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Reyes S, Vázquez-López F, Galache C, Díaz-Louzao C, González-López MA. Premature chondrodermatitis nodularis (<61 years): Another acquired perforating dermatosis with a potential association with diabetes mellitus in a two-centre, case-control, retrospective, 22-year study. J Dermatol 2023; 50:e384-e385. [PMID: 37424136 DOI: 10.1111/1346-8138.16886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023]
Affiliation(s)
- S Reyes
- Department of Dermatology, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
| | - F Vázquez-López
- Department of Dermatology, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
- GRIDER, Investigation Group of Dermatology Asturias, University of Oviedo, Oviedo, Spain
| | - C Galache
- Department of Dermatology, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain
- GRIDER, Investigation Group of Dermatology Asturias, University of Oviedo, Oviedo, Spain
| | - C Díaz-Louzao
- Research Methodology Group, University Clinical Hospital of Santiago, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - M A González-López
- Department of Dermatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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Porché M, Dumurgier J, Blaise C, Machado C, Reyes S, Paquet C. Inaugural late-onset temporal lobe epilepsy as a new non-cognitive Alzheimer's disease phenotype. Rev Neurol (Paris) 2023; 179:927-929. [PMID: 37598090 DOI: 10.1016/j.neurol.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 08/21/2023]
Affiliation(s)
- M Porché
- Department of Neurology, Lariboisière Hospital, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - J Dumurgier
- Center of Cognitive Neurology, Fernand-Widal Hospital, AP-HP, 200, rue du Faubourg Saint-Denis, 75010 Paris, France.
| | - C Blaise
- Department of Neurology, Lariboisière Hospital, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - C Machado
- Department of Neurology, Lariboisière Hospital, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - S Reyes
- Department of Neurology, Lariboisière Hospital, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
| | - C Paquet
- Center of Cognitive Neurology, Fernand-Widal Hospital, AP-HP, 200, rue du Faubourg Saint-Denis, 75010 Paris, France.
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Pappas L, Baiev I, Reyes S, Bocobo AG, Jain A, Spencer K, Le TM, Rahma OE, Maurer J, Stanton J, Zhang K, De Armas AD, Deleon TT, Roth M, Peters MLB, Zhu AX, Boyhen K, VanCott C, Patel T, Roberts LR, Lindsey S, Horick N, Lennerz JK, Iafrate AJ, Goff LW, Mody K, Borad MJ, Shroff RT, Javle MM, Kelley RK, Goyal L. The Cholangiocarcinoma in the Young (CITY) Study: Tumor Biology, Treatment Patterns, and Survival Outcomes in Adolescent Young Adults With Cholangiocarcinoma. JCO Precis Oncol 2023; 7:e2200594. [PMID: 37561981 PMCID: PMC10581631 DOI: 10.1200/po.22.00594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/06/2023] [Accepted: 04/06/2023] [Indexed: 08/12/2023] Open
Abstract
PURPOSE Increased awareness of the distinct tumor biology for adolescents and young adults (AYAs) with cancer has led to improvement in outcomes for this population. However, in cholangiocarcinoma (CCA), a paucity of data exist on the AYA population. To our knowledge, we present the largest study to date on AYA disease biology, treatment patterns, and survival outcomes in CCA. METHODS A multi-institutional cohort of patients with CCA diagnosed with intrahepatic cholangiocarcinoma (ICC) or extrahepatic cholangiocarcinoma (ECC) was used for analysis. Retrospective chart review was conducted on patients who were 50 years old and younger (young; n = 124) and older than 50 years (older; n = 723). RESULTS Among 1,039 patients screened, 847 patients met eligibility (72% ICC, 28% ECC). Young patients had a larger median tumor size at resection compared with older patients (4.2 v 3.6 cm; P = .048), more commonly had N1 disease (65% v 43%; P = .040), and were more likely to receive adjuvant therapy (odds ratio, 4.0; 95% CI, 1.64 to 9.74). Tumors of young patients were more likely to harbor an FGFR2 fusion, BRAF mutation, or ATM mutation (P < .05 for each). Young patients were more likely to receive palliative systemic therapy (96% v 69%; P < .001), targeted therapy (23% v 8%; P < .001), and treatment on a clinical trial (31% v 19%; P = .004). Among patients who presented with advanced disease, young patients had a higher median overall survival compared with their older counterparts (17.7 v 13.5 months; 95% CI, 12.6 to 22.6 v 11.4 to 14.8; P = .049). CONCLUSION Young patients with CCA had more advanced disease at resection, more commonly received both adjuvant and palliative therapies, and demonstrated improved survival compared with older patients. Given the low clinical trial enrollment and poor outcomes among some AYA cancer populations, data to the contrary in CCA are highly encouraging.
