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Vanderbilt D, Julie D, An A, Christos P, Pannullo S, Knisely J, Schwartz T. Effect Of Timing Of Adjuvant Radiosurgery On Local Control For Brain Metastases. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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DiPiazza J, Caponnetto P, Askin G, Christos P, Maglia MLP, Gautam R, Roche S, Polosa R. Sensory experiences and cues among E-cigarette users. Harm Reduct J 2020; 17:75. [PMID: 33059666 PMCID: PMC7559939 DOI: 10.1186/s12954-020-00420-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIMS We characterized the extent and quality of respiratory sensations and sensory-related smoking cues associated with e-cigarette use among those who failed to quit combustible tobacco cigarette (CTC) use with traditional FDA approved medications but succeeded in doing so with e-cigarettes. Further, we sought to understand former smokers' perceptions about the influence of sensory experience with e-cigarette use on CTC cessation outcomes. METHODS A nonrandom purposive sample of 156 participants recruited in the USA through the Consumer Advocates for Smoke Free Alternatives Association Facebook page completed an online cross-sectional survey to assess sensory experiences and smoking cues associated with e-cigarette use. Descriptive statistics were calculated, and the ANOVA/Kruskal-Wallis test with post hoc testing and the two-sample t test/Wilcoxon rank-sum test, as appropriate based on distribution, were used to assess the association between sample characteristics and sensory experiences and cues using investigator constructed questions, the Modified Cigarette Evaluation Questionnaire (mCEQ) and the Smoking Cue Appeal Survey (SCAS). RESULTS With e-cigarette use, participants reported feeling the vapor in their throats, windpipes, noses, lungs, and on their tongues; reductions in nicotine craving; and enjoyment of their e-cigarette, including tasting, smelling, and seeing the vapor and touching the device. Women had greater craving reduction than men (p = 0.023). Those who began smoking at 13 years of age or younger had more satisfaction and had greater sensory enjoyment than those who began smoking at 16-17 years of age (p = 0.015 and p = 0.026, respectively), as well as greater sensory enjoyment than those who began smoking at 14-15 years of age (p = 0.047). There was a significant overall association between the number of years a respondent smoked and e-cigarette sensory enjoyment (p = 0.038). Participants 18-34 years old rated e-cigarettes as being more pleasant compared to 45 + years olds, (p = 0.012). Eighty-four percent of participants reported the sensation of the vapor as important in quitting CTCs, and 91% believed the sensations accompanying e-cigarette use contributed to their smoking cessation success. CONCLUSIONS For those who failed to quit previously using approved cessation medications to stop smoking cigarettes, sensory experiences associated with e-cigarette use may help smokers quit smoking.
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Affiliation(s)
- J DiPiazza
- Hunter Bellevue School of Nursing, Hunter College-City University of New York, New York, NY, USA
| | - P Caponnetto
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy.
- Institute of Internal Medicine, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Università di Catania, Catania, Italy.
- Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, UK.
| | - G Askin
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - P Christos
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - M Lyc Psych Maglia
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy
| | - R Gautam
- Clinical and Translational Science Center, Weill Cornell Medicine, New York, NY, USA
| | - S Roche
- Hunter Bellevue School of Nursing, Hunter College-City University of New York, New York, NY, USA
| | - R Polosa
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy
- Institute of Internal Medicine, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Università di Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Tagawa S, Osborne J, Hackett A, Niaz M, Cooley V, Christos P, Vlachostergios P, Thomas C, Gracey L, Beltran H, Molina A, Nanus D, Babich J, Vallabhajosula S, Sartor O, Ballman K, Bander N. Preliminary results of a phase I/II dose-escalation study of fractionated dose 177Lu-PSMA-617 for progressive metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Altorki N, Borczuk A, Saxena A, Port J, Stiles B, Lee B, Sanfilippo N, Ko E, Scheff R, Pua B, Gruden J, Christos P, Spinelli C, Gakuria J, Mittal V, Mcgraw T, Formenti S. P2.04-92 Neoadjuvant Durvalumab With or Without Sub-Ablative Stereotactic Radiotherapy (SBRT) in Patients with Resectable NSCLC (NCT02904954). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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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Pasternak M, Christos P, Rosenwaks Z, Spandorfer S, Thompson M. The relationship between body mass index and anti-mullerian hormone levels in reproductive outcomes for women undergoing infertility treatment; is there a negative correlation? Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kao J, Zucker A, Mauer E, Wong A, Christos P, Kang J. Radiation Oncology Physician Practice in the Modern Era: A Statewide Analysis of Medicare Reimbursement. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ramirez-Fort M, Pan S, Liu H, Navarro V, McCormick J, Guo M, Christos P, Leconet W, Frank S, Tagawa S, Scherr D, Bander N, Lange C. External Beam Irradiation May Increase the Therapeutic Index of J591 Brachytherapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Manzerova J, Mauer E, Christos P, Formenti S, Nagar H. Locoregional Management of Clinically Node-Negative Male Breast Cancer: An Analysis of a Clinical Oncology Database. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Herskovic A, Wu X, Christos P, Nagar H, Formenti S. Adjuvant Radiation Therapy for Older Women With Early-Stage Hormone Receptor--Positive and HER2-Negative Breast Cancer: An Analysis of the National Cancer Data Base. