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Mangla A, Singh AKS, Goel S. Squamous cell carcinoma of skin in a case of post-filariasis chronic lower limb lymphedema- a case study and review of literature. Int J Surg Case Rep 2024; 116:109355. [PMID: 38325110 PMCID: PMC10864193 DOI: 10.1016/j.ijscr.2024.109355] [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: 12/27/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Filariasis, predominantly caused by the parasite Wuchereria Bancrofti, is a key etiological factor in lymphedema development. Lymphedema, characterized by persistent lymphatic obstruction, leads to significant changes in immunological factors and protein composition. These alterations play a crucial role in the delayed diagnosis of squamous cell carcinoma within chronic lymphedema contexts. Notably, chronic lymphedema is an infrequent but significant precursor to squamous cell carcinoma, with fewer than 20 cases reported in medical literature, including only 11 cases affecting the lower limbs. The management of squamous cell carcinoma in lymphedema is challenging due to the rarity of cases and the resulting lack of experience among clinicians. CASE PRESENTATION The report focuses on a 69-year-old woman with long-standing right lower limb lymphedema following filariasis. She underwent treatment for a non-healing ulcer in the right gluteal region, diagnosed as moderately differentiated squamous cell carcinoma. Following a wide local excision with primary closure, her lower limb swelling persisted, and subsequent diagnosis confirmed regional lymph node metastasis. The patient was then considered for immunotherapy. CLINICAL DISCUSSION This case emphasizes the link between chronic lymphedema and squamous cell carcinoma. It highlights the necessity for a multidisciplinary approach for timely and effective treatment, addressing the rarity and complexity of such cases. CONCLUSION The successful application of immunotherapy in this case illustrates a favorable clinical outcome, marking a significant advancement in treating similar conditions. This finding contributes to the evolving knowledge in this medical field, suggesting immunotherapy as a promising treatment option. METHODS This case report meticulously follows the SCARE 2023 guidelines: updating consensus Surgical Case Report guidelines (Sohrabi et al., 2023) [1]. These guidelines ensure high-quality reporting in surgical case reports. The report details the evaluation, diagnosis, and a comprehensive review of the literature pertaining to a patient with squamous cell carcinoma of the skin and regional nodal metastasis, which developed in the context of post-filariasis chronic lower limb lymphedema. By employing a multidisciplinary approach, this report achieves a thorough and standardized presentation of the case, serving as a benchmark and an additional tool for raising awareness about such rare medical conditions.
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Affiliation(s)
- Aayushi Mangla
- Department of General Surgery, Indraprastha Apollo Hospitals, New Delhi, India.
| | | | - Saket Goel
- Department of General Surgery, Indraprastha Apollo Hospitals, New Delhi, India
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2
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Tilmon S, Aronsohn A, Boodram B, Canary L, Goel S, Hamlish T, Kemble S, Lauderdale DS, Layden J, Lee K, Millman AJ, Nelson N, Ritger K, Rodriguez I, Shurupova N, Wolf J, Johnson D. HepCCATT: a multilevel intervention for hepatitis C among vulnerable populations in Chicago. J Public Health (Oxf) 2022; 44:891-899. [PMID: 34156077 PMCID: PMC8692481 DOI: 10.1093/pubmed/fdab190] [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: 12/09/2020] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Hepatitis C infection could be eliminated. Underdiagnosis and lack of treatment are the barriers to cure, especially for vulnerable populations (i.e. unable to pay for health care). METHODS A multilevel intervention from September 2014 to September 2019 focused on the providers and organizations in 'the safety net' (providing health care to populations unable to pay), including: (i) public education, (ii) training for primary care providers (PCPs) and case managers, (iii) case management for high-risk populations, (iv) policy advice and (v) a registry (Registry) for 13 health centers contributing data. The project tracked the number of PCPs trained and, among Registry sites, the number of people screened, engaged in care (i.e. clinical follow-up after diagnosis), treated and/or cured. RESULTS In Chicago, 215 prescribing PCPs and 56 other health professionals, 86% of whom work in the safety net, were trained to manage hepatitis C. Among Registry sites, there was a 137% increase in antibody screening and a 32% increase in current hepatitis C diagnoses. Engagement in care rose by 18%. CONCLUSIONS Hepatitis C Community Alliance to Test and Treat (HepCCATT) successfully targeted safety net providers and organizations with a comprehensive care approach. While there were challenges, HepCCATT observed increased hepatitis C screening, diagnosis and engagement in care in the Chicago community.
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Affiliation(s)
- Sandra Tilmon
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
| | - A Aronsohn
- Gastroenterology, University of Chicago Medicine, Chicago, IL 60637, USA
| | - B Boodram
- Department of Public Health, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - L Canary
- CDC: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA 30329, USA
| | - S Goel
- Division of General Internal Medicine and Geriatrics, Northwestern University (Medicine), Chicago, IL 60611 USA
| | - T Hamlish
- Cancer Center, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - S Kemble
- Hawaii Department of Health, Honolulu, HI 96813, USA
| | - D S Lauderdale
- Public Health Sciences, University of Chicago Medicine, Chicago, IL 60637
| | - J Layden
- Illinois Department of Public Health, West Chicago, IL 60185, USA
| | - K Lee
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
| | - A J Millman
- CDC: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA 30329, USA
| | - N Nelson
- CDC: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA 30329, USA
| | - K Ritger
- Chicago Department of Public Health, Chicago, IL 60604, USA
| | - I Rodriguez
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
| | - N Shurupova
- Medical Research Analytics and Informatics Alliance (MRAIA), Chicago, IL 60606, USA
| | - J Wolf
- Caring Ambassadors Program, Oregon City, OR 97045, USA
| | - D Johnson
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
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3
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Goel S, Slomovich S, Edris S, Park WJ, Agarwal C, Hooda A, Krishnamoorthy PM, Gidwani U, Sharma S, Kini A. Fractional flow reserve versus angiography guided revascularization for patients with multivessel coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1368] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently published randomized controlled trials (RCT) have questioned the utility of Fraction Flow Reserve (FFR) to guide revascularization in patients with multivessel coronary artery disease (CAD) as compared to Angiography
Purpose
This current analysis aimed to compare the clinical outcomes associated with FFR guided versus standard angiography-guided revascularization for patients with multivessel CAD using a large number of randomized patients with stable CAD and acute coronary syndrome (ACS)
Methods
We conducted an electronic database search of all published data for RCT that compared FFR versus Angiography for patients with multivessel CAD and reported on subsequent mortality, cardiac death, myocardial infarction, revascularization, and other outcomes of interest. Event rates were compared using a forest plot of odds ratios using a fixed-effects model assuming interstudy heterogeneity.