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Affiliation(s)
- Leontios Pappas
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Islam Baiev
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA
| | | | - Andrea Grace Bocobo
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Apurva Jain
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kristen Spencer
- Department of Medicine, NYU Langone Health Perlmutter Cancer Center, NYU School of Medicine, New York, NY
| | - Tri Minh Le
- Department of Medicine, University of Virginia Comprehensive Cancer Center, Charlottesville, VA
| | - Osama E. Rahma
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jordan Maurer
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA
| | - Jen Stanton
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA
| | - Karen Zhang
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Anaemy Danner De Armas
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Marc Roth
- Department of Medical Oncology, St Luke's Cancer Institute, Kansas City, MO
| | | | - Andrew X. Zhu
- Jiahui International Cancer Center, Jiahui Health, Shanghai, China
- I-MAB Biopharma, Shanghai, China
| | | | | | - Tushar Patel
- Department of Transplantation, Mayo Clinic, Jacksonville, FL
| | - Lewis R. Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | | | - Nora Horick
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA
| | - Jochen K. Lennerz
- Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - A. John Iafrate
- Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | | | - Kabir Mody
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL
| | - Mitesh J. Borad
- Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ
| | - Rachna T. Shroff
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ
| | - Milind M. Javle
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R. Katie Kelley
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Lipika Goyal
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Medicine, Division of Oncology, Stanford Cancer Center, Palo Alto, CA
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Spencer K, Pappas L, Baiev I, Maurer J, Bocobo AG, Zhang K, Jain A, De Armas AD, Reyes S, Le TM, Rahma OE, Stanton J, DeLeon TT, Roth M, Peters MLB, Zhu AX, Lennerz JK, Iafrate AJ, Boyhen K, VanCott C, Roberts LR, Lindsey S, Horick N, Goff LW, Mody K, Borad MJ, Shroff RT, Kelley RK, Javle MM, Goyal L. Molecular Profiling and Treatment Pattern Differences between Intrahepatic and Extrahepatic Cholangiocarcinoma. J Natl Cancer Inst 2023:7114547. [PMID: 37040087 DOI: 10.1093/jnci/djad046] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/08/2022] [Accepted: 02/02/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Treatment patterns for intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC) differ, but limited studies exist comparing them. This study examines differences in molecular profiling rates and treatment patterns in these populations, focusing on use of adjuvant, liver-directed, targeted, and investigational therapies. METHODS This multi-center collaboration included patients with ICC or ECC treated at one of eight participating institutions. Retrospective data were collected on risk factors, pathology, treatments, and survival. Comparative statistical tests were two-sided. RESULTS Among 1,039 patients screened, 847 patients met eligibility (ICC = 611, ECC = 236). Patients with ECC were more likely than those with ICC to present with early-stage disease (53.8% vs 28.0%), undergo surgical resection (55.1% vs 29.8%), and receive adjuvant chemoradiation (36.5% vs 4.2%), (all p < 0.00001). However, they were less likely to undergo molecular profiling (50.3% vs 64.3%) or receive liver directed therapy (17.9% vs 35.7%), targeted therapy (4.7% vs 18.9%), and clinical trial therapy (10.6% vs 24.8%), (all p < 0.001). In patients with recurrent ECC after surgery, the molecular profiling rate was 64.5%. Patients with advanced ECC had a shorter median overall survival than those with advanced ICC (11.8 vs 15.1 months, p < 0.001). CONCLUSIONS Patients with advanced ECC have low rates of molecular profiling, possibly in part due to insufficient tissue. They also have low rates of targeted therapy use and clinical trial enrollment. While these rates are higher in advanced ICC, the prognosis for both subtypes of cholangiocarcinoma remains poor, and a pressing need exists for new effective targeted therapies and broader access to clinical trials.
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Affiliation(s)
- Kristen Spencer
- Department of Medicine, NYU Langone Health Perlmutter Cancer Center, NYU School of Medicine, New York, NY, USA
| | - Leontios Pappas
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Islam Baiev
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Jordan Maurer
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Andrea Grace Bocobo
- University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Karen Zhang
- University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Apurva Jain
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anaemy Danner De Armas
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Tri Minh Le
- Department of Medicine, University of Virginia Emily Couric Clinical Cancer Center, Charlottesville, VA, USA
| | - Osama E Rahma
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jennifer Stanton
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Thomas T DeLeon
- Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ, USA
| | - Marc Roth
- Department of Medical Oncology, St. Luke's Health System, Kansas City, MO, USA
| | | | - Andrew X Zhu
- Jiahui Health, Jiahui International Cancer Center, Shanghai, China
| | - Jochen K Lennerz
- Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - A John Iafrate
- Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | | | | | - Lewis R Roberts
- Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Nora Horick
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA, USA
| | | | - Kabir Mody
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Mitesh J Borad
- Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ, USA
| | - Rachna T Shroff
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - R Katie Kelley
- University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Milind M Javle
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lipika Goyal
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA, USA
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Strebe J, Rich NE, Wang L, Singal AG, McBryde J, Silva M, Jackson V, Fullington H, Villarreal DL, Reyes S, Flores B, Jain MK. Patient Navigation Increases Linkage to Care and Receipt of Direct-acting Antiviral Therapy in Patients with Hepatitis C. Clin Gastroenterol Hepatol 2023; 21:988-994.e2. [PMID: 35577048 DOI: 10.1016/j.cgh.2022.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/09/2022] [Accepted: 04/21/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Patient navigation interventions can improve health outcomes in underserved, low-income, and racial and ethnic minority groups, who often experience health disparities. We examined the effectiveness of patient navigation to improve linkage to hepatitis C virus (HCV) treatment receipt in a socioeconomically disadvantaged, racially diverse patient population. METHODS We performed a pre-post analysis evaluating the effectiveness of a patient navigation program among baby boomers who tested positive for HCV in a safety-net health system. The usual care group (June 2013 to May 2015) and patient navigation group (January 2016 to December 2017) were balanced using a stabilized inverse probability of treatment weighting approach. We used logistic regression analyses to evaluate associations between patient navigation and linkage to care for HCV treatment evaluation, treatment initiation, and sustained virologic response. RESULTS Among 1353 patients (62% black, 61% uninsured, 16% homeless), 769 were in the usual care group, and 584 were in the patient navigation group. The patient navigation group had significantly higher odds of linkage to care (odds ratio [OR], 3.7; 95% confidence interval [CI], 2.9-4.8) and treatment initiation (OR, 3.2; 95% CI, 2.3-4.2) within 6 months. The patient navigation group continued to have increased linkage to care (OR, 3.4; 95% CI, 2.7-4.3) and treatment initiation (OR 2.3; 95% CI, 1.7-3.0) at 12 months. However, there was no significant difference in sustained virologic response between the groups (86.9% vs 86.1%; P = .78). CONCLUSIONS Patient navigation was associated with significantly increased linkage to care and treatment initiation among patients with HCV infection. Patient navigation programs can be used to promote HCV elimination among traditionally difficult-to-reach patient populations.
