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Clift AK, Tan PS, Patone M, Liao W, Coupland C, Bashford-Rogers R, Sivakumar S, Hippisley-Cox J. Predicting the risk of pancreatic cancer in adults with new-onset diabetes: development and internal-external validation of a clinical risk prediction model. Br J Cancer 2024:10.1038/s41416-024-02693-9. [PMID: 38702436 DOI: 10.1038/s41416-024-02693-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The National Institute for Health and Care Excellence (NICE) recommends that people aged 60+ years with newly diagnosed diabetes and weight loss undergo abdominal imaging to assess for pancreatic cancer. More nuanced stratification could lead to enrichment of these referral pathways. METHODS Population-based cohort study of adults aged 30-85 years at type 2 diabetes diagnosis (2010-2021) using the QResearch primary care database in England linked to secondary care data, the national cancer registry and mortality registers. Clinical prediction models were developed to estimate risks of pancreatic cancer diagnosis within 2 years and evaluated using internal-external cross-validation. RESULTS Seven hundred and sixty-seven of 253,766 individuals were diagnosed with pancreatic cancer within 2 years. Models included age, sex, BMI, prior venous thromboembolism, digoxin prescription, HbA1c, ALT, creatinine, haemoglobin, platelet count; and the presence of abdominal pain, weight loss, jaundice, heartburn, indigestion or nausea (previous 6 months). The Cox model had the highest discrimination (Harrell's C-index 0.802 (95% CI: 0.797-0.817)), the highest clinical utility, and was well calibrated. The model's highest 1% of predicted risks captured 12.51% of pancreatic cancer cases. NICE guidance had 3.95% sensitivity. DISCUSSION A new prediction model could have clinical utility in identifying individuals with recent onset diabetes suitable for fast-track abdominal imaging.
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Affiliation(s)
- Ash Kieran Clift
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Cancer Research UK Oxford Centre, University of Oxford, Oxford, UK
| | - Pui San Tan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Martina Patone
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Weiqi Liao
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carol Coupland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rachael Bashford-Rogers
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Department of Biochemistry, University of Oxford, Oxford, UK
| | - Shivan Sivakumar
- Institute of Immunology and Immunotherapy, Birmingham Medical School, Birmingham, UK
- Cancer Centre, Queen Elizabeth Hospital, University Hospitals of Birmingham NHS Trust, Birmingham, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
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2
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Johnston AJ, Sivakumar S, Zhou Y, Funston G, Bradley SH. Improving early diagnosis of pancreatic cancer in symptomatic patients. Br J Gen Pract 2023; 73:534-535. [PMID: 38035808 PMCID: PMC10688932 DOI: 10.3399/bjgp23x735585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Affiliation(s)
| | - Shivan Sivakumar
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham
| | - Yin Zhou
- National Institute for Health and Care Research (NIHR) Academic Clinical Lecturer, Wolfson Institute of Population Health, Queen Mary University of London, London
| | - Garth Funston
- Wolfson Institute of Population Health, Queen Mary University of London, London
| | - Stephen H Bradley
- NIHR Academic Clinical Lecturer, Leeds Institute of Health Sciences, University of Leeds, Leeds
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3
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Mato Prado M, Puik JR, Castellano L, López-Jiménez E, Liu DSK, Meijer LL, Le Large TYS, Rees E, Funel N, Sivakumar S, Pereira SP, Kazemier G, Zonderhuis BM, Erdmann JI, Swijnenburg RJ, Frilling A, Jiao LR, Stebbing J, Giovannetti E, Krell J, Frampton AE. A bile-based microRNA signature for differentiating malignant from benign pancreaticobiliary disease. Exp Hematol Oncol 2023; 12:101. [PMID: 38041102 PMCID: PMC10693033 DOI: 10.1186/s40164-023-00458-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/12/2023] [Indexed: 12/03/2023] Open
Abstract
Differentiating between pancreatic ductal adenocarcinoma (PDAC) and cholangiocarcinoma (CCA) is crucial for the appropriate course of treatment, especially with advancements in the role of neoadjuvant chemotherapies for PDAC, compared to CCA. Furthermore, benign pancreaticobiliary diseases can mimic malignant disease, and indeterminate lesions may require repeated investigations to achieve a diagnosis. As bile flows in close proximity to these lesions, we aimed to establish a bile-based microRNA (miRNA) signature to discriminate between malignant and benign pancreaticobiliary diseases. We performed miRNA discovery by global profiling of 800 miRNAs using the NanoString nCounter platform in prospectively collected bile samples from malignant (n = 43) and benign (n = 14) pancreaticobiliary disease. Differentially expressed miRNAs were validated by RT-qPCR and further assessed in an independent validation cohort of bile from malignant (n = 37) and benign (n = 38) pancreaticobiliary disease. MiR-148a-3p was identified as a discriminatory marker that effectively distinguished malignant from benign pancreaticobiliary disease in the discovery cohort (AUC = 0.797 [95% CI 0.68-0.92]), the validation cohort (AUC = 0.772 [95% CI 0.66-0.88]), and in the combined cohorts (AUC = 0.752 [95% CI 0.67-0.84]). We also established a two-miRNA signature (miR-125b-5p and miR-194-5p) that distinguished PDAC from CCA (validation: AUC = 0.815 [95% CI 0.67-0.96]; and combined cohorts: AUC = 0.814 [95% CI 0.70-0.93]). Our research stands as the largest, multicentric, global profiling study of miRNAs in the bile from patients with pancreaticobiliary disease. We demonstrated their potential as clinically useful diagnostic tools for the detection and differentiation of malignant pancreaticobiliary disease. These bile miRNA biomarkers could be developed to complement current approaches for diagnosing pancreaticobiliary cancers.
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Affiliation(s)
- Mireia Mato Prado
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK
- UK Dementia Research Institute, Institute of Neurology, University College London, London, UK
| | - Jisce R Puik
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Leandro Castellano
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK
- School of Life Sciences, University of Sussex, John Maynard Smith Building, Falmer, Brighton, BN1 9QG, UK
| | - Elena López-Jiménez
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Daniel S K Liu
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Laura L Meijer
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Tessa Y S Le Large
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Eleanor Rees
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Niccola Funel
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Shivan Sivakumar
- Oncology Department and Institute of Immunology and Immunotherapy, Birmingham Medical School, University of Birmingham, Birmingham, B15 2TT, UK
| | - Stephen P Pereira
- Institute for Liver & Digestive Health, Royal Free Hospital Campus, University College London, London, UK
| | - Geert Kazemier
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Babs M Zonderhuis
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Joris I Erdmann
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Rutger-Jan Swijnenburg
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Andrea Frilling
- HPB Surgical Unit, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Long R Jiao
- HPB Surgical Unit, Department of Surgery & Cancer, Imperial College London, London, UK
| | - Justin Stebbing
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK
- Department of Biomedical Sciences, Anglia Ruskin University, Cambridge, UK
| | - Elisa Giovannetti
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.
- Cancer Pharmacology Lab, Fondazione Pisana per la Scienza, Pisa, Italy.
| | - Jonathan Krell
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK.
| | - Adam E Frampton
- Division of Cancer, Department of Surgery & Cancer, Imperial College London, London, UK.
- HPB Surgical Unit, Department of Surgery & Cancer, Imperial College London, London, UK.
- HPB Surgical Unit, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK.
- Section of Oncology, Dept. of Clinical & Experimental Medicine, FHMS, University of Surrey, Guildford, UK.
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Merali N, Chouari T, Terroire J, Jessel MD, Liu DSK, Smith JH, Wooldridge T, Dhillon T, Jiménez JI, Krell J, Roberts KJ, Rockall TA, Velliou E, Sivakumar S, Giovannetti E, Demirkan A, Annels NE, Frampton AE. Bile Microbiome Signatures Associated with Pancreatic Ductal Adenocarcinoma Compared to Benign Disease: A UK Pilot Study. Int J Mol Sci 2023; 24:16888. [PMID: 38069211 PMCID: PMC10706407 DOI: 10.3390/ijms242316888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/18/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) has a very poor survival. The intra-tumoural microbiome can influence pancreatic tumourigenesis and chemoresistance and, therefore, patient survival. The role played by bile microbiota in PDAC is unknown. We aimed to define bile microbiome signatures that can effectively distinguish malignant from benign tumours in patients presenting with obstructive jaundice caused by benign and malignant pancreaticobiliary disease. Prospective bile samples were obtained from 31 patients who underwent either Endoscopic Retrograde Cholangiopancreatography (ERCP) or Percutaneous Transhepatic Cholangiogram (PTC). Variable regions (V3-V4) of the 16S rRNA genes of microorganisms present in the samples were amplified by Polymerase Chain Reaction (PCR) and sequenced. The cohort consisted of 12 PDAC, 10 choledocholithiasis, seven gallstone pancreatitis and two primary sclerosing cholangitis patients. Using the 16S rRNA method, we identified a total of 135 genera from 29 individuals (12 PDAC and 17 benign). The bile microbial beta diversity significantly differed between patients with PDAC vs. benign disease (Permanova p = 0.0173). The separation of PDAC from benign samples is clearly seen through unsupervised clustering of Aitchison distance. We found three genera to be of significantly lower abundance among PDAC samples vs. benign, adjusting for false discovery rate (FDR). These were Escherichia (FDR = 0.002) and two unclassified genera, one from Proteobacteria (FDR = 0.002) and one from Enterobacteriaceae (FDR = 0.011). In the same samples, the genus Streptococcus (FDR = 0.033) was found to be of increased abundance in the PDAC group. We show that patients with obstructive jaundice caused by PDAC have an altered microbiome composition in the bile compared to those with benign disease. These bile-based microbes could be developed into potential diagnostic and prognostic biomarkers for PDAC and warrant further investigation.
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Affiliation(s)
- Nabeel Merali
- Minimal Access Therapy Training Unit (MATTU), Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK
- Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - Tarak Chouari
- Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - Julien Terroire
- Surrey Institute for People-Centred AI, University of Surrey, Guildford GU2 7XH, UK
- Section of Statistical Multi-Omics, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - Maria-Danae Jessel
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - Daniel S. K. Liu
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, UK
| | - James-Halle Smith
- Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TH, UK
| | - Tyler Wooldridge
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - Tony Dhillon
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - José I. Jiménez
- Department of Life Sciences, Imperial College London, London SW7 2AZ, UK
| | - Jonathan Krell
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Keith J. Roberts
- Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TH, UK
| | - Timothy A. Rockall
- Minimal Access Therapy Training Unit (MATTU), Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK
| | - Eirini Velliou
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, University College London (UCL), London W1W 7TY, UK
| | - Shivan Sivakumar
- Oncology Department, Institute of Immunology and Immunotherapy, Birmingham Medical School, University of Birmingham, Birmingham B15 2TT, UK
| | - Elisa Giovannetti
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands
- Cancer Pharmacology Lab, AIRC Start Up Unit, Fondazione Pisana per la Scienza, San Giuliano Terme PI, 56017 Pisa, Italy
| | - Ayse Demirkan
- Surrey Institute for People-Centred AI, University of Surrey, Guildford GU2 7XH, UK
- Section of Statistical Multi-Omics, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - Nicola E. Annels
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
| | - Adam E. Frampton
- Minimal Access Therapy Training Unit (MATTU), Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK
- Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7WG, UK
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, UK
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5
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Kurokawa K, Shukuya T, Greenstein RA, Kaplan BG, Wakelee H, Ross JS, Miura K, Furuta K, Kato S, Suh J, Sivakumar S, Sokol ES, Carbone DP, Takahashi K. Genomic characterization of thymic epithelial tumors in a real-world dataset. ESMO Open 2023; 8:101627. [PMID: 37703595 PMCID: PMC10594028 DOI: 10.1016/j.esmoop.2023.101627] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/25/2023] [Accepted: 08/02/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Thymic epithelial tumors (TETs) are rare neoplasms arising in the mediastinum, including thymic carcinomas and thymomas. Due to their rarity, little is known about the genomic profiles of TETs. Herein, we investigated the genomic characteristics of TETs evaluated in a large comprehensive genomic profiling database in a real-world setting. METHODS We included data from two different cohorts: Foundation Medicine Inc. (FMI) in the United States and the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) in Japan. Samples profiled were examined for all classes of alterations in 253 genes targeted across all assays. Tumor mutational burden (TMB) and microsatellite instability (MSI) were also evaluated. RESULTS A total of 794 patients were collected in our study, including 722 cases from FMI and 72 cases from C-CAT. In the FMI data, CDKN2A (39.9%), TP53 (30.2%) and CDKN2B (24.6%) were frequently altered in thymic carcinoma, versus TP53 (7.8%), DNMT3A (6.8%), and CDKN2A (5.8%) in thymoma. TMB-high (≥10 mutations/Mb) and MSI were present in 7.0% and 2.3% of thymic carcinomas, and 1.6% and 0.3% of thymomas, respectively. Within C-CAT data, CDKN2A (38.5%), TP53 (36.5%) and CDKN2B (30.8%) were also frequently altered in thymic carcinoma, while alterations of TSC1, SETD2 and LTK (20.0% each) were found in thymoma. CONCLUSIONS To the best of our knowledge, this is the largest cohort in which genomic alterations, TMB and MSI status of TETs were investigated. Potential targets for treatment previously unbeknownst in TETs are identified in this study, entailing newfound opportunities to advance therapeutic development.