Results
Eleven RCT (n=6052; FFR = 3043, Angiography = 3027) were included in the final analysis. Mean follow-up period was 1.7 years. In our analysis, FFR guided revascularization as compared to angiography guided revascularization alone was not associated with any significant reduction in overall mortality (OR = 1.10, 95% CI = 0.83–1.47, P=0.47, I2=0), cardiac mortality (OR = 0.95, 95% CI = 0.63–1.45, P=0.42, I2=0), all revascularization (OR = 0.96, 95% CI = 0.80–1.14, P=0.17, I2=31%) or myocardial infarction (OR = 0.99, 95% CI = 0.79–1.23, P=0.33, I2=12%). There was also no difference between two groups in terms of major adverse cardiac or cerebrovascular event [MACCE] (OR = 1.13, 95% CI = 0.90–1.42, P=0.39, I2=5%), major adverse cardiac event [MACE] (OR = 0.86, 95% CI = 0.70–1.07, P=0.55, I2=0), stroke/TIA (OR = 1.61, 95% CI = 0.92–2.82, P=0.36, I2=8%) or target lesion revascularization [TLR] (OR = 0.86, 95% CI = 0.44–1.67, P=0.71, I2=0). Furthermore, sensitivity analysis was conducted to include only studies with ACS patients and studies which used CABG only for revascularization. However, there was no difference between the two groups for any of the above outcomes
Conclusion
There is no difference in clinical outcomes in patients undergoing FFR-guided versus angiography guided revascularization for multivessel CAD
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Goel
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - S Slomovich
- South Nassau Communities Hospital, Internal Medicine , Oceanside , United States of America
| | - S Edris
- South Nassau Communities Hospital, Internal Medicine , Oceanside , United States of America
| | - W J Park
- South Nassau Communities Hospital, Cardiology , Oceanside , United States of America
| | - C Agarwal
- Maimonides Medical Center, Cardiology , Brooklyn , United States of America
| | - A Hooda
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - P M Krishnamoorthy
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - U Gidwani
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - S Sharma
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - A Kini
- Icahn School of Medicine at Mount Sinai , New York , United States of America
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André F, Nadal J, Denys H, Goel S, Litchfield L, Appiah A, Chen Y, Tolaney S. LBA18 Final overall survival (OS) for abemaciclib plus trastuzumab +/- fulvestrant versus trastuzumab plus chemotherapy in patients with HR+, HER2+ advanced breast cancer (monarcHER): A randomized, open-label, phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.013] [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] [Indexed: 11/25/2022] Open
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5
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Supehia S, Bahurupi Y, Singh M, Goel S, Kishore S, Aggarwal P, Sharma N. Compliance of vendors with legislation restricting the sale of tobacco near educational institutions in India. Int J Tuberc Lung Dis 2022; 26:883-885. [PMID: 35996286 DOI: 10.5588/ijtld.22.0174] [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: 11/10/2022] Open
Affiliation(s)
- S Supehia
- Department of Community and Family Medicine, Dr Rajendra Prasad Government Medical College, Kangra, India
| | - Y Bahurupi
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - M Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - S Goel
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - P Aggarwal
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - N Sharma
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
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Mdkhana B, Goel S, Saleh MA, Siddiqui R, Khan NA, Elmoselhi AB. Role of oxidative stress in angiogenesis and the therapeutic potential of antioxidants in breast cancer. Eur Rev Med Pharmacol Sci 2022; 26:4677-4692. [PMID: 35856359 DOI: 10.26355/eurrev_202207_29192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The escalation of cancer cases globally, especially breast cancer, is of concern. Angiogenesis is hallmark of cancer pathogenesis and plays an important role in cancer progression and metastasis. Pro-angiogenic agents, secreted by tumor cells, form new blood vessels, and produce reactive oxygen species (ROS). ROS promote angiogenesis via two major pathways: namely Vascular Endothelial Growth Factor (VEGF) dependent and non-VEGF dependent pathways. As a consequence of unbalanced ROS overproduction and low antioxidants levels, oxidative stress occurs and promotes angiogenesis in breast cancer tissues. Thus, the potential use of antioxidants as a preventive therapy in breast cancer. Preclinical studies depict that vitamins A and E may counter oxidative stress resulting in reduction of metastasis and viability of breast cancer. Furthermore, clinical studies demonstrate a decline in breast cancer risk in postmenopausal women upon the consumption of antioxidants. Herein, we discuss various pro-angiogenic agents that may play an important role in breast cancer angiogenesis. Moreover, the contribution of oxidative stress in inducing the angiogenic process is extensively reviewed here. Furthermore, the findings of pre-clinical and clinical studies on the use of antioxidants, namely vitamins A and E, in breast cancer are deliberated upon, along with the role of angiogenesis in cancer therapy.
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Affiliation(s)
- B Mdkhana
- Sharjah Institute of Medical Research, Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE.
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Swain L, Qiao X, Everett K, Bhave S, Reyelt L, Aryaputra T, Surks W, Goel S, Zweck E, Diakos N, Kapur N. Trans-Valvular Unloading Reduces Anaerobic Glycolysis Before Reperfusion and Preserves Energy Substrate Utilization After Reperfusion in Models of Acute Myocardial Infarction. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1710] [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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8
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Ravindra K, Malik V, Padhi B, Goel S, Gupta M. Asymptomatic infection and transmission of COVID-19 among clusters: systematic review and meta-analysis. Public Health 2022; 203:100-109. [PMID: 35038628 PMCID: PMC8654597 DOI: 10.1016/j.puhe.2021.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/08/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Countries throughout the world are experiencing COVID-19 viral load in their populations, leading to potential transmission and infectivity of asymptomatic COVID-19 cases. The current systematic review and meta-analysis aims to investigate the role of asymptomatic infection and transmission reported in family clusters, adults, children and health care workers, globally. STUDY DESIGN Systematic review and meta-analysis. METHODS An online literature search of PubMed, Google Scholar, medRixv and BioRixv was performed using standard Boolean operators and included studies published up to 17 August 2021. For the systematic review, case reports, short communications and retrospective studies were included to ensure sufficient asymptomatic COVID-19 transmission data were reported. For the quantitative synthesis (meta-analysis), participant data from a collection of cohort studies focusing on groups of familial clusters, adults, children and health care workers were included. Inconsistency among studies was assessed using I2 statistics. The data synthesis was computed using the STATA 16.0 software. RESULTS This study showed asymptomatic transmission among familial clusters, adults, children and health care workers of 15.72%, 29.48%, 24.09% and 0%, respectively. Overall, asymptomatic transmission was 24.51% (95% confidence interval [CI]: 14.38, 36.02) among all studied population groups, with a heterogeneity of I2 = 95.30% (P < 0.001). No heterogeneity was seen in the population subgroups of children and health care workers. The risk of bias in all included studies was assessed using the Newcastle Ottawa Scale. CONCLUSIONS For minimising the spread of COVID-19 within the community, this study found that following the screening of asymptomatic cases and their close contacts for chest CT scan (for symptomatic patients), even after negative nucleic acid testing, it is essential to perform a rigorous epidemiological history, early isolation, social distancing and an increased quarantine period (a minimum of 14-28 days). This systematic review and meta-analysis supports the notion of asymptomatic COVID-19 infection and person-to-person transmission and suggests that this is dependent on the varying viral incubation period among individuals. Children, especially those of school age (i.e. <18 years), need to be monitored carefully and follow mitigation strategies (e.g. social distancing, hand hygiene, wearing face masks) to prevent asymptomatic community transmission of COVID-19.
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Affiliation(s)
- K. Ravindra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Corresponding author. Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. Tel.: +911722755262; fax: +911722744401
| | - V.S. Malik
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - B.K. Padhi
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S. Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - M. Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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9
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Brodin P, Velten C, Zhu S, Hauze M, Tome W, Rajdev L, Goel S, Chuy J, Guha C, Kalnicki S, Garg M, Kabarriti R. Outcomes of Patients Living With HIV and Anal Cancer Treated With Definitive Intensity-Modulated Radiation Therapy and 5-Fluorouracil- or Capecitabine-Based Chemotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.342] [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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10
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Kyaw H, Vengrenyuk A, Johal G, Goel S, Sharma S, Kini A. New era of education: mobile learning of coronary guidewires in cardiovascular medicine. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3116] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Online education has transformed the way we teach and learn, especially in the midst of a global pandemic. Multiple devices, including coronary guidewires, are required to perform a successful coronary intervention, and understanding the engineering aspect of coronary guidewire technology is paramount.
Purpose
We aim to develop and evaluate a novel teaching tool/mobile learning app to understand a complex guidewire architecture and appropriate wire selection based on a lesion characteristics.
Methods
A guidewire is incredibly complex, consisting of a multitude of technologies allowing a range of tip softness, trackability around curves, and precise torque control. Despite operator preference, the process of choosing an appropriate coronary guidewire has gone mostly unchanged. We envisioned developing the GuidewireAID app with three main parts: 1) wire basics, 2) lesion-based guidewire selection, and 3) cased-based approach. Appropriate teaching cases were selected from a large-volume catheterization laboratory and divided into non-chronic total occlusion (non-CTO) and CTO. Non-CTO cases include simple, calcified, angulated, and bifurcation lesions, as well as thrombotic occlusion and tortuous vessels (Figure 1). Each case is described and analysis is offered on how to select an appropriate wire, followed by teaching points pertinent to the topic.
Results
Twenty-three detailed clinical cases and more than a hundred wires are illustrated in the GuidewireAID app. Case presentation, angiographic analysis, and a thorough understanding of wire characteristics allows the operator to know which wire to use and when it is time to switch, especially when dealing with complex coronary cases.
