1
|
Thomson CG, Aicher TD, Cheng W, Du H, Dudgeon C, Li AH, Li B, Lightcap E, Luo D, Mulvihill M, Pan P, Rahemtulla BF, Rigby AC, Sherborne B, Sood S, Surguladze D, Talbot EPA, Tameire F, Taylor S, Wang Y, Wojnarowicz P, Xiao F, Ramurthy S. Discovery of HC-7366: An Orally Bioavailable and Efficacious GCN2 Kinase Activator. J Med Chem 2024; 67:5259-5271. [PMID: 38530741 DOI: 10.1021/acs.jmedchem.3c02384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
A series of activators of GCN2 (general control nonderepressible 2) kinase have been developed, leading to HC-7366, which has entered the clinic as an antitumor therapy. Optimization resulted in improved permeability compared to that of the original indazole hinge binding scaffold, while maintaining potency at GCN2 and selectivity over PERK (protein kinase RNA-like endoplasmic reticulum kinase). The improved ADME properties of this series led to robust in vivo compound exposure in both rats and mice, allowing HC-7366 to be dosed in xenograft models, demonstrating that activation of the GCN2 pathway by this compound leads to tumor growth inhibition.
Collapse
Affiliation(s)
- Christopher G Thomson
- Integrated Drug Discovery Services, Pharmaron UK Ltd., West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, U.K
| | - Thomas D Aicher
- Department of Chemistry, Lycera Corporation, Ann Arbor, Michigan 48103, United States
| | - Weiwei Cheng
- Pharmaron Beijing, Company Ltd., No. 6, TaiHe Road, BDA, Beijing 100176, China
| | - Hongwen Du
- Pharmaron Beijing, Company Ltd., No. 6, TaiHe Road, BDA, Beijing 100176, China
| | - Crissy Dudgeon
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - An-Hu Li
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - Baozhong Li
- Pharmaron Beijing, Company Ltd., No. 6, TaiHe Road, BDA, Beijing 100176, China
| | - Eric Lightcap
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - Diheng Luo
- Pharmaron Xi'an, Company Ltd., No. 1, 12th Fengcheng Road, Xi'an 710018, China
| | - Mark Mulvihill
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - Pengwei Pan
- Pharmaron Beijing, Company Ltd., No. 6, TaiHe Road, BDA, Beijing 100176, China
| | - Benjamin F Rahemtulla
- Integrated Drug Discovery Services, Pharmaron UK Ltd., West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, U.K
| | - Alan C Rigby
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - Bradley Sherborne
- Integrated Drug Discovery Services, Pharmaron UK Ltd., West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, U.K
| | - Sanjeev Sood
- Preformulation and Preclinical Services, Pharmaron UK Ltd., West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, U.K
| | - David Surguladze
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - Eric P A Talbot
- Integrated Drug Discovery Services, Pharmaron UK Ltd., West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, U.K
| | - Feven Tameire
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - Simon Taylor
- Integrated Drug Discovery Services, Pharmaron UK Ltd., West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, U.K
| | - Yi Wang
- Pharmaron Beijing, Company Ltd., No. 6, TaiHe Road, BDA, Beijing 100176, China
| | - Paulina Wojnarowicz
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| | - Fenfen Xiao
- Pharmaron Xi'an, Company Ltd., No. 1, 12th Fengcheng Road, Xi'an 710018, China
| | - Savithri Ramurthy
- HiberCell Inc., 619 West 54th Street, New York, New York 10019, United States
| |
Collapse
|
2
|
Yung AE, Luong J, Crouch G, Hong AM, Ananda A, Taylor S, Kotronakis I, Low TH(H, Elliott MS, McBride K, Rutherford C, Clark JR, Ch’ng S. First Phase Development of a Patient-reported Outcome Measure for Midface Oncology. Plast Reconstr Surg Glob Open 2024; 12:e5689. [PMID: 38525491 PMCID: PMC10959565 DOI: 10.1097/gox.0000000000005689] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/06/2024] [Indexed: 03/26/2024]
Abstract
Background Facial cancer surgery involving the midface (comprising the lower eyelids, nose, cheeks, and upper lip) can have debilitating life-changing functional, social, and psychological impacts on the patient. Midface symptoms are inadequately captured by existing patient-reported outcome measures (PROMs). PROMs are increasingly used for individual patient care, quality improvement, and standardized reporting of treatment outcomes. This study aimed to present our findings from the first phase of the development of a midface, specifically periocular and nasal, PROM. Methods After international guidance for PROM development, the first phase comprised identification of salient issues and item generation. Fifteen patients who had midface surgery and 10 clinicians from various specialties with more than 5 years' experience treating these patients were recruited. Semi-structured interviews explored aesthetic, functional, social, and psychological outcomes, with specific attention to deficiencies in current PROMs. Thematic analysis was used to develop an item pool, and group interviews with clinicians were carried out to create and refine PROM scales. Results Qualitative data from patient interviews were grouped into aesthetic, functional, and psychosocial domains for the eyelids and nose. Ninety-nine draft items were generated across these domains. Following focus group discussions, the final version of the midface-specific PROM contained 31 items (13 eye-specific, 10-nose-specific, eight general midface items). Conclusions This midface-specific PROM is valuable in assessing and comparing patient-reported outcomes in those who have undergone complex resection and reconstruction of the midface. This PROM is currently undergoing field testing.
Collapse
Affiliation(s)
- Amanda E. Yung
- From the Sydney Medical School, University of Sydney, NSW, Australia
- Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Jason Luong
- From the Sydney Medical School, University of Sydney, NSW, Australia
- Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Gareth Crouch
- From the Sydney Medical School, University of Sydney, NSW, Australia
- Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Angela M. Hong
- From the Sydney Medical School, University of Sydney, NSW, Australia
- Department of Radiation Oncology, Chris O’Brien Lifehouse Cancer Centre, Sydney, NSW, Australia
- Melanoma Institute Australia, University of Sydney, NSW, Australia
| | - Arjuna Ananda
- Department of Ear, Nose and Throat Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Simon Taylor
- Department of Oculoplastic Surgery, Sydney Adventist Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ilias Kotronakis
- Department of Plastic and Reconstructive Surgery, Royal Prince Alfred Hospital, Sydney, NSW Australia
| | - Tsu-Hui (Hubert) Low
- From the Sydney Medical School, University of Sydney, NSW, Australia
- Department of Ear, Nose and Throat Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Sydney Head & Neck Cancer Institute, Chris O’Brien Lifehouse Cancer Centre, Sydney, NSW, Australia
| | - Michael S. Elliott
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Plastic and Reconstructive Surgery, Royal Prince Alfred Hospital, Sydney, NSW Australia
| | - Kate McBride
- Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Claudia Rutherford
- Faculty of Medicine and Health, Sydney Nursing School, Cancer Care Research Unit (CNRU), Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Jonathan R. Clark
- Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Head & Neck Cancer Institute, Chris O’Brien Lifehouse Cancer Centre, Sydney, NSW, Australia
| | - Sydney Ch’ng
- Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Melanoma Institute Australia, University of Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Head & Neck Cancer Institute, Chris O’Brien Lifehouse Cancer Centre, Sydney, NSW, Australia
| |
Collapse
|
3
|
Crosignani S, Campos S, Bouix-Peter C, Harris C, Talbot E, Hu H, Wang S, Maclean J, Zanelli U, Taylor S, Foote K, Hacini-Rachinel F, Nicodeme E, Julia V. Discovery of a novel series of selective macrocyclic PKCTheta inhibitors. Bioorg Med Chem Lett 2024; 100:129630. [PMID: 38307441 DOI: 10.1016/j.bmcl.2024.129630] [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] [Received: 10/18/2023] [Revised: 01/20/2024] [Accepted: 01/27/2024] [Indexed: 02/04/2024]
Abstract
A series of macrocyclic PKCθ inhibitors based on a 1,3-dihydro-2H-imidazo[4,5-b]pyridin-2-one hinge binder has been studied. Different aromatic and heteroaromatic substituents have been explored in order to optimize potency, isoform selectivity as well as DMPK properties. The importance of the length of the macrocyclic linker has also been analyzed. In particular, it has been found that methyl substitutions on the linker can have a profound influence on both potency and metabolic stability. Several compounds showing very good profiles, suitable for in vivo testing, are disclosed.
Collapse
Affiliation(s)
| | - Sebastien Campos
- Pharmaron Discovery & Early Development, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, UK
| | | | - Craig Harris
- Galderma SA, Av. d'Ouchy 4, 1006 Lausanne, Switzerland
| | - Eric Talbot
- Pharmaron Discovery & Early Development, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, UK
| | - Haiyang Hu
- Pharmaron Discovery & Early Development, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, UK
| | - Shun Wang
- Pharmaron Discovery & Early Development, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, UK
| | - John Maclean
- Pharmaron Discovery & Early Development, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, UK
| | - Ugo Zanelli
- Galderma SA, Av. d'Ouchy 4, 1006 Lausanne, Switzerland
| | - Simon Taylor
- Pharmaron Discovery & Early Development, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, UK
| | - Kevin Foote
- Pharmaron Discovery & Early Development, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire EN11 9FH, UK
| | | | | | - Valerie Julia
- Galderma SA, Av. d'Ouchy 4, 1006 Lausanne, Switzerland
| |
Collapse
|
4
|
Davis SR, Taylor S, Hemachandra C, Magraith K, Ebeling PR, Jane F, Islam RM. The 2023 Practitioner's Toolkit for Managing Menopause. Climacteric 2023; 26:517-536. [PMID: 37902335 DOI: 10.1080/13697137.2023.2258783] [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: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE The Practitioner's Toolkit for Managing the Menopause, developed in 2014, provided an accessible desk-top tool for health-care practitioners caring for women at midlife. To ensure the Toolkit algorithms and supporting information reflect current best practice, the Toolkit has been revised in accordance with the published literature. METHODS A systematic search for guidelines, position and consensus statements pertaining to the menopause and published after 2014 was undertaken, and key recommendations extracted from the Clinical Practice Guidelines determined to be the most robust by formal evaluation. The peer-reviewed literature was further searched for identified information gaps. RESULTS The revised Toolkit provides algorithms that guide the clinical assessment and care of women relevant to menopause. Included are the reasons why women present, information that should be ascertained, issues that may influence shared decision-making and algorithms that assist with determination of menopausal status, menopause hormone therapy (MHT) and non-hormonal treatment options for symptom relief. As clear guidelines regarding when MHT might be indicated to prevent bone loss and subsequent osteoporosis in asymptomatic women were found to be lacking, the Toolkit has been expanded to support shared decision-making regarding bone health. CONCLUSIONS The 2023 Toolkit and supporting document provide accessible desk-top information to support health-care providers caring for women at midlife.The Toolkit has been endorsed by the International Menopause Society, Australasian Menopause Society, British Menopause Society, Endocrine Society of Australia and Jean hailes for Women's Health.