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Affiliation(s)
- K Kurokawa
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - T Shukuya
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.
| | | | - B G Kaplan
- Foundation Medicine, Inc., Cambridge, USA
| | - H Wakelee
- Department of Medicine, Division of Oncology, Stanford University, Stanford, USA
| | - J S Ross
- Foundation Medicine, Inc., Cambridge, USA; Departments of Pathology and Urology, Upstate Medical University, Syracuse, USA
| | - K Miura
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - K Furuta
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | - S Kato
- Department of Medical Oncology, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - J Suh
- Genentech, South San Francisco, USA
| | | | - E S Sokol
- Foundation Medicine, Inc., Cambridge, USA
| | - D P Carbone
- Comprehensive Cancer Center, Division of Medical Oncology, The Ohio State University, Columbus, USA
| | - K Takahashi
- Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
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6
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Spiers L, Gray M, Lyon P, Sivakumar S, Bekkali N, Scott S, Collins L, Carlisle R, Wu F, Middleton M, Coussios C. Clinical trial protocol for PanDox: a phase I study of targeted chemotherapy delivery to non-resectable primary pancreatic tumours using thermosensitive liposomal doxorubicin (ThermoDox®) and focused ultrasound. BMC Cancer 2023; 23:896. [PMID: 37741968 PMCID: PMC10517508 DOI: 10.1186/s12885-023-11228-z] [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: 08/23/2022] [Accepted: 07/24/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND The dense stroma of pancreatic ductal adenocarcinomas is a major barrier to drug delivery. To increase the local drug diffusion gradient, high doses of chemotherapeutic agent doxorubicin can be released from thermally-sensitive liposomes (ThermoDox®) using ultrasound-mediated hyperthermia at the tumour target. PanDox is designed as a Phase 1 single centre study to investigate enhancing drug delivery to adult patients with non-operable pancreatic ductal adenocarcinomas. The study compares a single cycle of either conventional doxorubicin alone or ThermoDox® with focused ultrasound-induced hyperthermia for targeted drug release. METHODS Adults with non-resectable pancreatic ductal adenocarcinoma are allocated to receive a single cycle of either doxorubicin alone (Arm A) or ThermoDox® with focused ultrasound-induced hyperthermia (Arm B), based on patient- and tumour-specific safety conditions. Participants in Arm B will undergo a general anaesthetic and pre-heating of the tumour by extra-corporal focused ultrasound (FUS). Rather than employing invasive thermometry, ultrasound parameters are derived from a patient-specific treatment planning model to reach the 41 °C target temperature for drug release. ThermoDox® is then concurrently infused with further ultrasound exposure. Tumour biopsies at the targeted site from all patients are analysed post-treatment using high performance liquid chromatography to quantify doxorubicin delivered to the tumour. The primary endpoint is defined as a statistically significant enhancement in concentration of total intra-tumoural doxorubicin, comparing samples from patients receiving liposomal drug with FUS to free drug alone. Participants are followed for 21 days post-treatment to assess secondary endpoints, including radiological assessment to measure changes in tumour activity by Positron Emission Tomography Response Criteria in Solid Tumours (PERCIST) criteria, adverse events and patient-reported symptoms. DISCUSSION This early phase study builds on previous work targeting tumours in the liver to investigate whether enhancement of chemotherapy delivery using ultrasound-mediated hyperthermia can be translated to the stroma-dense environment of pancreatic ductal adenocarcinoma. If successful, it could herald a new approach towards managing these difficult-to-treat tumours. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04852367 . Registered 21st April 2022. EudraCT number: 2019-003950-10 (Registered 2019) Iras Project ID: 272253 (Registered 2019) Ethics Number: 20/EE/0284.
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Affiliation(s)
- Laura Spiers
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Michael Gray
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Institute of Biomedical Engineering, University of Oxford, Marcella Wing, Botnar Research Centre, Old Rd, Headington, Oxford, OX3 7LD, UK
| | - Paul Lyon
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Noor Bekkali
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Shaun Scott
- Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, OX3 7LE, UK
| | - Linda Collins
- Department of Oncology, Oncology Clinical Trials Office (OCTO), University of Oxford, Oxford, UK
| | - Robert Carlisle
- Institute of Biomedical Engineering, University of Oxford, Marcella Wing, Botnar Research Centre, Old Rd, Headington, Oxford, OX3 7LD, UK
| | - Feng Wu
- Nuffield Department of Surgery, Churchill Hospital, Oxford, OX3 7LE, UK
| | - Mark Middleton
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Constantin Coussios
- Institute of Biomedical Engineering, University of Oxford, Marcella Wing, Botnar Research Centre, Old Rd, Headington, Oxford, OX3 7LD, UK.
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7
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Chouari T, La Costa FS, Merali N, Jessel MD, Sivakumar S, Annels N, Frampton AE. Advances in Immunotherapeutics in Pancreatic Ductal Adenocarcinoma. Cancers (Basel) 2023; 15:4265. [PMID: 37686543 PMCID: PMC10486452 DOI: 10.3390/cancers15174265] [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: 05/05/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) accounts for up to 95% of all pancreatic cancer cases and is the seventh-leading cause of cancer death. Poor prognosis is a result of late presentation, a lack of screening tests and the fact some patients develop resistance to chemotherapy and radiotherapy. Novel therapies like immunotherapeutics have been of recent interest in pancreatic cancer. However, this field remains in its infancy with much to unravel. Immunotherapy and other targeted therapies have yet to yield significant progress in treating PDAC, primarily due to our limited understanding of the disease immune mechanisms and its intricate interactions with the tumour microenvironment (TME). In this review we provide an overview of current novel immunotherapies which have been studied in the field of pancreatic cancer. We discuss their mechanisms, evidence available in pancreatic cancer as well as the limitations of such therapies. We showcase the potential role of combining novel therapies in PDAC, postulate their potential clinical implications and the hurdles associated with their use in PDAC. Therapies discussed with include programmed death checkpoint inhibitors, Cytotoxic T-lymphocyte-associated protein 4, Chimeric Antigen Receptor-T cell therapy, oncolytic viral therapy and vaccine therapies including KRAS vaccines, Telomerase vaccines, Gastrin Vaccines, Survivin-targeting vaccines, Heat-shock protein (HSP) peptide complex-based vaccines, MUC-1 targeting vaccines, Listeria based vaccines and Dendritic cell-based vaccines.
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Affiliation(s)
- Tarak Chouari
- Hepato-Pancreato-Biliary Department, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UK; (T.C.); (F.S.L.C.); (N.M.)
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7WG, UK; (M.-D.J.); (N.A.)
| | - Francesca Soraya La Costa
- Hepato-Pancreato-Biliary Department, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UK; (T.C.); (F.S.L.C.); (N.M.)
| | - Nabeel Merali
- Hepato-Pancreato-Biliary Department, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UK; (T.C.); (F.S.L.C.); (N.M.)
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7WG, UK; (M.-D.J.); (N.A.)
- The Minimal Access Therapy Training Unit, University of Surrey, Guildford GU2 7WG, UK
| | - Maria-Danae Jessel
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7WG, UK; (M.-D.J.); (N.A.)
| | - Shivan Sivakumar
- Oncology Department and Institute of Immunology and Immunotherapy, Birmingham Medical School, University of Birmingham, Birmingham B15 2TT, UK;
| | - Nicola Annels
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7WG, UK; (M.-D.J.); (N.A.)
| | - Adam E. Frampton
- Hepato-Pancreato-Biliary Department, Royal Surrey NHS Foundation Trust, Guildford GU2 7XX, UK; (T.C.); (F.S.L.C.); (N.M.)
- Section of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7WG, UK; (M.-D.J.); (N.A.)
- The Minimal Access Therapy Training Unit, University of Surrey, Guildford GU2 7WG, UK
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Rajendran P, Padmapriyadarsini C, Nair S, Sivakumar S. Newer TB diagnostics: An update. Indian J Tuberc 2023; 70:372-375. [PMID: 37562916 DOI: 10.1016/j.ijtb.2023.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/06/2023] [Accepted: 04/20/2023] [Indexed: 08/12/2023]
Abstract
In recent years, nucleic-acid amplification tests (NAATs), which are highly specific and sensitive, have helped to transform the TB diagnostic landscape. According to the WHO 2021 Guidelines on Diagnostics, the NAATs used in TB diagnosis at the point of care (POC) include Xpert MTB/RIF a cartridge-based test manufactured by Cepheid, and Truenat a chip-based test manufactured by Molbio. Other POC tests that are expected to be implemented in near future include Xpert Omni and Xpert MTB/XDR. The use of line probe assay is involved at the level of reference labs for the detection of MTB and its resistance to first-line (Isoniazid and Rifampicin) and second-line (fluoroquinolones and second-line injectables) drugs. When the currently available NAATs detect mutations for drug resistance at a particular region of MTB sequence, the Whole genome sequencing (WGS) platform demonstrates the exceptional potential for reliable and comprehensive resistance prediction for MTB isolates, by multiple gene regions or whole genome sequence analysis allowing for accurate clinical decisions.