Conclusion
The GuidewireAID app will help fellows in training (FIT), early career interventionists, and practicing interventional cardiologists understand the complex aspects of a coronary guidewire and appreciate how their nuances could overcome real-world clinical challenging scenarios.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- H Kyaw
- Mount Sinai Medical Center, New York, United States of America
| | - A Vengrenyuk
- Mount Sinai Medical Center, New York, United States of America
| | - G Johal
- Mount Sinai Medical Center, New York, United States of America
| | - S Goel
- Mount Sinai Medical Center, New York, United States of America
| | - S Sharma
- Mount Sinai Medical Center, New York, United States of America
| | - A Kini
- Mount Sinai Medical Center, New York, United States of America
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Hamilton E, Goel S, Arend R, Chu C, Richardson D, Corr B, John V, Janku F, Hays J, Michenzie M, Reichmann W, Achour H, Sherman M, Ruiz-Soto R, Mathews C. 728P A phase Ib/II study of rebastinib and paclitaxel in advanced/metastatic platinum-resistant ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1171] [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] Open
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12
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Agarwal N, McGregor B, Maughan B, Dorff T, Kelly W, Fang B, McKay R, Singh P, Pagliaro L, Dreicer R, Srinivas S, Loriot Y, Vaishampayan U, Goel S, Curran D, Panneerselvam A, Liu LF, Choueiri T, Pal S. LBA24 Cabozantinib (C) in combination with atezolizumab (A) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): Results of expanded cohort 6 of the COSMIC-021 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2100] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Singh S, Goel S, Iqbal A. Anatomical segment 4b/5 resection for gall bladder cancer using intraoperative ultrasound. J Visc Surg 2021; 158:253-257. [PMID: 33896696 DOI: 10.1016/j.jviscsurg.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S Singh
- Department of GI and HPB Oncosurgery, Rajiv-Gandhi cancer Institute and research centre, Delhi, India.
| | - S Goel
- Department of GI and HPB Oncosurgery, Rajiv-Gandhi cancer Institute and research centre, Delhi, India
| | - A Iqbal
- Department of GI and HPB Oncosurgery, Rajiv-Gandhi cancer Institute and research centre, Delhi, India
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Tiwari R, Pandey SK, Goel S, Bhatia V, Shukla S, Jing X, Dhanasekaran SM, Ateeq B. Correction: SPINK1 promotes colorectal cancer progression by downregulating Metallothioneins expression. Oncogenesis 2021; 10:16. [PMID: 33619267 PMCID: PMC7900126 DOI: 10.1038/s41389-021-00305-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- R Tiwari
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - S K Pandey
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - S Goel
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - V Bhatia
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - S Shukla
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - X Jing
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - S M Dhanasekaran
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - B Ateeq
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India.
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Stradella A, Johnson M, Goel S, Chandana S, Galsky M, Calvo E, Moreno V, Park H, Arkenau T, Cervantes A, Fariñas-Madrid L, Mileshkin L, Fu S, Plummer R, Evans J, Horvath L, Prawira A, Qu K, Pelham R, Barve M. 530MO Clinical benefit in biomarker-positive patients (pts) with locally advanced or metastatic solid tumours treated with the PARP1/2 inhibitor pamiparib in combination with low-dose (LD) temozolomide (TMZ). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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16
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Hamilton E, Goel S, Arend R, Chu C, Richardson D, Diamond J, John V, Janku F, Matthews C, JeBailey L, Kuida K, Achour H, Ruiz-Soto R, Hays J. 839P A phase Ib/II study of rebastinib and paclitaxel in advanced or metastatic platinum-resistant ovarian cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Guigay J, Lee KW, Patel M, Daste A, Wong D, Goel S, Gordon M, Gutierrez M, Balmanoukian A, Le Tourneau C, Mita A, Vansteene D, Keilholz U, Schöffski P, Grote H, Zhou D, Bajars M, Penel N. 920P Avelumab (anti-PD-L1) in patients with platinum-refractory/ineligible recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Results from a phase Ib cohort. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Meric-Bernstam F, Somaiah N, DuBois S, Dumbrava EEI, Shapiro G, Patel M, Goel S, Bauer T, Pinchasik D, Annis A, Aivado M, Vukovic V, Saleh M. A phase IIa clinical trial combining ALRN-6924 and palbociclib for the treatment of patients with tumours harboring wild-type p53 and MDM2 amplification or MDM2/CDK4 co-amplification. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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Percy E, Luc J, Hirji S, Vervoort D, Zhu K, Goel S, Pelletier M. CHARACTERISTICS OF HIGH-IMPACT ARTICLES IN THE CANADIAN JOURNAL OF CARDIOLOGY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Tolaney S, Wardley A, Zambelli S, Hilton J, Troso-Sandoval T, Ricci F, Im SA, Kim SB, Johnston S, Chan A, Goel S, Catron K, Yang Z, Gainford C, André F. MonarcHER: A randomized phase II study of abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with HR+, HER2+ advanced breast cancer (ABC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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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Stradella A, Johnson M, Goel S, Chandana S, Galsky M, Calvo E, Moreno V, Park H, Arkenau HT, Cervantes A, Madrid LF, Mileshkin L, Plummer R, Evans J, Horvath L, Prawira A, Pelham R, Mu S, Andreu-Vieyra C, Barve M. Updated results of the PARP1/2 inhibitor pamiparib in combination with low-dose (ld) temozolomide (TMZ) in patients (pts) with locally advanced or metastatic solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pernas S, Goel S, Johnson N, Harrison B, Guerriero J, Hu J, Winship G, Sokolov A, Regan M, Mittendorf E, Overmoyer B. Early on-treatment vs pre-treatment tumour transcriptomes as predictors of response to neoadjuvant therapy for HER2-positive inflammatory breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hrinczenko B, Spigel D, Iannotti N, Safran H, Taylor M, Bennouna J, Goel S, Leach J, Wong D, Kelly K, Verschraegen C, Bajars M, Manitz J, Ruisi M, Gulley J. Long-term avelumab treatment in patients with advanced non-small cell lung cancer (NSCLC): Post hoc analyses from JAVELIN solid tumour. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mullane KM, Morrison VA, Camacho LH, Arvin A, McNeil SA, Durrand J, Campbell B, Su SC, Chan ISF, Parrino J, Kaplan SS, Popmihajlov Z, Annunziato PW, Cerana S, Dictar MO, Bonvehi P, Tregnaghi JP, Fein L, Ashley D, Singh M, Hayes T, Playford G, Morrissey O, Thaler J, Kuehr T, Greil R, Pecherstorfer M, Duck L, Van Eygen K, Aoun M, De Prijck B, Franke FA, Barrios CHE, Mendes AVA, Serrano SV, Garcia RF, Moore F, Camargo JFC, Pires LA, Alves RS, Radinov A, Oreshkov K, Minchev V, Hubenova AI, Koynova T, Ivanov I, Rabotilova B, Minchev V, Petrov PA, Chilingirov P, Karanikolov S, Raynov J, Grimard D, McNeil S, Kumar D, Larratt LM, Weiss K, Delage R, Diaz-Mitoma FJ, Cano PO, Couture F, Carvajal P, Yepes A, Torres Ulloa R, Fardella P, Caglevic C, Rojas C, Orellana E, Gonzalez P, Acevedo A, Galvez KM, Gonzalez ME, Franco S, Restrepo JG, Rojas CA, Bonilla C, Florez LE, Ospina AV, Manneh R, Zorica R, Vrdoljak DV, Samarzija M, Petruzelka L, Vydra J, Mayer J, Cibula D, Prausova J, Paulson G, Ontaneda M, Palk K, Vahlberg A, Rooneem R, Galtier F, Postil D, Lucht F, Laine F, Launay O, Laurichesse H, Duval X, Cornely OA, Camerer B, Panse J, Zaiss M, Derigs HG, Menzel H, Verbeek M, Georgoulias V, Mavroudis D, Anagnostopoulos A, Terpos E, Cortes D, Umanzor J, Bejarano S, Galeano RW, Wong RSM, Hui P, Pedrazzoli P, Ruggeri L, Aversa F, Bosi A, Gentile G, Rambaldi A, Contu A, Marei L, Abbadi A, Hayajneh W, Kattan J, Farhat F, Chahine G, Rutkauskiene J, Marfil Rivera LJ, Lopez Chuken YA, Franco Villarreal H, Lopez Hernandez J, Blacklock H, Lopez RI, Alvarez R, Gomez AM, Quintana TS, Moreno Larrea MDC, Zorrilla SJ, Alarcon E, Samanez FCA, Caguioa PB, Tiangco BJ, Mora EM, Betancourt-Garcia RD, Hallman-Navarro D, Feliciano-Lopez LJ, Velez-Cortes HA, Cabanillas F, Ganea DE, Ciuleanu TE, Ghizdavescu DG, Miron L, Cebotaru CL, Cainap CI, Anghel R, Dvorkin MV, Gladkov OA, Fadeeva NV, Kuzmin AA, Lipatov ON, Zbarskaya II, Akhmetzyanov FS, Litvinov IV, Afanasyev BV, Cherenkova M, Lioznov D, Lisukov IA, Smirnova YA, Kolomietz S, Halawani H, Goh YT, Drgona L, Chudej J, Matejkova M, Reckova M, Rapoport BL, Szpak WM, Malan DR, Jonas N, Jung CW, Lee DG, Yoon SS, Lopez Jimenez J, Duran Martinez I, Rodriguez Moreno JF, Solano Vercet C, de la Camara R, Batlle Massana M, Yeh SP, Chen CY, Chou HH, Tsai CM, Chiu CH, Siritanaratkul N, Norasetthada L, Sriuranpong V, Seetalarom K, Akan H, Dane F, Ozcan MA, Ozsan GH, Kalayoglu Besisik SF, Cagatay A, Yalcin S, Peniket A, Mullan SR, Dakhil KM, Sivarajan K, Suh JJG, Sehgal A, Marquez F, Gomez EG, Mullane MR, Skinner WL, Behrens RJ, Trevarthe DR, Mazurczak MA, Lambiase EA, Vidal CA, Anac SY, Rodrigues GA, Baltz