Collapse
Affiliation(s)
- S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
| | - S Taylor
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - C Hemachandra
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Ministry of Health, Colombo, Sri Lanka
| | - K Magraith
- Cascade Road General Practice, TAS, Australia
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - F Jane
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R M Islam
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
5
|
Taylor S, D'Souza D, Moinuddin S, Gains J, Gaze MN, Gaunt T, Veiga C, Lim P. Pancreas: An Organ-at-Risk to Consider in Future Pediatric Abdominal Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:S135. [PMID: 37784347 DOI: 10.1016/j.ijrobp.2023.06.538] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Irradiation to the pancreas during pediatric radiotherapy is associated with secondary late effects, yet the pancreas is not typically considered an organ-at-risk (OAR) during radiotherapy planning. This audit investigated incidental pancreatic doses to estimate the relative risk (RR) of developing diabetes in later life. MATERIALS/METHODS Incidental pancreas doses were audited from 92 patients aged 2 to 19 historically treated with photons for craniospinal irradiation (CSI, N = 73) and for abdominal neuroblastoma (N = 19). Prescription doses ranged 21-36 Gy and 21-39 Gy (with boost to spine up to 50 Gy) for neuroblastoma and CSI patients, respectively. The pancreas was segmented on all planning CT scans following RTOG guidelines. Furthermore, the pancreas was split into its sub-volumes (head, body and tail) for abdominal cases only, since these scans were acquired with contrast enhancement. The RR of developing subsequent diabetes was estimated as a function of dose (D): RR = 1+0.65 × D × exp(-0.3 × D). Dose to the pancreas tail was used for neuroblastoma cases, whereas dose to the whole pancreas was used for CSI patients given that the pancreas could not be split in non-contrast scans. RESULTS The mean dose delivered to the whole pancreas was 15.4±7.5 Gy for all patients, 12.7±4.7 Gy for CSI patients and 25.9±7.4 Gy for abdominal patients. Pancreas V10Gy was 61.2% for all patients, 51.5% for CSI, and 98.6% for abdominal patients; V30Gy = 0% in all cases. These doses represented an estimated diabetes RR of 7.3±1.5, 6.6±1.3, and 8.7±0.6, respectively; RR>5 in 88%, 85% and 100% of all patients, CSI and abdominal patients audited, respectively. CONCLUSION Current incidental doses were associated with a diabetes RR>5 in all patients treated for abdominal neuroblastoma and the majority who received CSI. These findings suggest the pancreas should be routinely delineated and considered as an OAR in radiotherapy planning. This may help to identify higher risk patients and inform late-effect monitoring during survivorship. Further work in underway to assess if proton therapy could reduce the RR of diabetes particularly in abdominal cases. Improved availability of high-quality imaging during radiotherapy planning, such as contrast administration or planning MRI, is becoming more necessary to accurately delineate subsegments of the pancreas for improved RR estimations.
Collapse
Affiliation(s)
- S Taylor
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - D D'Souza
- Radiotherapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - S Moinuddin
- Radiotherapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - J Gains
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - M N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - T Gaunt
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - C Veiga
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - P Lim
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
6
|
Elgohari B, Patwardhan PP, Abdelhakiem MK, Bhargava R, Sukumvanich P, Courtney-Brooks M, Boisen MM, Berger JL, Taylor S, Olawaiye A, Lesnock J, Edwards RP, Beriwal S, Soong TR, Vargo JAA. Is Programmed Death Ligand 1(PD-L1) Expression in Vulvar Cancer Prognostic for Locoregional Control? Int J Radiat Oncol Biol Phys 2023; 117:e511. [PMID: 37785600 DOI: 10.1016/j.ijrobp.2023.06.1768] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Vulvar cancer is a rare female genital neoplasm in which surgery and radiotherapy play an integral role in the treatment paradigm; however, locoregional recurrence remains the predominant pattern of failure. Little is known about the impact of PD-L1 status in vulvar cancer and its value for clinical outcomes and response prediction to immunotherapy. We sought to explore clinical outcomes of patients with positive PD-L1 expression in vulvar cancer. MATERIALS/METHODS Single-institution retrospective analysis of patients with surgically resectable invasive vulvar carcinoma from 2001-2021 was performed. Patients with locally advanced disease not amendable to upfront surgery or de novo metastatic disease were excluded. Immunohistochemical PD-L1 expression was assessed using the Combined Positive Score (CPS) with positive expression defined as ≥1, and Tumor Proportion Score (TPS) with positive expression defined as ≥1%. Survival and disease control outcomes were calculated using the Kaplan-Meier Method with log-rank t-test. Multivariable analysis was conducted using a parsimonious cox regression analysis using forward conditional selection. RESULTS A total of 85 patients were identified with a median age of 69 years old (IQR: 59-78), 54% (n = 46) FIGO stage I-II, 97% (n = 82) squamous cell carcinoma histology, 41% (n = 35) p16 positive status, 74% (n = 63) without a history of lichen sclerosis, 40% (n = 34) without co-existing vulvar intraepithelial neoplasm (VIN), and 49% (n = 42) treated with surgery alone. There were 72% (n = 61) with positive PD-L1 TPS (≥1%), and 81% (n = 69) with positive PD-L1 CPS (≥1) expression. The median follow up was 49 months (IQR: 21-75 months). The 5-year OS was 79% (95% CI, 70%-89%), DFS 55% (95% CI, 43%-67%), local control (LC) 59% (95% CI, 47%-72%), regional control (RC) 86% (95% CI, 78%-94%), and distant metastasis (DM) 96% (95% CI, 92%-100%). PD-L1 expression was associated with lower LC and DFS by TPS ≥1%. The 5-year LC of 82% (95% CI, 65%-98%) for PD-L1 negative versus 50% (95% CI, 34%-65%) positive disease (p = 0.03). The 5-year DFS was 77% (95% CI, 59%-95%) for PD-L1 negative versus 46% (95% CI, 31%-61%) positive disease (p = 0.03). No significant DFS or LC difference was noted by CPS levels ≥1. No significant difference was observed for RC, DM, or OS. On multivariable analysis, PD-L1 TPS remained a significant predictor for LC (HR = 3.01, 95% CI, 1.07-8.95, p = 0.04). No significant difference in DFS was observed for PD-L1 TPS on multivariable analysis. CONCLUSION PD-L1 expression is associated with higher rates of local recurrence and may represents a potentially important actionable target independent of p16 status to improve the predominant pattern of relapse in this uncommon malignancy.
Collapse
Affiliation(s)
- B Elgohari
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - P P Patwardhan
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M K Abdelhakiem
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - R Bhargava
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - P Sukumvanich
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M Courtney-Brooks
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M M Boisen
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J L Berger
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Taylor
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - A Olawaiye
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J Lesnock
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - R P Edwards
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Beriwal
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - T R Soong
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J A A Vargo
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| |
Collapse
|
7
|
Lisiecki J, Buta M, Taylor S, Tait M, Farina N, Levin J, Schulz J, Sangji N, Friedstat J, Hemmila M, Wang S, Levi B, Goverman J. Efficacy of Mepliex ® Ag Versus Xeroform ® As A Split-Thickness Skin Graft Donor Site Dressing: Bad Habits Die Hard. Ann Burns Fire Disasters 2023; 36:243-250. [PMID: 38680433 PMCID: PMC11041881] [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] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/01/2022] [Indexed: 05/01/2024]
Abstract
Autografting with split-thickness skin grafts (STSG) remains an essential procedure in burn and reconstructive surgery. The process of harvesting STSG, however, leaves behind a donor site, an exposed area of partial-thickness dermis left to heal by secondary intention. There has yet to be a consensus amongst surgeons regarding optimal management of the donor site. The ideal donor site dressing is one that allows for expeditious healing while minimizing pain and infection. Despite numerous studies demonstrating the superiority of moist wound healing, many surgeons continue to treat STSG donor sites dry, with petroleum-based gauze. In this study, two burn centers performed a retrospective review of burn patients whose STSG donor sites were treated with either Xeroform® or Mepilex® Ag dressings. Infections were documented and in a subgroup analysis of patients, postoperative pain scores were noted and total opiate usage during hospitalization was calculated. Analysis revealed an overall infection rate of 1.2% in the Mepilex® Ag group and 11.4% in the Xeroform® group (p<0.0001). Patients with Xeroform® donor site dressings had increased odds of donor site infection (OR=10.8, p=0.002). In subgroup analysis, there were no significant differences in maximum pain scores between Mepilex® Ag and Xeroform® groups, nor were there differences in opiate usage. STSG donor sites dressed with silver foam dressings have a lower rate of donor site infection relative to those dressed with petroleum-based gauze. Moist donor site dressings such as foam dressings (including Mepilex® Ag) should be the standard of care in STSG donor site wound care.
Collapse
Affiliation(s)
- J.L. Lisiecki
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - M.R. Buta
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - S. Taylor
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - M. Tait
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - N. Farina
- Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USA
| | - J. Levin
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - J. Schulz
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - N. Sangji
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - J. Friedstat
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - M.R. Hemmila
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - S. Wang
- Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - B. Levi
- Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - J. Goverman
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
8
|
Ambasta A, Omodon O, Herring A, Ferrie L, Pokharel S, Mehta A, Liu L, Hews-Girard J, Tam C, Taylor S, Lonergan K, Faris P, Duncan D, Woodhouse D. Repurposing the Ordering of Routine Laboratory Tests in Hospitalised Medical Patients (RePORT): results of a cluster randomised stepped-wedge quality improvement study. BMJ Qual Saf 2023; 32:517-525. [PMID: 37164639 DOI: 10.1136/bmjqs-2022-015611] [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: 10/05/2022] [Accepted: 04/19/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Low-value use of laboratory tests is a global challenge. Our objective was to evaluate an intervention bundle to reduce repetitive use of routine laboratory testing in hospitalised patients. METHODS We used a stepped-wedge design to implement an intervention bundle across eight medical units. Our intervention included educational tools and social comparison reports followed by peer-facilitated report discussion sessions. The study spanned October 2020-June 2021, divided into control, feasibility testing, intervention and a follow-up period. The primary outcomes were the number and costs of routine laboratory tests ordered per patient-day. We used generalised linear mixed models, and analyses were by intention to treat. RESULTS We included a total of 125 854 patient-days. Patient groups were similar in age, sex, Charlson Comorbidity Index and length of stay during the control, intervention and follow-up periods. From the control to the follow-up period, there was a 14% (incidence rate ratio (IRR)=0.86, 95% CI 0.79 to 0.92) overall reduction in ordering of routine tests with the intervention, along with a 14% (β coefficient=-0.14, 95% CI -0.07 to -0.21) reduction in costs of routine testing. This amounted to a total cost savings of $C1.15 per patient-day. There was also a 15% (IRR=0.85, 95% CI 0.79, 0.92) reduction in ordering of all common tests with the intervention and a 20% (IRR=1.20, 95% CI 1.10 to 1.30) increase in routine test-free patient-days. No worsening was noted in patient safety endpoints with the intervention. CONCLUSIONS A multifaceted intervention bundle using education and facilitated multilevel social comparison was associated with a safe and effective reduction in use of routine daily laboratory testing in hospitals. Further research is needed to understand how system-level interventions may increase this effect and which intervention elements are necessary to sustain results.
Collapse
Affiliation(s)
- Anshula Ambasta
- Medicine, University of Calgary Cumming School of Medicine, Calgary, Canada
| | - Onyebuchi Omodon
- Ward of the 21st Century, University of Calgary Cumming School of Medicine, Calgary, Canada
| | | | - Leah Ferrie
- Physician Learning Program, University of Calgary, Calgary, Canada
| | | | - Ashi Mehta
- Health Quality Council of Alberta, Calgary, Canada
| | | | | | - Cheuk Tam
- Medicine, University of Calgary Faculty of Medicine, Calgary, Canada
| | - Simon Taylor
- Medicine, University of Calgary, Calgary, Canada
| | | | - Peter Faris
- Measurement and Analysis; Research Excellence Support Team, Alberta Bone and Joint Health Institute; Alberta Health Services, Calgary, Canada
| | - Diane Duncan
- Physician Learning Program, University of Calgary, Calgary, Canada
| | | |
Collapse
|
9
|
Wheelwright S, Maunsell R, Taylor S, Drinkwater N, Erridge C, Foster C, Hardcastle M, Hogden A, Lawson I, Lisiecka D, Mcdermott C, Morrison KE, Muir C, Recio-Saucedo A, White S. Development of 'gastrostomy tube - is it for me?', a web-based patient decision aid for people living with motor neurone disease considering having a gastrostomy tube placed. Amyotroph Lateral Scler Frontotemporal Degener 2023; 24:1-9. [PMID: 37332172 DOI: 10.1080/21678421.2023.2220743] [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: 04/04/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023]
Abstract
Objective: To develop and pilot a web-based patient decision aid (PDA) to support people living with motor neurone disease (plwMND) considering having a gastrostomy tube placed. Methods: In Phase 1, content and design were informed by semi-structured interviews, literature reviews and a prioritization survey. In Phase 2, the prototype PDA was tested with users and developed iteratively with feedback from surveys and 'think-aloud' interviews. Phase 1 and 2 participants were plwMND, carers and healthcare professionals (HCPs). In Phase 3, the PDA was evaluated by plwMND using validated questionnaires and HCPs provided feedback in focus groups. Results: Sixteen plwMND, 16 carers and 25 HCPs took part in Phases 1 and 2. Interviews and the literature review informed a prioritization survey with 82 content items. Seventy-seven per cent (63/82) of the content of the PDA was retained. A prototype PDA, which conforms to international standards, was produced and improved during Phase 2. In Phase 3, 17 plwMND completed questionnaires after using the PDA. Most plwMND (94%) found the PDA completely acceptable and would recommend it to others in their position, 88% had no decisional conflict, 82% were well prepared and 100% were satisfied with their decision-making. Seventeen HCPs provided positive feedback and suggestions for use in clinical practice. Conclusion: Gastrostomy Tube: Is it for me? was co-produced with stakeholders and found to be acceptable, practical and useful. Freely available from the MND Association website, the PDA is a valuable tool to support the shared decision-making process for gastrostomy tube placement.