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Affiliation(s)
- Priya Rajendran
- ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai, India
| | - C Padmapriyadarsini
- ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai, India.
| | | | - S Sivakumar
- ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai, India
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Malathy A, Manikandan V, Devanesan S, Farhat K, Priyadharsan A, Ragavendran C, Ragupathy S, Ranjith R, Sivakumar S. Development of biohybrid Ag 2CrO 4/rGO based nanocomposites with stable flotation properties as enhanced Photocatalyst for sewage treatment and antibiotic-conjugated for antibacterial evaluation. Int J Biol Macromol 2023:125303. [PMID: 37311516 DOI: 10.1016/j.ijbiomac.2023.125303] [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: 03/07/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
The proposed research outlines a facile method to synthesize Silver Chromate/reduced graphene oxide nanocomposites (Ag2CrO4/rGO NCs) with a narrow dissemination size for the ecological treatment of hazardous organic dyes. The photodegradation performance toward the decontamination of model artificial methylene blue dye was assessed under solar light irradiation. The crystallinity, particle size, recombination of photogenerated charge carriers, energy gap and surface morphologies of synthesized nanocomposites were determined. The experiment objective is to use rGO nanocomposites to increase Ag2CrO4 photocatalytic efficiency in the solar spectrum. Tauc plots of ultraviolet-visible (UV-vis) spectrum were used to calculate the optical bandgap energy of the produced nanocomposites ~1.52 eV, which resulted in a good photodegradation percentage of ~92 % after 60 min irradiation of Solar light. At the same time, pure Ag2CrO4 and rGO nanomaterials showed ~46 % and ~ 30 %, respectively. The ideal circumstances were discovered by investigating the effects of several parameters, including catalyst loading and different pH levels, on the degradation of dyes. However, the final composites maintain their ability to degrade for up to five cycles. According to the investigations, Ag2CrO4/rGO NCs are an effective photocatalyst and can be used as the ideal material to prevent water pollution. Furthermore, antibacterial efficacy for the hydrothermally synthesized nanocomposite was tested against gram-positive (+ve) bacteria viz. Staphylococcus aureus and gram-negative (-ve) bacteria viz. Escherichia coli. The maximum zone of inhibition for S. aureus and E. coli were 18.5 and 17 mm, respectively.
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Affiliation(s)
- A Malathy
- Department of Chemistry, E.R.K Arts and Science College, Erumiyampatti, Dharmapuri, Tamilnadu 636 905, India
| | - Velu Manikandan
- Department of Food Science and Technology, Seoul Women's University, 621 Hwarangno, Nowon-gu, Seoul, South Korea
| | - Sandhanasamy Devanesan
- Department of Physics and Astronomy, College of Science, King Saud University, P. O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Karim Farhat
- Department of Urology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Priyadharsan
- Department of Cariology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamilnadu 600 077, India.
| | - C Ragavendran
- Department of Cariology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamilnadu 600 077, India
| | - S Ragupathy
- Department of Physics, E.R.K Arts and Science College, Erumiyampatti, Dharmapuri, Tamilnadu 636 905, India
| | - R Ranjith
- Department of Physics, KSR College of Engineering, Thiruchengode 637 215, Tamilnadu, India
| | - S Sivakumar
- Department of Chemistry, E.R.K Arts and Science College, Erumiyampatti, Dharmapuri, Tamilnadu 636 905, India.
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Jothi S, Anita S, Sivakumar S. Modified Exigent Features Block in JAN Net for Analysing SPECT Scan Images to Diagnose Early-Stage Parkinson's Disease. Curr Med Imaging 2023:CMIR-EPUB-132279. [PMID: 37282573 DOI: 10.2174/1573405620666230605092654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/27/2022] [Accepted: 12/29/2022] [Indexed: 06/08/2023]
Abstract
BACKGROUND The quantitative measure of dopamine transporter (DaT) in the human midbrain is generally used as a biomarker for analyzing Parkinson's disease (PD). INTRODUCTION DaT scan images or Single- photon emission computed tomography (SPECT) images are utilized to capture the dopamine content more accurately. METHODS Only sixteen slices out of ninety-one of SPECT images were chosen on the basis of the high amount of dopamine content and were named Volume rendering image slices (VRIS). This paper proposes a novel Convolutional Neural Network (CNN) called JAN Net which particularly treats the VRIS for identifying PD. The JAN Net preserves the edges and spatial features of the striatum by using a modified exigent feature (M-ExFeat) block, that contains convolutional and additive layer. The different-sized convolutional layer extracts both low- and high-level features of Striatum. The additive layer adds up all the features of different filter sized convolutional layers like 1x1, 3x3, and 5x5. The added output features are used to improve the learnability of neurons in the hidden layer. The network performance is tested for stride 1 and stride 2. RESULTS The results are validated using the dataset taken from the Parkinson's Progression Markers Initiative (PPMI) database. The JAN Net ensures improved performance in terms of accuracy. The training and validation accuracy for stride 2 is 100% with minimum losses. The outcome has been compared with different deep learning architectures and the machine learning techniques like Extreme Learning Machines (ELM), and Artificial Neural Networks (ANN) to highlight the efficacy of the proposed architecture. CONCLUSION Hence, the present work could be of great aid to the experts in neurology to protect the neurons from impairment.
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Affiliation(s)
- S Jothi
- Department of Computer Science, Jayaraj Annapackiam College for Women, M. K. University, Madurai, Tamilnadu, India
| | - S Anita
- Department of Electronics and Communication Engineering, St. Anne's College of Engineering and Technology, Anna University, Chennai, Tamilnadu, India
| | - S Sivakumar
- Department of Computer Science, Cardamom Planters' Association College, M. K. University, Madurai, Tamilnadu, India
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Sivakumar S, Kamalakannan M, Kalpana AP, Prakash J, Arun B. Effect of Mulligan’s Mobilization Versus Muscle Energy Technique on Sacroiliac Joint Dysfunction. Int J Life Sci Pharm Res 2023. [DOI: 10.22376/ijlpr.2023.13.3.l167-l176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
Sacroiliac joint dysfunction (SIJDF) is about 15% to 30% identified in a patient with low back aches. This Study aimed to determine the effect of mulligan mobilization versus muscle energy technique on sacroiliac joint dysfunction. The study was a randomized controlled trial that involved 66 participants with SIJDF, after a thorough evaluation the participants were divided into three groups. In experimental group I (Mulligan's mobilization group (MMG)), participants underwent Mulligan mobilization for 20 minutes. The experimental group II (Muscle energy group (MEG)) participants underwent the muscle energy technique for 20 minutes, and the third group underwent moist heat therapy (moist heat group (MHG)) for 20 minutes. For all three groups, 10 minutes of exercise were taught to the patients. All the participants of the groups were included based on pre-determined selection criteria, and all were willing to participate in the Study. The outcome measures of Pain, functional disability, and kinesiophobia were measured by the Numerical pain scale, Oswestry disability index, and Tampa scale respectively. The result was computed using One-way ANOVA, showing significant differences between the three groups. When significant differences were obtained on ANOVA, further analysis was done using a post hoc test. The values for the outcomes are Pain was compared with MMG vs. MEG is 8.045 and the MMG vs. MHG is 4.022 and MMG vs. MEG is 12.07, on Oswestry disability index MEG vs. MHG 9.85, MMG vs. MHG is 2.23 and MMG vs. MEG is 12.08. For kinesiophobia, MMG vs. MEG is 20.25, MMG vs. MHG is 15.35, and MMG vs. MEG is 35.60. This Study concludes that Mulligan's mobilization is more effective in reducing pain, improving function, and kinesiophobia in SI joint dysfunction than the other two groups.
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Heij L, Bednarsch J, Tan X, Rosin M, Appinger S, Reichel K, Pecina D, Doukas M, van Dam RM, Garcia Vallejo J, Ulmer F, Lang S, Luedde T, Rocha FG, Sivakumar S, Neumann UP. Expression of Checkpoint Molecules in the Tumor Microenvironment of Intrahepatic Cholangiocarcinoma: Implications for Immune Checkpoint Blockade Therapy. Cells 2023; 12:cells12060851. [PMID: 36980192 PMCID: PMC10047585 DOI: 10.3390/cells12060851] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023] Open
Abstract
Background: The tumor microenvironment (TME) in cholangiocarcinoma (CCA) influences the immune environment. Checkpoint blockade is promising, but reliable biomarkers to predict response to treatment are still lacking. Materials and Methods: The levels of checkpoint molecules (PD-1, PD-L1, PD-L2, LAG-3, ICOS, TIGIT, TIM-3, CTLA-4), macrophages (CD68), and T cells (CD4 and CD8 cells) were assessed by multiplexed immunofluorescence in 50 intrahepatic cases. Associations between marker expression, immune cells, and region of expression were studied in the annotated regions of tumor, interface, sclerotic tumor, and tumor-free tissue. Results: ICCA demonstrated CD4_TIM-3 high densities in the tumor region of interest (ROI) compared to the interface (p = 0.014). CD8_PD-L1 and CD8_ICOS densities were elevated in the sclerotic tumor compared to the interface (p = 0.011 and p = 0.031, respectively). In a multivariate model, high expression of CD8_PD-L2 (p = 0.048) and CD4_ICOS_TIGIT (p = 0.011) was associated with nodal metastases. Conclusions: High densities of PD-L1 were more abundant in the sclerotic tumor region; this is meaningful for the stratification of immunotherapy. Lymph node metastasis correlates with CD4_ICOS_TIGIT co-expression and CD8_PD-L2 expression, indicating the checkpoint expression profile of patients with a poor prognosis. Also, multiple co-expressions occur, and this potentially suggests a role for combination therapy with different immune checkpoint targets than just PD-1 blockade monotherapy.
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Affiliation(s)
- Lara Heij
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany
- Department of Pathology, Erasmus Medical Center Rotterdam, 3000 CB Rotterdam, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6211 ER Maastricht, The Netherlands
- Correspondence:
| | - Jan Bednarsch
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Xiuxiang Tan
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6211 ER Maastricht, The Netherlands
| | - Mika Rosin
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Simone Appinger
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Konrad Reichel
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Dana Pecina
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Michail Doukas
- Department of Pathology, Erasmus Medical Center Rotterdam, 3000 CB Rotterdam, The Netherlands
| | - Ronald M. van Dam
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
- Department of Surgery, Maastricht University Medical Center (MUMC), 6202 AZ Maastricht, The Netherlands
- GROW—School for Oncology and Reproduction, Maastricht University, 6211 ER Maastricht, The Netherlands
| | - Juan Garcia Vallejo
- Department of Molecular Cell Biology & Immunology, VU University Medical Center, 1081 HZ Amsterdam, The Netherlands
| | - Florian Ulmer
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Sven Lang
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Tom Luedde
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, 40225 Duesseldorf, Germany
| | - Flavio G. Rocha
- Division of Surgical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7DQ, UK
| | - Ulf Peter Neumann
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
- Department of Surgery, Maastricht University Medical Center (MUMC), 6202 AZ Maastricht, The Netherlands
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Tan PS, Garriga C, Clift A, Liao W, Patone M, Coupland C, Bashford-Rogers R, Sivakumar S, Hippisley-Cox J. Temporality of body mass index, blood tests, comorbidities and medication use as early markers for pancreatic ductal adenocarcinoma (PDAC): a nested case-control study. Gut 2023; 72:512-521. [PMID: 35760494 PMCID: PMC9933161 DOI: 10.1136/gutjnl-2021-326522] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/14/2022] [Indexed: 12/08/2022]
Abstract
OBJECTIVE Prior studies identified clinical factors associated with increased risk of pancreatic ductal adenocarcinoma (PDAC). However, little is known regarding their time-varying nature, which could inform earlier diagnosis. This study assessed temporality of body mass index (BMI), blood-based markers, comorbidities and medication use with PDAC risk . DESIGN We performed a population-based nested case-control study of 28 137 PDAC cases and 261 219 matched-controls in England. We described the associations of biomarkers with risk of PDAC using fractional polynomials and 5-year time trends using joinpoint regression. Associations with comorbidities and medication use were evaluated using conditional logistic regression. RESULTS Risk of PDAC increased with raised HbA1c, liver markers, white blood cell and platelets, while following a U-shaped relationship for BMI and haemoglobin. Five-year trends showed biphasic BMI decrease and HbA1c increase prior to PDAC; early-gradual changes 2-3 years prior, followed by late-rapid changes 1-2 years prior. Liver markers and blood counts (white blood cell, platelets) showed monophasic rapid-increase approximately 1 year prior. Recent diagnosis of pancreatic cyst, pancreatitis, type 2 diabetes and initiation of certain glucose-lowering and acid-regulating therapies were associated with highest risk of PDAC. CONCLUSION Risk of PDAC increased with raised HbA1c, liver markers, white blood cell and platelets, while followed a U-shaped relationship for BMI and haemoglobin. BMI and HbA1c derange biphasically approximately 3 years prior while liver markers and blood counts (white blood cell, platelets) derange monophasically approximately 1 year prior to PDAC. Profiling these in combination with their temporality could inform earlier PDAC diagnosis.