B, Boccia R, Wertheim MS, Holladay CS, Zenk D, Fusselman W, Wade III JL, Jaslowsk AJ, Keegan J, Robinson MO, Go RS, Farnen J, Amin B, Jurgens D, Risi GF, Beatty PG, Naqvi T, Parshad S, Hansen VL, Ahmed M, Steen PD, Badarinath S, Dekker A, Scouros MA, Young DE, Graydon Harker W, Kendall SD, Citron ML, Chedid S, Posada JG, Gupta MK, Rafiyath S, Buechler-Price J, Sreenivasappa S, Chay CH, Burke JM, Young SE, Mahmood A, Kugler JW, Gerstner G, Fuloria J, Belman ND, Geller R, Nieva J, Whittenberger BP, Wong BMY, Cescon TP, Abesada-Terk G, Guarino MJ, Zweibach A, Ibrahim EN, Takahashi G, Garrison MA, Mowat RB, Choi BS, Oliff IA, Singh J, Guter KA, Ayrons K, Rowland KM, Noga SJ, Rao SB, Columbie A, Nualart MT, Cecchi GR, Campos LT, Mohebtash M, Flores MR, Rothstein-Rubin R, O'Connor BM, Soori G, Knapp M, Miranda FG, Goodgame BW, Kassem M, Belani R, Sharma S, Ortiz T, Sonneborn HL, Markowitz AB, Wilbur D, Meiri E, Koo VS, Jhangiani HS, Wong L, Sanani S, Lawrence SJ, Jones CM, Murray C, Papageorgiou C, Gurtler JS, Ascensao JL, Seetalarom K, Venigalla ML, D'Andrea M, De Las Casas C, Haile DJ, Qazi FU, Santander JL, Thomas MR, Rao VP, Craig M, Garg RJ, Robles R, Lyons RM, Stegemoller RK, Goel S, Garg S, Lowry P, Lynch C, Lash B, Repka T, Baker J, Goueli BS, Campbell TC, Van Echo DA, Lee YJ, Reyes EA, Senecal FM, Donnelly G, Byeff P, Weiss R, Reid T, Roeland E, Goel A, Prow DM, Brandt DS, Kaplan HG, Payne JE, Boeckh MG, Rosen PJ, Mena RR, Khan R, Betts RF, Sharp SA, Morrison VA, Fitz-Patrick D, Congdon J, Erickson N, Abbasi R, Henderson S, Mehdi A, Wos EJ, Rehmus E, Beltzer L, Tamayo RA, Mahmood T, Reboli AC, Moore A, Brown JM, Cruz J, Quick DP, Potz JL, Kotz KW, Hutchins M, Chowhan NM, Devabhaktuni YD, Braly P, Berenguer RA, Shambaugh SC, O'Rourke TJ, Conkright WA, Winkler CF, Addo FEK, Duic JP, High KP, Kutner ME, Collins R, Carrizosa DR, Perry DJ, Kailath E, Rosen N, Sotolongo R, Shoham S, Chen T. Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial. The Lancet Infectious Diseases 2019; 19:1001-1012. [DOI: 10.1016/s1473-3099(19)30310-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
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Janakiram M, Ye H, Carjaval L, Villaorduna A, Ramesh K, Shah U, Kornblum N, Fehn K, Braunschweig I, Ueda K, Thiruthuvanathan V, Will B, Pinchasik D, Aivado M, Goel S, Steidl U, Verma A. EXCEPTIONAL RESPONSE OF REFRACTORY ATLL WITH MDM4 AMPLIFICATION TO NOVEL STAPLED PEPTIDE DUAL MDM4/2 INHIBITOR. Hematol Oncol 2019. [DOI: 10.1002/hon.210_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M. Janakiram
- HOT; University of Minnesota; Minneapolis United States
| | - H.B. Ye
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | | | - A. Villaorduna
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - K. Ramesh
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - U. Shah
- Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - N. Kornblum
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - K. Fehn
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - I. Braunschweig
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - K. Ueda
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | | | - B. Will
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | | | - M. Aivado
- ALRN Therapeutics; MA; United States
| | - S. Goel
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - U. Steidl
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - A.K. Verma
- Oncology; Albert Einstein College of Medicine; Bronx United States
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Borcoman E, Kanjanapan Y, Champiat S, Kato S, Servois V, Kurzrock R, Goel S, Bedard P, Le Tourneau C. Novel patterns of response under immunotherapy. Ann Oncol 2019. [PMID: 30657859 DOI: 10.1093/annonc/mdz003.] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Novel patterns of response and progression to immunotherapy have been reported that are not observed with conventional cytotoxic or targeted anticancer treatments. A major breakthrough with immunotherapy is its potential to achieve durable responses in a subset of patients with advanced cancer that can be maintained several years even after stopping the treatment. No standardized definition of durable response exists in the literature, and the optimal duration of treatment in case of durable response is not clearly established. However, the majority of patients do not respond to immunotherapy. Initially reported in advanced melanoma patients, pseudoprogression occurs when tumor index lesions regress after initial progression, supporting the concept of treating some patients beyond progression. Overall, reported rates of pseudoprogression never exceeded 10%, meaning that the large majority of patients who have a disease progression will not eventually respond to treatment. The decision to pursue treatment beyond progression must therefore only be taken in carefully selected patients with clinical benefit, who did not experience severe toxicities with immunotherapy. Conversely, rapid progressions, called hyperprogressions, were reported by several teams with rates ranging from 4% to 29%. These observations need to be confirmed from randomized trials. It is essential to interrupt the treatment in patients with hyperprogression, in order to switch to another potentially active treatment. Finally, some patients experience dissociated responses, with some lesions shrinking and others growing. Local treatment with surgery or radiotherapy for growing lesions may be considered. Several immune-specific-related response criteria were developed to better capture benefits of immunotherapy. These criteria only address the pseudoprogression pattern of response, and do not capture the other patterns of response such as hyperprogression and dissociated response. The classic RECIST remains a reasonable and meaningful method to assess response to immunotherapy in the clinic.
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Affiliation(s)
- E Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France
| | - Y Kanjanapan
- Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - S Champiat
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - S Kato
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - V Servois
- Department of Imaging, Institut Curie, Paris, France
| | - R Kurzrock
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - S Goel
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, USA
| | - P Bedard
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada
| | - C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud; Paris-Saclay University, Paris, France.
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Borcoman E, Kanjanapan Y, Champiat S, Kato S, Servois V, Kurzrock R, Goel S, Bedard P, Le Tourneau C. Novel patterns of response under immunotherapy. Ann Oncol 2019; 30:385-396. [PMID: 30657859 DOI: 10.1093/annonc/mdz003] [Citation(s) in RCA: 307] [Impact Index Per Article: 61.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- E Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France
| | - Y Kanjanapan
- Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - S Champiat
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - S Kato
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - V Servois
- Department of Imaging, Institut Curie, Paris, France
| | - R Kurzrock
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - S Goel
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, USA
| | - P Bedard
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada
| | - C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud; Paris-Saclay University, Paris, France.
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Pernas S, Goel S, Harrison BT, Hu J, Johnson N, Regan M, Chichester LA, Nakhlis F, Schlosnagle EJ, Winship G, Guerriero JL, Parsons H, Mittendorf EA, Overmoyer B. Abstract PD3-08: Assessment of the tumor immune environment in inflammatory breast cancer treated with neoadjuvant dual-HER2 blockade. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd3-08] [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: 11/16/2022]
Abstract
Abstract
Background: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer that remains relatively understudied. We examined the efficacy of neoadjuvant dual-HER2 blockade (trastuzumab (H) and pertuzumab (P)) combined with paclitaxel (T) in HER2+ IBC, including a planned analysis to elucidate associations between the tumor immune microenvironment profile and response to therapy.
Methods: An IRB-approved, single-arm phase II trial for patients (pts) with newly diagnosed HER2+ IBC was conducted. Pts had a pre-treatment biopsy of the affected breast (D1) followed by a loading dose of HP. A second biopsy was performed 1 week (wk) later (D8), when T (80mg/m2/wk x 16 wks) was added to HP. Responding pts underwent modified radical mastectomy (MRM) where residual disease was collected. The primary objective was to determine the rate of pathologic complete response (pCR) defined as ypT0/isN0. Residual Cancer Burden (RCB) was also determined. Tumor specimens from D1, D8 and MRM were assessed for disease cellularity and scored for percentage of tumor infiltrating lymphocytes (TILs): low=0-10%, intermediate=11-59%, high>60%. RNA-sequencing was performed on tumor tissue from D1 and D8 to explore the impact of short-term HP treatment on the tumor transcriptomic profile and to identify potential predictors of pCR.
