Ou FS, Mahipal A, Larson JJ, Mody K, Jin Z, Hubbard J, Halfdanarson T, Alberts SR, Jatoi A, McWilliams RR, Ma WW, Ilyas S, Smoot R, Roberts L, Gores G, Borad M, Bekaii-Saab TS, Tran NH. FGFR Inhibitor Toxicity and Efficacy in Cholangiocarcinoma: Multicenter Single-Institution Cohort Experience. JCO Precis Oncol 2021; 5:PO.21.00064. [PMID: 34778691 PMCID: PMC8575436 DOI: 10.1200/po.21.00064] [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: 02/12/2021] [Revised: 06/08/2021] [Accepted: 07/07/2021] [Indexed: 11/20/2022] Open
Abstract
Cholangiocarcinomas (CCA) are a group of heterogeneous tumors arising from the biliary epithelia. Significant sequencing efforts have provided further insights into the molecular mechanisms of this disease including fibroblast growth factor receptor (FGFR) alterations, which occurs in approximately 15%-20% of intrahepatic CCAs. Herein, we describe the FGFR inhibitor (FGFRi)-associated treatment toxicity and cancer-specific outcomes from a multicenter single-institution cohort. METHODS This is a retrospective study of patients with CCA and known FGFR alterations treated with FGFRi. We describe the toxicity and efficacy in patients treated at Mayo Clinic between January 2010 and December 2020. RESULTS Our group identified 61 patients with advanced or metastatic CCA, 19 males (31%) and 42 females (69%), harboring FGFR alterations who received FGFRi. The most common grade 1 or higher adverse events for all patients included fatigue (92%), AST elevations (78%), anemia (80%), decreased platelet count (63%), and hyperphosphatemia (74%). Median progression-free survival on FGFRi was 5.8 months for all patients (95% CI, 4.9 to 9.0). Females had significantly longer progression-free survival at 6.9 months (95% CI, 5.2 to 11.8) on FGFRi compared with males at 4.9 months (95% CI, 2.8 to not estimable; P = .038). CONCLUSION FGFRi are well tolerated with clinical efficacy. With the recent approval of FGFRi by the US Food and Drug Administration and ongoing clinical trials for new FGFRi, understanding outcomes and toxicity associated with these medications is important for precision oncology.
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Affiliation(s)
| | - Fang-Shu Ou
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Amit Mahipal
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Joseph J. Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Kabir Mody
- Division of Oncology, Department of Medicine, Mayo Clinic, FL USA
| | - Zhaohui Jin
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Joleen Hubbard
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | | | - Steven R. Alberts
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Aminah Jatoi
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | | | - Wen Wee Ma
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Sumera Ilyas
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Rory Smoot
- Department of Surgery, Mayo Clinic, Rochester, MN
| | - Lewis Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Gregory Gores
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Mitesh Borad
- Division of Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ
| | | | - Nguyen H. Tran
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN
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32
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Abi B, Albahri T, Al-Kilani S, Allspach D, Alonzi LP, Anastasi A, Anisenkov A, Azfar F, Badgley K, Baeßler S, Bailey I, Baranov VA, Barlas-Yucel E, Barrett T, Barzi E, Basti A, Bedeschi F, Behnke A, Berz M, Bhattacharya M, Binney HP, Bjorkquist R, Bloom P, Bono J, Bottalico E, Bowcock T, Boyden D, Cantatore G, Carey RM, Carroll J, Casey BCK, Cauz D, Ceravolo S, Chakraborty R, Chang SP, Chapelain A, Chappa S, Charity S, Chislett R, Choi J, Chu Z, Chupp TE, Convery ME, Conway A, Corradi G, Corrodi S, Cotrozzi L, Crnkovic JD, Dabagov S, De Lurgio PM, Debevec PT, Di Falco S, Di Meo P, Di Sciascio G, Di Stefano R, Drendel B, Driutti A, Duginov VN, Eads M, Eggert N, Epps A, Esquivel J, Farooq M, Fatemi R, Ferrari C, Fertl M, Fiedler A, Fienberg AT, Fioretti A, Flay D, Foster SB, Friedsam H, Frlež E, Froemming NS, Fry J, Fu C, Gabbanini C, Galati MD, Ganguly S, Garcia A, Gastler DE, George J, Gibbons LK, Gioiosa A, Giovanetti KL, Girotti P, Gohn W, Gorringe T, Grange J, Grant S, Gray F, Haciomeroglu S, Hahn D, Halewood-Leagas T, Hampai D, Han F, Hazen E, Hempstead J, Henry S, Herrod AT, Hertzog DW, Hesketh G, Hibbert A, Hodge Z, Holzbauer JL, Hong KW, Hong R, Iacovacci M, Incagli M, Johnstone C, Johnstone JA, Kammel P, Kargiantoulakis M, Karuza M, Kaspar J, Kawall D, Kelton L, Keshavarzi A, Kessler D, Khaw KS, Khechadoorian Z, Khomutov NV, Kiburg B, Kiburg M, Kim O, Kim SC, Kim YI, King B, Kinnaird N, Korostelev M, Kourbanis I, Kraegeloh E, Krylov VA, Kuchibhotla A, Kuchinskiy NA, Labe KR, LaBounty J, Lancaster M, Lee MJ, Lee S, Leo S, Li B, Li D, Li L, Logashenko I, Lorente Campos A, Lucà A, Lukicov G, Luo G, Lusiani A, Lyon AL, MacCoy B, Madrak R, Makino K, Marignetti F, Mastroianni S, Maxfield S, McEvoy M, Merritt W, Mikhailichenko AA, Miller JP, Miozzi S, Morgan JP, Morse WM, Mott J, Motuk E, Nath A, Newton D, Nguyen H, Oberling M, Osofsky R, Ostiguy JF, Park S, Pauletta G, Piacentino GM, Pilato RN, Pitts KT, Plaster B, Počanić D, Pohlman N, Polly CC, Popovic M, Price J, Quinn B, Raha N, Ramachandran S, Ramberg E, Rider NT, Ritchie JL, Roberts BL, Rubin DL, Santi L, Sathyan D, Schellman H, Schlesier C, Schreckenberger A, Semertzidis YK, Shatunov YM, Shemyakin D, Shenk M, Sim D, Smith MW, Smith A, Soha AK, Sorbara M, Stöckinger D, Stapleton J, Still D, Stoughton C, Stratakis D, Strohman C, Stuttard T, Swanson HE, Sweetmore G, Sweigart DA, Syphers MJ, Tarazona DA, Teubner T, Tewsley-Booth AE, Thomson K, Tishchenko V, Tran NH, Turner W, Valetov E, Vasilkova D, Venanzoni G, Volnykh VP, Walton T, Warren M, Weisskopf A, Welty-Rieger L, Whitley M, Winter P, Wolski A, Wormald M, Wu W, Yoshikawa C. Measurement of the Positive Muon Anomalous Magnetic Moment to 0.46 ppm. Phys Rev Lett 2021; 126:141801. [PMID: 33891447 DOI: 10.1103/physrevlett.126.141801] [Citation(s) in RCA: 111] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
We present the first results of the Fermilab National Accelerator Laboratory (FNAL) Muon g-2 Experiment for the positive muon magnetic anomaly a_{μ}≡(g_{μ}-2)/2. The anomaly is determined from the precision measurements of two angular frequencies. Intensity variation of high-energy positrons from muon decays directly encodes the difference frequency ω_{a} between the spin-precession and cyclotron frequencies for polarized muons in a magnetic storage ring. The storage ring magnetic field is measured using nuclear magnetic resonance probes calibrated in terms of the equivalent proton spin precession frequency ω[over ˜]_{p}^{'} in a spherical water sample at 34.7 °C. The ratio ω_{a}/ω[over ˜]_{p}^{'}, together with known fundamental constants, determines a_{μ}(FNAL)=116 592 040(54)×10^{-11} (0.46 ppm). The result is 3.3 standard deviations greater than the standard model prediction and is in excellent agreement with the previous Brookhaven National Laboratory (BNL) E821 measurement. After combination with previous measurements of both μ^{+} and μ^{-}, the new experimental average of a_{μ}(Exp)=116 592 061(41)×10^{-11} (0.35 ppm) increases the tension between experiment and theory to 4.2 standard deviations.