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Affiliation(s)
| | - Nicole E Rich
- Parkland Health and Hospital System, Dallas, Texas; Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas
| | - Li Wang
- Department of Internal Medicine, Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Amit G Singal
- Parkland Health and Hospital System, Dallas, Texas; Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas; Department of Internal Medicine, Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Jennifer McBryde
- Parkland Health and Hospital System, Dallas, Texas; Department of Internal Medicine, Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Mauro Silva
- Parkland Health and Hospital System, Dallas, Texas
| | | | - Hannah Fullington
- Department of Internal Medicine, Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Deyaun L Villarreal
- Department of Internal Medicine, Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Stephanie Reyes
- Department of Internal Medicine, Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Bertha Flores
- School of Nursing, UT Health San Antonio, San Antonio, Texas
| | - Mamta K Jain
- Parkland Health and Hospital System, Dallas, Texas; Department of Internal Medicine, Division of Infectious Disease and Geographic Medicine, UT Southwestern Medical Center, Dallas, Texas.
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Reyes S, Jabouley A, Alili N, De Sanctis MH, Machado C, Taleb A, Herve D, Dias-Gastellier N, Chabriat H. Psychological impact of COVID-19 containment on CADASIL patients. J Neurol 2023; 270:2370-2379. [PMID: 36869886 PMCID: PMC9985090 DOI: 10.1007/s00415-023-11648-8] [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: 01/16/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION COVID-19 restrictive containment was responsible for major psychological distress and alteration of quality of life (QoL) in the general population. Their impact in a group of patients having cerebral small vessel disease (SVD) and at high risk of stroke and disability was unknown. OBJECTIVE We aimed to determine the potential psychological impact of strict containment during the COVID-19 pandemic in a sample of CADASIL patients, a rare SVD caused by NOTCH3 gene mutations. METHODS Interviews of 135 CADASIL patients were obtained just after the end of the strict containment in France. Depression, QoL and negative subjective experience of the containment were analysed, as well as predictors of posttraumatic and stressor-related manifestations, defined as an Impact Event Scale-Revised score ≥ 24, using multivariable logistic analysis. RESULTS Only 9% of patients showed a depressive episode. A similar proportion had significant posttraumatic and stressor-related disorder manifestations independently associated only with socio-environment factors, rather than clinical ones: living alone outside a couple (OR 7.86 (1.87-38.32), unemployment (OR 4.73 (1.17-18.70)) and the presence of 2 or more children at home (OR 6.34 (1.35-38.34). CONCLUSION Psychological impact of the containment was limited in CADASIL patients and did not appear related to the disease status. About 9% of patients presented with significant posttraumatic and stressor-related disorder manifestations which were predicted by living alone, unemployment, or exhaustion related to parental burden.
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Affiliation(s)
- S Reyes
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - A Jabouley
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - N Alili
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - M H De Sanctis
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - C Machado
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - A Taleb
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - D Herve
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - N Dias-Gastellier
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - H Chabriat
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France. .,INSERM U1141-FHU-NeuroVasc, Paris, France.
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Hidalgo-Triana N, Picornell A, Reyes S, Circella G, Ribeiro H, Bates AE, Rojo J, Pearman PB, Vivancos JMA, Nautiyal S, Brearley FQ, Pereña J, Ferragud M, Monroy-Colín A, Maya-Manzano JM, Ouachinou JMAS, Salvo-Tierra AE, Antunes C, Trigo-Pérez M, Navarro T, Jaramillo P, Oteros J, Charalampopoulos A, Kalantzi OI, Freitas H, Ščevková J, Zanolla M, Marrano A, Comino O, Roldán JJ, Alcántara AF, Damialis A. Perceptions of change in the environment caused by the COVID-19 pandemic: Implications for environmental policy. Environ Impact Assess Rev 2023; 99:107013. [PMID: 36532697 PMCID: PMC9744709 DOI: 10.1016/j.eiar.2022.107013] [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] [Received: 08/23/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 lockdown measures have impacted the environment with both positive and negative effects. However, how human populations have perceived such changes in the natural environment and how they may have changed their daily habits have not been yet thoroughly evaluated. The objectives of this work were to investigate (1) the social perception of the environmental changes produced by the COVID-19 pandemic lockdown and the derived change in habits in relation to i) waste management, energy saving, and sustainable consumption, ii) mobility, iii) social inequalities, iv) generation of noise, v) utilization of natural spaces, and, vi) human population perception towards the future, and (2) the associations of these potential new habits with various socio-demographic variables. First, a SWOT analysis identified strengths (S), weaknesses (W), opportunities (O), and threats (T) generated by the pandemic lockdown measures. Second, a survey based on the aspects of the SWOT was administered among 2370 adults from 37 countries during the period from February to September 2021. We found that the short-term positive impacts on the natural environment were generally well recognized. In contrast, longer-term negative effects arise, but they were often not reported by the survey participants, such as greater production of plastic waste derived from health safety measures, and the increase in e-commerce use, which can displace small storefront businesses. We were able to capture a mismatch between perceptions and the reported data related to visits to natural areas, and generation of waste. We found that age and country of residence were major contributors in shaping the survey participants ´answers, which highlights the importance of government management strategies to address current and future environmental problems. Enhanced positive perceptions of the environment and ecosystems, combined with the understanding that livelihood sustainability, needs to be prioritized and would reinforce environmental protection policies to create greener cities. Moreover, new sustainable jobs in combination with more sustainable human habits represent an opportunity to reinforce environmental policy.