Results: 23 pts with HER2+ IBC were enrolled between 8/2013-6/2017. Mean age was 48 years (range 32-74); 11 pts (48%) had estrogen and progesterone receptor (ER/PR) negative disease. Matched tumor biopsies (D1, D8) were obtained in all 23 pts; 21 underwent MRM; 1 was lost to follow-up and 1 had disease progression. In the intent to treat analysis, 10/23 (43%) pts achieved a pCR and 7 (30%) had RCB-1. Ten of the 22 evaluable pts achieved a pCR (45.5%). TILs were evaluable in 20/23 (87%) matched tumor biopsies (D1, D8). Among the D1 biopsy specimens: 19 (95%) had low levels, 2 (10%) had intermediate levels, and none had high levels. When D1 TIL levels were compared with D8 levels, 3(15%) had an increase in TILs, 16(80%) had no change in TIL levels, and 1(5%) had a decrease in the level of TILs. Both samples with intermediate levels and 2 of 3 samples with high levels of TILs on D1 and D8 were seen in ER/PR negative disease. An evaluation of biopsy specimens associated with subsequent pCR using GO enrichment analysis from the RNA-Seq data showed significant upregulation of several immune-process related gene expression signatures both at D1 and D8 (e.g. antigen processing and presentation, TCR signaling, NK cell cytotoxicity, p-value: 2.99E-48 to 1.39E-16) when compared with those associated with residual disease at the time of MRM. Across the entire cohort, D8 biopsies showed evidence of upregulated anti-tumor immunity compared to D1 biopsies (p-value: 9.57E-06 to 0.012). Notably, this change from D1 to D8 was largely restricted to tumors that achieved a pCR.
Conclusion: THP for 16 weeks was a highly effective treatment for HER2+ IBC. Immune activation as determined by gene expression signatures predicted pCR, and moreover upregulation of anti-tumor immunity after 1 wk of HP might further predict a complete pathologic response to therapy. ClinicalTrials.gov identifier: NCT01796197
Citation Format: Pernas S, Goel S, Harrison BT, Hu J, Johnson N, Regan M, Chichester LA, Nakhlis F, Schlosnagle EJ, Winship G, Guerriero JL, Parsons H, Mittendorf EA, Overmoyer B. Assessment of the tumor immune environment in inflammatory breast cancer treated with neoadjuvant dual-HER2 blockade [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD3-08.
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Affiliation(s)
- S Pernas
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - S Goel
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - BT Harrison
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - J Hu
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - N Johnson
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - M Regan
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - LA Chichester
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - F Nakhlis
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - EJ Schlosnagle
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - G Winship
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - JL Guerriero
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - H Parsons
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - EA Mittendorf
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - B Overmoyer
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
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Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. Abstract P6-18-10: A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-10] [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
Introduction:
Despite the success of anti-HER2 therapy, acquired resistance usually develops in the metastatic setting. CDK4/6 pathway activity has been identified as a mediator of this resistance, and in preclinical studies the combination of CDK4/6 and HER2 blockade can be more effective than either therapy alone. We conducted a single-arm phase 1b/2 study of the CDK4/6 inhibitor ribociclib given with trastuzumab or T-DM1 to subjects with advanced, treatment-refractory HER2-positive breast cancer. The results of the trastuzumab cohort are presented below. The primary objective was to determine the clinical benefit rate (CBR) at 24 weeks, and secondary endpoints included objective response rate (ORR), progression-free survival (PFS), and adverse events.
Methods: Individuals with locally advanced or metastatic, measurable HER2-positive breast cancer were eligible. All subjects must have previously received trastuzumab, pertuzumab, and T-DM1 as (neo)adjuvant or metastatic therapy. There was no limit on the number of prior lines of treatment. Patients with previous CDK4/6 inhibitor exposure, QTcF > 450msec on EKG, or without stable brain metastases were excluded. An initial safety run-in phase (with dose-limiting toxicity (DLT) monitoring) included six subjects who received trastuzumab (8mg/kg loading then 6mg/kg IV three-weekly) and ribociclib 400mg PO daily on a continuous schedule (cycle length 21 days). The study had a two-stage design. The first stage required 20 patients, at least 6 of whom must have demonstrated clinical benefit (CR+PR+ SD>24 weeks) in order to recruit 15 more patients to the second stage. All patients with accessible disease underwent metastatic tumor biopsies at baseline and C2D1.
Results: 13 patients were enrolled (6 in the safety run-in and 7 in the expansion cohort). One patient was found to have HER2-negative disease and did not receive treatment. Patient characteristics are shown in Table 1 No DLTs were observed during the safety run-in phase, and ribociclib was thus used at 400mg po daily for the expansion cohort. Grade 3/4 toxicities were observed in 5 patients (41.7%) and included neutropenia (n=2), and fatigue, pain, and muscle weakness (all n=1). No patient demonstrated QTc prolongation >480 msec, or grade 3/4 LFTs. 1/12 patients ((8.3%); 95% CI 0.2%-38.5%) achieved stable disease>24 weeks; no objective responses were observed, and median PFS was 41.5 days. The trastuzumab portion of study was closed early due to limited clinical activity observed (the T-DM1 with ribociclib cohort remains open).
Table 1Age (median, range)50.5 (42 - 71)Number of prior lines of systemic therapy for metastatic disease (median, range)5.5 (0-14)Number with Hormone receptor-positive disease (%)8 (67 %)Number of metastatic sites (median, range)2.5 (2 - 5)
Conclusions: The combination of trastuzumab and ribociclib (400mg daily continuous schedule) is safe, with no new safety signals observed. The limited activity seen in this heavily pretreated population suggests that future efforts to incorporate CDK4/6 inhibition should be limited to a less extensively treat population.
Citation Format: Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-10.
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Affiliation(s)
- S Goel
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - L Spring
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - R Rees
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - C Andrews
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - RK Tahara
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EL Mayer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - A Bardia
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EP Winer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - SM Tolaney
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
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Goel S. Abstract TS3-2: Modulation of anti-tumor immunity using CDK4/6 inhibitors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ts3-2] [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
Several pharmacological inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) have now been approved for the treatment of metastatic estrogen receptor-positive breast cancer. Although CDK4/6 inhibitors were initially developed to prevent cancer cell proliferation, preclinical studies have now demonstrated that they can also exert other biological effects in solid tumors including augmentation of anti-tumor immunity. The detailed mechanisms underlying this are currently under investigation, and likely include enhanced antigen presentation by tumor cells as well as an increase in the ratio of effector to regulatory T lymphocytes. In this presentation, I will discuss our current understanding of how CDK4/6 inhibitors might stimulate anti-tumor immune responses, focusing on breast cancer. I will also discuss if and how this unexpected phenomenon might be leveraged for therapeutic benefit.
Citation Format: Goel S. Modulation of anti-tumor immunity using CDK4/6 inhibitors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr TS3-2.
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Affiliation(s)
- S Goel
- Dana-Farber Cancer Institute, Boston, MA
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31
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Lim Y, Goel S, Brimacombe JR. The ProSeal™ Laryngeal Mask Airway is an Effective Alternative to Laryngoscope-Guided Tracheal Intubation for Gynaecological Laparoscopy. Anaesth Intensive Care 2019; 35:52-6. [PMID: 17323666 DOI: 10.1177/0310057x0703500106] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We tested the hypothesis that the ProSeal™ laryngeal mask airway is superior to laryngoscope-guided tracheal intubation for gynaecological laparoscopy. One-hundred and eighty consecutive patients (ASA grade 1-2, aged 18-80y) were divided into two equal-sized groups for airway management with the ProSeal™ laryngeal mask airway or tracheal tube. Induction was with fentanyl/propofol, maintenance with sevoflurane and muscle relaxation with atracurium. The following primary variables were tested: time to achieve an effective airway, ventilatory capability, peak airway pressure before and after pneumoperitoneum, duration of surgery and pneumoperitoneum and haemodynamic responses. Data about gastric size, airway trauma and sore throat were collected. The number of attempts for successful insertion were similar, but effective airway time was shorter for the ProSeal™ laryngeal mask airway (20±2s vs 37±3s, P<0.001). All devices were successfully inserted within three attempts. There was no episode of failed ventilation or hypoxia. The haemodynamic stress responses to insertion and removal were greater for the tracheal tube than the ProSeal™ laryngeal mask airway. The duration of surgery, duration of pneumoperitoneum and intraabdominal pressures were similar. Gastric size was similar at the start and end of surgery. There were no differences in the frequency of complications or sore throat. We conclude that the ProSeal™ laryngeal mask airway is a similarly effective airway device to conventional laryngoscope-guided tracheal intubation for gynaecological laparoscopy, but is more rapidly inserted and associated with an attenuated haemodynamic response to insertion and removal.