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Affiliation(s)
- B Abi
- University of Oxford, Oxford, United Kingdom
| | - T Albahri
- University of Liverpool, Liverpool, United Kingdom
| | - S Al-Kilani
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - D Allspach
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - L P Alonzi
- University of Washington, Seattle, Washington, USA
| | | | - A Anisenkov
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | - F Azfar
- University of Oxford, Oxford, United Kingdom
| | - K Badgley
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Baeßler
- University of Virginia, Charlottesville, Virginia, USA
| | - I Bailey
- Lancaster University, Lancaster, United Kingdom
| | - V A Baranov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - E Barlas-Yucel
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - T Barrett
- Cornell University, Ithaca, New York, USA
| | - E Barzi
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Basti
- INFN, Sezione di Pisa, Pisa, Italy
- Università di Pisa, Pisa, Italy
| | | | - A Behnke
- Northern Illinois University, DeKalb, Illinois, USA
| | - M Berz
- Michigan State University, East Lansing, Michigan, USA
| | | | - H P Binney
- University of Washington, Seattle, Washington, USA
| | | | - P Bloom
- North Central College, Naperville, Illinois, USA
| | - J Bono
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - E Bottalico
- INFN, Sezione di Pisa, Pisa, Italy
- Università di Pisa, Pisa, Italy
| | - T Bowcock
- University of Liverpool, Liverpool, United Kingdom
| | - D Boyden
- Northern Illinois University, DeKalb, Illinois, USA
| | - G Cantatore
- INFN, Sezione di Trieste, Trieste, Italy
- Università di Trieste, Trieste, Italy
| | - R M Carey
- Boston University, Boston, Massachusetts, USA
| | - J Carroll
- University of Liverpool, Liverpool, United Kingdom
| | - B C K Casey
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Cauz
- INFN Gruppo Collegato di Udine, Sezione di Trieste, Udine, Italy
- Università di Udine, Udine, Italy
| | - S Ceravolo
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | | | - S P Chang
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | | | - S Chappa
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Charity
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - R Chislett
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - J Choi
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - Z Chu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - T E Chupp
- University of Michigan, Ann Arbor, Michigan, USA
| | - M E Convery
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Conway
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - G Corradi
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | - S Corrodi
- Argonne National Laboratory, Lemont, Illinois, USA
| | - L Cotrozzi
- INFN, Sezione di Pisa, Pisa, Italy
- Università di Pisa, Pisa, Italy
| | - J D Crnkovic
- Brookhaven National Laboratory, Upton, New York, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- University of Mississippi, University, Mississippi, USA
| | - S Dabagov
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | | | - P T Debevec
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | | | - P Di Meo
- INFN, Sezione di Napoli, Napoli, Italy
| | | | - R Di Stefano
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Cassino e del Lazio Meridionale, Cassino, Italy
| | - B Drendel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A Driutti
- INFN, Sezione di Trieste, Trieste, Italy
- Università di Udine, Udine, Italy
- University of Kentucky, Lexington, Kentucky, USA
| | - V N Duginov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - M Eads
- Northern Illinois University, DeKalb, Illinois, USA
| | - N Eggert
- Cornell University, Ithaca, New York, USA
| | - A Epps
- Northern Illinois University, DeKalb, Illinois, USA
| | - J Esquivel
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Farooq
- University of Michigan, Ann Arbor, Michigan, USA
| | - R Fatemi
- University of Kentucky, Lexington, Kentucky, USA
| | - C Ferrari
- INFN, Sezione di Pisa, Pisa, Italy
- Istituto Nazionale di Ottica-Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - M Fertl
- Institute of Physics and Cluster of Excellence PRISMA+, Johannes Gutenberg University Mainz, Mainz, Germany
- University of Washington, Seattle, Washington, USA
| | - A Fiedler
- Northern Illinois University, DeKalb, Illinois, USA
| | - A T Fienberg
- University of Washington, Seattle, Washington, USA
| | - A Fioretti
- INFN, Sezione di Pisa, Pisa, Italy
- Istituto Nazionale di Ottica-Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - D Flay
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - S B Foster
- Boston University, Boston, Massachusetts, USA
| | - H Friedsam
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - E Frlež
- University of Virginia, Charlottesville, Virginia, USA
| | - N S Froemming
- Northern Illinois University, DeKalb, Illinois, USA
- University of Washington, Seattle, Washington, USA
| | - J Fry
- University of Virginia, Charlottesville, Virginia, USA
| | - C Fu
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - C Gabbanini
- INFN, Sezione di Pisa, Pisa, Italy
- Istituto Nazionale di Ottica-Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - M D Galati
- INFN, Sezione di Pisa, Pisa, Italy
- Università di Pisa, Pisa, Italy
| | - S Ganguly
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - A Garcia
- University of Washington, Seattle, Washington, USA
| | - D E Gastler
- Boston University, Boston, Massachusetts, USA
| | - J George
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | | | - A Gioiosa
- INFN, Sezione di Pisa, Pisa, Italy
- Università del Molise, Campobasso, Italy
| | - K L Giovanetti
- Department of Physics and Astronomy, James Madison University, Harrisonburg, Virginia, USA
| | - P Girotti
- INFN, Sezione di Pisa, Pisa, Italy
- Università di Pisa, Pisa, Italy
| | - W Gohn
- University of Kentucky, Lexington, Kentucky, USA
| | - T Gorringe
- University of Kentucky, Lexington, Kentucky, USA
| | - J Grange
- Argonne National Laboratory, Lemont, Illinois, USA
- University of Michigan, Ann Arbor, Michigan, USA
| | - S Grant
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - F Gray
- Regis University, Denver, Colorado, USA
| | - S Haciomeroglu
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - D Hahn
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - D Hampai
- INFN, Laboratori Nazionali di Frascati, Frascati, Italy
| | - F Han
- University of Kentucky, Lexington, Kentucky, USA