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Affiliation(s)
- N Hidalgo-Triana
- University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - A Picornell
- University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - S Reyes
- University of Málaga, Faculty of Philosophy and Letters, Department of Geography (Geographic Analysis Research Group), 29071 Málaga, Spain
| | - G Circella
- Institute of Transportation Studies, University of California, Davis, USA
- Department of Geography, Ghent University. 9000 Ghent, Belgium
| | - H Ribeiro
- Department of Geosciences, Environment and Spatial Plannings, Faculty of Sciences, University of Porto and Earth Sciences Institute (ICT), Pole of the Faculty of Sciences, University of Porto, Portugal
| | - A E Bates
- Department of Biology, University of Victoria, Victoria, BC, Canada
| | - J Rojo
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - P B Pearman
- Department of Plant Biology and Ecology, Faculty of Science and Technology, University of the Basque Country UPV/EHU, Leioa, Bizkaia 48940, Spain
- IKERBASQUE, Basque Foundation for Science, Plaza Euskadi 5, 48009 Bilbao, Spain
- BC3 Basque Centre for Climate Change, Scientific Campus, University of the Basque Country, 48940 Leioa, Bizkaia, Spain
| | - J M Artes Vivancos
- Department of Chemistry, Kennedy College of Sciences, UMass Lowell, Lowell, MA 01854, USA
| | - S Nautiyal
- Centre for Ecological Economics and Natural Resources (CEENR), Institute for Social and Economic Change (ISEC), Nagarabhavi, Bengaluru 560 072, India
| | - F Q Brearley
- Department of Natural Sciences, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK
| | - J Pereña
- University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - M Ferragud
- University of Valencia, Faculty of Sciences, Spain
| | - A Monroy-Colín
- University of Extremadura, Faculty of Sciences, Department of Vegetal Biology, Ecology and Earth Science (Botany Area), 06006 Badajoz, Spain
| | - J M Maya-Manzano
- University of Valencia, Faculty of Sciences, Spain
- Center of Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University and Helmholtz Center, Munich, Germany
- University of Extremadura, Faculty of Sciences, Department of Vegetal Biology, Ecology and Earth Science (Botany Area), 06006 Badajoz, Spain
| | - J M A Sènami Ouachinou
- Laboratoire de Botanique et Ecologie Végétale, Faculté des Sciences et Techniques, Universite d'Abomey-Calavi, Benin
| | - A E Salvo-Tierra
- Technical Director Chair Climate Change on UMA, University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - C Antunes
- Department of Medical and Health Sciences, School of Health and Human Development & Institute of Earth Sciences - ICT, University of Évora, Evora, Portugal
| | - M Trigo-Pérez
- University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - T Navarro
- University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - P Jaramillo
- Charles Darwin Research Station, Charles Darwin Foundation, Santa Cruz, Galápagos, 200102, Ecuador
| | - J Oteros
- Department of Botany, Ecology and Plant Physiology, Agrifood Campus of International Excellence CeiA3, Andalusian Inter-University Institute for Earth System IISTA, University of Cordoba, Cordoba, Spain
| | - A Charalampopoulos
- Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - O I Kalantzi
- Department of Environment, University of the Aegean, Mytilene 81100, Greece
| | - H Freitas
- University of Coimbra, Department of Life Sciences, Centre for Functional Ecology, 3000-456 Coimbra, Portugal
| | - J Ščevková
- Comenius University, Faculty of Natural Sciences, Department of Botany, Révová 39, 811 02 Bratislava, Slovakia
| | - M Zanolla
- University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - A Marrano
- Phoenix Bioinformatics, Fremont, CA, USA
| | - O Comino
- Estudios de Flora y Vegetación SL (EFYVE), 29580 Cártama, Málaga, Spain
| | - J J Roldán
- University of Málaga, Faculty of Sciences, Department of Botany and Plant Physiology (Botany Area), 29010 Málaga, Spain
| | - A F Alcántara
- Centro de Cooperación del Mediterráneo de UICN, 29590 Campanillas, Málaga, Spain
| | - A Damialis
- Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
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8
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Pal Chaudhary S, Reyes S, Chase ML, Govindan A, Zhao L, Luther J, Bhan I, Bethea E, Franses JW, Paige Walsh E, Anne Dageford L, Kimura S, Elias N, Yeh H, Markman J, Bozorgzadeh A, Tanabe K, Ferrone C, Zhu AX, Andersson K, Thiim M, Antonio Catalano O, Kambadakone A, Vagefi PA, Qadan M, Pratt D, Hashemi N, Corey KE, Misdraji J, Goyal L, Clark JW. Resection of NAFLD/NASH-related Hepatocellular Carcinoma (HCC): Clinical Features and Outcomes Compared with HCC Due to Other Etiologies. Oncologist 2023; 28:341-350. [PMID: 36763374 PMCID: PMC10078904 DOI: 10.1093/oncolo/oyac251] [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: 08/21/2022] [Accepted: 10/19/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the leading causes of hepatocellular carcinoma (HCC) worldwide. Limited data exist on surgical outcomes for NAFLD/NASH-related HCC compared with other HCC etiologies. We evaluated differences in clinicopathological characteristics and outcomes of patients undergoing surgical resection for NAFLD/NASH-associated HCC compared with other HCC etiologies. METHODS Demographic, clinicopathological features, and survival outcomes of patients with surgically resected HCC were collected. NAFLD activity score (NAS) and fibrosis score were assessed by focused pathologic review in a subset of patients. RESULTS Among 492 patients screened, 260 met eligibility (NAFLD/NASH [n = 110], and other etiologies [n = 150]). Median age at diagnosis was higher in the NAFLD/NASH HCC cohort compared with the other etiologies cohort (66.7 vs. 63.4 years, respectively, P = .005), with an increased percentage of female patients (36% vs. 18%, P = .001). NAFLD/NASH-related tumors were more commonly >5 cm (66.0% vs. 45%, P = .001). There were no significant differences in rates of lymphovascular or perineural invasion, histologic grade, or serum AFP levels. The NAFLD/NASH cohort had lower rates of background liver fibrosis, lower AST and ALT levels, and higher platelet counts (P < .01 for all). Median overall survival (OS) was numerically shorter in NAFLD/NASH vs other etiology groups, however, not statistically significant. CONCLUSIONS Patients with NAFLD/NASH-related HCC more commonly lacked liver fibrosis and presented with larger HCCs compared with patients with HCC from other etiologies. No differences were seen in rates of other high-risk features or survival. With the caveat of sample size and retrospective analysis, this supports a similar decision-making approach regarding surgical resection for NAFLD/NASH and other etiology-related HCCs.