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tagawa S, Scherr D, Batra J, Jhanwar Y, Robinson B, Nanus D, Beltran H, Molina A, Christos P, Bander N. Anti-prostate-specific membrane antigen (PSMA) monoclonal antibody (mAb) J591 immunotherapy for prostate cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mann J, Wu X, Christos P, Nori D, Formenti S, Nagar H. National Practice Patterns of Axillary Management and Adjuvant Radiation After ACOSOG Z0011. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chen J, Wu X, Christos P, Nori D, Formenti S, Nagar H. Practice Patterns and Outcomes for Postmastectomy Radiation After Complete Pathological Response in Stage II and IIIA Breast Cancer Patients: Analysis of the National Cancer Data Base. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Byun D, Wu X, Christos P, Moo T, Nori D, Formenti S, Nagar H. Omission of Adjuvant Radiation Therapy Following Breast Conservation Surgery for Ductal Carcinoma In Situ: Analysis of the National Cancer Data Base. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ye J, Wu X, Christos P, Nori D, Formenti S, Nagar H. Breas-Conserving Therapy Is Associated with Improved Overall Survival Compared to Mastectomy in Women with Stage pT1-2N0M0 Breast Cancer: A National Cancer Data Base Analysis. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mann J, Wu X, Christos P, Nori D, Formenti S, Nagar H. Combined Modality Therapy for Early-Stage Grade 3 Follicular Lymphoma Improves Overall Survival. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brandmaier A, Wu X, Christos P, Nori D, Formenti S, Nagar H. The Role of Postmastectomy Radiation Therapy for T1-T3, N1 Breast Cancer: Analysis of the National Cancer Data Base. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chen J, Wu X, Christos P, Yan W, Ravi A. The Impact of Adjuvant Radiation Therapy on Survival in T3N0 Breast Cancer Patients Older than Age 75 Years After Mastectomy: A Surveillance, Epidemiology, and End Results Analysis. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kim S, Oromendia C, Christos P, Wernicke A, Parashar B. Sequence of Radiation Therapy Versus Surgery on Outcomes in Gastroesophageal Junction Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Herskovic A, Christos P, Mauer E, Nagar H. The Role of Postoperative Radiation Therapy in pN2 Non-Small Cell Lung Cancer: An Analysis of the National Cancer Data Base. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Taube S, Lazow S, Yondorf M, Parashar B, Kovanlikaya I, Nedialkova L, Kulidzhanov F, Trichter S, Sabbas A, Christos P, Ramakrishna R, Pannullo S, Stieg P, Schwartz T, Wernicke A. A Matched-Pair Analysis of Clinical Outcomes of Intracavitary Cesium-131 Brachytherapy Versus Stereotactic Radiosurgery for Resected Brain Metastases. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Thompson A, Nori S, Wu G, Christos P, Wernicke A, Nori D, Parashar B. Neuroendocrine Lung Carcinoma: Analysis and Comparison of Treatment Outcomes in a Large Population Database. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ye J, Yan W, Wu X, Christos P, Nori D, Ravi A. Pattern of Presentation, Treatment, Outcome, and Prognostic Factors of Male Breast Cancer over 13 Years: A National Database Analysis. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kim S, Manzerova J, Christos P, Wernicke A, Nori D, Parashar B. Surgery Alone Versus Surgery Plus Radiation Therapy in Patients With Limited Stage Small Cell Lung Carcinoma: A Population-Based Analysis. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mann J, Osian A, Brandmaier A, Yan W, Wu G, Christos P, Nori D, Ravi A. Excellent Long-term Breast Preservation Rate Following Accelerated Partial-Breast Irradiation Using a Balloon Device. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Herskovic A, Wu X, Christos P, Ravi A, Nori D, Yan W. The Impact of Adjuvant Radiation Therapy on Survival in Patients With Surgically Resected Pancreatic Adenocarcinoma: A SEER Study From 2004 to 2010. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Brandmaier A, Wu X, Christos P, Mann J, Wernicke A, Nori D, Parashar B. A Population-Based Comparative Outcome of Adjuvant Radiation Therapy in Patients With Soft Tissue Sarcoma of the Head and Neck. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.2169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Basciano PA, Matakas J, Pecci A, Civaschi E, Cagioni C, Bompiani N, Burger P, Christos P, Snyder JP, Bussel J, Balduini CL, Giannakakou P, Noris P. β-1 tubulin R307H SNP alters microtubule dynamics and affects severity of a hereditary thrombocytopenia. J Thromb Haemost 2015; 13:651-9. [PMID: 25529050 DOI: 10.1111/jth.12824] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/12/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Single nucleotide polymorphisms (SNPs) in platelet-associated genes partly explain inherent variability in platelet counts. Patients with monoallelic Bernard Soulier syndrome due to the Bolzano mutation (GPIBA A156V) have variable platelet counts despite a common mutation for unknown reasons. OBJECTIVES We investigated the effect of the most common SNP (R307H) in the hematopoietic-specific tubulin isotype β-1 in these Bernard Soulier patients and potential microtubule-based mechanisms of worsened thrombocytopenia. PATIENTS/METHODS Ninety-four monoallelic Bolzano mutation patients were evaluated for the R307H β-1 SNP and had platelet counts measured by three methods; the Q43P SNP was also evaluated. To investigate possible mechanisms underlying this association, we used molecular modeling of β-1 tubulin with and without the R307H SNP. We transfected SNP or non-SNP β-1 tubulin into MCF-7 and CMK cell lines and measured microtubule regrowth after nocodazole-induced depolymerization. RESULTS We found that patients with at least one R307H SNP allele had significantly worse thrombocytopenia; manual platelet counting revealed a median platelet count of 124 in non-SNP patients and 76 in SNP patients (both ×10(9) L(-1) ; P < 0.01). The Q43P SNP had no significant association with platelet count. Molecular modeling suggested a structural relationship between the R307H SNP and microtubule stability via alterations in the M-loop of β tubulin; in vitro microtubule recovery assays revealed that cells transfected with R307H SNP β-1 had significantly impaired microtubule recovery. CONCLUSIONS Our data show that the R307H SNP is significantly associated with the degree of thrombocytopenia in congenital and acquired platelet disorders, and may affect platelets by altering microtubule behavior.