| | - E Hazen
- Boston University, Boston, Massachusetts, USA
| | - J Hempstead
- University of Washington, Seattle, Washington, USA
| | - S Henry
- University of Oxford, Oxford, United Kingdom
| | - A T Herrod
- University of Liverpool, Liverpool, United Kingdom
| | - D W Hertzog
- University of Washington, Seattle, Washington, USA
| | - G Hesketh
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - A Hibbert
- University of Liverpool, Liverpool, United Kingdom
| | - Z Hodge
- University of Washington, Seattle, Washington, USA
| | - J L Holzbauer
- University of Mississippi, University, Mississippi, USA
| | - K W Hong
- University of Virginia, Charlottesville, Virginia, USA
| | - R Hong
- Argonne National Laboratory, Lemont, Illinois, USA
- University of Kentucky, Lexington, Kentucky, USA
| | - M Iacovacci
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Napoli, Napoli, Italy
| | | | - C Johnstone
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - J A Johnstone
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - P Kammel
- University of Washington, Seattle, Washington, USA
| | | | - M Karuza
- INFN, Sezione di Trieste, Trieste, Italy
- University of Rijeka, Rijeka, Croatia
| | - J Kaspar
- University of Washington, Seattle, Washington, USA
| | - D Kawall
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - L Kelton
- University of Kentucky, Lexington, Kentucky, USA
| | - A Keshavarzi
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - D Kessler
- Department of Physics, University of Massachusetts, Amherst, Massachusetts, USA
| | - K S Khaw
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
- University of Washington, Seattle, Washington, USA
| | | | - N V Khomutov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - B Kiburg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Kiburg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
- North Central College, Naperville, Illinois, USA
| | - O Kim
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - S C Kim
- Cornell University, Ithaca, New York, USA
| | - Y I Kim
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - B King
- University of Liverpool, Liverpool, United Kingdom
| | - N Kinnaird
- Boston University, Boston, Massachusetts, USA
| | | | - I Kourbanis
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - E Kraegeloh
- University of Michigan, Ann Arbor, Michigan, USA
| | - V A Krylov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - A Kuchibhotla
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | | | - K R Labe
- Cornell University, Ithaca, New York, USA
| | - J LaBounty
- University of Washington, Seattle, Washington, USA
| | - M Lancaster
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | - M J Lee
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - S Lee
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - S Leo
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - B Li
- Argonne National Laboratory, Lemont, Illinois, USA
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - D Li
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - L Li
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai, China
| | - I Logashenko
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | | | - A Lucà
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - G Lukicov
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - G Luo
- Northern Illinois University, DeKalb, Illinois, USA
| | - A Lusiani
- INFN, Sezione di Pisa, Pisa, Italy
- Scuola Normale Superiore, Pisa, Italy
| | - A L Lyon
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - B MacCoy
- University of Washington, Seattle, Washington, USA
| | - R Madrak
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - K Makino
- Michigan State University, East Lansing, Michigan, USA
| | - F Marignetti
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Cassino e del Lazio Meridionale, Cassino, Italy
| | | | - S Maxfield
- University of Liverpool, Liverpool, United Kingdom
| | - M McEvoy
- Northern Illinois University, DeKalb, Illinois, USA
| | - W Merritt
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | - J P Miller
- Boston University, Boston, Massachusetts, USA
| | - S Miozzi
- INFN, Sezione di Roma Tor Vergata, Roma, Italy
| | - J P Morgan
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - W M Morse
- Brookhaven National Laboratory, Upton, New York, USA
| | - J Mott
- Boston University, Boston, Massachusetts, USA
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - E Motuk
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - A Nath
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Napoli, Napoli, Italy
| | - D Newton
- University of Liverpool, Liverpool, United Kingdom
| | - H Nguyen
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Oberling
- Argonne National Laboratory, Lemont, Illinois, USA
| | - R Osofsky
- University of Washington, Seattle, Washington, USA
| | - J-F Ostiguy
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - S Park
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - G Pauletta
- INFN Gruppo Collegato di Udine, Sezione di Trieste, Udine, Italy
- Università di Udine, Udine, Italy
| | - G M Piacentino
- INFN, Sezione di Roma Tor Vergata, Roma, Italy
- Università del Molise, Campobasso, Italy
| | - R N Pilato
- INFN, Sezione di Pisa, Pisa, Italy
- Università di Pisa, Pisa, Italy
| | - K T Pitts
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - B Plaster
- University of Kentucky, Lexington, Kentucky, USA
| | - D Počanić
- University of Virginia, Charlottesville, Virginia, USA
| | - N Pohlman
- Northern Illinois University, DeKalb, Illinois, USA
| | - C C Polly
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Popovic
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - J Price
- University of Liverpool, Liverpool, United Kingdom
| | - B Quinn
- University of Mississippi, University, Mississippi, USA
| | - N Raha
- INFN, Sezione di Pisa, Pisa, Italy
| | | | - E Ramberg
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - N T Rider
- Cornell University, Ithaca, New York, USA
| | - J L Ritchie
- Department of Physics, University of Texas at Austin, Austin, Texas, USA
| | - B L Roberts
- Boston University, Boston, Massachusetts, USA
| | - D L Rubin
- Cornell University, Ithaca, New York, USA
| | - L Santi
- INFN Gruppo Collegato di Udine, Sezione di Trieste, Udine, Italy
- Università di Udine, Udine, Italy
| | - D Sathyan
- Boston University, Boston, Massachusetts, USA
| | - H Schellman
- Northwestern University, Evanston, Illinois, USA
| | - C Schlesier
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - A Schreckenberger