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Affiliation(s)
- Y Lim
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
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Mau-Sorensen M, van Bussel M, Kuipers M, Nielsen D, Verheul H, Aftimos P, de Jonge M, van Triest B, Falkenius J, Debus J, Troost E, Samuels M, Sarholz B, Budach V, Goel S, Locatelli G, Geertsen P. Safety, clinical activity and pharmacological biomarker evaluation of the DNA-dependent protein kinase (DNA-PK) inhibitor M3814: Results from two phase I trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.015] [Citation(s) in RCA: 10] [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: 11/12/2022] Open
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33
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Johnson M, Galsky M, Barve M, Goel S, Park H, Du B, Mu S, Ramakrishnan V, Wood K, Wang V, Lakhani N. Preliminary results of pamiparib (BGB-290), a PARP1/2 inhibitor, in combination with temozolomide (TMZ) in patients (pts) with locally advanced or metastatic solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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34
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Glisson B, Leidner R, Ferris R, Powderly J, Rizvi N, Keam B, Schneider R, Goel S, Ohr J, Zheng Y, Eck S, Gribbin M, Townsley D, Chiou V, Patel S. Safety and clinical activity of MEDI0562, a humanized OX40 agonist monoclonal antibody, in adult patients with advanced solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.025] [Citation(s) in RCA: 10] [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: 11/12/2022] Open
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35
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Goel S, Ocean A, Parakrama R, Ghalib M, Chaudhary I, Shah U, Coffey M, Kaledzi E, Maitra R. Dose finding and safety study of reovirus (Reo) with irinotecan/ fluorouracil/ leucovorin/ bevacizumab (FOLFIRI/B) in patients with KRAS mutant metastatic colorectal cancer (mCRC): Final results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Bazhenova L, Carvajal R, Cho B, Eaton K, Goel S, Heist R, Ingham M, Wang D, Werner T, Neuteboom S, Potvin D, Chen I, Christensen J, Chao R, Alva A. Sitravatinib demonstrates activity in patients with novel genetic alterations that inactivate CBL. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Affiliation(s)
- R. Saran
- Division of Nephrology, Department of Internal Medicine, University of Missouri-Columbia, Columbia Missouri Dalton Cardiovascular Research Center, Columbia, Missouri - USA
| | - S. Goel
- Division of Nephrology, Department of Internal Medicine, University of Missouri-Columbia, Columbia Missouri Dalton Cardiovascular Research Center, Columbia, Missouri - USA
| | - R. Khanna
- Division of Nephrology, Department of Internal Medicine, University of Missouri-Columbia, Columbia Missouri Dalton Cardiovascular Research Center, Columbia, Missouri - USA
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38
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Metzger-Filho O, Mandrekar S, Loibl S, Ciruelos E, Gianni L, Lim E, Miller K, Huang C, Koehler M, Francis P, Valagussa P, Goel S, Prat A, Goetz M, Loi S, Krop I, Carey L, Lanzillotti J, Winer E, Tripathy D, DeMichele A. Abstract OT3-05-07: PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2 positive metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-05-07] [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: 11/16/2022]
Abstract
Abstract
Background
Pre-clinical data and initial results from clinical studies point to the added benefit of CDK4/6 inhibition when combined with anti-HER2 tx. The current study is designed to evaluate the added benefit of palbociclib when given in combination with anti-HER2 and endocrine tx maintenance in the 1st†line setting of metastatic HER2+HR+ breast cancer.
Trial design
PATINA is an international, open-label, pivotal Phase III study. Primary objective is to demonstrate that the combination of palbociclib with anti-HER2 plus endocrine tx is superior to anti-HER2 plus endocrine tx in prolonging PFS. Sample size is 496 pts. The study starts after completion of 6-8 cycles of chemotherapy-containing anti-HER2 tx for metastatic breast cancer in the 1st line setting. Pts are eligible provided they are without evidence of disease progression by local assessment (i.e. CR, PR or SD). To account for the need for less intense tx regimens for a subset of pts diagnosed with HER2+ER+ disease, clinicians may recommend the combination of trastuzumab with either a taxane or vinorelbine prior to study initiation. Clinicians might also choose a non-pertuzumab option for pts previously treated with pertuzumab in the neo(adjuvant) setting. Secondary objectives include measures of tumor control (OR, CBR, DOR), OS, safety and QOL. The translational science main objective is to compare PFS estimates according to PIK3CA mutation status assessed by cfDNA analysis. Endocrine tx options are AI or fulvestrant. Premenopausal pts must receive ovarian suppression. The study has a 90% power to detect a hazard ratio of 0.667 in favor of the palbociclib arm. Pts approached to participate in AFT-38 will be asked to indicate on the informed consent forms whether remaining biospecimens and clinical data from the control arm of the study can be shared with the Mastering Breast Cancer (MBC) Initiative. The overarching purpose of the MBC is to create a mechanism for understanding the natural history of metastatic breast cancer by cataloguing longitudinally studied tumor-specific markers and treatment effects.
ClinicalTrials.gov Identifier: NCT02947685
Citation Format: Metzger-Filho O, Mandrekar S, Loibl S, Ciruelos E, Gianni L, Lim E, Miller K, Huang C, Koehler M, Francis P, Valagussa P, Goel S, Prat A, Goetz M, Loi S, Krop I, Carey L, Lanzillotti J, Winer E, Tripathy D, DeMichele A. PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2 positive metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-05-07.
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Affiliation(s)
- O Metzger-Filho
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Mandrekar
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Loibl
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Ciruelos
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - L Gianni
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Lim
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - K Miller
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - C Huang
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - M Koehler
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - P Francis
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - P Valagussa
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Goel
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - A Prat
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - M Goetz
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Loi
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - I Krop
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - L Carey
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - J Lanzillotti
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Winer
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - D Tripathy
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - A DeMichele
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
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Goel S, Ocean A, Chaudhary I, Ghalib M, Kaledzi E, Shah U, Gutierrez A, Coffey M, Gill G, Maitra R. Mechanism of pelareorep (Pel)-mediated cell death in a Phase I study in combination with irinotecan/fluorouracil/leucovorin/bevacizumab (FOLFIRI/B) in patients with KRAS mutant metastatic colorectal cancer (mCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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40
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Atiemo K, Skaro A, Maddur H, Zhao L, Montag S, VanWagner L, Goel S, Kho A, Ho B, Kang R, Holl JL, Abecassis MM, Levitsy J, Ladner DP. Mortality Risk Factors Among Patients With Cirrhosis and a Low Model for End-Stage Liver Disease Sodium Score (≤15): An Analysis of Liver Transplant Allocation Policy Using Aggregated Electronic Health Record Data. Am J Transplant 2017; 17:2410-2419. [PMID: 28226199 PMCID: PMC5769449 DOI: 10.1111/ajt.14239] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 09/20/2016] [Revised: 02/07/2017] [Accepted: 02/12/2017] [Indexed: 01/25/2023]
Abstract
Although the Model for End-Stage Liver Disease sodium (MELD Na) score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7834 adult patients with cirrhosis, we determined whether the cause of cirrhosis or cirrhosis complications was associated with an increased risk of death among patients with a MELD Na score ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT). Over median follow-up of 2.3 years, 3715 patients had a maximum MELD Na score ≤15. Overall, 3.4% were waitlisted for LT. Severe hypoalbuminemia, hepatorenal syndrome, and hepatic hydrothorax conferred the greatest risk of death independent of MELD Na score with 1-year predicted mortality >14%. Approximately 10% possessed these risk factors. Of these high-risk patients, only 4% were waitlisted for LT, despite no difference in nonliver comorbidities between waitlisted patients and those not listed. In addition, risk factors for death among waitlisted patients were the same as those for patients not waitlisted, although the effect of malnutrition was significantly greater for waitlisted patients (hazard ratio 8.65 [95% CI 2.57-29.11] vs. 1.47 [95% CI 1.08-1.98]). Using the MELD Na score for allocation may continue to limit access to LT.