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Affiliation(s)
- P A Basciano
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Strain GW, Kolotkin RL, Dakin GF, Gagner M, Inabnet WB, Christos P, Saif T, Crosby R, Pomp A. The effects of weight loss after bariatric surgery on health-related quality of life and depression. Nutr Diabetes 2014; 4:e132. [PMID: 25177912 PMCID: PMC4183970 DOI: 10.1038/nutd.2014.29] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/02/2014] [Accepted: 07/20/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In severe obesity, impairments in health-related quality of life (HRQoL) and dysphoric mood are reported. This is a post-surgery analysis of the relationship between HRQoL and depressive symptoms, and weight change after four different types of bariatric procedures. METHODS A total of 105 consented patients completed the Short-Form-36 Health Survey (SF-36), the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and the Beck Depression Inventory (BDI) before and 25 months after surgery. Analysis of variance or Kruskal-Wallis test evaluated changes. RESULTS Patients with Roux-en Y gastric bypass (46 patients), decreased body mass indexes (BMIs; kg m(-)(2)) 47-31 kg m(-)(2) (P<0.0001); biliopancreatic diversion with duodenal switch (18 patients), decreased BMIs 57-30 kg m(-)(2) (P<0.0001); adjustable gastric banding (18 patients), decreased BMIs 45-38 kg m(-)(2) (P<0.0001); and sleeve gastrectomies (23 patients), decreased BMIs 58 42 kg m(-)(2) (P<0.0001). The excess percentage BMI loss was 69, 89, 36 and 53 kg m(-)(2), respectively (P<0.0001). Before surgery, the SF-36 differences were significant regarding bodily pain (P=0.008) and social functioning (P=0.01). After surgery, physical function (P=0.03), general health (P=0.05) and physical component (P=0.03) were different. IWQOL-Lite recorded no differences until after surgery: physical function (P=0.003), sexual life (P=0.04) and public distress (P=0.003). BDI scores were not different for the four groups at baseline. All improved with surgery, 10.6-4.4 (P=0.0001). CONCLUSIONS HRQoL and depressive symptoms significantly improvement after surgery. These improvements do not have a differential effect over the wide range of weight change.Nutrition & Diabetes (2014) 4, e132; doi:10.1038/nutd.2014.29; published online 1 September 2014.
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Affiliation(s)
- G W Strain
- Department of Surgery, Weill Cornell College of Medicine, New York, NY, USA
| | - R L Kolotkin
- Obesity and Quality of Life Consulting, and Duke University School of Medicine, Durham, NC, USA
| | - G F Dakin
- Department of Surgery, Weill Cornell College of Medicine, New York, NY, USA
| | - M Gagner
- Department of Surgery, Hospital du Sacre Coeur, Montreal, Quebec, Canada
| | - W B Inabnet
- Department of Surgery, Mt Sinai Medical Center, New York, NY, USA
| | - P Christos
- Department of Surgery, Weill Cornell College of Medicine, New York, NY, USA
| | - T Saif
- Department of Surgery, Weill Cornell College of Medicine, New York, NY, USA
| | - R Crosby
- University of North Dakota Neuropsychiatry Institute, Fargo, ND, USA
| | - A Pomp
- Department of Surgery, Weill Cornell College of Medicine, New York, NY, USA
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Ye J, Yan W, Christos P, Nori D, Chao K, Ravi A. Triple-Negative Receptor Status and Other Predictors of Lymph Node Positivity in Small (T1) Breast Cancers: A National Registry Study. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Chuang E, Stanton S, Ward MM, Christos P, Sanford R, Lam C, Cobham MV, Donovan D, Scheff R, Cigler T, Moore A, Vahdat LT, Lane ME. Abstract P6-05-06: Association of HER2/neu single nucleotide polymorphism with trastuzumab-related cardiotoxicity. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-05-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Treatment with trastuzumab prolongs overall survival when given to patients (pts) with Her2/neu+ breast cancer (BC). The primary toxicity of trastuzumab is cardiotoxicity and the incidence is estimated at 2-4% in the adjuvant setting. The mechanism for trastuzumab-induced cardiotoxicity is not known. Although Her2neu expression is usually not seen on cardiac myocytes, its expression has been shown to be upregulated after chemotherapy. Trastuzumab is a monoclonal antibody that binds to the extracellular domain of Her2/neu. We hypothesized that single nucleotide polymorphisms (SNPs) in the Her2/neu receptor may play a role in trastuzumab associated cardiotoxicity.