- Boston University, Boston, Massachusetts, USA
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Department of Physics, University of Texas at Austin, Austin, Texas, USA
| | - Y K Semertzidis
- Center for Axion and Precision Physics (CAPP)/Institute for Basic Science (IBS), Daejeon, Republic of Korea
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Y M Shatunov
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | - D Shemyakin
- Budker Institute of Nuclear Physics, Novosibirsk, Russia
| | - M Shenk
- Northern Illinois University, DeKalb, Illinois, USA
| | - D Sim
- University of Liverpool, Liverpool, United Kingdom
| | - M W Smith
- INFN, Sezione di Pisa, Pisa, Italy
- University of Washington, Seattle, Washington, USA
| | - A Smith
- University of Liverpool, Liverpool, United Kingdom
| | - A K Soha
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Sorbara
- INFN, Sezione di Roma Tor Vergata, Roma, Italy
- Università di Roma Tor Vergata, Rome, Italy
| | - D Stöckinger
- Institut für Kern-und Teilchenphysik, Technische Universität Dresden, Dresden, Germany
| | - J Stapleton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Still
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - C Stoughton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - D Stratakis
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - C Strohman
- Cornell University, Ithaca, New York, USA
| | - T Stuttard
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - H E Swanson
- University of Washington, Seattle, Washington, USA
| | - G Sweetmore
- Department of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
| | | | - M J Syphers
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
- Northern Illinois University, DeKalb, Illinois, USA
| | - D A Tarazona
- Michigan State University, East Lansing, Michigan, USA
| | - T Teubner
- University of Liverpool, Liverpool, United Kingdom
| | | | - K Thomson
- University of Liverpool, Liverpool, United Kingdom
| | - V Tishchenko
- Brookhaven National Laboratory, Upton, New York, USA
| | - N H Tran
- Boston University, Boston, Massachusetts, USA
| | - W Turner
- University of Liverpool, Liverpool, United Kingdom
| | - E Valetov
- Lancaster University, Lancaster, United Kingdom
- Michigan State University, East Lansing, Michigan, USA
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Shanghai, China
| | - D Vasilkova
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | | | - V P Volnykh
- Joint Institute for Nuclear Research, Dubna, Russia
| | - T Walton
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Warren
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - A Weisskopf
- Michigan State University, East Lansing, Michigan, USA
| | - L Welty-Rieger
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - M Whitley
- University of Liverpool, Liverpool, United Kingdom
| | - P Winter
- Argonne National Laboratory, Lemont, Illinois, USA
| | - A Wolski
- University of Liverpool, Liverpool, United Kingdom
| | - M Wormald
- University of Liverpool, Liverpool, United Kingdom
| | - W Wu
- University of Mississippi, University, Mississippi, USA
| | - C Yoshikawa
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
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Pham C, Nguyen DT, Tran NH, Nguyen KK, Cheriet M. Optimized IoT Service Chain Implementation in Edge Cloud Platform: A Deep Learning Framework. IEEE Trans Netw Serv Manage 2021. [DOI: 10.1109/tnsm.2021.3049824] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Tran NH, Foster NR, Mahipal A, Byrne T, Hubbard J, Silva A, Mody K, Alberts S, Borad MJ. Phase IB study of sorafenib and evofosfamide in patients with advanced hepatocellular and renal cell carcinomas (NCCTG N1135, Alliance). Invest New Drugs 2021; 39:1072-1080. [PMID: 33646489 DOI: 10.1007/s10637-021-01090-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/30/2022]
Abstract
Background Sorafenib (Sor) remains a first-line option for hepatocellular carcinoma (HCC) or refractory renal cell carcinomas (RCC). PLC/PRF/5 HCC model showed upregulation of hypoxia with enhanced efficacy when Sor is combined with hypoxia-activated prodrug evofosfamide (Evo). Methods This phase IB 3 + 3 design investigated 3 Evo dose levels (240, 340, 480 mg/m2 on days 8, 15, 22), combined with Sor 200 mg orally twice daily (po bid) on days 1-28 of a 28-day cycle. Primary objectives included determining maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of Sor + Evo. Results Eighteen patients were enrolled (median age 62.5 years; 17 male /1 female; 12 HCC/6 RCC) across three dose levels (DL0: Sor 200 mg bid/Evo 240 mg/m2 [n = 6], DL1:Sor 200 mg bid/Evo 480 mg/m2 [n = 5], DL1a: Sor 200 mg bid/Evo 340 mg/m2 [n = 7]). Two dose-limiting toxicities (DLTs) were reported with Evo 480 mg/m2 (grade 3 mucositis, grade 4 hepatic failure). Grade 3 rash DLT was observed in one patient at Evo 240 mg/m2. No DLTs were observed at Evo 340 mg/m2. MTD and RP2D were established as Sor 200 mg/Evo 340 mg/m2 and Sor 200/Evo 240 mg/m2, respectively. The most common treatment-related adverse events included fatigue, hand-foot syndrome, hypertension, and nausea/vomiting. Two partial responses were observed, one each at DL0 and DL1a.; disease control rate was 55%. Conclusions RP2D was established as sorafenib 200 mg bid + Evo 240 mg/m2. While preliminary anti-tumor activity was observed, future development must account for advances in immunotherapy in HCC/RCC.
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Affiliation(s)
- Nguyen H Tran
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nathan R Foster
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA
| | - Amit Mahipal
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Thomas Byrne
- Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA
| | - Joleen Hubbard
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alvin Silva
- Department of Radiology, Mayo Clinic, AZ, Scottsdale, USA
| | - Kabir Mody
- Division of Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Steven Alberts
- Division of Oncology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mitesh J Borad
- Mayo Clinic Cancer Center, Mayo Clinic, Phoenix, AZ, USA. .,Division of Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ, USA. .,Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA. .,Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA. .,Director - Precision Cancer Therapeutics Program, Mayo Clinic Center for Individualized Medicine (CIM) Program Leader - Gene and Virus Therapy Program, Mayo Clinic Cancer Center, 5777 E Mayo Blvd, Phoenix, AZ, 85254, USA.