Collapse
Affiliation(s)
| | - R Maunsell
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - S Taylor
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - N Drinkwater
- Motor Neurone Disease Association, Northampton, UK
| | - C Erridge
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Foster
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | | | - A Hogden
- School of Population Health, University of New South Wales, Sydney, Australia
| | - I Lawson
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - D Lisiecka
- Munster Technological University - Kerry Campus, Republic of Ireland, Tralee, UK
| | | | - K E Morrison
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - C Muir
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - A Recio-Saucedo
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - S White
- University of Sheffield, Sheffield, UK, and
| |
Collapse
|
10
|
Salman D, Le Feuvre P, Hill O, Conway D, Taylor S, Turner S, Korgaonkar J, Hettiaratchy S, McGregor AH. Movement Foundations. The perceived impact of a digital rehabilitation tool for returning to fitness following a period of illness, including COVID-19 infection: a qualitative study. BMJ Open Sport Exerc Med 2023; 9:e001557. [PMID: 37063170 PMCID: PMC10083518 DOI: 10.1136/bmjsem-2023-001557] [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] [Accepted: 03/11/2023] [Indexed: 04/05/2023] Open
Abstract
Digital interventions can increase physical activity (PA) levels in adults. However, the COVID-19 pandemic highlighted the complexities faced when guiding people to start or return to PA following illness or inactivity. A digital tool, Movement Foundations, was developed to provide remote guidance on building strength and capacity across functional movement patterns, with graduated progression based on user responses and input. This qualitative study aimed to explore the perceived impacts of using the tool. Nine participants aged over 35 years from the healthcare and academic healthcare sectors were recruited to use it and were subsequently interviewed. Thematic analysis identified three themes falling under the overarching concept of ‘Capability, Opportunity and Motivation—Behaviour (COM-B) Plus’, encompassing: skills and capacity for movement; opportunities, motivations and barriers for movement; and a personalised, safe space in which to develop. Participants felt that the digital tool increased their capacity and confidence in movement and positively impacted their daily activities. External factors such as illness and stress clouded perceptions of the impacts of PA. Time, work pressures and needing equipment were still considered significant barriers to PA. Still, participants appreciated the flexibility and non-prescriptive nature of the tool and felt that it helped movement to become opportunistic and habitual. Increased capacity for PA and feeling the subsequent physical and mental effects positively influenced motivation. Structure and guidance, with graduated progress, were seen as protective. Guided self-reflection helped participants understand their capacity and limitations with regard to movement and promoted motivation. Although acquiring technical skills to guide movement may be important for those recovering from illness, participants found that a structure promoting individualised guidance, graduated progression and guided self-reflection were important motivational factors for continuing use. Digital interventions should consider these aspects when seeking to promote habitual PA.
Collapse
Affiliation(s)
- David Salman
- MSk Lab, Faculty of Medicine, Imperial College London, London, UK
- Emergency Medicine—Sport and Exercise Medicine, Imperial College Healthcare NHS Trust, London, UK
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Peter Le Feuvre
- MSk Lab, Faculty of Medicine, Imperial College London, London, UK
- Royal Centre for Defence Medicine (RCDM), John Radcliffe Hospital, Oxford, UK
| | - Oliver Hill
- MSk Lab, Faculty of Medicine, Imperial College London, London, UK
- Defence Medical Rehabilitation Centre (DMRC), Stanford Hall, Loughborough, UK
| | - Dean Conway
- MSk Lab, Faculty of Medicine, Imperial College London, London, UK
- Defence Medical Rehabilitation Centre (DMRC), Stanford Hall, Loughborough, UK
| | - Simon Taylor
- Suite 2C, Brosnan House, Rehab Guru, Potters Bar, UK
| | - Shruti Turner
- MSk Lab, Faculty of Medicine, Imperial College London, London, UK
| | - Jonathan Korgaonkar
- Emergency Medicine—Sport and Exercise Medicine, Imperial College Healthcare NHS Trust, London, UK
| | | | | |
Collapse
|
11
|
Silkens MEWM, Alexander K, Viney R, O'Keeffe C, Taylor S, Noble LM, Griffin A. A national qualitative investigation of the impact of service change on doctors' training during Covid-19. BMC Med Educ 2023; 23:174. [PMID: 36941665 PMCID: PMC10027255 DOI: 10.1186/s12909-023-04143-1] [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] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The Covid-19 crisis sparked service reconfigurations in healthcare systems worldwide. With postgraduate medical education sitting within these systems, service reconfigurations substantially impact trainees and their training environment. This study aims to provide an in-depth qualitative understanding of the impact of service reconfiguration on doctors' training during the pandemic, identifying opportunities for the future as well as factors that pose risks to education and training and how these might be mitigated. METHODS Qualitative parallel multi-centre case studies examined three Trusts/Health Boards in two countries in the United Kingdom. Data were collected from online focus groups and interviews with trainees and supervisors using semi-structured interview guides (September to December 2020). A socio-cultural model of workplace learning, the expansive-restrictive continuum, informed data gathering, analysis of focus groups and coding. RESULTS Sixty-six doctors participated, representing 25 specialties/subspecialties. Thirty-four participants were male, 26 were supervisors, 17 were specialty trainees and 23 were foundation doctors. Four themes described the impact of pandemic-related service reconfigurations on training: (1) Development of skills and job design, (2) Supervision and assessments, (3) Teamwork and communication, and (4) Workload and wellbeing. Service changes were found to both facilitate and hinder education and training, varying across sites, specialties, and trainees' grades. Trainees' jobs were redesigned extensively, and many trainees were redeployed to specialties requiring extra workforce during the pandemic. CONCLUSIONS The rapid and unplanned service reconfigurations during the pandemic caused unique challenges and opportunities to doctors' training. This impaired trainees' development in their specialty of interest, but also presented new opportunities such as cross-boundary working and networking.
Collapse
Affiliation(s)
- M E W M Silkens
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
- Centre for Healthcare Innovation Research, Department of Health Services Research and Management, City University of London, London, UK
| | - K Alexander
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
- School of Medicine, University of Dundee, Dundee, UK
| | - R Viney
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
| | - C O'Keeffe
- UCL Medical School, University College London, London, UK
| | - S Taylor
- Institute of Education, University College London, London, UK
| | - L M Noble
- UCL Medical School, University College London, London, UK
| | - A Griffin
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK.
| |
Collapse
|
12
|
Bryde DJ, Shahgholian A, Joby R, Taylor S, Singh R. Impact pathways: managing relational risk in project operations. IJOPM 2023. [DOI: 10.1108/ijopm-08-2022-0484] [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: 02/11/2023]
Abstract
PurposeThe purpose of this paper is to assess how we implement new ways of managing relational risk at the operational level of outsourced projects and to provide guidance to project management (PM) policy makers and practitioners seeking to ensure project operations consistently deliver project relational risk management (PRRM) strategies.Design/methodology/approachThrough exploratory study data were obtained from a panel of six experts in PM and from a pilot survey of PM practitioners. The data reveal future directions and vectors for scholarship and research activity in terms of the impact of PRMM-related mechanisms and deliverables on project success and the implementation process to enhance PRRM as a key PM capability.FindingsDeliverables for PRRM need to part of a multidimensional framework that includes mechanisms besides the contract. Such a framework enables the codification of PM knowledge so that PRRM contributes to project success. With knowledge codified, PRRM strategies can be consistently delivered at the operational level. The framework is novel in that it integrates hereto disparate elements that are encompassed under the broad umbrella of relational governance mechanisms.Practical implicationsPM policy makers and practitioners recognise the importance of effective relationships to deliver projects successfully, yet they lack practical solutions to address the negative effects of dysfunctional relationships. The authors provide a list of PM deliverables for effective PRRM, including deliverables besides those related to the contract, which can be used in practice to bring the gap between PRRM strategy development and implementation. This will enable client organisations that outsource their projects to an external contractor to enhance their PRRM capability and increase the likelihood of project success.Originality/valueThe authors provide insights into how PRRM is practised at the project operations’ level where PM is outsourced. These insights lead to three pathways of impactful Operations Management (OM)/PM scholarship and research, namely, the following: 1) How PM deliverables act as a key success factor for effective PRRM? 2) How the duality of roles carried out by PM actors influences PRMM practices? 3) How companies innovate to enhance their PRMM capability? These pathways will enable PM research and scholarship to address disconnects between PRMM strategy and operations and hence go beyond answering “what” PRMM is to encompass “how” it is implemented.
Collapse
|
13
|
Sultana F, Davis SR, Bell RJ, Taylor S, Islam RM. Association between testosterone and cognitive performance in postmenopausal women: a systematic review of observational studies. Climacteric 2023; 26:5-14. [PMID: 36366914 DOI: 10.1080/13697137.2022.2139600] [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] [Indexed: 11/13/2022]
Abstract
This review was conducted to explore the association between endogenous testosterone blood concentrations and cognitive performance among community dwelling postmenopausal women. We searched Ovid MEDLINE, EMBASE, PsycINFO and Web of Science databases for observational studies with at least 100 postmenopausal participants. The results were categorized by study design, reporting of total or free testosterone and risk of bias assessments, narratively. Ten of the 26 articles retrieved for full-text review met the inclusion criteria, six provided cross-sectional data, seven provided longitudinal data and one provided case-control data. Cognitive performance tests differed between studies. Eight studies measured testosterone by immunoassay, one by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and one did not specify their methodology. Eleven different cognitive domains were tested by 37 different instruments. Irrespective of the study design, the findings were inconsistent and inconclusive. Both positive and inverse associations were reported for each of global cognition and immediate and delayed verbal recall. The majority of studies reported no association between total or free testosterone and cognitive performance. Although this review did not demonstrate an association between testosterone and cognitive performance in postmenopausal women, the findings should be considered inconclusive due to the imprecision of testosterone measurement and the methodological heterogeneity of the included studies.