Methods: 140 pts with BC who were treated with chemotherapy and trastuzumab were enrolled into an IRB approved protocol at the Weill Cornell Medical College between July 2008 and March 2013. Cardiotoxicity was defined as either symptomatic CHF, or a decline in LVEF of 15% (or if LVEF <55% a decline in LVEF of 10%) that required management with medications and led to temporary or permanent discontinuation of trastuzumab. 11 nonsynonomous human ErbB2 SNPs were identified in the National Center for Biotechnology Information SNP database (rs1136201, rs2172826, rs28933368, rs28933369, rs28933370, rs34602395, rs36085723, rs4252633, rs55943169, rs56366519, rs61552325). Genotyping of SNPs was performed on DNA prepared from blood or buccal washes. The relationship between SNP characteristics and cardiotoxicity status was assessed by the chi-square test and multivariable logistic regression analysis.
Results: 140 subjects (29 with cardiotoxicity and 111 without) had 11 SNPs sequenced. Median age of subjects was 56 years (range: 32-85), mean baseline LVEF was 65% (±6%). 16.4% of subjects had hypertension (HTN). 80% of patients were Caucasian, 10% East Asian, 7.1% African American, 2.9% South Asian. There were two SNPs for which there was variation seen among subjects: rs 1136201 (corresponding to codon 655) and rs61552325 (codon 1170). The frequencies of the codon 655 polymorphisms were: AA (Ile/Ile) 67.9%, AG (Ile/Val) 29.3%, and GG (Val/Val) 2.9%. The frequencies of the codon 1170 polymorphisms were: CC (Pro/Pro) 20.7%, GC (Ala/Pro) 45.7%, and GG (Ala/Ala) 33.6%. There was no association observed between the codon 655 polymorphism and cardiotoxicity (p = 0.96). A significant association between cardiotoxicity and the codon 1170 polymorphism was observed, with subjects having cardiotoxicity being more likely to carry the CC allele compared with subjects without cardiotoxicity (34.5% vs 17.1%, p = 0.04). This association persisted after multivariable adjustment for age, race, and HTN status (adjusted OR = 2.60, 95% CI = 1.02-6.62, p = 0.046).
Conclusion: In this study, the Her2/neu 1170 Pro/Pro polymorphism was associated with trastuzumab cardiotoxicity. If confirmed in a larger series, this polymorphism could be used to identify pts who may be at increased risk for cardiotoxicity and who may benefit from treatments associated with less cardiotoxicity. Furthermore, the Her2/neu 1170 SNP has previously been implicated as a minor histocompatibility antigen, and our findings raise the possibility that immune mediated mechanisms may play a role in trastuzumab related cardiotoxicity.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-06.
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Affiliation(s)
- E Chuang
- Weill Cornell Medical College, New York, NY
| | - S Stanton
- Weill Cornell Medical College, New York, NY
| | - MM Ward
- Weill Cornell Medical College, New York, NY
| | - P Christos
- Weill Cornell Medical College, New York, NY
| | - R Sanford
- Weill Cornell Medical College, New York, NY
| | - C Lam
- Weill Cornell Medical College, New York, NY
| | - MV Cobham
- Weill Cornell Medical College, New York, NY
| | - D Donovan
- Weill Cornell Medical College, New York, NY
| | - R Scheff
- Weill Cornell Medical College, New York, NY
| | - T Cigler
- Weill Cornell Medical College, New York, NY
| | - A Moore
- Weill Cornell Medical College, New York, NY
| | - LT Vahdat
- Weill Cornell Medical College, New York, NY
| | - ME Lane
- Weill Cornell Medical College, New York, NY
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Parashar B, Arora S, Christos P, Port J, Wernicke A, Nori D, Chao K. Comparison of Wedge Resection Versus Wedge Resection Plus Cesium-131 Brachytherapy Versus Stereotactic Body Radiation Therapy in Management of Early Stage Lung Cancer Patients That Are Not Candidates for a Standard Lobectomy. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Arora S, Singh P, Christos P, Wernicke A, Nori D, Chao K, Parashar B. Primary Radiation Therapy Is Equivalent to Robotic Prostatectomy Plus Adjuvant Radiation Therapy in Patients With High-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Christos P, Mazumdar M, Mushlin A. The Influence of Surgical Subspecialty Training on In-Hospital Mortality for Cancer Procedures. Ann Epidemiol 2013. [DOI: 10.1016/j.annepidem.2013.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yan W, Christos P, Nori D, Chao C, Ravi A. Age, Hormonal Receptor Status, Ethnicity, and Adjuvant Radiation Therapy as Predictive Factors for Cancer-related Death in Elderly Patients Aged 70 Years and Older With Early Stage pT1a,b N0 Breast Cancer: A NCI-SEER Database Analysis. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Parashar B, Arora S, Stessin A, Wernicke A, Christos P, Nori D, Chao K. Adenocarcinoma Is Associated With Improved Survival Compared to Squamous Cell Carcinoma in Patients With Esophagus Cancer Treated With Radiation: A SEER Analysis. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rauch E, Stubbs R, Christos P, Costantini-Ferrando M, Schattman G. A randomized open label clinical trial of fixed vs.titrated dose letrozole for ovarian stimulation in breast cancer patients: an interim analysis. Fertil Steril 2012. [DOI: 10.1016/j.fertnstert.2012.07.433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Jeon JY, Kovanlikaya I, Boockvar JA, Mao X, Shin B, K Burkhardt J, Kesavabhotla K, Christos P, Riina H, Shungu DC, Tsiouris AJ. Metabolic response of glioblastoma to superselective intra-arterial cerebral infusion of bevacizumab: a proton MR spectroscopic imaging study. AJNR Am J Neuroradiol 2012; 33:2095-102. [PMID: 22576886 DOI: 10.3174/ajnr.a3091] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE SIACI of bevacizumab has emerged as a promising novel therapy in the treatment of recurrent GB. This study assessed the potential of (1)H-MRS as an adjunctive technique in detecting metabolic changes reflective of antiproliferative effects of targeted infusion of bevacizumab in the treatment of GB. MATERIALS AND METHODS Eighteen patients enrolled in a phase I/II study of SIACI of bevacizumab for treatment of recurrent GB were included. Concurrent MR imaging and (1)H-MRS scans were performed before and after treatment. Five distinct morphologic ROIs were evaluated for structural and metabolic changes on MR imaging and (1)H-MRS, which included enhancing, nonenhancing T2 hyperintense signal abnormality, and multiple control regions. Pre- and post-SIACI of bevacizumab peak areas for NAA, tCho, tCr, as well as tCho/tCr and tCho/NAA ratios, were derived for all 5 ROIs and compared using the Wilcoxon signed-rank test. RESULTS A significant median decrease of 25.99% (range -55.76 to 123.94; P = .006) in tCho/NAA was found post-SIACI of bevacizumab relative to pretreatment values in regions of enhancing disease. A trend-level significant median decrease of 6.45% (range -23.71 to 37.67; P = .06) was noted in tCho/NAA posttreatment in regions of nonenhancing T2-hyperintense signal abnormality. CONCLUSIONS The results of this (1)H-MRS analysis suggest that GB treatment with SIACI of bevacizumab may be associated with a direct antiproliferative effect, as demonstrated by significant reductions of tCho/NAA after the intervention.
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Affiliation(s)
- J Y Jeon
- Departments of Neuroradiology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY 10065, USA
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Bastiaens J, Dorfman B, Christos P, Nirenberg M. Prospective Cohort Study of Impulse Control Disorders in Parkinson's Disease (S52.003). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s52.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cha E, Tirsar LA, Schwentner C, Hennenlotter J, Stenzl A, Christos P, Mian C, Martini T, Pycha A, Shariat S, Schmitz-Dräger B. Accurate risk assessment of patients with painless hematuria for the presence of bladder cancer. Journal of Men's Health 2011. [DOI: 10.1016/j.jomh.2011.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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40
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Yan W, Christos P, Chao K, Nori D, Ravi A. Post-mastectomy Radiation Therapy in Younger Women Aged Less Than 50 with T3N0 Invasive Breast Cancer: Outcomes by Receptor Status/Race/Age. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Christos P, Patel H, Chioza BA, Dick K, Al-Memar A, Chrzanowksa-Lightowlers ZMA, Cross H, Patton MA, Lightowlers RN, Crosby AH. 07 Defective mitochondrial mRNA maturation is associated with spastic ataxia. J Neurol Psychiatry 2011. [DOI: 10.1136/jnnp.2010.235572.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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42
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Chuang E, Wiener N, Christos P, Kessler R, Cobham M, Donovan D, Goldberg GL, Caputo T, Doyle A, Vahdat L, Sparano JA. Phase I trial of ixabepilone plus pegylated liposomal doxorubicin in patients with adenocarcinoma of breast or ovary. Ann Oncol 2010; 21:2075-2080. [PMID: 20357034 DOI: 10.1093/annonc/mdq080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ixabepilone is a semisynthetic epothilone B analogue that is active in taxane-resistant cell lines and has shown activity in patients with refractory breast and ovarian cancer. We carried out a phase I trial of ixabepilone plus pegylated liposomal doxorubicin (PLD) in patients with advanced taxane-pretreated ovarian and breast cancer. METHODS Patients with recurrent ovarian or breast carcinoma received PLD every 3 or 4 weeks plus five different dose schemas of ixabepilone in cohorts of three to six patients. RESULTS Thirty patients received a total of 142 treatment cycles of the PLD-ixabepilone combination. The recommended phase II dose and schedule of ixabepilone was 16 mg/m(2) on days 1, 8, and 15 plus PLD 30 mg/m(2) given on day 1, repeated every 4 weeks. Hand-foot syndrome and mucositis were dose limiting when both ixabepilone and PLD were given every 3 or 4 weeks. Objective responses were observed in 3 of 13 patients (23%) with breast cancer and 5 of 17 patients (29%) with ovarian cancer. CONCLUSION Ixabepilone may be safely combined with PLD, but tolerability is highly dependent upon the scheduling of both agents. This combination demonstrated efficacy in patients with breast and ovarian cancer and merits further evaluation in these settings.