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Affiliation(s)
- Pui San Tan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Cesar Garriga
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ashley Clift
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Oncology, Cancer Research UK Oxford Centre, University of Oxford, Oxford, UK
| | - Weiqi Liao
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Martina Patone
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carol Coupland
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford, UK
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
- Department of Oncology, Oxford University Hospitals NHS Foundation Trusts, Oxford, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Sivakumar S, Thangadurai TD, Nataraj D. Role of Interfacial AuNPs in Solid-state Direct Z-scheme MoS2/Au/g-C3N4 Heterojunction Nanocomposite’s Pollutant Degradation activity under sunlight. Colloids Surf A Physicochem Eng Asp 2023. [DOI: 10.1016/j.colsurfa.2023.131365] [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: 03/30/2023]
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15
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Kumar S, Chawla R, Sivakumar S, Khatkar SK, Kumar N, Goel N. Comparative study illustrating the efficacy of novel ultrasonication assisted heat treatment over conventional heat treatment in functional smoothie. Int J Food Sci Technol 2023. [DOI: 10.1111/ijfs.16363] [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: 02/23/2023]
Affiliation(s)
- Shubham Kumar
- Department of Dairy Technology College of Dairy Science and Technology GADVASU
| | - Rekha Chawla
- Department of Dairy Technology College of Dairy Science and Technology GADVASU
| | - S. Sivakumar
- Department of Dairy Technology College of Dairy Science and Technology GADVASU
| | - Sunil Kumar Khatkar
- Department of Dairy Technology College of Dairy Science and Technology GADVASU
| | - Narender Kumar
- Department of Dairy Engineering College of Dairy Science and Technology GADVASU
| | - Nitika Goel
- Department of Dairy Technology College of Dairy Science and Technology GADVASU
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Bai LY, Macarulla T, Grell P, Chee CE, Krishnamurthy A, Wong MK, Michael M, Milella M, Prager G, Springfeld C, Collignon J, Siveke J, Santoro A, Lin CC, Peltola KJ, Bostel G, Jankovic D, Altzerinakou MA, Fabre C, Sivakumar S. Phase II study (daNIS-1) of the anti–TGF-β monoclonal antibody (mAb) NIS793 with and without the PD-1 inhibitor spartalizumab in combination with nab-paclitaxel/gemcitabine (NG) versus NG alone in patients (pts) with first-line metastatic pancreatic ductal adenocarcinoma (mPDAC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.tps761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
TPS761 Background: Overall survival remains short for pts with mPDAC despite approved therapies, highlighting the need for more effective treatment options. While TGF-β can act as a tumor suppressor in normal tissue and early-stage PDAC, it is associated with tumorigenic processes (such as enhanced genomic instability, neoangiogenesis, epithelial-to-mesenchymal transition, and metastasis) observed in late-stage PDAC. Within the pancreatic tumor microenvironment (TME), TGF-β activates stellate cells and cancer-associated fibroblasts, thereby promoting fibrotic network development and immune exclusion, maintaining an immunosuppressive TME. Preclinical data in murine models have shown that addition of TGF-β blockade to anti-PD-1 therapy or NG augmented the antitumor activity of those agents, leading to tumor regression. These data provide the rationale for combining TGF-β-targeting agents with chemotherapy and/or immunotherapy. This study investigates NIS793, a human IgG2 mAb that binds TGF-β1 and 2, with and without spartalizumab (PD-1 antagonist) combined with NG in treatment-naïve mPDAC. Methods: This is a phase II open-label, randomized study (NCT04390763) with a safety run-in period followed by randomization. Eligible pts are adults with previously untreated mPDAC with measurable disease as per RECIST 1.1 and ECOG performance status score ≤1. Pts are excluded if they have a microsatellite-unstable tumor. The safety run-in was completed and confirmed a dose of NIS793 (intravenously [IV] 2100 mg Q2W) + spartalizumab (IV 400 mg Q4W) + nab-paclitaxel (IV 125 mg/m2 on Days 1, 8, and 15) + gemcitabine (IV 1000 mg/m2 on Days 1, 8, and 15). In the randomized part, pts will be randomized 1:1:1 to NIS793 + spartalizumab + NG (n = 50) or NIS793 + NG (n = 50) or NG (n = 50). Treatment will continue until disease progression, unacceptable toxicity, discontinuation by investigator’s/pt’s choice, or withdrawal of consent. The primary objective is to evaluate the progression-free survival per RECIST v1.1 of NIS793 + NG with or without spartalizumab, versus NG alone. Secondary objectives include safety and tolerability, antitumor activity, overall survival, change in tumoral CD8 and PD-L1 status, and characterization of immunogenicity and pharmacokinetics. Efficacy will be assessed by investigator per RECIST v1.1 and iRECIST at screening, every 8 weeks for 1 year and then every 12 weeks until disease progression. The study is ongoing and has an estimated enrollment of 161 pts. There are currently 31 sites participating across 14 countries. The study is funded by Novartis. Clinical trial information: NCT04390763 .
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Affiliation(s)
- Li-Yuan Bai
- China Medical University Hospital, Taichung, Taiwan
| | | | - Peter Grell
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | | | | | - Mark Ka Wong
- Westmead Cancer Care Centre, Westmead, Australia
| | | | - Michele Milella
- Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | | | | | | | - Chia-Chi Lin
- National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | | | - Claire Fabre
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford, United Kingdom
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Gopinathan A, Sivakumar S, Aneeja T. Recent advances and prospects in palladium catalyzed Hiyama coupling reaction. ARKIVOC 2023. [DOI: 10.24820/ark.5550190.p011.845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Sivakumar S, Daniel Thangadurai T, Manjubaashini N, Nataraj D. Two-dimensional z-type MoS2/g-C3N4 semiconductor heterojunction nanocomposites for industrial methylene blue dye degradation under daylight. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2022.130090] [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: 11/29/2022]
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Sivakumar S, Nelson Prabu L. Enhancement in electrochemical behavior of cobalt doped α-MnO nanoparticles. INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2022.110247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gorantla A, Alsaiqali M, Sivakumar S, Francois J, Freytes-Santiago L, Jallad A, Budzikowski A. Effectiveness of various radiofrequency ablation catheters in the treatment of typical atrial flutter. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.458] [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
Introduction
Although ablation of typical atrial flutter (AFL) can be easily achieved with radiofrequency energy (RF), there are no studies that compare effectiveness of different ablation catheters. Our study aimed to compare the effectiveness of various types of ablation catheters in the treatment of AFL.
Methods
We analysed patients with AFL who underwent RF ablation by a single operator at our institution. Successful ablation was evidenced by presence of bidirectional conduction block (trans-isthmus conduction time ≥130 ms, or doubling of baseline conduction time, or presence of double potentials ≥90ms). Logistic regression was used to compare success rate and linear regression to compare lesion time.
Results
Out of the 222 patients, only 6 patients did not meet success criteria (2.7%). Catheters used were 8 mm tip in 16 patients, internally irrigated (Chili II Boston Scientific) in 47 patients, externally irrigated (non-force sensing) catheters (CoolPath, Abbott) in 40 patients. Externally irrigated force sensing catheter (Tacticath, Abbott) was used with >10 gm of force and (LPLD) setting (30W-45°C-60 sec) in 50 patients, and high-power short duration (HPSD) setting (50W-43°C −12 sec,) in 70 patients. No complications were encountered. Catheter type had no statistically significant association with ablation success. In terms of lesion time, HPSD catheter statistically significantly shortened lesion time by 758.3s, [CI −1128.29, −388.35s] followed by LPLD by 419.0s [CI −808.49, −29.47s]. Table 1 shows the lesion time difference for the catheters used as compared with 8 mm tip.
Conclusions
Typical atrial flutter radiofrequency ablation procedure had a high success rate, not influenced by type of ablation catheter. Contact force ablation catheter on HPSD is associated with shorter total lesion time.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Gorantla
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - M Alsaiqali
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - S Sivakumar
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - J Francois
- Suny Downstate Medical Center , Brooklyn , United States of America
| | | | - A Jallad
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - A Budzikowski
- Suny Downstate Medical Center , Brooklyn , United States of America
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Sivakumar S, Kalaimani N. An optimization of supplements and physical factors for growth of hemocytes culture from Penaeus vannamei (White shrimp) in selective medium. Mol Biol Rep 2022; 49:9489-9497. [PMID: 36006504 DOI: 10.1007/s11033-022-07834-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Standardization of cell culture medium plays a vital role in the development of primary or continuous cell line. Apart from the basal media, supplements in the medium and various physical factors promote the cell growth. With this context, the study was carried out to optimize the culture medium using various supplements and physical factors for the growth of hemocytes culture from Penaeus vannamei. METHODS Various concentrations of Fetal Bovine Serum (FBS; 1-25%), Shrimp Muscle Extract (SME; 1-25%) and basic Fibroblast Growth Factor (bFGF; 0.5-5 ng mL -1) were attempted to optimize the cell culture media for the development of primary hemocytes culture of P. vannamei. Various pH, temperature and osmolality was also screened to optimize the medium. RESULTS 15% FBS was ideal for the healthy morphology of cells with rapid replication. SME supplementation at 5-20% supported the cell growth for 24 h but only 30% of cell viability was observed after 48 h. bFGF (0.5-5 ng mL-1) enhanced cell growth in the medium with 15% FBS; The ideal pH level was examined by preparing the HBSCM-5 medium at pH between 6.8-8.0. Osmolality of 730 ± 20, pH of 7.2 and temperature of 28 °C resulted in the healthy cells with good morphology. NSW supplement supported the cell growth at low concentrations of salt; however, more than 2% salt concentrations cells did not form fibroblast-like morphology and instead a crystal-like morphology was observed. CONCLUSION The hemocytes culture were optimized for use as an in vitro cell culture system by testing cell growth on HBSCM-5 medium with various supplements, growth factors and physical parameters.