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Affiliation(s)
- K Atiemo
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - A Skaro
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - H Maddur
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine
| | - L Zhao
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - S Montag
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - L VanWagner
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - S Goel
- Center for Health Information Partnerships, Institute for Public Health and Medicine
| | - A Kho
- Center for Health Information Partnerships, Institute for Public Health and Medicine
| | - B Ho
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - R Kang
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine
| | - JL Holl
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine,Department of Pediatrics, Feinberg School of Medicine
| | - MM Abecassis
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - J Levitsy
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine
| | - DP Ladner
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine
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Metzger O, Mandrekar S, Ciruelos E, Loibl S, Valagussa P, Demichele A, Lim E, Tripathy D, Winer E, Huang C, Khoeler M, Carey L, Francis P, Miller K, Goel S, Goetz M, Prat A, Loi S, Krop I, Gianni L. PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2-positive metastatic breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Payton M, Pinchasik D, Mehta A, Goel S, Zain J, Sokol L, Jacobsen E, Patel M, Horwitz S, Meric-Bernstam F, Shustov A, Weinstock D, Aivado M, Annis D. Phase 2a study of a novel stapled peptide ALRN-6924 disrupting MDMX- and MDM2-mediated inhibition of wild-type TP53 in patients with peripheral t-cell lymphoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.045] [Citation(s) in RCA: 4] [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: 11/14/2022] Open
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43
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Lofters AK, Vahabi M, Prakash V, Banerjee L, Bansal P, Goel S, Dunn S. Lay health educators within primary care practices to improve cancer screening uptake for South Asian patients: challenges in quality improvement. Patient Prefer Adherence 2017; 11:495-503. [PMID: 28331296 PMCID: PMC5352230 DOI: 10.2147/ppa.s127147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cancer screening uptake is known to be low among South Asian residents of Ontario. The objective of this pilot study was to determine if lay health educators embedded within the practices of primary care providers could improve willingness to screen and cancer screening uptake for South Asian patients taking a quality improvement approach. MATERIALS AND METHODS Participating physicians selected quality improvement initiatives to use within their offices that they felt could increase willingness to screen and cancer screening uptake. They implemented initiatives, adapting as necessary, for six months. RESULTS Four primary care physicians participated in the study. All approximated that at least 60% of their patients were of South Asian ethnicity. All physicians chose to work with a preexisting lay health educator program geared toward South Asians. Health ambassadors spoke to patients in the office and telephoned patients. For all physicians, ~60% of South Asian patients who were overdue for cancer screening and who spoke directly to health ambassadors stated they were willing to be screened. One physician was able to track actual screening among contacted patients and found that screening uptake was relatively high: from 29.2% (colorectal cancer) to 44.6% (breast cancer) of patients came in for screening within six months of the first phone calls. Although physicians viewed the health ambassadors positively, they found the study to be time intensive and resource intensive, especially as this work was additional to usual clinical duties. DISCUSSION Using South Asian lay health educators embedded within primary care practices to telephone patients in their own languages showed promise in this study to increase awareness about willingness to screen and cancer screening uptake, but it was also time intensive and resource intensive with numerous challenges. Future quality improvement efforts should further develop the phone call invitation process, as well as explore how to provide infrastructure for lay health educator training and time.
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Affiliation(s)
- AK Lofters
- Department of Family and Community Medicine
- Dalla Lana School of Public Health, University of Toronto
- Department of Family and Community Medicine
- Centre for Urban Health Solutions, St Michael’s Hospital
| | - M Vahabi
- Daphne Cockwell School of Nursing, Ryerson University, Toronto
| | - V Prakash
- Screening Saves Lives Program, Canadian Cancer Society, Mississauga
| | - L Banerjee
- Wise Elephant Family Health Team, Brampton
| | - P Bansal
- Mississauga Halton Central West Regional Cancer Program, Mississauga
| | - S Goel
- Wise Elephant Family Health Team, Brampton
- Mississauga Halton Central West Regional Cancer Program, Mississauga
| | - S Dunn
- Department of Family and Community Medicine
- Dalla Lana School of Public Health, University of Toronto
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
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Overmoyer B, Goel S, Regan M, Hirshfield-Bartek J, Schlosnagel E, Yeh E, Qin L, Bellon J, Nakhlis F, Jacene H, Winer E. Abstract OT1-01-07: A phase 2 study of eribulin followed by doxorubicin and cyclophosphamide as preoperative therapy for HER2-negative inflammatory breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-01-07] [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: HER2 negative(neg) inflammatory breast cancer(IBC) exhibits relative resistance to chemotherapy evidenced by pCR(pathologic complete response rate) rates of 12-25% with preoperative taxane/anthracycline regimens. Eribulin(Eisai®) inhibits microtubular function via sequestration of tubulin into nonfunctional aggregates, thus being effective against taxane-resistant cancer. Preclinical data shows 2 mechanisms of action: reversion of EMT(epithelial to mesenchymal transition) and normalization of tumor vascularity. Treatment of triple negative breast cancer(TNBC) cell-lines with eribulin results in downregulation of mesenchymal markers with concomitant increase in expression of classical epithelial markers(Yoshida BJC 2014). In PDX models, eribulin improved blood perfusion in central region of tumors, increased vessel density, reduced vessel diameter, and reduced hypoxia. IBC is highly angiogenic, with increased microvessel density, higher fraction of proliferating endothelial cells and greater expression of pro-angiogenic genes compared with non-IBC(McCarthy CCR 2002). This preoperative study(EAC) exploits the angiogenic properties of IBC with the treatment scheme of eribulin(E) followed by doxorubicin/cyclosphosphamide(AC) in newly diagnosed HER2neg IBC.
Methods: Pts with HER2neg Stage III (cT4d,any N,M0) IBC are eligible if they have not received prior therapy for BC, have adequate organ function, cardiac ejection fraction > 50%, and willing to undergo 2 research biopsies (rbx) of the affected breast. Following baseline rbx, pts receive cycle 1, day(d)1 eribulin 1.4 mg/m2. A 2nd rbx occurs on d8, prior to dosing of E. Following 3 more cycles of E(1.4mg/m2 d1,d8,every 21d), pts receive 4 cycles of dose-dense AC(A-60 mg/m2,C-600mg/m2 every 14d). Pts with adequate disease response undergo mastectomy/axillary lymph node dissection followed by chest wall/regional lymph node radiation. Adjuvant endocrine therapy is used if hormone receptor positive. An imaging sub-study evaluates tumor perfusion via DCE-MRI pre and post 1st dose E.
Correlatives: To investigate whether E induces reversion of EMT in IBC, expression of 10 EMT-related genes are determined in each rbx, and normalization of tumor vessel phenotype are assessed by expression of 15 angiogenesis-related genes in rbx by RT-qPCR. Gene expression will be repeated on residual tumor at mastectomy. An imaging sub-study of DCE-MRI (10 pts) will assess vascular remodeling via changes in Ktrans , ve and vp determination of IBC region of interest, core and rim and changes in the iAUC computed pre and post 1st dose E.
Statistics: The primary endpoint is pCR. A Simon two-stage design is used. If the proportion of pts having pCR is < 0.10 then EAC is considered minimally effective, versus alternative hypothesis that EAC is worthy of further study if proportion pCR > 0.30. In the 1st stage, if < 2/16 pts have pCR, the study is stopped; if > 3 pts have pCR, the study proceeds. In the 2nd stage, EAC is rejected if < 4 of 25 pts have a pCR(α=0.10;β=0.10). Up to 25 pts will be enrolled. Secondary endpoints are residual cancer burden, disease-free survival, time to treatment failure and overall survival. Clinical trial information: NCT02623972.
Citation Format: Overmoyer B, Goel S, Regan M, Hirshfield-Bartek J, Schlosnagel E, Yeh E, Qin L, Bellon J, Nakhlis F, Jacene H, Winer E. A phase 2 study of eribulin followed by doxorubicin and cyclophosphamide as preoperative therapy for HER2-negative inflammatory breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-01-07.
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Affiliation(s)
- B Overmoyer
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - S Goel
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - M Regan
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - J Hirshfield-Bartek
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - E Schlosnagel
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - E Yeh
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - L Qin
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - J Bellon
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - F Nakhlis
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - H Jacene
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - E Winer
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
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Jacene HA, Overmoyer B, Schlosnagle EJ, Abbott A, Yeh E, Paolino J, Goel S, Culhane A, Bellon JR, Nakhlis F, Hirshfield-Bartek J, Van den Abbeele A. Abstract OT2-02-03: Pilot study of zirconium-89 bevacizumab positron emission tomography for imaging angiogenesis in patients with inflammatory breast carcinoma receiving preoperative chemotherapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot2-02-03] [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: Inflammatory breast cancer (IBC) continues to have a poor prognosis despite standard tri-modality treatment with chemotherapy, mastectomy and radiation. Current methods of assessing primary tumor response (i.e., clinical exam and breast magnetic resonance imaging [MRI]) are limited for distinguishing residual tumor from responsive disease because of persistent morphologic changes in the breast. Therefore, the inability to accurately assess tumor response during treatment often results in the continuation of ineffective systemic chemotherapy until definitive pathologic evaluation at mastectomy. IBC has a highly angiogenic phenotype which is believed to play a role in this tumor's aggressiveness. The novel radiotracer Zirconium-89 (89Zr)-bevacizumab was developed for imaging tumor angiogenesis with PET. We hypothesize that, as an imaging biomarker of angiogenesis, 89Zr-bevacizumab-PET/CT is a more specific noninvasive functional imaging modality for detecting the presence of tumor angiogenesis compared to current diagnostic methods and will serve as a predictor of response to therapy in patients (pts) with IBC.