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Nguyen MN, Pandey SR, Thar K, Tran NH, Chen M, Saad W, Hong CS. Distributed and Democratized Learning: Philosophy and Research Challenges. IEEE COMPUT INTELL M 2021. [DOI: 10.1109/mci.2020.3039068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Xie H, Borad MJ, Ahn DH, Bekaii-Saab TS, Tran NH, Jin Z, Pitot HC, Huebner LJ, Shi Q, Wessling J, Durgin LM, Liu MC, Hogenson TL, Phillips WJ, Fernandez-Zapico M, Alberts SR, Mahipal A. Phase II trial of trifluridine/tipiracil and irinotecan for the treatment of advanced refractory biliary tract cancer. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.tps594] [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
TPS594 Background: Effective treatment options are very limited for patients with advanced refractory biliary tract cancer (BTC). Fluoropyrimidine-based chemotherapy regimen such as 5-fluorouracil and irinotecan are frequently utilized for these patients after first-line therapy despite lack of FDA approval. Trifluridine/tipiracil (FTD/TPI) is a novel oral nucleoside with antitumor activity in both fluoropyrimidine sensitive and resistant tumors due to its unique mechanisms of action. Given early toxicity and efficacy data from our previous study on single-agent trifluridine/tipiracil (FTD/TPI) in advanced BTC, the clinical evaluation of its combination with irinotecan represents a rational approach for the treatment of advanced refractory BTC. Methods: This is a single-arm phase II trial with a two-stage design to assess the efficacy of trifluridine/tipiracil (FTD/TPI) and irinotecan in advanced refractory BTC. Key eligibility criteria include histologically confirmed advanced, unresectable BTC who have progressed on at least one line of systemic therapy and have measurable disease per RECIST v1.1. Target accrual is 25. Treatment includes trifluridine/tipiracil (FTD/TPI) 25 mg/m2 on days 1-5 and irinotecan 180 mg/m2 on day 1 in 14-day cycles. Patients will be evaluated for response every 4 cycles and in the absence of disease progression, therapy may be given up to 2 years. The primary end point is the progression-free survival rate at 16 weeks. Secondary endpoints include overall response rate, disease control rate, progression-free survival, overall survival, and incidence of adverse events. Correlative biomarker studies include evaluations of circulating tumor DNA and circulating tumor cells at baseline, after 4 cycles and at progression; and development of patient-derived tumor organoids from pre-treatment biopsies for parallel treatments. This study was approved and funded in part by the National Comprehensive Cancer Network (NCCN) Oncology Research Program from general research support provided by Taiho Oncology, Inc. Clinical trial information: NCT 04072445.
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Tran NH, Sahai V, Griffith KA, Nathan H, Kaza R, Cuneo KC, Shi J, Kim E, Sonnenday CJ, Cho CS, Lawrence TS, Zalupski MM. Phase 2 Trial of Neoadjuvant FOLFIRINOX and Intensity Modulated Radiation Therapy Concurrent With Fixed-Dose Rate-Gemcitabine in Patients With Borderline Resectable Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2020; 106:124-133. [PMID: 31494181 PMCID: PMC7245020 DOI: 10.1016/j.ijrobp.2019.08.057] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 02/26/2019] [Revised: 08/11/2019] [Accepted: 08/26/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE Preoperative therapy in borderline resectable pancreatic cancer (BRPC) is intended to increase R0 resection rates. An optimal approach in BRPC is yet to be defined. METHODS AND MATERIALS Patients with BRPC, confirmed adenocarcinoma, performance status ≤1, and adequate organ function enrolled in a single-institution, phase 2 trial. Patients received FOLFIRINOX × 6 cycles, then radiation therapy (50 Gy in 25 fractions) concurrent with fixed-dose rate gemcitabine (1 g/m2 over 100 minutes) followed by 2 additional gemcitabine infusions. Computed tomography scans were performed at 2-month intervals during treatment. Patients without distant disease were offered surgical exploration. The primary objective was R0 resection rate with an alternate hypothesis of 55%. Secondary objectives included median progression-free survival (PFS), median overall survival (OS), response rate, and safety. The trial registration number is NCT01661088. RESULTS Twenty-five patients with median age of 60 years (range, 47-77 years) enrolled from November 2011 through January 2017. Twenty-one (84%) completed FOLFIRINOX and 19 (76%) completed all protocol therapy. Treatment-related grade 3 to 4 toxicities included neutropenia (40%), nausea and vomiting (28%), diarrhea (16%), and fatigue (12%). Eighteen patients (72%) underwent laparotomy, 13 (52%) were resected (all R0). The median PFS and OS in 25 patients were 13.1 months (95% confidence interval [CI], 7.3-24.7) and 24.4 months (95% CI, 12.6-40.0), respectively. For resected patients, median PFS was 21.6 months (95% CI, 8.2-37.1) and OS was 37.1 months (95% CI, 15.4-not reached). CONCLUSIONS Neoadjuvant therapy with FOLFIRINOX, followed by intensity modulated radiation therapy concurrent with fixed-dose-rate gemcitabine in BRPC is feasible and tolerated. Although the alternate hypothesis was not met, the OS of the resected cohort was favorable.
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Affiliation(s)
| | | | | | | | - Ravi Kaza
- University of Michigan, Ann Arbor, Michigan
| | | | - Jiaqi Shi
- University of Michigan, Ann Arbor, Michigan
| | - Edward Kim
- Work completed at University of Michigan. Currently at University of California, Davis, California
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Tran NH, Trinh QT, Nguyen QB. Comments on "Antibiotic pollution in surface fresh waters: Occurrence and effects", Science of the Total Environment, 664, 793-804 (2019). Sci Total Environ 2019; 685:1308-1309. [PMID: 30857725 DOI: 10.1016/j.scitotenv.2019.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/03/2019] [Indexed: 06/09/2023]
Abstract
This article found mistakes and misunderstandings regarding the collection of occurrence data of antibiotics in surface freshwater from the previous literature. These mistakes and misunderstandings were corrected to avoid the propagation of inaccurate information in the scientific literature.
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Affiliation(s)
- N H Tran
- NUS Environmental Research Institute, National University of Singapore, 5A Engineering Drive 1, T-Lab Building, Singapore 117411, Singapore.
| | - Q T Trinh
- Cambridge Centre for Advanced Research and Education in Singapore (CARES), 1 Create Way, Singapore 138602, Singapore
| | - Q B Nguyen
- Institute of Research and Development, Duy Tan University, Da Nang 550000, Viet Nam.