Collapse
Affiliation(s)
- F Sultana
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Environmental Interventions Unit, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
| | - R J Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - S Taylor
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R M Islam
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
14
|
Yau T, Rimmer SN, Taylor S. Can’t see, can’t climb a tree, can’t defecate pain free: reactive arthritis due to chlamydial proctitis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00326-9] [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: 01/28/2023]
|
15
|
Karimi A, Taylor M, Taylor S. Radiotherapy for nasopharyngeal carcinoma: Effect on the eye 10 years later: A case report. Oncol Lett 2022; 25:40. [PMID: 36589670 PMCID: PMC9773324 DOI: 10.3892/ol.2022.13626] [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: 08/12/2022] [Accepted: 10/18/2022] [Indexed: 12/13/2022] Open
Abstract
A patient who had previously received radiotherapy for a nasopharyngeal carcinoma was rightfully discharged from otorhinolaryngology and oncology once treatment was completed. After 10 years, the patient presented with visual loss in one eye and was found to have radiation retinopathy. This case highlights the importance of recognising the effects that radiation administered to structures near the eye can have on vision. The latency of this case demonstrates the need for routine eye tests in patients who have undergone radiotherapy near the orbit. Prompt recognition and referral to ophthalmologists is necessary for all suspected cases to best manage visual loss.
Collapse
Affiliation(s)
- Ayesha Karimi
- Department of Ophthalmology, Royal Surrey County Hospital, Guildford GU2 7XX, UK,Correspondence to: Miss Ayesha Karimi, Department of Ophthalmology, Royal Surrey County Hospital, Egerton Road, Guildford GU2 7XX, UK, E-mail:
| | - Michael Taylor
- Department of Ophthalmology, University Hospital of Leicester, Leicester LE1 5WW, UK
| | - Simon Taylor
- School of Biosciences and Medicine, University of Surrey, Guildford, Surrey GU2 7XH, UK
| |
Collapse
|
16
|
Liu Y, Li Q, Alikarami F, Barrett DR, Mahdavi L, Li H, Tang S, Khan TA, Michino M, Hill C, Song L, Yang L, Li Y, Pokharel SP, Stamford AW, Liverton N, Renzetti LM, Taylor S, Watt GF, Ladduwahetty T, Kargman S, Meinke PT, Foley MA, Shi J, Li H, Carroll M, Chen CW, Gardini A, Maillard I, Huggins DJ, Bernt KM, Wan L. Small-Molecule Inhibition of the Acyl-Lysine Reader ENL as a Strategy against Acute Myeloid Leukemia. Cancer Discov 2022; 12:2684-2709. [PMID: 36053276 PMCID: PMC9627135 DOI: 10.1158/2159-8290.cd-21-1307] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 10/07/2021] [Revised: 06/27/2022] [Accepted: 08/29/2022] [Indexed: 02/06/2023]
Abstract
The chromatin reader eleven-nineteen leukemia (ENL) has been identified as a critical dependency in acute myeloid leukemia (AML), but its therapeutic potential remains unclear. We describe a potent and orally bioavailable small-molecule inhibitor of ENL, TDI-11055, which displaces ENL from chromatin by blocking its YEATS domain interaction with acylated histones. Cell lines and primary patient samples carrying MLL rearrangements or NPM1 mutations are responsive to TDI-11055. A CRISPR-Cas9-mediated mutagenesis screen uncovers an ENL mutation that confers resistance to TDI-11055, validating the compound's on-target activity. TDI-11055 treatment rapidly decreases chromatin occupancy of ENL-associated complexes and impairs transcription elongation, leading to suppression of key oncogenic gene expression programs and induction of differentiation. In vivo treatment with TDI-11055 blocks disease progression in cell line- and patient-derived xenograft models of MLL-rearranged and NPM1-mutated AML. Our results establish ENL displacement from chromatin as a promising epigenetic therapy for molecularly defined AML subsets and support the clinical translation of this approach. SIGNIFICANCE AML is a poor-prognosis disease for which new therapeutic approaches are desperately needed. We developed an orally bioavailable inhibitor of ENL, demonstrated its potent efficacy in MLL-rearranged and NPM1-mutated AML, and determined its mechanisms of action. These biological and chemical insights will facilitate both basic research and clinical translation. This article is highlighted in the In This Issue feature, p. 2483.
Collapse
Affiliation(s)
- Yiman Liu
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Qinglan Li
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Fatemeh Alikarami
- Division of Pediatric Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Declan R. Barrett
- Division of Pediatric Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Leila Mahdavi
- Division of Pediatric Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Hangpeng Li
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of the School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sylvia Tang
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tanweer A. Khan
- Tri-Institutional Therapeutics Discovery Institute, New York, New York
| | - Mayako Michino
- Tri-Institutional Therapeutics Discovery Institute, New York, New York
| | - Connor Hill
- Wistar Institute, Gene Expression and Regulation Program, Philadelphia, Pennsylvania.,Cell and Molecular Biology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Pennsylvania
| | - Lele Song
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lu Yang
- Department of Systems Biology, Beckman Research Institute, City of Hope, Duarte, California
| | - Yuanyuan Li
- MOE Key Laboratory of Protein Sciences, Beijing Frontier Research Center for Biological Structure, School of Medicine, Tsinghua University, and Tsinghua-Peking Center for Life Sciences, Beijing, China
| | | | | | - Nigel Liverton
- Tri-Institutional Therapeutics Discovery Institute, New York, New York
| | | | - Simon Taylor
- Pharmaron Drug Discovery, Pharmaron UK, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire, United Kingdom
| | - Gillian F. Watt
- Pharmaron Drug Discovery, Pharmaron UK, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire, United Kingdom
| | - Tammy Ladduwahetty
- Pharmaron Drug Discovery, Pharmaron UK, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire, United Kingdom
| | - Stacia Kargman
- Tri-Institutional Therapeutics Discovery Institute, New York, New York.,Bridge Medicines, New York, New York
| | - Peter T. Meinke
- Tri-Institutional Therapeutics Discovery Institute, New York, New York.,Department of Pharmacology, Weill Cornell Medical College, New York, New York
| | - Michael A. Foley
- Tri-Institutional Therapeutics Discovery Institute, New York, New York
| | - Junwei Shi
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Epigenetics Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Haitao Li
- MOE Key Laboratory of Protein Sciences, Beijing Frontier Research Center for Biological Structure, School of Medicine, Tsinghua University, and Tsinghua-Peking Center for Life Sciences, Beijing, China
| | - Martin Carroll
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chun-Wei Chen
- Department of Systems Biology, Beckman Research Institute, City of Hope, Duarte, California
| | - Alessandro Gardini
- Wistar Institute, Gene Expression and Regulation Program, Philadelphia, Pennsylvania
| | - Ivan Maillard
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David J. Huggins
- Tri-Institutional Therapeutics Discovery Institute, New York, New York.,Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York
| | - Kathrin M. Bernt
- Division of Pediatric Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Corresponding Authors: Liling Wan, University of Pennsylvania, BRB II/III, RM751, 421 Curie Boulevard, Philadelphia, PA 19104. Phone: 215-898-3116; E-mail: ; and Kathrin M. Bernt, Children's Hospital of Philadelphia, Colket Translational Research Center, Room 3064, 3501 Civic Center Boulevard, Philadelphia, PA 19104. Phone: 215-370-3171; E-mail:
| | - Liling Wan
- Department of Cancer Biology, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Family Cancer Research Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Epigenetics Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Institute for Regenerative Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Corresponding Authors: Liling Wan, University of Pennsylvania, BRB II/III, RM751, 421 Curie Boulevard, Philadelphia, PA 19104. Phone: 215-898-3116; E-mail: ; and Kathrin M. Bernt, Children's Hospital of Philadelphia, Colket Translational Research Center, Room 3064, 3501 Civic Center Boulevard, Philadelphia, PA 19104. Phone: 215-370-3171; E-mail:
| |
Collapse
|
17
|
Elgohari B, Abdelhakiem M, Lesnock J, Sukumvanich P, Courtney-Brooks M, Boisen M, Berger J, Taylor S, Mahdi H, Olawaiye A, Edwards R, Beriwal S, Vargo J. Can Adjuvant Chemoradiotherapy Replace Inguinal Lymph Node Dissection after a Positive Sentinel Lymph Node Biopsy in Vulvar Cancer? Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
18
|
Tong JY, Smith M, Gout T, Tumuluri K, Taylor S. Orbital and Sinonasal Complications of Hydrogel Scleral Buckle: A Case Report. Ophthalmic Plast Reconstr Surg 2022; 38:e162-e165. [PMID: 35604377 DOI: 10.1097/iop.0000000000002216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The hydrogel scleral buckle is a hydrophilic implant that is characterized by progressive expansion and can present with secondary orbital changes. The authors present a unique case of hydrogel-induced erosion of the orbital roof into the frontal sinus, with formation of a sino-orbital communication that resulted in frontal sinusitis and adjacent cerebritis. The hydrogel material is radiologically characterized as a fluid-filled hypertense T2 mass with rim enhancement and peripheral calcification. Awareness of late orbital complications from the hydrogel material is important to distinguish this entity from other mimicking orbital pathologies.
Collapse
Affiliation(s)
- Jessica Y Tong
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia
- Department of Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Murray Smith
- Department of Otolaryngology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Taras Gout
- Department of Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Krishna Tumuluri
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia
- Department of Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Simon Taylor
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia
- Department of Ophthalmology, Sydney Eye Hospital, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia
| |
Collapse
|
19
|
Taylor S, Henshall J, Beaumont K, Hood S, Jones B, Wilson I, Smith D. The 50 th Anniversary of the DMDG. Xenobiotica 2022; 52:767-769. [PMID: 36214565 DOI: 10.1080/00498254.2022.2134835] [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: 10/17/2022]
Affiliation(s)
- Simon Taylor
- Pharmaron UK, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire, EN11 9FH. United Kingdom
| | - Jamie Henshall
- Development Science, UCB Biopharma SRL, 216 Bath Rd, Slough, Berkshire SL1 3WE, UK
| | - Kevin Beaumont
- Early Oncology DMPK, Astrazeneca, Hodgkin Building, Chesterford Research Park, Little Chesterford, CB10 1TS. United Kingdom
| | - Steve Hood
- GSK Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, UK
| | - Barry Jones
- Pharmaron UK, West Hill Innovation Park, Hertford Road, Hoddesdon, Hertfordshire, EN11 9FH. United Kingdom
| | - Ian Wilson
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College, Burlington Danes Building, Du Cane Road, London W12 0NN, United Kingdom
| | - Dennis Smith
- Independent, 4 The Maltings, Walmer, Kent CT14 7AR, United Kingdom
| |
Collapse
|
20
|
Gama F, Rosmini S, Bandula S, Patel KP, Thornton GD, Bennett JB, Wechelakar A, Gillmore JD, Whelan C, Lachmann H, Taylor S, Fontana M, Moon J, Hawkins PN, Treibel T. Extracellular volume fraction by computed tomography predicts long-term prognosis among patients with cardiac amyloidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.184] [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
Objective
This study sought to investigate the association of extracellular volume fraction by computed tomography (ECVCT), myocardial remodeling and mortality in patients with systemic amyloidosis.
Background
Light chain (AL) and transthyretin (ATTR) amyloid fibrils are deposited in the extracellular space of the myocardium, resulting in heart failure and premature mortality. Extracellular expansion can be quantified by CT, offering a rapid and cost-effective alternative to cardiovascular magnetic resonance (CMR), especially among patients with cardiac devices or on renal dialysis.
Methods
Patients with confirmed systemic amyloidosis and varying degrees of cardiac involvement underwent ECG-gated cardiac CT. ECVCT was analysed in the inter-ventricular septum. All patients also underwent clinical assessment, ECG, echocardiography, serum amyloid protein component (SAP) and/or technetium-99m (99mTc) 3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy. ECVCT was compared across different extents of cardiac infiltration (ATTR Perugini Grade / AL Mayo Class) and evaluated for its association with myocardial remodelling and all-cause mortality.