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Affiliation(s)
- Surendra Pal Chaudhary
- Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA
| | | | | | | | - Lei Zhao
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jay Luther
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Irun Bhan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Emily Bethea
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joseph W Franses
- Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA
| | - Elizabeth Paige Walsh
- Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA
| | - Leigh Anne Dageford
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Shoko Kimura
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Nahel Elias
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Heidi Yeh
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - James Markman
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Adel Bozorgzadeh
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kenneth Tanabe
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Cristina Ferrone
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrew X Zhu
- Jiahui Health, Jiahui International Cancer Center, Shanghai, People's Republic of China
| | - Karin Andersson
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael Thiim
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Onofrio Antonio Catalano
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Avinash Kambadakone
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Parsia A Vagefi
- Division of Surgical Transplantation, University of Texas Southwestern, Dallas, TX, USA
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Daniel Pratt
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Nikroo Hashemi
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kathleen E Corey
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joseph Misdraji
- Department of Pathology, Yale New Haven Hospital, Yale University, New Haven, CT, USA
| | - Lipika Goyal
- Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA
| | - Jeffrey W Clark
- Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA
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9
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Sridharan V, Neyaz A, Chogule A, Baiev I, Reyes S, Barr Fritcher EG, Lennerz JK, Sukov W, Kipp B, Ting DT, Deshpande V, Goyal L. FGFR mRNA Expression in Cholangiocarcinoma and Its Correlation with FGFR2 Fusion Status and Immune Signatures. Clin Cancer Res 2022; 28:5431-5439. [PMID: 36190545 PMCID: PMC9751751 DOI: 10.1158/1078-0432.ccr-22-1244] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 04/25/2022] [Revised: 07/28/2022] [Accepted: 09/28/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Selective FGFR inhibitors are effective against cholangiocarcinomas that harbor gene alterations in FGFR2. Clinical trials suggest that expression of wild-type FGFR mRNA can predict sensitivity to FGFR inhibitors, but this biomarker has not been well characterized in cholangiocarcinoma. This study explores the prevalence of FGFR mRNA overexpression in cholangiocarcinoma, its role in predicting sensitivity to FGFR inhibitors, and its association with immune markers. EXPERIMENTAL DESIGN Tissue microarrays of intrahepatic (ICC) and extrahepatic cholangiocarcinomas (ECC) resected between 2004 and 2015 were used to evaluate FGFR1-4 mRNA expression levels by RNA in situ hybridization (ISH). Expression levels of FGFR2 mRNA were correlated with FGFR2 fusion status and with patient outcomes. Immune markers expression was assessed by IHC and CSF1 and CSF1 receptor expression were examined by RNA ISH. RESULTS Among 94 patients with resected cholangiocarcinoma, the majority had ICC (77%). FGFR2 fusions were identified in 23% of ICCs and 5% of ECCs. High levels of FGFR mRNA in FGFR2 fusion-negative ICC/ECC were seen for: FGFR1 (ICC/ECC: 15%/0%), FGFR2 (ICC/ECC: 57%/0%), FGFR3 (ICC/ECC: 53%/18%), and FGFR4 (ICC/ECC: 32%/0%). Overall, 62% of fusion-negative cholangiocarcinomas showed high levels of FGFR mRNA. In patients with advanced FGFR2 fusion-positive ICC, high levels of FGFR2 mRNA did not correlate with clinical benefit. FGFR2 fusion-positive tumors showed a paucity of PD-L1 on tumor cells. CONCLUSIONS FGFR mRNA overexpression occurs frequently in cholangiocarcinoma in the absence of genetic alterations in FGFR. This study identifies a molecular subpopulation in cholangiocarcinoma for which further investigation of FGFR inhibitors is merited outside currently approved indications.