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Affiliation(s)
- S Sivakumar
- Aquatic Animal Health and Environment Division, ICAR-Central Institute of Brackishwater Aquaculture, #75, Santhome High Road, Raja Annamalaipuram, Chennai, Tamil Nadu, 600028, India.
| | - N Kalaimani
- Aquatic Animal Health and Environment Division, ICAR-Central Institute of Brackishwater Aquaculture, #75, Santhome High Road, Raja Annamalaipuram, Chennai, Tamil Nadu, 600028, India
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Mala NA, Dar MA, Rather MUD, Sivakumar S, Husain S, Batoo KM. Enhanced electrochemical properties of zinc and manganese co-doped NiO nanostructures for its high-performance supercapacitor applications. INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2022.109661] [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: 11/05/2022]
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Bradley SH, Hemphill S, Markham S, Sivakumar S. Healthcare systems must get fair value for their data. BMJ 2022; 377:e070876. [PMID: 35760419 DOI: 10.1136/bmj-2022-070876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - Sarah Markham
- Visiting Researcher, Department of Biostatistics and Health Informatics, King's College London, London, UK
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Sivakumar S, Macarulla T, Grell P, Chee C, Krishnamurthy A, Ka Wong M, Michael M, Milella M, Prager G, Springfeld C, Collignon J, Siveke J, Santoro A, Lin C, Peltola K, Bostel G, Jankovic D, Altzerinakou M, Fabre C, Bai L. P-5 Phase II study (daNIS-1) of the anti-TGF-β monoclonal antibody (mAb) NIS793 +/- spartalizumab in combination with nab-paclitaxel/gemcitabine (NG) versus NG alone in patients with first-line metastatic pancreatic ductal adenocarcinoma (mPDAC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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25
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Sivakumar S, Rocha FG, Heij L. Editorial on “Perihilar Cholangiocarcinoma—Novel Benchmark Values for Surgical and Oncological Outcomes From 24 Expert Centers”. Hepatobiliary Surg Nutr 2022; 11:422-424. [DOI: 10.21037/hbsn-22-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/04/2022] [Indexed: 11/06/2022]
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Bai LY, Macarulla T, Grell P, Chee CE, Krishnamurthy A, Wong MK, Michael M, Milella M, Prager G, Springfeld C, Collignon J, Siveke J, Santoro A, Lin CC, Peltola KJ, Bostel G, Jankovic D, Altzerinakou MA, Fabre C, Sivakumar S. Phase II study (daNIS-1) of the anti-TGF-β monoclonal antibody (mAb) NIS793 with and without the PD-1 inhibitor spartalizumab in combination with nab-paclitaxel/gemcitabine (NG) versus NG alone in patients (pts) with first-line metastatic pancreatic ductal adenocarcinoma (mPDAC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps4183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS4183 Background: Overall survival remains low for pts with mPDAC despite approved therapies, highlighting the need for further innovative treatment options. Intra-tumoral fibrosis that characterizes PDAC has been associated with a state of immune exclusion and may constitute a mechanical obstacle to the intra-tumoral penetration of chemotherapy as well as contribute to the lack of efficacy of immunotherapy. TGF-β plays a key role in regulating the tumor microenvironment and emerging evidence points to its role as a pivotal activator of cancer-associated fibroblasts, leading to the development of fibrotic networks. Preclinical data in murine models have shown that TGF-β blockade augmented the antitumor activity of both NG and anti-PD-1 therapy, leading to tumor regression. These data provide the rationale for combining TGF-β-targeting agents with immunotherapy and chemotherapy. NIS793 is a human IgG2 mAb that binds to TGF-β. This study investigates NIS793 with and without spartalizumab (PD-1 antagonist) combined with NG in treatment naïve mPDAC. Methods: This is a phase II open-label, randomized, multicenter study (NCT04390763) beginning with a safety run-in period followed by randomization. Eligible pts are adults with previously untreated mPDAC and ECOG performance status score ≤1. Pts are excluded if they have a microsatellite-unstable tumor. The safety run-in data will be analyzed after ≥6 pts have received NIS793 (intravenously [IV] 2100 mg Q2W) + spartalizumab (IV 400 mg Q4W) + nab-paclitaxel (IV 125 mg/m2 on Days 1, 8 and 15) + gemcitabine (IV 1000 mg/m2 on Days 1, 8 and 15) for 1 cycle (28 days) to assess the safety and tolerability of the combination. In the randomized part, pts will be randomized 1:1:1 to NIS793 + spartalizumab + NG (n = 50) or NIS793 + NG (n = 50) or NG (n = 50). Treatment will continue until unacceptable toxicity, disease progression, discontinuation by investigator’s/pt’s choice, or withdrawal of consent. The primary objective is to evaluate the progression-free survival per RECIST 1.1, of NIS793 + NG ± spartalizumab versus NG alone. Secondary objectives include safety and tolerability, antitumor activity, overall survival, change in tumoral CD8 and PD-L1 status, and characterization of immunogenicity and pharmacokinetics. Efficacy will be assessed locally per RECIST v1.1 and iRECIST at screening, every 8 weeks for 1 year and then every 12 weeks until disease progression. Blood and tumor samples will be taken at baseline and during study treatment for pharmacokinetic, immunogenicity and biomarker assessments. This study is ongoing and will enroll pts from 31 sites across 14 countries. The first pt was treated on October 22, 2020. Enrollment for the randomized part of the study started on August 09, 2021. Clinical trial information: NCT04390763.
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Affiliation(s)
- Li-Yuan Bai
- China Medical University Hospital, Taichung, Taiwan
| | - Teresa Macarulla
- Department of Medical Oncology, Vall d’Hebron Unveristy Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Peter Grell
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | | | | | | | - Michael Michael
- Peter MacCallum Cancer Centre Parkville, Melbourne, VIC, Australia
| | - Michele Milella
- Section of Oncology, University of Verona, School of Medicine and Verona University Hospital Trust, Verona, Italy
| | | | | | | | | | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Chia-Chi Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | | | - Claire Fabre
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford, United Kingdom
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Mohanavel V, Ravichandran M, Ashraff Ali KS, Sathish T, Karthick A, Arungalai Vendan S, Velmurugan P, Salmen SH, Alfarraj S, Sivakumar S, Gebrekidan AM. Synthesis and Workability Behavior of Cu-X wt.% TiC ( x = 0, 4, 8, and 12) Powder Metallurgy Composites. Bioinorg Chem Appl 2022; 2022:8101680. [PMID: 35637640 PMCID: PMC9148246 DOI: 10.1155/2022/8101680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/20/2022] [Indexed: 11/24/2022] Open
Abstract
In this work, copper (Cu) matrix composite reinforced with titanium carbide (TiC) was fabricated by powder metallurgy (PM) method with the varying TiC content from 0% to 12% by weight in the step of 4%. The required weight percentage of powders was milled in an indigenously developed ball milling setup. Green compacts were made using a computer-controlled hydraulic press (400 kN) and sintered in a muffle furnace at a temperature of 950°C. Scanning electron microscope (SEM) was used to analyze the distribution of TiC particles in Cu matrix in as-sintered conditions. X-ray diffraction (XRD) analysis resulted in the existence of respective phases in the produced composites. The structural characteristics such as stress, strain, dislocation density, and grain size of the milled composites were evaluated. Cold upsetting was conducted for the sintered composites at room temperature to evaluate the axial (σ z ), hoop (σ ө ), hydrostatic (σ m ), and effective (σ eff ) true stresses. These stresses were analyzed against true axial strain (ε z ). Results showed that the increase in the inclusion of weight percentage of TiC into the Cu matrix increases density, hardness, (σ z ), (σ ө ), (σ m ), (σ eff ), and stress ratio parameters such as (σ z /σ eff ), (σ θ /σ eff ), (σ m /σ eff ), and (σ z /σ θ ) of the composites.
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Affiliation(s)
- V. Mohanavel
- Centre for Materials Engineering and Regenerative Medicine, Bharath Institute of Higher Education and Research, Chennai, 600073 Tamil Nadu, India
- Department of Mechanical Engineering, Chandigarh University, Mohali 140413, Punjab, India
| | - M. Ravichandran
- Department of Mechanical Engineering, K. Ramakrishnan College of Engineering, Trichy-621112, Tamil Nadu, India
- Department of Mechanical Engineering and University Centre for Research & Development, Chandigarh University, Mohali 140413, Punjab, India
| | - K. S. Ashraff Ali
- Department of Mechanical Engineering, C. Abdul Hakeem College of Engineering and Technology, Vellore 632509, Tamil Nadu, India
| | - T. Sathish
- Department of Mechanical Engineering, Saveetha School of Engineering, SIMATS, Chennai 602 105, Tamil Nadu, India
| | - Alagar Karthick
- Department of Electrical and Electronics Engineering, KPR Institute of Engineering and Technology, Coimbatore 641407, Tamil Nadu, India
| | - S. Arungalai Vendan
- Department of Electronics and Communication, Dayananda Sagar University, Bengaluru, Karnataka, India
| | - Palanivel Velmurugan
- Centre for Materials Engineering and Regenerative Medicine, Bharath Institute of Higher Education and Research, Chennai, 600073 Tamil Nadu, India
| | - Saleh H. Salmen
- Department of Botany and Microbiology, College of Science, King Saud University, PO. Box 2455, Riyadh 11451, Saudi Arabia
| | - Saleh Alfarraj
- Zoology Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - S. Sivakumar
- Department of Bioenvironmental Energy, College of Natural Resources and Life Science, Pusan National University, Miryang-si 50463, Republic of Korea
| | - Atkilt Mulu Gebrekidan
- Department of Mechanical Engineering, Faculty of Mechanical Engineering, Arba Minch Institute of Technology (AMIT), Arba Minch University, Arba Minch, Ethiopia
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Tan X, Bednarsch J, Rosin M, Appinger S, Liu D, Wiltberger G, Garcia Vallejo J, Lang SA, Czigany Z, Boroojerdi S, Gaisa NT, Boor P, Bülow RD, De Vos-Geelen J, Valkenburg-van Iersel L, Clahsen-van Groningen MC, de Jong EJM, Groot Koerkamp B, Doukas M, Rocha FG, Luedde T, Klinge U, Sivakumar S, Neumann UP, Heij LR. PD-1+ T-Cells Correlate with Nerve Fiber Density as a Prognostic Biomarker in Patients with Resected Perihilar Cholangiocarcinoma. Cancers (Basel) 2022; 14:cancers14092190. [PMID: 35565318 PMCID: PMC9103905 DOI: 10.3390/cancers14092190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Recent studies have identified Nerve Fiber Density (NFD) as a prognostic biomarker for Cholangiocarcinoma (CCA). In the field of CCA treatment with checkpoint inhibitors (ICI) is increasing but not all patients respond. Good biomarkers to predict response to ICI are lacking. The present study investigates the immune cell composition and expression of checkpoint molecules in relation to NFD in perihilar cholangiocarcinoma (pCCA) patients. Our study identified NFD to correlate with PD-1+ T cells as a biomarker indicative for a good prognosis. Abstract Background and Aims: Perihilar cholangiocarcinoma (pCCA) is a hepatobiliary malignancy, with a dismal prognosis. Nerve fiber density (NFD)—a novel prognostic biomarker—describes the density of small nerve fibers without cancer invasion and is categorized into high numbers and low numbers of small nerve fibers (high vs low NFD). NFD is different than perineural invasion (PNI), defined as nerve fiber trunks invaded by cancer cells. Here, we aim to explore differences in immune cell populations and survival between high and low NFD patients. Approach and Results: We applied multiplex immunofluorescence (mIF) on 47 pCCA patients and investigated immune cell composition in the tumor microenvironment (TME) of high and low NFD. Group comparison and oncological outcome analysis was performed. CD8+PD-1 expression was higher in the high NFD than in the low NFD group (12.24 × 10−6 vs. 1.38 × 10−6 positive cells by overall cell count, p = 0.017). High CD8+PD-1 expression was further identified as an independent predictor of overall (OS; Hazard ratio (HR) = 0.41; p = 0.031) and recurrence-free survival (RFS; HR = 0.40; p = 0.039). Correspondingly, the median OS was 83 months (95% confidence interval (CI): 18–48) in patients with high CD8+PD-1+ expression compared to 19 months (95% CI: 5–93) in patients with low CD8+PD-1+ expression (p = 0.018 log rank). Furthermore, RFS was significantly lower in patients with low CD8+PD-1+ expression (14 months (95% CI: 6–22)) compared to patients with high CD8+PD-1+ expression (83 months (95% CI: 17–149), p = 0.018 log rank). Conclusions: PD-1+ T-cells correlate with high NFD as a prognostic biomarker and predict good survival; the biological pathway needs to be investigated.