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Affiliation(s)
| | | | - P Christos
- Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical College, New York, NY
| | | | | | | | - G L Goldberg
- Department of Obstetrics and Gynecology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - T Caputo
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY
| | - A Doyle
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD
| | | | - J A Sparano
- Department of Medicine and Gynecology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Vahdat L, Ward M, Chuang E, Cigler T, Moore A, Donovan D, Cobham M, Schpero J, Wiener N, Blinder V, Christos P, Rafii S, Lane M. A Phase II Trial Tetrathiomolybdate (TM), a Copper Depleting Compound, and Its Effect on Circulating Endothelial Progenitor Cells (EPCs) in Patients with Breast Cancer (BC) at High Risk of Recurrence. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: EPCs are critical to tumor angiogenesis, are increased in BC patients (pts) and are probably an early marker for paclitaxel response. Copper is required for angiogenesis, and pre-clinical data suggest that TM, a copper-depleting compound, inhibits angiogenesis and maintains tumor dormancy. We sought to measure the effect of TM on circulating endothelial progenitor cells (EPCs) in pts at high risk of BC recurrence and to evaluate the effect of copper depletion on EPCs. Methods: This analysis is part of an ongoing phase II study of TM in BC pts at high risk of recurrence defined as any node positive triple negative (TN) BC, Stage III or IV with no evidence of disease (NED). All therapy other than hormonal was completed at least 6 weeks prior to study. Treatment: TM 180 mg daily to achieve a target ceruloplasmin (Cp) level of 5-15 mg/dL (copper depletion), and then 100 mg daily. We monitored levels of EPCs (CD45dim, CD133+, VEGFR2+), CEA, CA15-3, and Cp at baseline and monthly. Imaging studies are done every 6 months (mos). Results: 28 pts are enrolled and 304 cycles of TM have been administered. Adjuvant: 20 pts, Stage 4 NED: 8 pts, Triple negative: 8 pts (5 stage IV NED, 3 Adjuvant) The median age is 51 years (range: 29-64), median number of positive lymph nodes among Stage III patients is 7 (4-42). The median baseline Cp level was 28 mg/dL (21-43). Among 21 patients who have reached target Cp, the median time to target is 6 weeks (2-16 weeks). Two pts discontinued treatment before reaching target. The median baseline EPCs is 17.38 cells/ml (0.0-286.1) Although there was a trend toward increased EPCs at month 1, this was not statistically significant (p=0.8964) and the majority of pts EPCs were maintained below baseline over time when Cp levels were below target (ie. copper depleted). Toxicity: Grade 3/4 neutropenia occurred in 3 patients (0.02%) with 1 pt with febrile neutropenia. All resolved 5-13 days later with TM held and resumed at a lower dose in 2 patients. No other grade 3/4 toxicity was observed. Three patients were diagnosed with recurrent breast cancer at 1, 9 and 10 mos. An EPC rise preceded an abnormal marker or overt relapse by 3-5 months in 2 of 3 pts. Conclusions: TM is well tolerated in breast cancer patients. TM might contribute to maintaining EPCs below baseline in pts who are copper depleted. We postulate that the increased EPCs noted in both patients with recurrent disease 2-4 months prior to overt relapse could represent the turning on of an angiogenic switch, resulting in an outpouring of CEPCs to the new site of metastasis. Other studies geared toward understanding the mechanism for metastases are underway. The trial continues to accrue.Supported by the Susan B Komen for the Cure, NY Community Trust, Breast Cancer Alliance of Greenwich and the Madeline and Stephen Anbinder Foundation.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6090.