Results
72 patients were studied (AL n=35, ATTR n=37; age 67 (59–76) years, 71% males). Mean septal ECVCT was 42.7±13.1% and 55.8±10.9% in AL and ATTR, respectively, and correlated with indexed left ventricular (LV) mass (r=0.426, p<0.001), LV ejection fraction [LVEF, (r=0.460, p<0.001)], NT-proBNP (r=0.563, p<0.001) and hsTnT (r=0.546, p=0.02). ECVCT increased with cardiac amyloid involvement in both AL and ATTR (Figure 1). Over a mean follow-up of 5.3±2.4 years, 40 deaths occurred (AL 14 [35%]; ATTR 26 [65%]). ECVCT was independently associated with all-cause mortality in ATTR (not AL) after adjustment for age and IV septal wall thickness (HR: 1.046, 95% CI: 1.003–1.090, p=0.037).
Conclusion
Cardiac amyloid burden quantified by ECVCT is associated with adverse cardiac remodelling as well as all-cause mortality among ATTR amyloid patients. ECVCT may address the need for better identification and risk stratification of amyloid patients, using a widely-accessible imaging modality (Figure 2).
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- F Gama
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - S Rosmini
- Barts Heart Centre , London , United Kingdom
| | - S Bandula
- University College of London , London , United Kingdom
| | - K P Patel
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - G D Thornton
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - J B Bennett
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - A Wechelakar
- Queen Mary University of London , London , United Kingdom
| | - J D Gillmore
- Queen Mary University of London , London , United Kingdom
| | - C Whelan
- University College of London , London , United Kingdom
| | - H Lachmann
- Queen Mary University of London , London , United Kingdom
| | - S Taylor
- University College of London , London , United Kingdom
| | - M Fontana
- University College of London , London , United Kingdom
| | - J Moon
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - P N Hawkins
- Queen Mary University of London , London , United Kingdom
| | - T Treibel
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| |
Collapse
|
21
|
Rodrigues JCL, O'Regan T, Darekar A, Taylor S, Goh V. Current pressure on the UK imaging workforce deters imaging research in the NHS and requires urgent attention. Clin Radiol 2022; 77:913-919. [PMID: 36167569 DOI: 10.1016/j.crad.2022.07.015] [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] [Received: 03/26/2022] [Revised: 06/08/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022]
Abstract
Medical imaging is a multidisciplinary specialty, combining clinical expertise from medical physics, radiography, and radiology, and plays a key role in patient care. Research is vital to ensure the care delivered to patients is evidence-based, and is a core component of clinical governance; however, there are pressures on the imaging workforce, which are significantly impeding imaging research. This commentary presents a research gap analysis pertaining to the multidisciplinary imaging workforce on behalf of the National Institute for Health Research (NIHR) Imaging Workforce Group. Data were summarised from membership surveys of the Royal College of Radiologists, Society and College of Radiographers, and Institute of Physics and Engineering in Medicine; national reports; and feedback from NIHR Clinical Research Network Imaging Champions meeting in 2020/2021. Common barriers to delivering research were found across the multidisciplinary workforce. The key issues were lack of staff, lack of time, and lack of funding to backfill clinical services. Given the ongoing workforce shortages and increasing clinical demands on radiologists, diagnostic radiographers, and medical physicists, these issues must be tackled with a high priority to ensure the future of clinical research within the NHS.
Collapse
Affiliation(s)
- J C L Rodrigues
- Department of Radiology, Royal United Hospitals Bath NHS Foundation Trust and Department of Health, University of Bath, Bath, UK.
| | - T O'Regan
- Society and College of Radiographers, UK
| | - A Darekar
- Department of Medical Physics, University Hospital Southampton NHS Trust, Southampton, UK
| | - S Taylor
- Centre for Medical Imaging, University College London and Department of Radiology, University College Hospital NHS Foundation Trust, London, UK
| | - V Goh
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London and Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | | |
Collapse
|
22
|
Morgan R, Clamp A, Barnes B, Schlecht H, Yarram-Smith L, Wallis Y, Morgan S, Valganon M, Hudson E, McKenna S, Sundar S, Nicum S, Brenton J, Kristeleit R, Banerjee S, McNeish I, Ledermann J, Taylor S, Evans G, Jayson G. 575P Homologous recombination deficiency in newly diagnosed FIGO stage III/IV high-grade serous or endometrioid ovarian cancer: A multi-national observational study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
23
|
Gardner I, Xu M, Han C, Wang Y, Jiao X, Jamei M, Khalidi H, Kilford P, Neuhoff S, Southall R, Turner DB, Musther H, Jones B, Taylor S. Non-specific binding of compounds in in vitro metabolism assays: a comparison of microsomal and hepatocyte binding in different species and an assessment of the accuracy of prediction models. Xenobiotica 2022; 52:943-956. [PMID: 36222269 DOI: 10.1080/00498254.2022.2132426] [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] [Indexed: 12/24/2022]
Abstract
Non-specific binding in in vitro metabolism systems leads to an underestimation of the true intrinsic metabolic clearance of compounds being studied. Therefore in vitro binding needs to be accounted for when extrapolating in vitro data to predict the in vivo metabolic clearance of a compound. While techniques exist for experimentally determining the fraction of a compound unbound in in vitro metabolism systems, early in drug discovery programmes computational approaches are often used to estimate the binding in the in vitro system.Experimental fraction unbound data (n = 60) were generated in liver microsomes (fumic) from five commonly used pre-clinical species (rat, mouse, dog, minipig, monkey) and humans. Unbound fraction in incubations with mouse, rat or human hepatocytes was determined for the same 60 compounds. These data were analysed to determine the relationship between experimentally determined binding in the different matrices and across different species. In hepatocytes there was a good correlation between fraction unbound in human and rat (r2=0.86) or mouse (r2=0.82) hepatocytes. Similar correlations were observed between binding in human liver microsomes and microsomes from rat, mouse, dog, Göttingen minipig or monkey liver microsomes (r2 of >0.89, n = 51 - 52 measurements in different species). Physicochemical parameters (logP, pKa and logD) were predicted for all evaluated compounds. In addition, logP and/or logD were measured for a subset of compounds.Binding to human hepatocytes predicted using 5 different methods was compared to the measured data for a set of 59 compounds. The best methods evaluated used measured microsomal binding in human liver microsomes to predict hepatocyte binding. The collated physicochemical data were used to predict the human fumic using four different in silico models for a set of 53-60 compounds. The correlation (r2) and root mean square error between predicted and observed microsomal binding was 0.69 & 0.20, 0.47 & 0.23, 0.56 & 0.21 and 0.54 & 0.26 for the Turner-Simcyp, Austin, Hallifax-Houston and Poulin models, respectively. These analyses were extended to include measured literature values for binding in human liver microsomes for a larger set of compounds (n=697). For the larger dataset of compounds, microsomal binding was well predicted for neutral compounds (r2=0.67 - 0.70) using the Poulin, Austin, or Turner-Simcyp methods but not for acidic or basic compounds (r2<0.5) using any of the models. While the lipophilicity-based models can be used, the in vitro binding should be measured for compounds where more certainty is needed, using appropriately calibrated assays and possibly established weak, moderate, and strong binders as reference compounds to allow comparison across databases.
Collapse
Affiliation(s)
| | - Mandy Xu
- Pharmaron Beijing Co. Ltd., Beijing, China
| | | | - Yi Wang
- Pharmaron Beijing Co. Ltd., Beijing, China
| | | | | | | | - Peter Kilford
- Certara UK Ltd., Sheffield, United Kingdom.,Labcorp Drug Development, Harrogate, United Kingdom
| | | | | | | | | | - Barry Jones
- Pharmaron UK, Hoddesdon, Hertfordshire, United Kingdom
| | - Simon Taylor
- Pharmaron UK, Hoddesdon, Hertfordshire, United Kingdom
| |
Collapse
|
24
|
Simpson C, Taylor S. Could Alveogyl cause nerve injury? Br Dent J 2022; 233:245. [PMID: 36028664 DOI: 10.1038/s41415-022-4930-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
25
|
Zheng S, Deng W, Zheng Q, Yang Y, Li N, Pang T, Feng X, Taylor S, Ma L, Wu Y, Zhao Z. Abstract 5457: QLH11811, a selective 4th-generation EGFR inhibitor for osimertinib-resistant EGFR-mutant NSCLC. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The 3rd-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI), like osimertinib, provide marked clinical benefit for EGFR-mutant non-small cell lung cancer (NSCLC) patients with extended overall survival vs former EGFR TKIs (e.g., gefitinib). Approximate 10%-24% of NSCLC patients acquired C797S mutation when treated with osimertinib. Unfortunately, limited treatments are available for patients after osimertinib resistance. QLH11811 is a new generation EGFR TKI designed to target the EGFR with ex19del/L858R/T790M/C797S mutations. Here, we disclosed its preclinical data to support its clinical development in EGFR-mutant NSCLC.
Methods: The inhibitory activity of QLH11811 on mutated and wild-type EGFR was tested in engineered cell lines and patient-derived organoid (PDO). The in vivo antitumor activity of QLH11811 was evaluated in the patient-derived xenograft (PDX) model with cis EGFR ex19del/T790M/C797S triple mutations, and the H1975 (cis EGFR L858R/T790M/C797S and cis EGFR ex19del/T790M/C797S), PC-9 (EGFR ex19del), and Ba/F3 (EGFR ex19del/C797S) cell line-derived xenograft (CDX) models. The pharmacokinetic (PK) profile was investigated in animals, and the human PK profile was projected using allometric scaling method.
Results: QLH11811 displayed potent anti-proliferation activity against Ba/F3 (EGFR ex19del/T790M/C797S, L858R/T790M/C797S, ex19del/C797S, or L858R/C797S), PC-9 (EGFR ex19del/T790M/C797S), H1975 (EGFR L858R/T790M/C797S, L858R/T790M), H3255 (L858R) and HCC827 (ex19del) with IC50 of 2.6, 3.1, 2.4, 4.1, 51, 50, 27, 21, and 11 nM, respectively. QLH11811 also showed excellent selectivity when compared the above values with its IC50 against Ba/F3 (EGFR wild-type, 61 nM) and A431 (EGFR wild-type, 440nM). QLH11811 demonstrated excellent inhibitory activities against seven osimertinib-resistant PDO models. Daily oral QLH11811 significantly inhibited tumor growth at all doses tested (P <0.001) in the PDX model, the H1975, PC-9, and Ba/F3 CDX models. QLH11811 had good PK profile in mice, rats, dogs, and monkeys, with the absolute bioavailability at 71%, 29%, 80% and 42%. The human PK parameters were obtained by allometric scaling method, and the efficacious dose in human was projected to 103 mg, daily.
Conclusion: The in vitro and in vivo preclinical data demonstrated QLH11811 is a highly potent and selective 4th-generation EGFR TKI with activity against the osimertinib-resistant NSCLC with EGFR C797S mutation. The preclinical PK data supported the efficacious dose of QLH11811 in human would be 103 mg.
Citation Format: Shansong Zheng, Wei Deng, Qingmei Zheng, Yingying Yang, Na Li, Tan Pang, Xueying Feng, Simon Taylor, Lina Ma, Yaqiong Wu, Ziwei Zhao. QLH11811, a selective 4th-generation EGFR inhibitor for osimertinib-resistant EGFR-mutant NSCLC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5457.