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Affiliation(s)
- Xiuxiang Tan
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Jan Bednarsch
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Mika Rosin
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Simone Appinger
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Dong Liu
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Georg Wiltberger
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Juan Garcia Vallejo
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands;
| | - Sven Arke Lang
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Zoltan Czigany
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Shiva Boroojerdi
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Nadine T. Gaisa
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany; (N.T.G.); (P.B.); (R.D.B.)
| | - Peter Boor
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany; (N.T.G.); (P.B.); (R.D.B.)
| | - Roman David Bülow
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany; (N.T.G.); (P.B.); (R.D.B.)
| | - Judith De Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (J.D.V.-G.); (L.V.-v.I.); (E.J.M.d.J.)
| | - Liselot Valkenburg-van Iersel
- Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (J.D.V.-G.); (L.V.-v.I.); (E.J.M.d.J.)
| | | | - Evelien J. M. de Jong
- Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (J.D.V.-G.); (L.V.-v.I.); (E.J.M.d.J.)
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands;
| | - Michail Doukas
- Department of Pathology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (M.C.C.-v.G.); (M.D.)
| | - Flavio G. Rocha
- Division of Surgical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA;
| | - Tom Luedde
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, 40225 Düsseldorf, Germany;
| | - Uwe Klinge
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
| | - Shivan Sivakumar
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK;
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK
| | - Ulf Peter Neumann
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
- Department of Surgery, Maastricht University Medical Centre (MUMC), 6229 HX Maastricht, The Netherlands
| | - Lara Rosaline Heij
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (X.T.); (J.B.); (M.R.); (S.A.); (D.L.); (G.W.); (S.A.L.); (Z.C.); (S.B.); (U.K.); (U.P.N.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HX Maastricht, The Netherlands
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany; (N.T.G.); (P.B.); (R.D.B.)
- Department of Pathology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (M.C.C.-v.G.); (M.D.)
- Correspondence:
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Cai S, Sivakumar S. The 11th revision of the International Statistical Classification of Disease and Related Health Problems and Cholangiocarcinoma. Hepatobiliary Surg Nutr 2022; 11:276-279. [DOI: 10.21037/hbsn-22-69] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/14/2022] [Indexed: 11/06/2022]
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Sivakumar S, Kathiresan K, Pandian P. Recent Approaches of Drugs and Vaccines Used in COVID 19: A Review. JPRI 2022. [DOI: 10.9734/jpri/2022/v34i22a35848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A novel SARS-CoV-2 coronavirus developed in December 2019, triggering a life-threatening pneumonia outbreak in China, and has since expanded worldwide, producing a pandemic. Because of the urgent need to control the disease and the dearth of specific and effective treatment options, FDA-approved medicines that have proven efficacy against comparable viruses are being used. In vitro, chloroquine, remdesivir, lopinavir/ritonavir or ribavirin are effective at inhibiting SARS-CoV-2. The preliminary findings of a variety of clinical trials utilising various chloroquine or hydroxychloroquine delivery procedures all indicate a positive outcome. They may not be effective in cases of consistently high viremia, and data on ivermectin (another antiparasitic medication) is currently unavailable. Intriguingly, azithromycin, a macrolide antibiotic, in conjunction with hydroxychloroquine may provide therapeutic benefits. Favipiravir, tocilizumab, and azithromycin types are among the other treatment options being investigated.
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Li H, van der Merwe PA, Sivakumar S. Biomarkers of response to PD-1 pathway blockade. Br J Cancer 2022; 126:1663-1675. [PMID: 35228677 PMCID: PMC9174485 DOI: 10.1038/s41416-022-01743-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/17/2022] [Accepted: 02/03/2022] [Indexed: 12/15/2022] Open
Abstract
The binding of T cell immune checkpoint proteins programmed death 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) to their ligands allows immune evasion by tumours. The development of therapeutic antibodies, termed checkpoint inhibitors, that bind these molecules or their ligands, has provided a means to release this brake on the host anti-tumour immune response. However, these drugs are costly, are associated with potentially severe side effects, and only benefit a small subset of patients. It is therefore important to identify biomarkers that discriminate between responders and non-responders. This review discusses the determinants for a successful response to antibodies that bind PD-1 or its ligand PD-L1, dividing them into markers found in the tumour biopsy and those in non-tumour samples. It provides an update on the established predictive biomarkers (tumour PD-L1 expression, tumour mismatch repair deficiency and tumour mutational burden) and assesses the evidence for new potential biomarkers.
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Affiliation(s)
- Hanxiao Li
- Green Templeton College, University of Oxford, Oxford, UK.
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Bolm L, Petruch N, Sivakumar S, Annels NE, Frampton AE. Gene of the month: T-cell immunoreceptor with immunoglobulin and ITIM domains (TIGIT). J Clin Pathol 2022; 75:217-221. [DOI: 10.1136/jclinpath-2021-207789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 12/30/2022]
Abstract
Immune modulators play a crucial role in carcinogenesis and cancer progression by impairing cancer cell-targeted immune responses. T-cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domains (TIGIT) regulates T-cell function and cancer cell recognition and was therefore identified as a promising target for cancer immunotherapy. TIGIT is expressed in T cells and natural killer (NK) cells and has three ligands: CD155, CD112 and CD113. CD155 binds TIGIT with the highest affinity and promotes direct and indirect downregulation of T-cell response. TIGIT signalling further inhibits NK function and secretion of proinflammatory cytokines. An association between TIGIT expression and poor survival was identified in multiple cancer entities. Blocking TIGIT with monoclonal antibodies, and a combination of TIGIT and programmed cell death protein 1 blockade in particular, prevented tumour progression, distant metastasis and tumour recurrence in in vivo models. Inhibition of TIGIT is currently evaluated in first clinical trials.
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Affiliation(s)
- Adam E Frampton
- From the Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, and the HPB Surgical Unit, Royal Surrey NHS Foundation Trust, Guildford, and the Department of Surgery and Cancer, Imperial College London, London (A.E.F.), and the Department of Oncology, University of Oxford, and the Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford (S.S.) - all in the United Kingdom
| | - Shivan Sivakumar
- From the Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, and the HPB Surgical Unit, Royal Surrey NHS Foundation Trust, Guildford, and the Department of Surgery and Cancer, Imperial College London, London (A.E.F.), and the Department of Oncology, University of Oxford, and the Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford (S.S.) - all in the United Kingdom
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Jainarayanan A, Mouroug Anand N, Arbe-Barnes E, Bashford-Rogers R, Abu-Shah E, Dustin M, Sivakumar S. 173P Pseudotime dynamics in pancreatic ductal adenocarcinoma reveal different mechanisms of hindrance in immunity through bifurcation of regulatory and cytotoxic T-cell differentiation. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.193] [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: 10/19/2022] Open
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Chawla R, Sivakumar S, Kaur H, Mishra SK. Effect of starch based edible antimicrobial films and modified atmospheric packaging (MAP) on extended life of composite sweetmeat. Carbohydrate Polymer Technologies and Applications 2021. [DOI: 10.1016/j.carpta.2021.100055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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Sivakumar S, Mala NA, Batoo KM, Ijaz MF. Conserved crystal phase and morphology: Electrochemical supremacy of copper (Cu) and iron (Fe) dual-doped nickel oxide and its supercapacitor applications. INORG CHEM COMMUN 2021. [DOI: 10.1016/j.inoche.2021.108959] [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: 12/18/2022]
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Chawla R, Sivakumar S, Kaur H. Antimicrobial edible films in food packaging: Current scenario and recent nanotechnological advancements- a review. Carbohydrate Polymer Technologies and Applications 2021. [DOI: 10.1016/j.carpta.2020.100024] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Siejka-Zielińska P, Cheng J, Jackson F, Liu Y, Soonawalla Z, Reddy S, Silva M, Puta L, McCain MV, Culver EL, Bekkali N, Schuster-Böckler B, Palamara PF, Mann D, Reeves H, Barnes E, Sivakumar S, Song CX. Cell-free DNA TAPS provides multimodal information for early cancer detection. Sci Adv 2021; 7:eabh0534. [PMID: 34516908 PMCID: PMC8442905 DOI: 10.1126/sciadv.abh0534] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/14/2021] [Indexed: 05/05/2023]
Abstract
Multimodal, genome-wide characterization of epigenetic and genetic information in circulating cell-free DNA (cfDNA) could enable more sensitive early cancer detection, but it is technologically challenging. Recently, we developed TET-assisted pyridine borane sequencing (TAPS), which is a mild, bisulfite-free method for base-resolution direct DNA methylation sequencing. Here, we optimized TAPS for cfDNA (cfTAPS) to provide high-quality and high-depth whole-genome cell-free methylomes. We applied cfTAPS to 85 cfDNA samples from patients with hepatocellular carcinoma (HCC) or pancreatic ductal adenocarcinoma (PDAC) and noncancer controls. From only 10 ng of cfDNA (1 to 3 ml of plasma), we generated the most comprehensive cfDNA methylome to date. We demonstrated that cfTAPS provides multimodal information about cfDNA characteristics, including DNA methylation, tissue of origin, and DNA fragmentation. Integrated analysis of these epigenetic and genetic features enables accurate identification of early HCC and PDAC.
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Affiliation(s)
- Paulina Siejka-Zielińska
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jingfei Cheng
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Felix Jackson
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Yibin Liu
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Srikanth Reddy
- Oxford Transplant Centre, Churchill Hospital, Oxford, UK
| | - Michael Silva
- Department of HPB Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Luminita Puta
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Misti Vanette McCain
- Newcastle University Translational and Clinical Research Institute, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Newcastle University Centre for Cancer, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Emma L. Culver
- Peter Medawar Building and Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Noor Bekkali
- Department of Gastroenterology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Benjamin Schuster-Böckler
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Big Data Institute, University of Oxford, Oxford, UK
| | - Pier Francesco Palamara
- Department of Statistics, University of Oxford, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Derek Mann
- Newcastle University Translational and Clinical Research Institute, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Fibrosis Research Group, Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Fibrofind, Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Helen Reeves
- Newcastle University Translational and Clinical Research Institute, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Newcastle University Centre for Cancer, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Liver Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Eleanor Barnes
- Peter Medawar Building and Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford, UK
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Chun-Xiao Song
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Mala NA, Sivakumar S, Batoo KM, Hadi M. Design and fabrication of iron-doped nickel oxide-based flexible electrode for high-performance energy storage applications. INORG CHEM COMMUN 2021. [DOI: 10.1016/j.inoche.2021.108797] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Divya G, Sivakumar S, Sakthi D, Priyadharsan A, Arun V, Kavitha R, Boobas S. Developing the NiO/CuTiO3/ZnO Ternary Semiconductor Heterojunction for Harnessing Photocatalytic Activity of Reactive Dye with Enhanced Durability. J Inorg Organomet Polym Mater 2021. [DOI: 10.1007/s10904-021-02068-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Bednarsch J, Tan X, Czigany Z, Liu D, Lang SA, Sivakumar S, Kather JN, Appinger S, Rosin M, Boroojerdi S, Dahl E, Gaisa NT, den Dulk M, Coolsen M, Ulmer TF, Neumann UP, Heij LR. The Presence of Small Nerve Fibers in the Tumor Microenvironment as Predictive Biomarker of Oncological Outcome Following Partial Hepatectomy for Intrahepatic Cholangiocarcinoma. Cancers (Basel) 2021; 13:cancers13153661. [PMID: 34359564 PMCID: PMC8345152 DOI: 10.3390/cancers13153661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Nerve fibers in the microenvironment of malignant tumors have been shown to be an important prognostic factor for long-term survival in various cancer types; however, their role in intrahepatic cholangiocarcinoma remains to be determined. Therefore, the impact of nerve fibers on long-term survival was investigated in a large European cohort of patients with intrahepatic cholangiocarcinoma who were treated by curative-intent surgical resection. By univariate and multivariate statistics, the absence of nerve fibers was determined to be an independent predictor of impaired long-term survival. A group comparison between patients with and without nerve fibers showed a statically significant difference with a cancer-specific 5-year-survival of 47% in patients with nerve fibers compared to 21% in patients without nerve fibers. Thus, the presence of nerve fibers in the microenvironment of intrahepatic cholangiocarcinoma is revealed as a novel and important prognostic biomarker in these patients. Abstract The oncological role of the density of nerve fibers (NFs) in the tumor microenvironment (TME) in intrahepatic cholangiocarcinoma (iCCA) remains to be determined. Therefore, data of 95 iCCA patients who underwent hepatectomy between 2010 and 2019 was analyzed regarding NFs and long-term outcome. Extensive group comparisons were carried out and the association of cancer-specific survival (CSS) and recurrence-free survival (RFS) with NFs were assessed using Cox regression models. Patients with iCCA and NFs showed a median CSS of 51 months (5-year-CSS = 47%) compared to 27 months (5-year-CSS = 21%) in patients without NFs (p = 0.043 log rank). Further, NFs (hazard ratio (HR) = 0.39, p = 0.002) and N-category (HR = 2.36, p = 0.010) were identified as independent predictors of CSS. Patients with NFs and without nodal metastases displayed a mean CSS of 89 months (5-year-CSS = 62%), while patients without NFs or with nodal metastases but not both showed a median CCS of 27 months (5-year-CSS = 25%) and patients with both positive lymph nodes and without NFs showed a median CCS of 10 months (5-year-CSS = 0%, p = 0.001 log rank). NFs in the TME are, therefore, a novel and important prognostic biomarker in iCCA patients. NFs alone and in combination with nodal status is suitable to identify iCCA patients at risk of poor oncological outcomes following curative-intent surgery.