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Affiliation(s)
- Vishwajith Sridharan
- Mass General Cancer Center, Boston, Massachusetts.,Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Azfar Neyaz
- Mass General Cancer Center, Boston, Massachusetts
| | | | - Islam Baiev
- Mass General Cancer Center, Boston, Massachusetts
| | - Stephanie Reyes
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | | | | | - William Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Benjamin Kipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - David T. Ting
- Mass General Cancer Center, Boston, Massachusetts.,Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Vikram Deshpande
- Mass General Cancer Center, Boston, Massachusetts.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lipika Goyal
- Mass General Cancer Center, Boston, Massachusetts.,Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Corresponding Author: Lipika Goyal, Stanford Cancer Center, 875 Blake Wilbur Drive, Palo Alto, CA 94304. Phone: 650-498-6000; E-mail:
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10
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Berchuck JE, Facchinetti F, DiToro DF, Baiev I, Majeed U, Reyes S, Chen C, Zhang K, Sharman R, Junior PLSU, Maurer J, Shroff RT, Pritchard CC, Wu MJ, Catenacci DVT, Javle M, Friboulet L, Hollebecque A, Bardeesy N, Zhu AX, Lennerz JK, Tan B, Borad M, Parikh AR, Kiedrowski LA, Kelley RK, Mody K, Juric D, Goyal L. The Clinical Landscape of Cell-Free DNA Alterations in 1,671 Patients with Advanced Biliary Tract Cancer. Ann Oncol 2022; 33:1269-1283. [PMID: 36089135 DOI: 10.1016/j.annonc.2022.09.150] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [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: 08/09/2022] [Revised: 08/18/2022] [Accepted: 09/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Targeted therapies have transformed clinical management of advanced biliary tract cancer (BTC). Cell-free DNA (cfDNA) analysis is an attractive approach for cancer genomic profiling that overcomes many limitations of traditional tissue-based analysis. We examined cfDNA as a tool to inform clinical management of patients with advanced BTC and generate novel insights into BTC tumor biology. PATIENTS AND METHODS We analyzed next-generation sequencing data of 2,068 cfDNA samples from 1,671 patients with advanced BTC generated with Guardant360. We performed clinical annotation on a multi-institutional subset (n=225) to assess intra-patient cfDNA-tumor concordance and the association of cfDNA variant allele fraction (VAF) with clinical outcomes. RESULTS Genetic alterations were detected in cfDNA in 84% of patients, with targetable alterations detected in 44% of patients. FGFR2 fusions, IDH1 mutations, and BRAF V600E were clonal in majority of cases, affirming these targetable alterations as early driver events in BTC. Concordance between cfDNA and tissue for mutation detection was high for IDH1 mutations (87%) and BRAF V600E (100%), and low for FGFR2 fusions (18%). cfDNA analysis uncovered novel putative mechanisms of resistance to targeted therapies, including mutation of the cysteine residue (FGFR2 C492F) to which covalent FGFR inhibitors bind. High pre-treatment cfDNA VAF associated with poor prognosis and shorter response to chemotherapy and targeted therapy. Finally, we report the frequency of promising targets in advanced BTC currently under investigation in other advanced solid tumors, including KRAS G12C (1.0%), KRAS G12D (5.1%), PIK3CA mutations (6.8%), and ERBB2 amplifications (4.9%). CONCLUSIONS These findings from the largest and most comprehensive study to date of cfDNA from patients with advanced BTC highlight the utility of cfDNA analysis in current management of this disease. Characterization of oncogenic drivers and mechanisms of therapeutic resistance in this study will inform drug development efforts to reduce mortality for patients with BTC.
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Affiliation(s)
- Jacob E Berchuck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Francesco Facchinetti
- Université Paris-Saclay, Institut Gustave Roussy, Inserm U981, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France
| | - Daniel F DiToro
- Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Islam Baiev
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA
| | - Umair Majeed
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL
| | | | - Christopher Chen
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - Karen Zhang
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - Reya Sharman
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ
| | | | - Jordan Maurer
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA
| | - Rachna T Shroff
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ
| | - Colin C Pritchard
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Meng-Ju Wu
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA
| | | | - Milind Javle
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Luc Friboulet
- Université Paris-Saclay, Institut Gustave Roussy, Inserm U981, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France
| | - Antoine Hollebecque
- Université Paris-Saclay, Institut Gustave Roussy, Inserm U981, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France
| | - Nabeel Bardeesy
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA
| | - Andrew X Zhu
- Jiahui International Cancer Center, Jihaui Health, Shanghai, China; I-Mab Biopharma, Shanghai, China
| | - Jochen K Lennerz
- Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Benjamin Tan
- Department of Medicine, Washington University, St. Louis, MO
| | - Mitesh Borad
- Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ
| | - Aparna R Parikh
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA
| | | | - Robin Kate Kelley
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - Kabir Mody
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL
| | - Dejan Juric
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA
| | - Lipika Goyal
- Department of Medicine, Mass General Cancer Center, Harvard Medical School, Boston, MA.
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11
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Ramos-Zaldívar H, Reyes-Perdomo K, Espinoza-Moreno N, Dox-Cruz E, Urbina T, Caballero A, Dominguez E, Calix S, Monterroso-Reyes J, Vásquez E, Ortiz T, Rodríguez-Machado H, Solis M, Silva I, Galeano M, Alvarado A, Medina A, Guerrero-Díaz L, Jiménez-Faraj J, Santos C, Arita W, Montufar D, Sabillón J, Sorto M, Navarro X, Palomo-Bermúdez V, Andino H, Guzman S, Reyes M, Pazf E, Enamorado J, Sagastume Y, Rivera A, Sarmiento C, Pineda X, Puerto V, Landaverde J, Reyes S, Perdomo I, Rivera J, Girón W, Sabillón K, Leiva P, Toro K, Montes-Gambarelli J, Flores C, Salas-Huenuleo E, Andia M. SAFETY AND EFFICACY OF THYMIC PEPTIDES IN THE TREATMENT OF HOSPITALIZED COVID-19 PATIENTS IN HONDURAS. Georgian Med News 2022:99-105. [PMID: 36427851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.