Collapse
Affiliation(s)
| | - Wei Deng
- 2Pharmaron Beijing Co., Ltd., Beijing, China
| | | | | | - Na Li
- 1Qilu Pharmaceutical Co., Ltd., Jinan, China
| | - Tan Pang
- 2Pharmaron Beijing Co., Ltd., Beijing, China
| | | | | | - Lina Ma
- 1Qilu Pharmaceutical Co., Ltd., Jinan, China
| | - Yaqiong Wu
- 2Pharmaron Beijing Co., Ltd., Beijing, China
| | - Ziwei Zhao
- 2Pharmaron Beijing Co., Ltd., Beijing, China
| |
Collapse
|
26
|
Shitara K, Golan T, Mileham K, Voskoboynik M, Rha S, Gutierrez M, Perets R, Taylor S, Chen D, Keenan T, Rajasagi M, Healy J, Shoji H. PD-3 Phase 1 trial of vibostolimab plus pembrolizumab for PD-1/PD-L1 inhibitor-naive advanced gastric cancer: The KEYVIBE-001 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
27
|
Morlock R, Divino V, Dekoven M, Lamoreaux B, Powers A, Barretto N, Holt R, Taylor S. AB1051 CLINICAL OUTCOMES AND HEALTHCARE RESOURCE UTILIZATION OF UNCONTROLLED GOUT PRIOR TO PEGLOTICASE THERAPY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2502] [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: 11/03/2022]
Abstract
BackgroundBy definition, uncontrolled gout (UG) cannot be managed with oral urate lowering therapies (ULTs) and is associated with substantial morbidity. UG, also known as refractory gout, results in escalated treatment and management. Recent American College of Rheumatology guidelines recommend treating gout to serum uric acid targets; if targets are not achieved or patients continue to have symptoms, pegloticase is recommended. There is a paucity of data documenting the clinical and economic burden of UG patients.ObjectivesAssess clinical outcomes and healthcare resource utilization (HCRU) of UG prior to pegloticase initiation.MethodsA retrospective observational database analysis was conducted among patients initiating pegloticase between April 1, 2011 and August 31, 2020 using the PharMetrics Plus database. Eligible subjects had ≥1 pegloticase claim (first claim = index date) and continuous enrollment for 24 months prior to index. Relevant clinical and economic (HCRU) outcomes were evaluated over a 24-month pre-index period and compared between two different time intervals prior to index: time interval 1 (Day -720 to Day -361) and time interval 2 (Day -360 to Day -1). Assessment of comorbid disease burden included Charlson Comorbidity Index (CCI) and relevant health conditions. Dependent pairwise comparisons were conducted to compare clinical and economic outcomes between time intervals prior to pegloticase initiation. To assess statistical differences, paired t-tests (continuous variables) or McNemar’s tests (categorical variables) were used.ResultsOf the 408 eligible subjects, most were male (88.5%), with an average age (SD) of 55.2 (11.3) years, 66.9% were between the ages of 45-64 years and 78.2% had a preferred provider organization (PPO) health plan. Most often (34.8% of patients), a rheumatologist was associated with initiation of pegloticase therapy, while primary care physicians accounted for 23.8% of initiations. Mean (SD) CCI score was 2.4 (2.4) with 37.3% of subjects having a CCI score of >3. Prevalence of relevant health conditions over the 24-month pre-index period included tophi (62.5%), urolithiasis (8.6%), chronic kidney disease (34.6%) and chronic pain/fibromyalgia (76.5%), all of which significantly increased from time interval 1 (Day -720 to Day -361) to time interval 2 (Day -360 to Day -1) prior to pegloticase initiation (Table 1). Of patients initiating pegloticase, 57.4% had 1 ULT (excluding probenecid), 11.3% had >2 ULT (excluding probenecid), and 10.3% UG patients had ≥1 probenecid claim over the 24-month pre-index period. Most patients (98.3%) had ≥1 physician office visit, 27.2% had ≥1 hospitalization and 45.3% had ≥1 emergency room (ER) visit over the 24-month pre-index period. HCRU significantly increased from time interval 1 to time interval 2, prior to pegloticase (Figure 1).Table 1.Relevant Health Conditions and Disease-specific Health Care Resource Utilization (HCRU)Overall N= 408Time Interval 1Time Interval 2Tophi62.5%15.4%61.5%***Urolithiasis8.6%4.2%6.9%*Chronic kidney disease34.6%22.5%31.6%***Cardiovascular disease32.6%21.3%28.4%**Type 2 diabetes mellitus31.4%23.3%28.9%**Hypertension76.2%58.1%70.3%***≥1 gout flare87.7%48.5%83.8%***Mean number of gout flare (SD)3.5 (2.4)1.02.1***Gout-related medications ≥1 claim for colchicine56%39.5%63.7%***≥1 claim for opioids71%52.9%60.3%*≥1 claim for oral corticosteroids80%50.2%75.7%***≥1 claim for injectable corticosteroids64%38.5%53.7%***†Time Interval 1: Day -720 to Day -361 prior to pegloticase initiation; ††Time Interval 2: Day -360 to Day -1 prior to pegloticase initiation***, p<0.0001; **, p<0.001; *, p<0.05ConclusionOverall, these data demonstrate the progressive nature of UG as confirmed by significant increases in gout-related conditions and healthcare resource utilization prior to pegloticase initiation. Further research is needed on healthcare resource utilization among patients with UG post-pegloticase use.Disclosure of InterestsRobert Morlock Consultant of: Horizon Therapeutics, Victoria Divino Grant/research support from: Horizon Therapeutics, Mitchell DeKoven Grant/research support from: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Atsuko Powers Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Naina Barretto Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Robert Holt Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephanie Taylor Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics
Collapse
|
28
|
Khanna D, Furst D, LI JW, Shah S, Lesperance T, Ali F, Lamoreaux B, Taylor S. POS0867 COMORBIDITY AND COMPLICATIONS PRIOR TO SYSTEMIC SCLEROSIS DIAGNOSIS: A RETROSPECTIVE COHORT ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1888] [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: 11/03/2022]
Abstract
BackgroundSystemic sclerosis (SSc) is a rare autoimmune disease characterized by progressive microvascular damage, collagen deposition and subsequent fibrosis of the skin and internal organs which contributes to substantial morbidity and premature death.1-2ObjectivesThe objective was to evaluate the disease burden of SSc patients prior to their SSc diagnosis.MethodsPatients with SSc were identified in a claims dataset (IBM MarketScan Commercial Database, 2015-2019) using ICD 10 diagnosis codes for SSc. Eligible subjects were required to have > 1 inpatient or >2 outpatient/office claims with a scleroderma diagnosis code on separate days and > 24 months of continuous health plan enrollment without a SSc diagnosis before the first SSc claim (‘index date’) and > 12 months of enrollment after the index date. Overall comorbid disease burden was assessed via the Charlson Comorbidity Index (CCI) 13-24 and 12 months before and 12 months after index date. The prevalence of SSc-related complications for atherosclerosis, pulmonary arterial hypertension (PAH), pulmonary fibrosis (PF), Raynaud’s Phenomenon (RP), and gastrointestinal (GI) complications (e.g., GERD, dysphagia, etc.) were identified using ICD codes and reported as percentages for the aforementioned time intervals relative to patients’ index dates.Results902 eligible SSc patients were identified for analysis. The mean age at index SSc diagnosis was 54.3 years and 84.7% of patients were female. Mean CCI scores 13-24 months before, 12 months before, and 12 months after index SSc diagnosis were 0.84, 1.13 and 1.30, respectively. From the time points 13-24 months before, 12 months before, and 12 months after index SSc diagnosis, increasing rates were also observed of atherosclerosis, PAH, PF, RP, and GI complications (Table 1).Table 1.Charlson Comorbidity Index (CCI) and systemic sclerosis-related complications by time-intervalClinical characteristic13-24 months before Index12 months before Index12 months after IndexMean CCI (std dev)0.84 (1.58)1.13 (1.71)1.30 (1.75)Systemic sclerosis-related complicationsAtherosclerosis7%9%14%Pulmonary arterial hypertension (PAH)1%4%12%Pulmonary fibrosis (PF)5%8%16%Raynaud’s Phenomenon (RP)13%29%43%GI complications23%32%46%ConclusionResults from this analysis suggests that SSc-related sequalae are present at least two years prior to SSc diagnosis and rates of these complications increased markedly over time. Patients’ overall comorbid disease burden also worsened substantially over this period, likely because of these complications. The internal organ involvement is likely under reported due to requirements to link each diagnosis with an ICD-10 code. These data indicate the significant burden of SSc, prior to and after diagnosis, highlighting the need for awareness, prompt diagnosis, and effective therapies for SSc and its related complications.References[1]Cutolo M, et al. Expert Rev Clin Immunol. 2019;15(7):753-764.[2]Steen VD, Medsger TA. Ann Rheum Dis. 2007;66(7):940-944.Disclosure of InterestsDinesh Khanna Consultant of: Horizon Therapeutics, Daniel Furst Consultant of: Horizon Therapeutics, Justin W. Li Grant/research support from: Horizon Therapeutics, Saloni Shah Grant/research support from: Horizon Therapeutics, Tamara Lesperance Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Farah Ali Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephanie Taylor Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics
Collapse
|
29
|
Szmul A, Taylor S, Lim P, Cantwell J, D’Souza D, Moinuddin S, Gaze M, Gains J, Veiga C. OC-0773 CBCT-to-CT synthesis using weakly-paired cycle-consistent generative adversarial networks. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
30
|
Pifer P, Jaishankar S, Bhargava R, Keller A, Musunuru H, Cohen M, Sukumvanich P, Courtney-Brooks M, Boisen M, Berger J, Taylor S, Olawaiye A, Lesnock J, Edwards R, Vargo J, Beriwal S. PD-0913 Is substantial LVSI prognostic in patients with pathological lymph node-negative endometrial cancer? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02992-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
31
|
Taylor S, Lim P, Cantwell J, D’Souza D, Moinuddin S, Ching-Chang Y, Gaze M, Gains J, Veiga C. OC-0786 Surface imaging to track inter-fractional anatomical variation in paediatric abdominal radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02692-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
32
|
Mehta A, Taylor S, Halliday E, Chiu M, Needleman S. Irradiation of the Internal Mammary Chain in the Adjuvant Treatment of Breast Cancer – a Retrospective, Single Institution Review of Outcomes. Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2021.12.036] [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: 11/03/2022]
|
33
|
Samarasekara N, Dinsdale E, Taylor S, Sulaiman M, Gittens A, Ahmed E, Jain A, Tang M, Ninan S. 715 REDUCING OVERTREATMENT OF TYPE 2 DIABETES IN OLDER PEOPLE LIVING IN CARE HOMES. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Older people in care homes living with frailty are less likely to benefit from tight glycaemic control in the management of type 2 diabetes with increased risk of adverse effects for example hypoglycaemia, falls and hospital admission. We wished to ascertain the scale of the problem and reduce overtreatment. We defined overtreatment based on American Diabetes Association guidelines as being on an agent that can cause hypoglycaemia and having an HBA1C of ≤53 mmol/mol or, an HbA1c 53–64 mmol/mol with either three or more co-morbidities.
Methods
In 2016, we audited the management of type 2 diabetes in older people discharged from LTHT to care homes. We discussed our concerns with diabetes and geriatric medicine colleagues across medical, nursing and pharmacy disciplines. We engaged the support of the citywide diabetes network which comprises secondary care colleagues, general practitioners and pharmacists. We presented the findings of our initial audit to colleagues within primary and secondary care through departmental meetings and citywide network meetings. We wrote a new guideline, specifically for frail older people that was disseminated citywide through these networks. We re-audited in 2020.
Results
In total, 113 cases were reviewed in 2016 and 105 cases in 2020. In 2020, only 6% (6 patients) were overtreated compared to 38% (43 patients) in 2016.
Conclusions
There has been a marked reduction in overtreatment which should result in less adverse events. We believe the reasons for success lie in wide engagement of relevant stakeholder groups around an issue that is important, large in scale and meaningful to both patient and clinician. There are potential cost savings from reducing medications and reducing harm.