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Sahai V, Tran NH, Griffith KA, Zalupski M. A multicenter phase II trial of rucaparib in combination with nivolumab as maintenance therapy for patients with advanced biliary tract cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps4153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS4153 Background: Patients (pts) with advanced biliary tract cancers (BTC) have a poor prognosis with a median overall survival (OS) less than 12 months. Using whole exome NGS, 26 (49%) pts in a 53 pt cohort had either DNA damage repair (DDR) pathway mutations (somatic and/or germline, n = 18), or isocitrate dehydrogenase 1 (IDH1) mutations (n = 8), and may have potentially benefited from PARP inhibition. Further, disruption of the mutated DDR pathways with a PARP inhibitor may result in increased mutational burden and neoantigens leading to immunogenicity, thus providing the rationale for combination with a PD-1 antibody. This phase 2 trial is designed to investigate the role of a PARP inhibitor in combination with a PD-1 antibody in pts with advanced BTC. Methods: Key eligibility criteria include histologically confirmed advanced, unresectable biliary adenocarcinoma (intra- or extra-hepatic, and gallbladder) without progression after 4-6 months of 1st line platinum-based systemic chemotherapy, measurable disease per RECIST v1.1, ECOG PS 0-1, Child-Pugh A or B7, and absence of autoimmune disease or chronic steroid use. Primary objective is to evaluate progression-free survival (PFS) rate at 4 months. Secondary objectives include evaluation of objective response rate per immune related (ir)RECIST criteria, median PFS and OS, and safety in this patient population. Exploratory objectives include identification of predictive biomarkers of response and mechanisms of resistance through serial biopsies and blood collection (pre, on and post therapy), including sequential whole exome/transcriptomic analysis with immune cell subset analysis. Treatment includes rucaparib 600 mg PO BID on days 1-28 with nivolumab 240 mg on days 1, 15 Q4 weeks. In absence of disease progression, pts may continue therapy up to 2 years. Accrual goal is 32 evaluable pts. Using a null hypothesis value of a 63% PFS rate at 4 months, and an 85% alternative hypothesis, this ongoing study has 80% power, with a one-sided alpha of 0.05 to identify treatment efficacy in the study arm. Clinical trial information: NCT03639935.
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Le BH, Liu X, Tran NH, Zhao S, Mi Z. An electrically injected AlGaN nanowire defect-free photonic crystal ultraviolet laser. Opt Express 2019; 27:5843-5850. [PMID: 30876179 DOI: 10.1364/oe.27.005843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/09/2018] [Indexed: 06/09/2023]
Abstract
We report on the demonstration of an electrically injected AlGaN nanowire photonic crystal laser that can operate in the ultraviolet spectral range. The nanowire heterostructures were grown on sapphire substrate using a site-controlled selective area growth process. By exploiting the topological high-Q resonance of a defect-free nanowire photonic crystal, we have demonstrated electrically pumped lasers that can operate at 369.5 nm with a relatively low threshold current density of ~2.1 kA/cm2 under continuous wave operation at room-temperature. This work provides a promising approach for achieving low threshold semiconductor laser diodes operating in the UV spectral range that were previously difficult.
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Pham C, Nguyen LAT, Tran NH, Huh EN, Hong CS. Phishing-Aware: A Neuro-Fuzzy Approach for Anti-Phishing on Fog Networks. IEEE Trans Netw Serv Manage 2018. [DOI: 10.1109/tnsm.2018.2831197] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Arredondo-García JL, Hadinegoro SR, Reynales H, Chua MN, Rivera Medina DM, Chotpitayasunondh T, Tran NH, Deseda CC, Wirawan DN, Cortés Supelano M, Frago C, Langevin E, Coronel D, Laot T, Perroud AP, Sanchez L, Bonaparte M, Limkittikul K, Chansinghakul D, Gailhardou S, Noriega F, Wartel TA, Bouckenooghe A, Zambrano B. Four-year safety follow-up of the tetravalent dengue vaccine efficacy randomized controlled trials in Asia and Latin America. Clin Microbiol Infect 2018; 24:755-763. [PMID: 29408333 DOI: 10.1016/j.cmi.2018.01.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/16/2018] [Accepted: 01/18/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Our objective was to describe the risk of hospital admission for virologically confirmed dengue (VCD) and the risk of clinically severe hospitalized VCD occurring up to 4 years after the first dose (years 1 to 4) in three randomized clinical trials comparing tetravalent dengue vaccine with placebo. METHODS The relative risks (RR) for hospitalized VCD from first dose to year 4 were estimated by year and age-group in individual and combined studies. RESULTS Overall, from Year 1 to Year 4, 233 and 228 participants had at least one episode of hospitalized VCD in the vaccinated (n = 22 603) and placebo (n = 11 301) groups, respectively (RR = 0.511, 95% CI 0.42-0.62). Among these, 48 and 47 cases, respectively, were classified as clinically severe. In children aged ≥9 years, 88 and 136 participants had at least one episode of hospitalized VCD in the vaccinated (n = 17 629) and placebo (n = 8821) groups, respectively (RR = 0.324; 95% CI 0.24-0.43). In vaccinated participants aged <9 years, particularly in those aged 2-5 years, there were more hospitalized VCD cases compared with the control participants in Year 3 but not in Year 4. The overall RR in those aged <9 years for Year 1 to Year 4 was 0.786 (95% CI 0.60-1.03), with a higher protective effect in the 6-8 year olds than in the 2-5 year olds. CONCLUSIONS The overall benefit-risk remained positive in those aged ≥9 years up to year 4, although the protective effect was lower in years 3 and 4 than in years 1 and 2.