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Affiliation(s)
- Jan Bednarsch
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Xiuxiang Tan
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Zoltan Czigany
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Dong Liu
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Sven Arke Lang
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK;
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK
| | - Jakob Nikolas Kather
- Department of Medicine III, University Hospital RWTH Aachen, 52074 Aachen, Germany;
| | - Simone Appinger
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Mika Rosin
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Shiva Boroojerdi
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Edgar Dahl
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany; (E.D.); (N.T.G.)
| | - Nadine Therese Gaisa
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany; (E.D.); (N.T.G.)
| | - Marcel den Dulk
- Department of Surgery, Maastricht University Medical Center (MUMC), 6229 HX Maastricht, The Netherlands; (M.d.D.); (M.C.)
| | - Mariëlle Coolsen
- Department of Surgery, Maastricht University Medical Center (MUMC), 6229 HX Maastricht, The Netherlands; (M.d.D.); (M.C.)
| | - Tom Florian Ulmer
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
| | - Ulf Peter Neumann
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
- Department of Surgery, Maastricht University Medical Center (MUMC), 6229 HX Maastricht, The Netherlands; (M.d.D.); (M.C.)
| | - Lara Rosaline Heij
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.B.); (X.T.); (Z.C.); (D.L.); (S.A.L.); (S.A.); (M.R.); (S.B.); (T.F.U.); (U.P.N.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6211 LK Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center (MUMC), 6229 HX Maastricht, The Netherlands; (M.d.D.); (M.C.)
- Correspondence:
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Sivakumar S, Kamalakannan M, B A, Kalpana A, Prakash J, Vishnu Pradeep K. Prevalence of sacroiliac joint dysfunction in college students. Biomedicine (Taipei) 2021. [DOI: 10.51248/.v41i2.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Sacroiliac (SI) joint is considered as one of the pain generators in students. Sacroiliac joint dysfunction is one of the common sources of low back pain, and many times the SI joint dysfunction mis-lead as the lumbar problem. Students who sit for longer duration cause stress in the sacroiliac joint. So, this study intended to investigate the prevalence and the contributing risk factors amongst students’ population with work-related musculoskeletal problems and also to identify the percentage of SI joint involvement in them.Materials and Methods: The study was conducted with 590 students from a private paramedical college, involving full time college students, with age group of 17-27 years, no recent falls or those not on current medications related to any musculoskeletal problems, and students without any congenital problems. Evaluation was done using Nordic musculoskeletal questionnaire along with a self-developed demographic questionnaire. The involved students were assessed using questionnaire and sacroiliac joint tests to identify the SI Joint dysfunction. Provocation tests included i) Sacroiliac joint distraction test, ii) SI Compression test iii) Thigh thrust test iv) Faber’s test and v) Gaenslen’s Test. Inference considered was presence of pain in more than 3 test indicates Sacroiliac joint involvement. On completion of assessment, a thank you card was given to all the volunteer students participated in the study. The collected data was filled and analyzed.Results: The study results showed that students with lower back pain also had complaints of neck pain. It was also noted that about 30% of the individuals were positive to the sacroiliac joint tests, among them 93 participants complained of low back pain.Conclusion: This study concluded that 61% of individuals were suffering with musculoskeletal disorders in the selected population. Around 30% of the low back pain participants complained of sacroiliac joint dysfunctions.
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Santhosh Kumar S, Sivakumar S, Abdul Majeed S, Vimal S, Taju G, Sahul Hameed AS. In vitro propagation of infectious myonecrosis virus in C6/36 mosquito cell line. J Fish Dis 2021; 44:987-992. [PMID: 33631045 DOI: 10.1111/jfd.13359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
Infectious myonecrosis (IMN) is an important shrimp viral disease caused by infectious myonecrosis virus (IMNV). Based on previous reports, an attempt was made to propagate IMNV in apparently healthy C6/36 subclone of Aedes albopictus cell line. The confirmatory assays such as RT-PCR, real-time PCR and bioassay revealed that C6/36 cells were found to be susceptible to IMNV and these cells could be used easily for isolation and propagation of IMNV. The results of real-time PCR assay showed that a lower CT value of 22.25 in IMNV-infected cells was obtained on 10 day post-infection (d p.i.), whereas the higher CT value of 35.21 was obtained in IMNV-infected cells on 2 d p.i. There is no significant difference between CT values of IMNV production in vitro using C6/36 cell line and in vivo using shrimp. The IMNV propagated in C6/36 cells is capable of infecting shrimp and caused 100% mortality in shrimp. Clinical signs observed in shrimp injected with IMNV propagated in C6/36 cell line were found to be similar to naturally infected shrimp.
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Affiliation(s)
- S Santhosh Kumar
- Aquatic Animal Health Laboratory, C. Abdul Hakeem College, Ranipet, India
| | - S Sivakumar
- Aquatic Animal Health Laboratory, C. Abdul Hakeem College, Ranipet, India
| | - S Abdul Majeed
- Aquatic Animal Health Laboratory, C. Abdul Hakeem College, Ranipet, India
| | - S Vimal
- Aquatic Animal Health Laboratory, C. Abdul Hakeem College, Ranipet, India
| | - G Taju
- Aquatic Animal Health Laboratory, C. Abdul Hakeem College, Ranipet, India
| | - A S Sahul Hameed
- Aquatic Animal Health Laboratory, C. Abdul Hakeem College, Ranipet, India
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Kaur M, Chawla R, Sivakumar S. Descriptive sensory profiling of thandai using principal component analysis. IJDS 2021. [DOI: 10.33785/ijds.2021.v74i02.002] [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: 11/23/2022]
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Bednarsch J, Kather J, Tan X, Sivakumar S, Cacchi C, Wiltberger G, Czigany Z, Ulmer F, Neumann UP, Heij LR. Nerve Fibers in the Tumor Microenvironment as a Novel Biomarker for Oncological Outcome in Patients Undergoing Surgery for Perihilar Cholangiocarcinoma. Liver Cancer 2021; 10:260-274. [PMID: 34239812 PMCID: PMC8237795 DOI: 10.1159/000515303] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/12/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Perihilar cholangiocarcinoma (pCCA) is a biliary tract cancer with a dismal prognosis, with surgery being the only chance of cure. A characteristic aggressive biological feature of pCCA is perineural growth which is defined by the invasion of cancer cells to nerves and nerve fibers. Recently, nerve fiber density (NFD) was linked to oncological outcomes in various malignancies; however, its prognostic role in pCCA remains to be elucidated. MATERIALS AND METHODS Data of 101 pCCA patients who underwent curative-intent surgery between 2010 and 2019 were included in this study. Extensive group comparisons between patients with high and low NFD were carried out, and the association of cancer-specific survival (CSS) and recurrence-free survival with NFD and other clinicopathological characteristics was assessed using univariate and multivariable cox regression models. RESULTS Patients with high NFD showed a median CSS of 90 months (95% CI: 48-132, 3-year CSS = 77%, 5-year CSS = 72%) compared to 33 months (95% CI: 19-47, 3-year CSS = 46%, 5-year CSS = 32%) in patients with low NFD (p = 0.006 log rank). Further, N1 category (HR = 2.84, p = 0.001) and high NFD (HR = 0.41, p = 0.024) were identified as independent predictors of CSS in multivariable analysis. Patients with high NFD and negative lymph nodes showed a median CSS of 90 months (3-year CSS = 88%, 5-year CSS = 80%), while patients with either positive lymph nodes or low NFD displayed a median CSS of 51 months (3-year CSS = 59%, 5-year CSS = 45%) and patients with both positive lymph nodes and low NFD a median CSS of 24 months (3-year CSS = 26%, 5-year CSS = 16%, p = 0.001 log rank). CONCLUSION NFD has been identified as an important novel prognostic biomarker in pCCA patients. NFD alone and in combination with nodal status in particular allows to stratify pCCA patients based on their risk for inferior oncological outcomes after curative-intent surgery.