Collapse
Affiliation(s)
| | | | - S Taylor
- Leeds Teaching Hospitals Trust (LTHT)
| | | | - A Gittens
- Leeds Teaching Hospitals Trust (LTHT)
| | - E Ahmed
- Leeds Teaching Hospitals Trust (LTHT)
| | - A Jain
- Leeds Teaching Hospitals Trust (LTHT)
| | - M Tang
- Leeds Teaching Hospitals Trust (LTHT)
| | - S Ninan
- Leeds Teaching Hospitals Trust (LTHT)
| |
Collapse
|
34
|
Gilmore S, Murray S, Taylor S, Ninan S. 771 LET’S TALK ABOUT RESUS. DO WE DO IT? WHO DOES IT? WHAT ARE THE OUTCOMES? Age Ageing 2022. [DOI: 10.1093/ageing/afac037.771] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Discussing preferences around cardiopulmonary resuscitation (CPR) is recommended to patients who wish to discuss this, or where there is foreseeable risk of life-threatening clinical deterioration. Our team felt that we discussed this routinely for our inpatients but wished to investigate how we did this, when we did this, why decisions were made and who led these discussions.
Methods
We retrospectively reviewed the electronic patient notes of 118 patients recently discharged from elderly medicine between February and November 2020 and recorded demographic details, co-morbidities and outcomes of discussions regarding resuscitation.
Results
100/118 patients had a RESPECT form documenting preferences. Of these 100 patients, 97% had a DNACPR recommendation, 2 had a ‘for resuscitation’ recommendation and one was undecided. 69% of patients had their preferences recorded during the current admission. 43% of discussions were led by a tier 1/2 doctor. 21% of discussions were led by a tier 3 doctor. 23% of discussions were led by a consultant. It was unclear who had led the discussion 13% of the time. 29/97 patients had a DNACPR due to their wishes. 16/97 patients had a DNACPR based on clinical grounds that it would not succeed. 33/97 patients had a DNACPR on the grounds that burden outweighed risks and they had capacity In 19/97 patients the reason for DNACPR was not clearly documented. There were 6 discussions where there was distress or disagreement—all of the discussions resulted in DNACPR recommendation 1 patient had a DNACPR reversed during their admission and none were reversed afterwards.
Conclusion
Systematically discussing preferences around resuscitation is feasible and rarely results in distress. The majority of patients have a recommendation for DNACPR and discussions are led by ‘junior’ doctors.
Collapse
Affiliation(s)
| | - S Murray
- Leeds Teaching Hospitals NHS Trust
| | - S Taylor
- Leeds Teaching Hospitals NHS Trust
| | - S Ninan
- Leeds Teaching Hospitals NHS Trust
| |
Collapse
|
35
|
Jaishankar S, Pifer PM, Bhargava R, Keller A, Musunuru HB, Patel AK, Sukumvanich P, Boisen M, Berger JL, Taylor S, Courtney-Brooks M, Olawaiye A, Lesnock J, Edwards R, Vargo JA, Beriwal S. Is Substantial Lymphovascular Space Invasion Prognostic for Clinical Outcomes in Type II Endometrial Cancer? Clin Oncol (R Coll Radiol) 2022; 34:452-458. [PMID: 35264314 DOI: 10.1016/j.clon.2022.02.018] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/26/2022] [Accepted: 02/21/2022] [Indexed: 11/03/2022]
Abstract
AIMS Substantial lymphovascular space invasion (LVSI) compared with none or focal LVSI is predictive of lymph node involvement and worse clinical outcomes in endometrioid-type endometrial carcinoma. We aimed to quantify the incidence of substantial LVSI in type II (clear cell and serous) endometrial cancer and correlate the extent of LVSI with clinical outcomes. MATERIALS AND METHODS A retrospective review was conducted on type II endometrial cancer patients who underwent surgical management from July 2017 to December 2019 using the three-tier LVSI scoring system. Binary logistic regression and Cox regression were used to analyse predictors of lymph node involvement or survival outcomes, respectively. The Kaplan-Meier method and Log-rank test were used to analyse differences in locoregional disease-free survival (LR-DFS), distant metastasis disease-free survival (DM-DFS) and overall survival between patients with substantial versus none/focal LVSI. RESULTS In 79 patients with type II endometrial carcinoma, no LVSI, focal LVSI and substantial LVSI was present in 48.1%, 15.2% and 36.7% of patients, respectively. Lymph nodes were involved in 0.0% with no LVSI, 20.0% with focal LVSI and 60.0% with substantial LVSI (P < 0.001). The median follow-up was 22.2 months. In patients with none/focal versus substantial LVSI, the 2-year LR-DFS and DM-DFS rates were 91.5% versus 71.4% (P = 0.01) and 90.2% versus 63.8% (P = 0.005), respectively. On univariate analysis, myometrial invasion ≥50%, tumour size ≥3.6 cm, substantial versus none/focal LVSI, lymph node involvement and omission of adjuvant radiotherapy were significant predictors for worse LR-DFS and DM-DFS (P < 0.05). DISCUSSION Substantial LVSI has a high incidence in type II pathology at our institution and predicts for lymph node involvement and worse clinical outcomes.
Collapse
Affiliation(s)
- S Jaishankar
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - P M Pifer
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - R Bhargava
- Department of Pathology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A Keller
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - H B Musunuru
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A K Patel
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - P Sukumvanich
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Boisen
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J L Berger
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Taylor
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Courtney-Brooks
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A Olawaiye
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J Lesnock
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - R Edwards
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J A Vargo
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Beriwal
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA; Varian Medical Systems, Charlottesville, VA, USA.
| |
Collapse
|
36
|
Zuniga C, Quintana E, Zuniga E, Lorca E, Cament R, Escobar L, Garcia B, Enos D, Taylor S, Castillo A, Hellman E, Aldunate T, Herrera P, Ruiz A, Arce I, Mª Francisca C, Sabando V, Letelier M. POS-319 TELENEPHROLOGY AS A PUBLIC POLICY FOR THE CARE OF PATIENTS WITH CKD AT THE PRIMARY HEALTH LEVEL. CHILEAN EXPERIENCE. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
37
|
Boccardo A, Compiani R, Baldi G, Pravettoni D, Grossi S, Sala G, Taylor S, Neville E, Sgoifo Rossi C. Effects of a supplemental calcareous marine algae bolus
on blood calcium concentration in dairy heifers. J Anim Feed Sci 2022. [DOI: 10.22358/jafs/144919/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
38
|
Humphreys PG, Atkinson SJ, Bamborough P, Bit RA, Chung CW, Craggs PD, Cutler L, Davis R, Ferrie A, Gong G, Gordon LJ, Gray M, Harrison LA, Hayhow TG, Haynes A, Henley N, Hirst DJ, Holyer ID, Lindon MJ, Lovatt C, Lugo D, McCleary S, Molnar J, Osmani Q, Patten C, Preston A, Rioja I, Seal JT, Smithers N, Sun F, Tang D, Taylor S, Theodoulou NH, Thomas C, Watson RJ, Wellaway CR, Zhu L, Tomkinson NCO, Prinjha RK. Design, Synthesis, and Characterization of I-BET567, a Pan-Bromodomain and Extra Terminal (BET) Bromodomain Oral Candidate. J Med Chem 2022; 65:2262-2287. [PMID: 34995458 DOI: 10.1021/acs.jmedchem.1c01747] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Through regulation of the epigenome, the bromodomain and extra terminal (BET) family of proteins represent important therapeutic targets for the treatment of human disease. Through mimicking the endogenous N-acetyl-lysine group and disrupting the protein-protein interaction between histone tails and the bromodomain, several small molecule pan-BET inhibitors have progressed to oncology clinical trials. This work describes the medicinal chemistry strategy and execution to deliver an orally bioavailable tetrahydroquinoline (THQ) pan-BET candidate. Critical to the success of this endeavor was a potency agnostic analysis of a data set of 1999 THQ BET inhibitors within the GSK collection which enabled identification of appropriate lipophilicity space to deliver compounds with a higher probability of desired oral candidate quality properties. SAR knowledge was leveraged via Free-Wilson analysis within this design space to identify a small group of targets which ultimately delivered I-BET567 (27), a pan-BET candidate inhibitor that demonstrated efficacy in mouse models of oncology and inflammation.
Collapse
Affiliation(s)
| | | | - Paul Bamborough
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Rino A Bit
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Chun-Wa Chung
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Peter D Craggs
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Leanne Cutler
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Rob Davis
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Alan Ferrie
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - GangLi Gong
- WuXi Shanghai STA Pharmaceutical R&D Co., Ltd., No. 90 Delin Road, WaiGaoQiao Free Trade Zone, Shanghai 200131, China
| | - Laurie J Gordon
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Matthew Gray
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Lee A Harrison
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Thomas G Hayhow
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Andrea Haynes
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Nick Henley
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - David J Hirst
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Ian D Holyer
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Matthew J Lindon
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Cerys Lovatt
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - David Lugo
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Scott McCleary
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Judit Molnar
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Qendresa Osmani
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Chris Patten
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Alex Preston
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Inmaculada Rioja
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Jonathan T Seal
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Nicholas Smithers
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Fenglai Sun
- WuXi Shanghai STA Pharmaceutical R&D Co., Ltd., No. 90 Delin Road, WaiGaoQiao Free Trade Zone, Shanghai 200131, China
| | - Dalin Tang
- WuXi Shanghai STA Pharmaceutical R&D Co., Ltd., No. 90 Delin Road, WaiGaoQiao Free Trade Zone, Shanghai 200131, China
| | - Simon Taylor
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Natalie H Theodoulou
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom.,WestCHEM, Department of Pure and Applied Chemistry, University of Strathclyde, Thomas Graham Building, 295 Cathedral Street, Glasgow G1 1XL, United Kingdom
| | - Clare Thomas
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | - Robert J Watson
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| | | | - Linrong Zhu
- WuXi Shanghai STA Pharmaceutical R&D Co., Ltd., No. 90 Delin Road, WaiGaoQiao Free Trade Zone, Shanghai 200131, China
| | - Nicholas C O Tomkinson
- WestCHEM, Department of Pure and Applied Chemistry, University of Strathclyde, Thomas Graham Building, 295 Cathedral Street, Glasgow G1 1XL, United Kingdom
| | - Rab K Prinjha
- GlaxoSmithKline R&D, Stevenage, Hertfordshire SG1 2NY, United Kingdom
| |
Collapse
|
39
|
Thompson T, Zentner D, James P, Taylor S. Practise Changing Research – Adding DNAH11 to a Congenital Heart Disease Panel. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
40
|
Rosello R, Girela-Serrano B, Gómez S, Baig B, Lim M, Taylor S. Characterizing the features and course of psychiatric symptoms in children and adolescents with autoimmune encephalitis. Eur Arch Psychiatry Clin Neurosci 2022; 272:477-482. [PMID: 34272976 PMCID: PMC8938365 DOI: 10.1007/s00406-021-01293-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 07/04/2021] [Indexed: 01/14/2023]
Abstract
Autoimmune encephalitis (AE) can present like a psychiatric disorder. We aimed to illustrate the psychiatric manifestations, course and management of AE in a paediatric cohort. Neuropsychiatric symptoms, investigations and treatment were retrospectively retrieved in 16 patients (mean age 11.31, SD 2.98) with an AE diagnosis at the liaison psychiatry services in two UK tertiary paediatric centres. Psychiatric presentation was characterised by an acute polysymptomatic (predominantly agitation, anger outbursts/aggressiveness, hallucinations, and emotional lability) onset. Antipsychotics produced side effects and significant worsening of symptoms in four cases, and benzodiazepines were commonly used. This psychiatric phenotype should make clinicians suspect the diagnosis of AE and carefully consider use of treatments.