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Affiliation(s)
| | - M. Ward
- 1Weill Cornell Medical College, NY,
| | | | | | - A. Moore
- 1Weill Cornell Medical College, NY,
| | | | | | | | | | | | | | - S. Rafii
- 3Weill Cornell Medical College, NY,
| | - M. Lane
- 1Weill Cornell Medical College, NY,
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McCarville K, Flam A, Forst M, Swistel A, Osborne M, Moore A, Vahdat L, Klein P, Christos P, Mazumdar M, Chuang E. Differences in Breast Cancer Subtypes among Asian-American Women with Invasive Breast Cancer in New York City. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Specific breast cancer (BC) subtypes conferring distinct phenotypic and prognostic outcomes have been defined by molecular gene expression arrays. A recent study suggested that differences in BC subtypes exist among ethnic subgroups of Asian women in California. It has also been reported that there are differences in clinical outcomes among Asians with BC in the US, with Filipinos having a worse prognosis compared with other Asians. We sought to determine whether differences in BC subtypes exist among Asians in New York.Methods: Using outpatient registration records from Weill Cornell Breast Center and St. Vincent's Medical Center in New York City, we identified patients who were diagnosed with stage I, II, or III invasive BC between 1997 and 2007 who were of Chinese, Filipino, Japanese or Korean ethnicity. We reviewed pathology records according to an IRB approved protocol and recorded patient data for age, stage, grade, estrogen receptor (ER), progesterone receptor (PR) status, and HER-2/neu at diagnosis. Immunohistochemical surrogates for the four molecularly defined breast cancer subtypes were used according to accepted definitions (Luminal A: ER+Her2-; Luminal B: ER+ Her2+; Her2/neu: Her2+ ER-; Basal-like: ER-PR-, Her2-) Using chi-square analysis, we explored the relationship between ethnicity and BC subtypes.Results: 346 Asian women were identified with invasive breast cancer. Among the Chinese subgroup, 67% were of the Luminal A subtype, 15.3% were Luminal B, 10% were the Her2/neu subtype and 8.5% were Basal-like. Filipinos had a higher proportion of Luminal B cancers compared to the other ethnic groups. Filipinos and Koreans had a higher proportion of the Her2+/ER- subtype compared to Chinese and Japanese (P=0.004 by chi-square test). When considering all Her2/neu positive cancers, Filipinos had a significantly higher proportion of HER-2/neu positivity (46%) compared to Chinese (25%), Japanese (14%) and Korean (29%) groups (P=0.002). Filipinos and Koreans had a higher proportion of ER negative cancers and Grade III cancers compared to Chinese and Japanese (P=0.001 for ER status and P=0.01 for grade). In our series, Korean subjects were significantly younger than the other three ethnic groups (P<0.0001 by AVOVA test).Conclusions: Differences in BC subtypes exist among Asian women with invasive breast cancer in New York. Filipino women are significantly more likely to have HER-2/neu positive BC compared with Chinese, Japanese, and Korean women. Our results are supportive of results from a study in which differences in distribution of Her2/neu positive cancers among Asians in California were seen. Furthermore, these findings provide one explanation for the worse clinical outcome for Filipinos compared with other Asians that has been previously reported.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3067.
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Affiliation(s)
| | - A. Flam
- 2 Weill Cornell Medical College, NY,
| | - M. Forst
- 1 St. Vincent's Medical Center, NY,
| | | | | | - A. Moore
- 2 Weill Cornell Medical College, NY,
| | - L. Vahdat
- 2 Weill Cornell Medical College, NY,
| | - P. Klein
- 1 St. Vincent's Medical Center, NY,
| | | | | | - E. Chuang
- 2 Weill Cornell Medical College, NY,
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Zakrzewski JA, Geraghty L, Hamilton H, Christos P, Krich D, Mazumdar M, Polsky D, Darvishian F, Pavlick A, Osman I. Prospective analysis of predictors of survival in melanoma patients with brain metastases. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9074] [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
9074 Background: Melanoma patients (pts) with brain metastases (BM) have limited survival, and BM remains an exclusion criterion in most clinical trials. A recent retrospective analysis at Memorial Sloan Kettering Cancer Center (MSKCC) identified 4 clinical variables that were associated with worse post BM survival (Raizer J et al, Neuro Oncol 2008). In this study, we investigated whether primary tumor features could improve the predictability of post BM survival and examined the reproducibility of the variables identified in MSKCC study. Methods: Melanoma pts with BM prospectively enrolled in an interdisciplinary database at NYU Medical Center from 2002 to 2008 were studied. Six primary tumor characteristics, 21 clinical variables, and treatments were examined. Univariate associations were analyzed using Kaplan Meier survival analysis and the independent effect of identified predictors was assessed by multivariate cox proportional hazards regression analysis. Results: Eighty-nine pts (36 F, 53 M, median age 57) were identified. Median post BM survival was 5.75 months. Median follow-up time based on survivors was 4.2 months. Ulceration and mitotic index ≥3/field were univariately associated with worse post BM survival (p=0.004, p=0.009 respectively). Age >65, ≥3 BM lesions, presence of neurological symptoms, and extracranial metastases were also univariately associated with worse post BM survival (the same 4 variables identified in MSKCC retrospective study). An additional 4 clinical parameters were significant by univariate analysis: frontal lobe location (p=0.01), bilateral lesions (p=0.01), ≥2 neurological symptoms (p=0.005), and weakness/fatigue (p<0.0001). After reproducing the significance of the 4 MSKCC variables in a multivariate model, ulceration of the primary tumor was also an independent predictor of post BM survival (hazard ratio [HR] = 2.75; 95% CI = 1.30, 5.83; p=0.008) whereas mitotic index ≥3/field was not (HR=1.24; 95% CI = 0.57, 2.71; p=0.59). Conclusions: Data suggest that ulceration of the primary melanoma might indicate an adverse biologic behavior that impacts post BM survival. Our data also lend independent support for the predictive model of post BM survival. No significant financial relationships to disclose.