Methods: Pts with newly diagnosed HER2neg IBC who will receive preoperative chemotherapy are eligible for this pilot study. 89Zr-bevacizumab-PET/CT, breast MRI and FDG-PET/CT are performed before, after 2 cycles, and at the completion of preoperative therapy. Biopsies of primary IBC tumors are obtained prior to and after 2 cycles of preoperative therapy. At the completion of preoperative therapy, pts proceed to mastectomy or biopsy if ineligible to proceed to mastectomy based on current standards for assessing primary tumor response, i.e., clinical exam, breast MRI and lack of systemic progression. At the time of mastectomy, standard evaluation of the surgical specimen will determine pathologic response of IBC to preoperative chemotherapy. A research sample will be collected if residual cancer is present at the time of mastectomy for histologic evaluation of tumor angiogenesis.
Objectives/Correlatives: The primary objective is to determine feasibility of 89Zr-bevacizumab-PET/CT imaging in pts with IBC. The primary endpoint is assessment of radiolabeling of chelated bevacizumab and number of successfully acquired 89Zr-bevacizumab-PET/CT scans. Correlative studies will be performed on IBC tissue to assess extent of angiogenesis including microvessel density, vessel diameter, vascular pericyte coverage and tumor VEGF levels. Secondary objectives are: 1) To determine if 89Zr-bevacizumab accumulation in primary IBC tumors correlates with the extent of angiogenesis determined by correlative analysis on IBC tissue; 2) To assess the predictive value of 89Zr-bevacizumab-PET/CT after 2 cycles and at the end of preoperative therapy for determining pathologic response at mastectomy as given by residual cancer burden.
Statistics: This is an accrual, not statistical based, feasibility justification. Planned sample size is 10 in order to make a preliminary statement about feasibility and ability for 89Zr-bevacizumab-PET/CT to serve as a surrogate in vivo biomarker of tumor angiogenesis and response to preoperative chemotherapy.
Clinical Trial Information: NCT01894451.
Citation Format: Jacene HA, Overmoyer B, Schlosnagle EJ, Abbott A, Yeh E, Paolino J, Goel S, Culhane A, Bellon JR, Nakhlis F, Hirshfield-Bartek J, Van den Abbeele A. Pilot study of zirconium-89 bevacizumab positron emission tomography for imaging angiogenesis in patients with inflammatory breast carcinoma receiving preoperative chemotherapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT2-02-03.
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Affiliation(s)
- HA Jacene
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - B Overmoyer
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - EJ Schlosnagle
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - A Abbott
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - E Yeh
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - J Paolino
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - S Goel
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - A Culhane
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - JR Bellon
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - F Nakhlis
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - J Hirshfield-Bartek
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - A Van den Abbeele
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
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Goel S, Arora J, Mehta V, Sharma M, Suri RK, Rath G, Das S. Adductor accessorius - an unusual supernumerary adductor muscle of thigh. Clin Ter 2016; 166:114-7. [PMID: 26152618 DOI: 10.7417/ct.2015.1840] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The knowledge of variant anatomy of medial compartment of thigh is extremely important in surgical procedures requiring obturator nerve block. The nerve block is also recommended for providing additional analgesia following major knee surgeries and for relieving painful adductor muscle spasm. The interfascial injection technique is commonly followed in ultrasound guided obturator nerve block. For this procedure it is imperative to identify the adductor muscles on sonography to inject the anesthetic solution in the intermuscular fascial planes. The presence of an additional muscle can prove useful in myocutaneous flap surgeries for reconstruction especially of perineum. We hereby report a case of such an anomalous supernumerary adductor muscle present between adductor brevis and proximal part of adductor magnus, in an adult Indian male cadaver, recorded during routine dissection in Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital. The muscle was innervated by the posterior division of obturator nerve. The morphology, embryological basis and clinical aspects are also discussed.
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Affiliation(s)
- S Goel
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - J Arora
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - V Mehta
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - M Sharma
- Department of Reproductive Biology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - R K Suri
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - G Rath
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - S Das
- Department of Anatomy, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
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Naing A, Goel S, Curti B, Weise A, Eder J, Marshall S, Morehouse C, Li X, Karakunnel J, Infante J. A Phase 1 first-in-human study of MEDI0680, an anti-PD-1 monoclonal antibody (mAb) in adult patients (pts) with advanced tumors. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.26] [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: 11/14/2022] Open
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Tolaney S, Bourayou N, Goel S, Forrester T, André F. monarcHER: A phase 2 randomized open-label study of abemaciclib plus trastuzumab (T) with or without fulvestrant (F) compared to standard-of-care chemotherapy of physician's choice plus T in women with HR +, HER2+ advanced breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.93] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bhardwaj A, Chauhan NS, Goel S, Singh V, Pulikkotil JJ, Senguttuvan TD, Misra DK. Tuning the carrier concentration using Zintl chemistry in Mg3Sb2, and its implications for thermoelectric figure-of-merit. Phys Chem Chem Phys 2016; 18:6191-200. [PMID: 26852729 DOI: 10.1039/c5cp07482g] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Zintl compounds are potential candidates for efficient thermoelectric materials, because typically they are small band gap semiconductors. In addition, such compounds allow fine tuning of the carrier concentration by chemical doping for the optimization of thermoelectric performance. Herein, such tunability is demonstrated in Mg3Sb2-based Zintl compounds via Zn(2+) doping at the Mg(2+) site of the anionic framework (Mg2Sb2)(2-), in the series Mg3-xZnxSb2 (0 ≤ x ≤ 0.1). The materials have been successfully synthesized using the spark plasma sintering (SPS) technique. X-ray diffraction (XRD) analysis confirms a single solid solution phase of Mg3-xZnxSb2 (0 ≤ x ≤ 0.1). The thermoelectric properties are characterized by the Seebeck coefficient, electrical conductivity, and thermal conductivity measurements from 323 K to 773 K. Isoelectronic Zn substitution at the Mg site presents the controlled variation in the carrier concentration for optimizing the high power factor and reduced thermal conductivity. These results lead to a substantial increase in ZT of 0.37 at 773 K for a composition with x = 0.10 which is ∼42% higher than undoped Mg3Sb2. The electronic transport data for the Mg3-xZnxSb2 (0 ≤ x ≤ 0.1) compound are analyzed using a single parabolic band model predicting that Mg2.9Zn0.1Sb2 exhibits a near-optimal carrier concentration for high ZT. The electronic structure of transport properties of these disordered Mg3-xZnxSb2 (0 ≤ x ≤ 0.1) is also studied using density functional theory and the results obtained are in good agreement with experimental results. The low cost, lightness and non-toxicity of the constituent elements make these materials ideal for mid-temperature thermoelectric applications.
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Affiliation(s)
- A Bhardwaj
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - N S Chauhan
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - S Goel
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - Vijeta Singh
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Quantum Phenomena & Applications Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - J J Pulikkotil
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Quantum Phenomena & Applications Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India and Computational and Networking Facility, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - T D Senguttuvan
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - D K Misra
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
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Chhabra S, Narang T, Joshi N, Goel S, Sawatkar G, Saikia B, Dogra S, Bansal F, Minz R. Circulating T-helper 17 cells and associated cytokines in psoriasis. Clin Exp Dermatol 2016; 41:806-10. [PMID: 27480070 DOI: 10.1111/ced.12845] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Recently, a new population of IL-17-producing CD4 T helper (Th) cells, named Th17, was identified and shown to be involved in various inflammatory and autoimmune diseases, including psoriasis. AIM To determine the frequency of Th17 cells and related cytokines in peripheral blood of patients with psoriasis, and to analyse their association with disease severity. METHODS This was a prospective study comprising 34 patients with psoriasis and 24 healthy controls. Clinicoepidemiological details of patients were recorded, and severity of psoriasis was assessed by means of the Psoriasis Area and Severity Index. Circulating Th1 and Th17 cells in untreated patients with psoriasis and healthy controls were quantified by flow cytometry. In sera collected from patients with psoriasis and healthy controls, concentrations of IL-17A and IL-23 were examined by ELISA. RESULTS Increased frequencies of CD4+ IL-17A+ T cells were seen in peripheral blood of patients with psoriasis vulgaris (P < 0.001). Although serum IL-17A and IL-23 concentrations were higher in patients with psoriasis than in controls, the results did not reach statistical significance. We could not find any correlation between the studied T cells or related cytokines and the disease severity. CONCLUSION Increased serum levels of circulating Th17 cells and related cytokines may contribute to the cutaneous pathology of psoriasis, as well as the inflammatory process that is a hallmark of psoriasis.
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Affiliation(s)
- S Chhabra
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Joshi
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Goel
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - G Sawatkar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B Saikia
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - F Bansal
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Minz
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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