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Affiliation(s)
- H Ramos-Zaldívar
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 2Doctoral Program in Medical Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile
| | - K Reyes-Perdomo
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 3Psiquiatría Infantil y del Adolescente, Hospital Barros Luco Trudeau, Facultad de Ciencias Médicas, Universidad de Santiago de Chile
| | - N Espinoza-Moreno
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - E Dox-Cruz
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - Th Urbina
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - A Caballero
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - E Dominguez
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - S Calix
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - J Monterroso-Reyes
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - E Vásquez
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - T Ortiz
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - H Rodríguez-Machado
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - M Solis
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - I Silva
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - M Galeano
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - A Alvarado
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - A Medina
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - L Guerrero-Díaz
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - J Jiménez-Faraj
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 4Hospital Civil de Guadalajara Juan I. Menchaca, México
| | - C Santos
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 5Hospital del Valle, San Pedro Sula, Honduras
| | - W Arita
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - D Montufar
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - J Sabillón
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - M Sorto
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - X Navarro
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - V Palomo-Bermúdez
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 5Hospital del Valle, San Pedro Sula, Honduras
| | - H Andino
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - S Guzman
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - M Reyes
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - E Pazf
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - J Enamorado
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - Y Sagastume
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - A Rivera
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - C Sarmiento
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - X Pineda
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - V Puerto
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - J Landaverde
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - S Reyes
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - I Perdomo
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - J Rivera
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - W Girón
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - K Sabillón
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - P Leiva
- 7Triaje de Santa Bárbara, Secretaría de Salud de Honduras
| | - K Toro
- 7Triaje de Santa Bárbara, Secretaría de Salud de Honduras
| | - J Montes-Gambarelli
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - C Flores
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 8Laboratorio de Biología Molecular de San Pedro Sula, Secretaría de Salud de Honduras
| | | | - M Andia
- 10Biomedical Imaging Center Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; 11Millennium Nucleus in Cardiovascular Magnetic Resonance, Santiago, Chile
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12
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Focht Garand KL, Suiter DM, Reyes S, York JD, Chen IHA. Aspiration Screening in Motor Neuron Disease: Preliminary Results From Utilization of the Yale Swallow Protocol. Am J Speech Lang Pathol 2021; 30:2693-2699. [PMID: 34670101 DOI: 10.1044/2021_ajslp-21-00092] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Dysphagia is a common symptom experienced by patients with motor neuron disease (MND). The Yale Swallow Protocol (YSP) is a validated screening instrument for identifying patients at risk for aspiration. The purpose of this exploratory cross-sectional, multicenter study was to investigate how the YSP results in identifying aspiration risk in patients with MND in comparison with aspiration observed during a videofluoroscopic swallow study (VFSS). Method Participants referred for VFSS as part of clinical management were recruited from four specialized MND clinics. All participants were administered the YSP immediately prior to the VFSS by a speech-language pathologist, with results recorded as pass or fail. Aspiration on VFSS was determined using the Penetration-Aspiration Scale (scores 6-8). A 2 × 2 contingency table was constructed to compare results of YSP with those on VFSS. Results Thirty-one patients with MND (13 males, 18 females; M age = 64 ± 12 years) referred for VFSS participated in this study. Of the 22 patients who failed the YSP, interrupted drinking was the most frequent reason (65%). Compared to the VFSS, the YSP yielded a sensitivity of 80%, a specificity of 33%, positive predictive value of 36%, and negative predictive value of 78%. Conclusions The YSP is a simple tool and easy to utilize and has a high sensitivity in identifying aspiration risk in amyotrophic lateral sclerosis. A future investigation with a larger sample size is needed to better investigate the utility of YSP as a screening tool for this population.
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Affiliation(s)
| | - Debra M Suiter
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington
| | | | | | - I-Hweii Amy Chen
- Department of Neurology, Medical University of South Carolina, Charleston
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13
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Méndez R, Balanzá-Martínez V, Luperdi SC, Estrada I, Latorre A, González-Jiménez P, Feced L, Bouzas L, Yépez K, Ferrando A, Hervás D, Zaldívar E, Reyes S, Berk M, Menéndez R. Short-term neuropsychiatric outcomes and quality of life in COVID-19 survivors. J Intern Med 2021; 290:621-631. [PMID: 33533521 PMCID: PMC8013333 DOI: 10.1111/joim.13262] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND The general medical impacts of coronavirus (COVID-19) are increasingly appreciated. However, its impact on neurocognitive, psychiatric health and quality of life (QoL) in survivors after the acute phase is poorly understood. We aimed to evaluate neurocognitive function, psychiatric symptoms and QoL in COVID-19 survivors shortly after hospital discharge. METHODS This was a cross-sectional analysis of a prospective study of hospitalized COVID-19 survivors followed up for 2 months after discharge. A battery of standardized instruments evaluating neurocognitive function, psychiatric morbidity and QoL (mental and physical components) was administered by telephone. RESULTS Of the 229 screened patients, 179 were included in the final analysis. Amongst survivors, the prevalence of moderately impaired immediate verbal memory and learning was 38%, delayed verbal memory (11.8%), verbal fluency (34.6%) and working memory (executive function) (6.1%), respectively. Moreover, 58.7% of patients had neurocognitive impairment in at least one function. Rates of positive screening for anxiety, depression and post-traumatic stress disorder were 29.6%, 26.8% and 25.1%, respectively. In addition, 39.1% of the patients had psychiatric morbidity. Low QoL for physical and mental components was detected in 44.1% and 39.1% of patients respectively. Delirium and psychiatric morbidity were associated with neurocognitive impairment, and female gender was related with psychiatric morbidity. CONCLUSION Hospitalized COVID-19 survivors showed a considerable prevalence of neurocognitive impairment, psychiatric morbidity and poor QoL in the short term. It is uncertain if these impacts persist over the long term.