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Affiliation(s)
- Jan Bednarsch
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany
| | - Jakob Kather
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Xiuxiang Tan
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany,Department of Surgery, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford, United Kingdom,Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Claudio Cacchi
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Georg Wiltberger
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany
| | - Zoltan Czigany
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany
| | - Florian Ulmer
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany
| | - Ulf Peter Neumann
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany,Department of Surgery, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Lara Rosaline Heij
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands,Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany,*Lara Rosaline Heij,
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Grell P, Lin CC, Milella M, Chee CE, Sivakumar S, Peltola KJ, Bostel G, Jankovic D, Altzerinakou MA, Fabre C, Santoro A. Phase II study of the anti-TGF-β monoclonal antibody (mAb) NIS793 with and without the PD-1 inhibitor spartalizumab in combination with nab-paclitaxel/gemcitabine (NG) versus NG alone in patients (pts) with first-line metastatic pancreatic ductal adenocarcinoma (mPDAC). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps4173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS4173 Background: Overall survival remains low for pts with mPDAC despite approved therapies, highlighting the need for further innovative treatment options. Intra-tumoral fibrosis that characterizes PDAC has been associated with a state of immune exclusion and may constitute a mechanical obstacle to the penetration of chemotherapy into the tumor as well as contribute to the lack of efficacy of immunotherapy. TGF-β plays a key role in regulating the tumor microenvironment and emerging evidence points to TGF-β as a pivotal activator of cancer-associated fibroblasts, leading to the development of fibrotic networks. Preclinical data in murine models have shown that TGF-β blockade augmented the benefit of both NG and anti-PD-1 therapy, leading to tumor regression. These data provide the rationale for combining TGF-β-targeting agents with immunotherapy and chemotherapy. NIS793 is a human IgG2 mAb that binds to TGF-β. This study investigates NIS793 with and without spartalizumab combined with NG in treatment naïve mPDAC. Methods: This is a phase II open-label, randomized, multicenter study (NCT04390763) beginning with a safety run-in period followed by randomization. Eligible pts are adults with previously untreated mPDAC and an ECOG performance status ≤1. Pts are excluded if they have a tumor histology other than adenocarcinoma or microsatellite instability-high tumor. The safety run-in data will be analyzed after ≥6 pts have received NIS793 (intravenously [IV] 2100 mg Q2W) + spartalizumab (IV 400 mg Q4W) + nab-paclitaxel (IV 125 mg/m2 on Days 1, 8 and 15) + gemcitabine (IV 1000 mg/m2 on Days 1, 8 and 15) for 1 cycle (28 days) to assess the safety and tolerability of the combination and confirm the dose for the randomized part. Pts will be randomized 1:1:1 to NIS793 + spartalizumab + NG (n=50) or NIS793 + NG (n=50) or NG (n=50). Treatment will continue until unacceptable toxicity, disease progression, discontinuation by investigator’s or pt’s choice, or withdrawal of consent. The primary objective is to evaluate the progression-free survival of NIS793 + NG ± spartalizumab versus NG alone. Secondary objectives include safety and tolerability, antitumor activity, overall survival, change in CD8 and PD-L1 status, and characterization of immunogenicity and pharmacokinetics. Efficacy will be assessed locally per RECIST v1.1 and iRECIST at screening, every 8 weeks for 1 year and then every 12 weeks until disease progression. Blood and tumor samples will be taken at baseline and during study treatment for pharmacokinetic, immunogenicity and biomarker assessments. This study is ongoing and will enroll pts from 30 sites across 15 countries. The first pt was treated on October 22, 2020. Clinical trial information: NCT04390763.
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Affiliation(s)
- Peter Grell
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Chia-Chi Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Michele Milella
- Section of Oncology, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Cheng Ean Chee
- National University Cancer Institute, Singapore, Singapore
| | | | | | | | | | | | - Claire Fabre
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Armando Santoro
- Humanitas Clinical and Research Center–IRCCS, Rozzano, Milan and Humanitas University, Department of Biomedical Sciences, Pieve Emanuele Hospital, Milan, Italy
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Sivakumar S, Abu-Shah E, Ahern DJ, Arbe-Barnes EH, Jainarayanan AK, Mangal N, Reddy S, Rendek A, Easton A, Kurz E, Silva M, Soonawalla Z, Heij LR, Bashford-Rogers R, Middleton MR, Dustin ML. Activated Regulatory T-Cells, Dysfunctional and Senescent T-Cells Hinder the Immunity in Pancreatic Cancer. Cancers (Basel) 2021; 13:1776. [PMID: 33917832 PMCID: PMC8068251 DOI: 10.3390/cancers13081776] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/20/2021] [Accepted: 03/29/2021] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cancer has one of the worst prognoses of any human malignancy and leukocyte infiltration is a major prognostic marker of the disease. As current immunotherapies confer negligible survival benefits, there is a need to better characterise leukocytes in pancreatic cancer to identify better therapeutic strategies. In this study, we analysed 32 human pancreatic cancer patients from two independent cohorts. A multi-parameter mass-cytometry analysis was performed on 32,000 T-cells from eight patients. Single-cell RNA sequencing dataset analysis was performed on a cohort of 24 patients. Multiplex immunohistochemistry imaging and spatial analysis were performed to map immune infiltration into the tumour microenvironment. Regulatory T-cell populations demonstrated highly immunosuppressive states with high TIGIT, ICOS and CD39 expression. CD8+ T-cells were found to be either in senescence or an exhausted state. The exhausted CD8 T-cells had low PD-1 expression but high TIGIT and CD39 expression. These findings were corroborated in an independent pancreatic cancer single-cell RNA dataset. These data suggest that T-cells are major players in the suppressive microenvironment of pancreatic cancer. Our work identifies multiple novel therapeutic targets that should form the basis for rational design of a new generation of clinical trials in pancreatic ductal adenocarcinoma.
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Affiliation(s)
- Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (S.S.); (A.E.); (M.R.M.)
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK; (D.J.A.); (A.K.J.); (E.K.)
- Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Enas Abu-Shah
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK; (D.J.A.); (A.K.J.); (E.K.)
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - David J. Ahern
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK; (D.J.A.); (A.K.J.); (E.K.)
| | | | - Ashwin K. Jainarayanan
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK; (D.J.A.); (A.K.J.); (E.K.)
- Interdisciplinary Bioscience Doctoral Training Program and Exeter College, University of Oxford, Oxford OX3 7DQ, UK
| | - Nagina Mangal
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK;
| | - Srikanth Reddy
- Department of Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; (S.R.); (M.S.); (Z.S.)
| | - Aniko Rendek
- Department of Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK;
| | - Alistair Easton
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (S.S.); (A.E.); (M.R.M.)
| | - Elke Kurz
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK; (D.J.A.); (A.K.J.); (E.K.)
| | - Michael Silva
- Department of Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; (S.R.); (M.S.); (Z.S.)
| | - Zahir Soonawalla
- Department of Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; (S.R.); (M.S.); (Z.S.)
| | - Lara R. Heij
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany;
- Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | | | - Mark R. Middleton
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (S.S.); (A.E.); (M.R.M.)
- Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Michael L. Dustin
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK; (D.J.A.); (A.K.J.); (E.K.)
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Rajni Swamy V, Krishnakumar R, Srinivasan N, Sivakumar S, Kumar RR. Coordinated compliance of chloro-methyl and bromo-methyl exchange rule in two dihydrofuran carbonitrile derivatives. J Mol Struct 2021. [DOI: 10.1016/j.molstruc.2020.129741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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49
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Tan X, Sivakumar S, Bednarsch J, Wiltberger G, Kather JN, Niehues J, de Vos-Geelen J, Valkenburg-van Iersel L, Kintsler S, Roeth A, Hao G, Lang S, Coolsen ME, den Dulk M, Aberle MR, Koolen J, Gaisa NT, Olde Damink SWM, Neumann UP, Heij LR. Nerve fibers in the tumor microenvironment in neurotropic cancer-pancreatic cancer and cholangiocarcinoma. Oncogene 2021; 40:899-908. [PMID: 33288884 PMCID: PMC7862068 DOI: 10.1038/s41388-020-01578-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/06/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) and cholangiocarcinoma (CCA) are both deadly cancers and they share many biological features besides their close anatomical location. One of the main histological features is neurotropism, which results in frequent perineural invasion. The underlying mechanism of cancer cells favoring growth by and through the nerve fibers is not fully understood. In this review, we provide knowledge of these cancers with frequent perineural invasion. We discuss nerve fiber crosstalk with the main different components of the tumor microenvironment (TME), the immune cells, and the fibroblasts. Also, we discuss the crosstalk between the nerve fibers and the cancer. We highlight the shared signaling pathways of the mechanisms behind perineural invasion in PDAC and CCA. Hereby we have focussed on signaling neurotransmitters and neuropeptides which may be a target for future therapies. Furthermore, we have summarized retrospective results of the previous literature about nerve fibers in PDAC and CCA patients. We provide our point of view in the potential for nerve fibers to be used as powerful biomarker for prognosis, as a tool to stratify patients for therapy or as a target in a (combination) therapy. Taking the presence of nerves into account can potentially change the field of personalized care in these neurotropic cancers.
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Affiliation(s)
- Xiuxiang Tan
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford, UK
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Jan Bednarsch
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Georg Wiltberger
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | | | - Jan Niehues
- Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Judith de Vos-Geelen
- Division of Medical Oncology, Department of Internal Medicine, GROW School for Oncology and Development Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Liselot Valkenburg-van Iersel
- Division of Medical Oncology, Department of Internal Medicine, GROW School for Oncology and Development Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Svetlana Kintsler
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Anjali Roeth
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Guangshan Hao
- Translational Neurosurgery and Neurobiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Sven Lang
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Mariëlle E Coolsen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marcel den Dulk
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Merel R Aberle
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Jarne Koolen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Nadine T Gaisa
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Steven W M Olde Damink
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Ulf P Neumann
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Lara R Heij
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, Aachen, Germany.
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.
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50
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Heij LR, Tan X, Kather JN, Niehues JM, Sivakumar S, Heussen N, van der Kroft G, Damink SWMO, Lang S, Aberle MR, Luedde T, Gaisa NT, Bednarsch J, Liu DHW, Cleutjens JPM, Modest DP, Neumann UP, Wiltberger GJ. Nerve Fibers in the Tumor Microenvironment Are Co-Localized with Lymphoid Aggregates in Pancreatic Cancer. J Clin Med 2021; 10:jcm10030490. [PMID: 33573277 PMCID: PMC7866811 DOI: 10.3390/jcm10030490] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 01/03/2023] Open
Abstract
B cells and tertiary lymphoid structures (TLS) are reported to be important in survival in cancer. Pancreatic Cancer (PDAC) is one of the most lethal cancer types, and currently, it is the seventh leading cause of cancer-related death worldwide. A better understanding of tumor biology is pivotal to improve clinical outcome. The desmoplastic stroma is a complex system in which crosstalk takes place between cancer-associated fibroblasts, immune cells and cancer cells. Indirect and direct cellular interactions within the tumor microenvironment (TME) drive key processes such as tumor progression, metastasis formation and treatment resistance. In order to understand the aggressiveness of PDAC and its resistance to therapeutics, the TME needs to be further unraveled. There are some limited data about the influence of nerve fibers on cancer progression. Here we show that small nerve fibers are located at lymphoid aggregates in PDAC. This unravels future pathways and has potential to improve clinical outcome by a rational development of new therapeutic strategies.
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Affiliation(s)
- Lara R. Heij
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany;
- Correspondence:
| | - Xiuxiang Tan
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Jakob N. Kather
- Department of Medicine III, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.N.K.); (J.M.N.); (T.L.)
| | - Jan M. Niehues
- Department of Medicine III, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.N.K.); (J.M.N.); (T.L.)
| | - Shivan Sivakumar
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK;
- Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK
| | - Nicole Heussen
- Department of Medical Statistics, RWTH Aachen University, 52074 Aachen, Germany;
- Center of Biostatistics and Epidemiology, Medical School, Sigmund Freud University, 1020 Vienna, Austria
| | - Gregory van der Kroft
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
| | - Steven W. M. Olde Damink
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Sven Lang
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
| | - Merel R. Aberle
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Tom Luedde
- Department of Medicine III, University Hospital RWTH Aachen, 52074 Aachen, Germany; (J.N.K.); (J.M.N.); (T.L.)
| | - Nadine T. Gaisa
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany;
| | - Jan Bednarsch
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
| | - Drolaiz H. W. Liu
- Department of Pathology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (D.H.W.L.); (J.P.M.C.)
| | - Jack P. M. Cleutjens
- Department of Pathology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (D.H.W.L.); (J.P.M.C.)
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Dominik P. Modest
- Department of Hematology, Oncology and Tumor Immunology, CVK, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany;
| | - Ulf P. Neumann
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
- Department of Surgery, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Georg J. Wiltberger
- Department of General, Gastrointestinal, Hepatobiliary and Transplant Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (X.T.); (G.v.d.K.); (S.W.M.O.D.); (S.L.); (M.R.A.); (J.B.); (U.P.N.); (G.J.W.)
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