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Affiliation(s)
| | - S R Hadinegoro
- Department of Child Health, Cipto Mangunkusumo Hospital, Medical School, University of Indonesia, Jakarta, Indonesia
| | - H Reynales
- Centro de Atención e Investigación Médica-CAIMED, Bogotá, Colombia
| | - M N Chua
- Department of Paediatrics, Chong Hua Hospital, Cebu City, Philippines
| | - D M Rivera Medina
- Inversiones en Investigación Médica, INVERIME SA, Tegucigalpa, Honduras
| | - T Chotpitayasunondh
- Department of Paediatrics, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - N H Tran
- Infectious Diseases Department, Institut Pasteur in Ho-Chi-Minh-City, Ho-Chi-Minh-City, Viet Nam
| | - C C Deseda
- Caribbean Travel Medicine Clinic, San Juan, Puerto Rico
| | - D N Wirawan
- Department of Preventive Medicine, School of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | | | - C Frago
- Sanofi Pasteur, Singapore, Singapore
| | | | | | - T Laot
- Sanofi Pasteur, Taguig, Philippines
| | | | | | | | - K Limkittikul
- Faculty of Tropical Medicine, Mahidol University, Thailand
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Tran NH, Vats P, Robinson DR, Zalupski M, Hersberger KE, Mendiratta-Lala M, Kumar-Sinha C, Wu YM, Lonigro RJ, Cao X, Chinnaiyan A, Sahai V. Integrative whole exome, transcriptome, and clinical profiling of biliary tract cancers (BTCs). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.279] [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
279 Background: BTC is clinically and genomically heterogeneous and next generation sequencing may identify disease subsets with distinct prognostic and therapeutic implications. Methods: Patients (pts) with BTC underwent whole exome and transcriptome sequencing via the Michigan Oncology Sequencing (MI-ONCOSEQ) platform between 09/2011 and 07/2017. Results: 53 pts (47.2% female) with median age 60 (range 17-72) years had 38 intrahepatic, 6 perihilar, and 4 extrahepatic distal cholangiocarcinoma (CCA) while 3 had gallbladder and 2 mixed CCA/hepatocellular carcinoma. Forty-one pts (77.3%) had advanced BTC at diagnosis and 40 (75.5%) received platinum doublet as first line therapy. The most frequent somatic mutations were TP53 (35.8%), BAP1 (18.9%), KRAS (17.0%), IDH1 (15.1%), PBRM1 (13.2%), ARID1A (11.3%), and SMAD4 (11.3%). Median overall survival (OS) in 8 pts with IDH1 mutation was 16.8 months (none received IDH1 inhibitor). Putative pathogenic germline variants were noted in 6 (11.3%) pts of which 4 were biallelic (MSH2, BRCA1, BRCA2 and MUTYH) and 2 monoallelic (ATM and FH). Germline mutation in FH has not been reported in BTC. Biallelic DNA damage repair pathway mutations were noted in 14 (26.4%; 11 somatic, 3 germline) pts and their median OS was 16.8 months. Of these 9 pts with advanced BTC received 1st line platinum therapy and had a median PFS of 9.3 months (4 PR, 3 SD). Nine (17%) pts had FGFR2 fusion (6 partners); median OS not yet reached (6 alive; 5 received FGFR inhibitor). Potentially targetable molecular alterations (IDH1, MSH2, BRCA1/2, PALB2, ATM, FGFR2, ERBB2) were identified in 27 (50.9%) pts. Copy number profile shows frequent loss of chr1p, chr3p, chr4, chr6q, chr8p, chr9, and gain of chr1q, chr7, and chr8q. Immune profiling & pathway analysis of BTCs with clinical correlation is ongoing. Conclusions: Integrative sequencing of BTCs with clinical profiling will lead to more precise treatment of pts with BTCs.
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Affiliation(s)
| | | | | | | | | | | | | | - Yi-Mi Wu
- University of Michigan, Ann Arbor, MI
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Tran NH, Sahai V, Griffith KA, Nathan H, Kaza R, Cuneo KC, Sonnenday CJ, Cho C, Lawrence TS, Zalupski M. Neoadjuvant FOLFIRINOX and IMRT concurrent with FDR-gemcitabine in patients with borderline resectable pancreatic cancer (BRPC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
381 Background: Preoperative therapy in BRPC is intended to increase the likelihood of R0 resection although an optimal regimen is yet to be defined. Methods: Patients (pts) with BRPC (NCCNv.2.2010 guidelines) and ECOG PS 0-1 were enrolled in a single-institution, phase II trial (NCT01661088). Pts received FOLFIRINOX x 6, followed by IMRT (50 Gy in 25 fractions) concurrent with FDR-gemcitabine 1 g/m2 on days 1, 8, 22, 29. Two additional FDR-gemcitabine infusions completed pre-operative treatment. Pancreatic protocol CT scans (dual phase, 0.65 mm slices) were performed after 4 infusions of FOLFIRINOX, 3 weeks after IMRT, and at treatment completion. Pts without distant disease were offered surgical exploration. The primary objective was to determine R0 resection rate. Secondary objectives included progression free survival (PFS), overall survival (OS), response rate and safety. Results: A total of 25 pts (64% men) median age 60 years (range 47-77) were enrolled from 11/2011 through 01/2017. Twenty-one (84%) pts completed FOLFIRINOX and 19 (76%) all protocol therapy. Treatment-related grade 3-4 adverse events ( > 10%) included neutropenia (40%), nausea/vomiting (28%), diarrhea (16%) and fatigue (12%). One early death and 1 discontinuation due to toxicity occurred during FOLFIRINOX. Response to pre-op therapy included 11 PR, 9 SD, 3 PD and 2 NE. Of 25 treated pts, 18 (72%) had laparotomy and 13 (52%) underwent resection (all R0). The median PFS and OS were 18.1 (95% CI, 10.6 to 25.1) and 24.2 (95% CI, 12.6 to 40.0) months, respectively. The median OS for R0 resected pts was 37.1 (95% CI, 15.4 – not reached) months. Conclusions: Neoadjuvant therapy with FOLFIRINOX, followed by IMRT with concurrent FDR-gemcitabine in BRPC is feasible and tolerated. While R0 resection rate was not obviously improved, OS of the entire cohort and especially in R0 resected pts was favorable. Clinical trial information: NCT01661088.
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Affiliation(s)
| | | | | | | | - Ravi Kaza
- University of Michigan, Ann Arbor, MI
| | | | | | | | | | - Mark Zalupski
- University of Massachusetts Memorial Medical Center, Ann Arbor, MI
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Sakin SA, Razzaque MA, Hassan MM, Alamri A, Tran NH, Fortino G. Self-Coexistence among IEEE 802.22 Networks: Distributed Allocation of Power and Channel. Sensors (Basel) 2017; 17:s17122838. [PMID: 29215591 PMCID: PMC5751528 DOI: 10.3390/s17122838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/02/2017] [Accepted: 12/04/2017] [Indexed: 11/27/2022]
Abstract
Ensuring self-coexistence among IEEE 802.22 networks is a challenging problem owing to opportunistic access of incumbent-free radio resources by users in co-located networks. In this study, we propose a fully-distributed non-cooperative approach to ensure self-coexistence in downlink channels of IEEE 802.22 networks. We formulate the self-coexistence problem as a mixed-integer non-linear optimization problem for maximizing the network data rate, which is an NP-hard one. This work explores a sub-optimal solution by dividing the optimization problem into downlink channel allocation and power assignment sub-problems. Considering fairness, quality of service and minimum interference for customer-premises-equipment, we also develop a greedy algorithm for channel allocation and a non-cooperative game-theoretic framework for near-optimal power allocation. The base stations of networks are treated as players in a game, where they try to increase spectrum utilization by controlling power and reaching a Nash equilibrium point. We further develop a utility function for the game to increase the data rate by minimizing the transmission power and, subsequently, the interference from neighboring networks. A theoretical proof of the uniqueness and existence of the Nash equilibrium has been presented. Performance improvements in terms of data-rate with a degree of fairness compared to a cooperative branch-and-bound-based algorithm and a non-cooperative greedy approach have been shown through simulation studies.