Collapse
Affiliation(s)
- R Rosello
- Division of Psychiatry, Imperial College, London, UK
| | | | - S Gómez
- Division of Psychiatry, King’s College, London, UK
| | - B Baig
- South London and Maudsley NHS Trust, London, UK
| | - M Lim
- Children's Neurosciences Centre, Evelina London Children's Hospital, London, UK. .,Department Women and Children's Health, School of Life Course Sciences (SoLCS), King's College London, London, UK.
| | - S Taylor
- Division of Psychiatry, Imperial College, London, UK
| |
Collapse
|
41
|
Taylor S, Metz D. 283: Improving medication adherence and patient engagement in cystic fibrosis patients: Retrospective analysis of a mobile application using gamification and incentives. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01708-2] [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]
|
42
|
Lowe J, Taylor S, Wilson H, Rahme J, Fuller J. External workload patterns of injured elite Rugby League players before and after return to play. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.179] [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]
|
43
|
Webster CS, Taylor S, Weller JM. Cognitive biases in diagnosis and decision making during anaesthesia and intensive care. BJA Educ 2021; 21:420-425. [PMID: 34707887 DOI: 10.1016/j.bjae.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- C S Webster
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
| | - S Taylor
- Auckland City Hospital, Auckland, New Zealand
| | - J M Weller
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand.,Auckland City Hospital, Auckland, New Zealand
| |
Collapse
|
44
|
Hodgkinson-Brechenmacher V, Lounsberry J, Abrahao A, Benstead T, Breiner A, Briemberg H, Genge A, Grant I, Kalra S, Marrero A, Massie R, Matte G, O'Connell C, Pfeffer G, Schellenberg K, Shoesmith C, Taylor S, Izenberg A, Johnston W, Korngut L. MOTOR NEURON DISORDERS AND NEUROPATHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
45
|
Gayman CM, Jimenez ST, Hammock S, Taylor S, Rocheleau JM. The Effects of Cumulative and Noncumulative Exams Within the Context of Interteaching. J Behav Educ 2021; 32:261-276. [PMID: 34511863 PMCID: PMC8423584 DOI: 10.1007/s10864-021-09451-4] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
Interteaching is a behavioral teaching method that has been empirically shown to increase student learning outcomes. The present study investigated the effect of combining interteaching with cumulative versus noncumulative exams in two sections of an online asynchronous class. Interteaching was used in both sections of the course. The noncumulative exam section experienced weekly exams with test questions that only covered material learned in that week of class. The cumulative exam section was given weekly exams in which half of the questions were from material learned that current week and the other half were cumulative up to that point in the class. This was followed by a cumulative final exam given to both groups. All exam questions were multiple choice. On average, students in the cumulative exam group scored 4.91% higher on the final exam than students in the noncumulative exam group. Students exposed to weekly cumulative exams also earned more As and Bs on the final compared to the noncumulative exam group. Overall, our experiment provides evidence that interteaching may be further improved when combined with cumulative weekly exams.
Collapse
Affiliation(s)
- C. M. Gayman
- Department of Psychology, Troy University, 215 Whitley Hall, Montgomery, AL 36104 USA
| | - S. T. Jimenez
- Department of Psychology, University of Pittsburgh at Johnstown, Johnstown, PA USA
| | - S. Hammock
- Department of Psychology, Troy University, 215 Whitley Hall, Montgomery, AL 36104 USA
| | - S. Taylor
- Department of Psychology, Troy University, 215 Whitley Hall, Montgomery, AL 36104 USA
| | - J. M. Rocheleau
- Department of Psychology, Western Michigan University, Kalamazoo, MI USA
| |
Collapse
|
46
|
Gelendi S, Taylor S, D'Aout C, Pitchford C, Coldrick O, Sanchez-Jimenez C, O'Halloran C. Mycobacterium avium infection associated with sterile polyarthritis in a dog. J Small Anim Pract 2021; 63:154-158. [PMID: 34468983 DOI: 10.1111/jsap.13420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 01/06/2023]
Abstract
A 1-year-old male neutered Portuguese Podengo dog was presented for lameness, inappetence, pyrexia, diarrhoea and abdominal moderate to severe lymphadenomegaly. Cytology of synovial fluid revealed neutrophilic inflammation in multiple joints suggestive of immune-mediated polyarthritis. Cytology of fine-needle-aspiration material obtained from lymph nodes revealed macrophages with intracytoplasmic, rod-like Ziehl-Neelsen positive staining structures, indicative of mycobacteria. Four-month treatment with enrofloxacin, rifampicin and clarithromycin resulted in clinical improvement and resolution of polyarthritis as evidenced on repeat synoviocentesis, but diarrhoea recurred, Ziehl-Neelsen positive organisms were again found on lymph node cytology and analysis of the 16S rRNA-gene using the Basic Local Alignment Search Tool facility resulted in a match to Mycobacterium avium with 100% sequence identity. Treatment was adjusted to include pradofloxacin, doxycycline, rifampicin and ethambutol and 3 months later the dog is clinically normal. Based on the literature search, this is the first time canine Mycobacterium avium infection associated with immune-mediated polyarthritis is reported. Based on scoping searches, this is the first report of canine Mycobacterium avium infection associated with immune-mediated polyarthritis.
Collapse
Affiliation(s)
- S Gelendi
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - S Taylor
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C D'Aout
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C Pitchford
- Department of Clinical Pathology, Synlab VPG, Exeter, Devon, EX5 2FN, UK
| | - O Coldrick
- Department of Clinical Pathology, Synlab VPG, Exeter, Devon, EX5 2FN, UK
| | - C Sanchez-Jimenez
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C O'Halloran
- Division of Infection and Immunity, The Royal (Dick) School of Veterinary Studies, Edinburgh, Midlothian, EH25 9RG, UK
| |
Collapse
|
47
|
Jones KL, Beaumont DM, Bernard SG, Bit RA, Campbell SP, Chung CW, Cutler L, Demont EH, Dennis K, Gordon L, Gray JR, Haase MV, Lewis AJ, McCleary S, Mitchell DJ, Moore SM, Parr N, Robb OJ, Smithers N, Soden PE, Suckling CJ, Taylor S, Walker AL, Watson RJ, Prinjha RK. Discovery of a Novel Bromodomain and Extra Terminal Domain (BET) Protein Inhibitor, I-BET282E, Suitable for Clinical Progression. J Med Chem 2021; 64:12200-12227. [PMID: 34387088 DOI: 10.1021/acs.jmedchem.1c00855] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The functions of the bromodomain and extra terminal (BET) family of proteins have been implicated in a wide range of diseases, particularly in the oncology and immuno-inflammatory areas, and several inhibitors are under investigation in the clinic. To mitigate the risk of attrition of these compounds due to structurally related toxicity findings, additional molecules from distinct chemical series were required. Here we describe the structure- and property-based optimization of the in vivo tool molecule I-BET151 toward I-BET282E, a molecule with properties suitable for progression into clinical studies.
Collapse
Affiliation(s)
- Katherine L Jones
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Dominic M Beaumont
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Sharon G Bernard
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Rino A Bit
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Simon P Campbell
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Chun-Wa Chung
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Leanne Cutler
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Emmanuel H Demont
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Kate Dennis
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Laurie Gordon
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - James R Gray
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Michael V Haase
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Antonia J Lewis
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Scott McCleary
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Darren J Mitchell
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Susanne M Moore
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Nigel Parr
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Olivia J Robb
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Nicholas Smithers
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Peter E Soden
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Colin J Suckling
- Department of Pure & Applied Chemistry, University of Strathclyde, Glasgow, G1 1XL, U.K
| | - Simon Taylor
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Ann L Walker
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Robert J Watson
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Rab K Prinjha
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| |
Collapse
|
48
|
Rawal R, Cheung M, Pliener D, Taylor S, Patterson R, Anders M, Siljehag P. Construction Law Quarterly. Proceedings of the Institution of Civil Engineers - Management, Procurement and Law 2021. [DOI: 10.1680/jmapl.2021.174.3.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | | | | | | | | | - Petter Siljehag
- ITER Organisation, St Paul lez Durance, France (on secondment from Mott MacDonald)
| |
Collapse
|
49
|
Lucas SCC, Atkinson SJ, Chung CW, Davis R, Gordon L, Grandi P, Gray JJR, Grimes T, Phillipou A, Preston AG, Prinjha RK, Rioja I, Taylor S, Tomkinson NCO, Wall I, Watson RJ, Woolven J, Demont EH. Optimization of a Series of 2,3-Dihydrobenzofurans as Highly Potent, Second Bromodomain (BD2)-Selective, Bromo and Extra-Terminal Domain (BET) Inhibitors. J Med Chem 2021; 64:10711-10741. [PMID: 34260229 DOI: 10.1021/acs.jmedchem.1c00344] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Herein, a series of 2,3-dihydrobenzofurans have been developed as highly potent bromo and extra-terminal domain (BET) inhibitors with 1000-fold selectivity for the second bromodomain (BD2) over the first bromodomain (BD1). Investment in the development of two orthogonal synthetic routes delivered inhibitors that were potent and selective but had raised in vitro clearance and suboptimal solubility. Insertion of a quaternary center into the 2,3-dihydrobenzofuran core blocked a key site of metabolism and improved the solubility. This led to the development of inhibitor 71 (GSK852): a potent, 1000-fold-selective, highly soluble compound with good in vivo rat and dog pharmacokinetics.
Collapse
Affiliation(s)
| | | | | | | | | | - Paola Grandi
- IVIVT Cellzome, Platform Technology and Science, GlaxoSmithKline, Meyerhofstrasse 1, 69117 Heidelberg, Germany
| | | | | | | | | | | | | | | | - Nicholas C O Tomkinson
- WestCHEM, Department of Pure and Applied Chemistry, University of Strathclyde, Thomas Graham Building, 259 Cathedral Street, Glasgow G1 1XL, U.K
| | | | | | | | | |
Collapse
|
50
|
Seal JT, Atkinson SJ, Bamborough P, Bassil A, Chung CW, Foley J, Gordon L, Grandi P, Gray JRJ, Harrison LA, Kruger RG, Matteo JJ, McCabe MT, Messenger C, Mitchell D, Phillipou A, Preston A, Prinjha RK, Rianjongdee F, Rioja I, Taylor S, Wall ID, Watson RJ, Woolven JM, Wyce A, Zhang XP, Demont EH. Fragment-based Scaffold Hopping: Identification of Potent, Selective, and Highly Soluble Bromo and Extra Terminal Domain (BET) Second Bromodomain (BD2) Inhibitors. J Med Chem 2021; 64:10772-10805. [PMID: 34255512 DOI: 10.1021/acs.jmedchem.1c00365] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The profound efficacy of pan-BET inhibitors is well documented, but these epigenetic agents have shown pharmacology-driven toxicity in oncology clinical trials. The opportunity to identify inhibitors with an improved safety profile by selective targeting of a subset of the eight bromodomains of the BET family has triggered extensive medicinal chemistry efforts. In this article, we disclose the identification of potent and selective drug-like pan-BD2 inhibitors such as pyrazole 23 (GSK809) and furan 24 (GSK743) that were derived from the pyrrole fragment 6. We transpose the key learnings from a previous pyridone series (GSK620 2 as a representative example) to this novel class of inhibitors, which are characterized by significantly improved solubility relative to our previous research.
Collapse
Affiliation(s)
| | | | | | | | | | - James Foley
- Cancer Epigenetics Research Unit, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, Pennsylvania 19426, United States
| | | | - Paola Grandi
- IVIVT Cellzome, Platform Technology and Science, GlaxoSmithKline, Meyerhofstr. 1, 69117 Heidelberg, Germany
| | | | | | - Ryan G Kruger
- Cancer Epigenetics Research Unit, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, Pennsylvania 19426, United States
| | - Jeanne J Matteo
- Cancer Epigenetics Research Unit, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, Pennsylvania 19426, United States
| | - Michael T McCabe
- Cancer Epigenetics Research Unit, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, Pennsylvania 19426, United States
| | | | | | | | | | | | | | | | | | | | | | | | - Anastasia Wyce
- Cancer Epigenetics Research Unit, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, Pennsylvania 19426, United States
| | - Xi-Ping Zhang
- Cancer Epigenetics Research Unit, GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, Pennsylvania 19426, United States
| | | |
Collapse
|