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Affiliation(s)
- J. A. Zakrzewski
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - L. Geraghty
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - H. Hamilton
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - P. Christos
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - D. Krich
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - M. Mazumdar
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - D. Polsky
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - F. Darvishian
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - A. Pavlick
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - I. Osman
- New York University School of Medicine, New York, NY; Weill Medical College of Cornell University, New York, NY
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Seetharamu N, Hamilton H, Tu T, Christos P, Osman I, Pavlick AC. Prognostic factors for survival in patients with stage (stg) IV malignant melanoma (MM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9072] [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
9072 Background: Prognosis for survival in MM is not uniform with some pts being long-term survivors. Identifying this subset of pts may have implications on surveillance and treatment (tx). Unfortunately, prognostic data available for MM and the utility of AJCC staging in predicting survival is limited. We analyzed prospectively collected data from the NYUCI Interdisciplinary Melanoma Cooperative Group program (IMCG) to identify clinicopathological variables predictive of MM survival. Methods: We identified 185 pts enrolled in the IMCG with MM diagnosed and treated at NYUCI. Demographic, clinical, and tx-related factors were included in the analysis. Kaplan-Meier (KM) survival analysis was used to identify univariate predictors of post-stage IV survival and their independent effect was assessed in a multivariate Cox proportional hazards regression model. Results: Median age at diagnosis (dx) of metastatic MM was 64 years (22–92). Median overall survival: 13.8 months(m) (128 deaths and a median follow up of 18.6 m (4–141) for survivors). Factors identified on univariate analysis at p<0.20 were evaluated in the multivariate model ( table ). Co-morbidities, site and histology of primary melanoma, initial staging, prior loco-regional recurrences, and adjuvant tx of primary melanoma were not associated with MM survival. Univariate analysis also showed significant survival advantage (p value 0.0011) for patients with AJCC stages M1a and M1b (21.6 m and 17.2 m respectively) over those with AJCC stage M1c (9 m). Conclusions: This cohort study of MM identified female gender, nl serum LDH, nl albumin, and solitary organ involvement as independent survival predictors. Patients who received systemic therapy± local measures had survival benefit over those that had surgery and/or radiation alone suggesting a role for systemic treatment in MM. Patients with personal history of another malignancy (n=37) showed a trend towards improved survival. This novel observation needs to be validated and studied further. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- N. Seetharamu
- New York University Langone Medical Center, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - H. Hamilton
- New York University Langone Medical Center, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - T. Tu
- New York University Langone Medical Center, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - P. Christos
- New York University Langone Medical Center, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - I. Osman
- New York University Langone Medical Center, New York, NY; Weill Medical College of Cornell University, New York, NY
| | - A. C. Pavlick
- New York University Langone Medical Center, New York, NY; Weill Medical College of Cornell University, New York, NY
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Acharya SS, Schloss R, Dyke JP, Mintz DN, Christos P, DiMichele DM, Adler RS. Power Doppler sonography in the diagnosis of hemophilic synovitis--a promising tool. J Thromb Haemost 2008; 6:2055-61. [PMID: 18823337 DOI: 10.1111/j.1538-7836.2008.03160.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recurrent hemarthroses in hemophilia results in synovitis and joint arthropathy. Primary prophylaxis when universally instituted at current doses can prevent joint deterioration but is expensive. Alternatively, the selective implementation of prophylaxis would require a more sensitive tool for detecting synovitis than possible with clinical surveillance or plain radiographs. Magnetic resonance imaging (MRI) is such a tool and is utilized for the evaluation of hemophilic joint disease (HJD). However, it is expensive, and requires sedation in younger children precluding its utility for monitoring of synovitis. Ultrasonography (USG) with power Doppler (USG-PDS) has been utilized to detect and quantitate synovial vascularity in other arthritides and could provide an equally effective but less costly tool for HJD, particularly in children who would not require sedation. OBJECTIVES To determine whether USG-PDS is comparable to MRI in the evaluation of hemophilic synovitis. PATIENTS A prospective cohort of 31 subjects including 33 joints (knees, elbows, ankles) underwent dynamic contrast enhanced (DCE)-MRI and USG-PDS. RESULTS USG-PDS measurements of synovial thickness(r = 0.70, P < 0.0001) and synovial vascularity (r = 0.73, P < 0.0001) correlated strongly with those obtained with DCE-MRI. A cutoff of PDS intensity of 1.3 decibels (dB) per mm(2) was found to yield a sensitivity of 100% and a specificity of 94.1% in 17 joints with/without a history of hemarthroses. Pettersson radiographic scores correlated significantly with synovial thickness in adults but not children. CONCLUSIONS Our data suggest that USG-PDS may be an inexpensive and easily implemented imaging tool for detecting hemophilic synovitis and could be useful in tailoring effective prophylaxis.
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Affiliation(s)
- S S Acharya
- Pediatrics-Hematology/Oncology, Weill Medical College, New York, NY, USA.
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Patel P, Ravi A, Allbright R, Christos P, Brennan J, Parashar B, Nori D, Wernicke A. Re-irradiation of Loco-regional Recurrences in Patients with Intermediate and High Risk Stages I and II Endometrial Cancer: Prognostic Factors and Outcomes. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Martin P, Chadburn A, Christos P, Furman R, Ruan J, Joyce M, Fusco E, Glynn P, Elstrom R, Niesvizky R, Feldman E, Shore T, Schuster M, Ely S, Knowles D, Chen-Kiang S, Coleman M, Leonard J. Intensive treatment strategies may not provide superior outcomes in mantle cell lymphoma: overall survival exceeding 7 years with standard therapies. Ann Oncol 2008; 19:1327-1330. [DOI: 10.1093/annonc/mdn045] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yu JZ, Christos P, Darvishian F, Yee H, Buckley MT, Liebes LF, Pavlick AC, Polsky D, Brooks P, Osman I. A complex role of insulin-like growth factor binding proteins (IGFBPs) in melanoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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