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Affiliation(s)
- Sayef Azad Sakin
- Department of Computer Science and Engineering, University of Dhaka, Dhaka 1000, Bangladesh.
| | - Md Abdur Razzaque
- Department of Computer Science and Engineering, University of Dhaka, Dhaka 1000, Bangladesh.
| | - Mohammad Mehedi Hassan
- College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia.
| | - Atif Alamri
- College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia.
| | - Nguyen H Tran
- Department of Computer Science and Engineering, Kyung Hee University, Gyeonggi-do 17104, Korea.
| | - Giancarlo Fortino
- Department of Informatics, Modeling, Electronics, and Systems, University of Calabria, 87036 Arcavacata, Italy.
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Tran NH, Cavalcante LL, Lubner SJ, Mulkerin DL, LoConte NK, Clipson L, Matkowskyj KA, Deming DA. Precision medicine in colorectal cancer: the molecular profile alters treatment strategies. Ther Adv Med Oncol 2015; 7:252-262. [PMID: 26327923 PMCID: PMC4543854 DOI: 10.1177/1758834015591952] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
When considering treatment options for patients with metastatic colorectal cancer (mCRC), molecular profiling has become a pivotal component in guiding clinical decisions. FOLFOX and FOLFIRI (fluorouracuil, leucovorin plus oxaliplatin or ininotecan, respectively) are the standard base regimens used for the treatment of mCRC. Biologic agents, such as the epidermal growth factor receptor (EGFR) targeted therapies, cetuximab and panitumumab and the vascular endothelial growth factor monoclonal antibody, bevacizumab, are safe and effective in the first-line setting. The most efficacious use of these agents in terms of timing and selection of the right patient population continues to be debated. Here we review multiple investigations into the effectiveness of treatment options as a function of the mutations present in colon cancers. Early studies have reported that KRAS mutations at exon 2 predict resistance to EGFR targeted therapies. More recently the data have expanded to include KRAS mutations at exons 3 and 4 and NRAS mutations at exons 2, 3 and 4 as well as other biomarkers including BRAF and PIK3CA, leading to the evolution of the treatment of mCRC to a more precision-based approach. As our understanding of relevant biomarkers increases, and data from both molecular profiling and treatment response become more readily available, treatment options will become more precise and their outcomes more effective.
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Affiliation(s)
- Nguyen H. Tran
- Division of Hematology and Oncology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ludimila L. Cavalcante
- Division of Hematology and Oncology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, and University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Sam J. Lubner
- Division of Hematology and Oncology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, and University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Daniel L. Mulkerin
- Division of Hematology and Oncology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, and University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Noelle K. LoConte
- Division of Hematology and Oncology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, and University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Linda Clipson
- Department of Oncology, University of Wisconsin–Madison, Madison, WI, USA
| | - Kristina A. Matkowskyj
- University of Wisconsin Carbone Cancer Center, and Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison School of Medicine and Public Health, and William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Dustin A. Deming
- Division of Hematology and Oncology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, 600 Highland Avenue, K6/544, Madison, WI 53792, USA
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Salehzadeh O, Tran NH, Liu X, Shih I, Mi Z. Exciton kinetics, quantum efficiency, and efficiency droop of monolayer MoS₂ light-emitting devices. Nano Lett 2014; 14:4125-30. [PMID: 24905765 DOI: 10.1021/nl5017283] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We have investigated the quantum efficiency of monolayer MoS2 light-emitting devices through detailed temperature and power-dependent photoluminescence studies and rate equation analysis. The internal quantum efficiency can reach 45 and 8.3% at 83 and 300 K, respectively. However, efficiency droop is clearly measured with increasing carrier injection due to the unusually large Auger recombination coefficient, which is found to be ∼10(-24) cm(6)/s at room temperature, nearly 6 orders of magnitude higher than that of conventional bulk semiconductors. The significantly elevated Auger recombination in the emerging two-dimensional (2D) semiconductors is primarily an indirect process and is attributed to the abrupt bounding surfaces and the enhanced correlation, mediated by magnified Coulomb interactions, between electrons and holes confined in a 2D structure.
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Affiliation(s)
- O Salehzadeh
- Department of Electrical and Computer Engineering, McGill University , 3480 University Street, Montreal, Quebec H3A 0E9, Canada
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Tran NH, Nguyen VT, Urase T, Ngo HH. Role of nitrification in the biodegradation of selected artificial sweetening agents in biological wastewater treatment process. Bioresour Technol 2014; 161:40-6. [PMID: 24681682 DOI: 10.1016/j.biortech.2014.02.116] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 02/22/2014] [Accepted: 02/24/2014] [Indexed: 05/21/2023]
Abstract
The biodegradation of the six artificial sweetening agents including acesulfame (ACE), aspartame (ASP), cyclamate (CYC), neohesperidindihydrochalcone (NHDC), saccharin (SAC), and sucralose (SUC) by nitrifying activated sludge was first examined. Experimental results showed that ASP and NHDC were the most easily degradable compounds even in the control tests. CYC and SAC were efficiently biodegraded by the nitrifying activated sludge, whereas ACE and SUC were poorly removed. However, the biodegradation efficiencies of the ASs were increased with the increase in initial ammonium concentrations in the bioreactors. The association between nitrification and co-metabolic degradation was investigated and a linear relationship between nitrification rate and co-metabolic biodegradation rate was observed for the target artificial sweeteners (ASs). The contribution of heterotrophic microorganisms and autotrophic ammonia oxidizers in biodegradation of the ASs was elucidated, of which autotrophic ammonia oxidizers played an important role in the biodegradation of the ASs, particularly with regards to ACE and SUC.
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Affiliation(s)
- N H Tran
- Department of Civil and Environmental Engineering, Faculty of Engineering, National University of Singapore, 1 Engineering Drive 2, Singapore 117576, Singapore.
| | - V T Nguyen
- Department of Civil and Environmental Engineering, Faculty of Engineering, National University of Singapore, 1 Engineering Drive 2, Singapore 117576, Singapore
| | - T Urase
- School of Bioscience and Biotechnology, Tokyo University of Technology, Katakura 1404-1, Hachioji, Tokyo 192-0982, Japan
| | - H H Ngo
- School of Civil and Environmental Engineering, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
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Garciano LO, Tran NH, Kannangara GK, Milev AS, Wilson MA, Volk H. Developing saponite supported cobalt–molybdenum catalysts for upgrading squalene, a hydrocarbon from the microalgae Botryococcus braunii. Chem Eng Sci 2014. [DOI: 10.1016/j.ces.2013.12.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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