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Affiliation(s)
- R Méndez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain.,University of Barcelona, Barcelona, Spain
| | - V Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - S C Luperdi
- Psychiatry Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,University of Valencia, Valencia, Spain
| | - I Estrada
- University of Valencia, Valencia, Spain
| | - A Latorre
- Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - P González-Jiménez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - L Feced
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - L Bouzas
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - K Yépez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - A Ferrando
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - D Hervás
- Data Science, Biostatistics & Bioinformatics, Health Research Institute La Fe, Valencia, Spain
| | - E Zaldívar
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - S Reyes
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - M Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - R Menéndez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain.,University of Valencia, Valencia, Spain.,Center for Biomedical Research Network in Respiratory Diseases (CIBERES), Madrid, Spain
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14
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Pereira B, Chen CT, Goyal L, Walmsley C, Pinto CJ, Baiev I, Allen R, Henderson L, Saha S, Reyes S, Taylor MS, Fitzgerald DM, Broudo MW, Sahu A, Gao X, Winckler W, Brannon AR, Engelman JA, Leary R, Stone JR, Campbell CD, Juric D. Cell-free DNA captures tumor heterogeneity and driver alterations in rapid autopsies with pre-treated metastatic cancer. Nat Commun 2021; 12:3199. [PMID: 34045463 PMCID: PMC8160338 DOI: 10.1038/s41467-021-23394-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/23/2021] [Indexed: 02/04/2023] Open
Abstract
In patients with metastatic cancer, spatial heterogeneity of somatic alterations may lead to incomplete assessment of a cancer's mutational profile when analyzing a single tumor biopsy. In this study, we perform sequencing of cell-free DNA (cfDNA) and distinct metastatic tissue samples from ten rapid autopsy cases with pre-treated metastatic cancer. We show that levels of heterogeneity in genetic biomarkers vary between patients but that gene expression signatures representative of the tumor microenvironment are more consistent. Across nine patients with plasma samples available, we are able to detect 62/62 truncal and 47/121 non-truncal point mutations in cfDNA. We observe that mutation clonality in cfDNA is correlated with the number of metastatic lesions in which the mutation is detected and use this result to derive a clonality threshold to classify truncal and non-truncal driver alterations with reasonable specificity. In contrast, mutation truncality is more often incorrectly assigned when studying single tissue samples. Our results demonstrate the utility of a single cfDNA sample relative to that of single tissue samples when treating patients with metastatic cancer.
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Affiliation(s)
- Bernard Pereira
- grid.418424.f0000 0004 0439 2056Novartis Institutes for Biomedical Research, Cambridge, MA USA
| | - Christopher T. Chen
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Lipika Goyal
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Charlotte Walmsley
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Christopher J. Pinto
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Islam Baiev
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Read Allen
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Laura Henderson
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Supriya Saha
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Stephanie Reyes
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Martin S. Taylor
- grid.32224.350000 0004 0386 9924Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Donna M. Fitzgerald
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Maida Williams Broudo
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Avinash Sahu
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Xin Gao
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
| | - Wendy Winckler
- grid.418424.f0000 0004 0439 2056Novartis Institutes for Biomedical Research, Cambridge, MA USA
| | - A. Rose Brannon
- grid.418424.f0000 0004 0439 2056Novartis Institutes for Biomedical Research, Cambridge, MA USA
| | - Jeffrey A. Engelman
- grid.418424.f0000 0004 0439 2056Novartis Institutes for Biomedical Research, Cambridge, MA USA
| | - Rebecca Leary
- grid.418424.f0000 0004 0439 2056Novartis Institutes for Biomedical Research, Cambridge, MA USA
| | - James R. Stone
- grid.32224.350000 0004 0386 9924Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Catarina D. Campbell
- grid.418424.f0000 0004 0439 2056Novartis Institutes for Biomedical Research, Cambridge, MA USA
| | - Dejan Juric
- grid.38142.3c000000041936754XMassachusetts General Hospital Cancer Center, Department of Medicine, Harvard Medical School, Boston, MA USA
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15
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Huckvale S, Reyes S, Kulikova A, Rohatgi A, Riggs KA, Brown ES. An Association Between the Inflammatory Biomarker GlycA and Depressive Symptom Severity. J Clin Psychiatry 2020; 82:20m13245. [PMID: 33211910 PMCID: PMC7932005 DOI: 10.4088/jcp.20m13245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/02/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The underlying mechanisms of depression remain unclear; however, current literature suggests a relationship between inflammation and depression. The association between the inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) and depression has been previously investigated, but the relationship between GlycA, a novel spectroscopic inflammatory biomarker, and depression does not appear to have been examined. METHODS Data were obtained from The Dallas Heart Study (DHS, conducted between 2000 and 2002), which consisted of a large community-based sample of Dallas County residents (N = 3,033). Depressive symptom severity was assessed with the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). It was hypothesized that the serum GlycA level would be a statistically significant predictor of QIDS-SR scores after control for demographic covariates. Multiple linear regression was used to assess the relationship between GlycA level and QIDS-SR scores. The role of hs-CRP in predicting QIDS-SR scores was also explored. RESULTS GlycA level was a statistically significant positive predictor of QIDS-SR score (β = .053, P = .038) with control for sex, age, antidepressant use, ethnicity, smoking status, drinking status, body mass index, and years of education. In a subset of adults with moderate-to-severe depression, GlycA level was not associated with QIDS-SR scores. Additionally, hs-CRP level was not a statistically significant predictor of QIDS-SR scores. CONCLUSIONS This study found a positive association between the inflammatory biomarker GlycA, but not hs-CRP, and depressive symptom severity in a large multiethnic and multiracial community-based sample. Thus, these results provide the first indication that GlycA may be a potentially useful novel biomarker of depression.
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Affiliation(s)
- Samara Huckvale
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stephanie Reyes
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alexandra Kulikova
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Anand Rohatgi
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kayla A. Riggs
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - E. Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas,Corresponding author: E. Sherwood Brown, MD, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, MC 8849, Dallas, TX 75390-8849 ()
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16
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Ahrendsen KJ, Reyes S, Gay TJ. Helmholtz spacing of thin rectangular magnetic field coils. Rev Sci Instrum 2020; 91:116103. [PMID: 33261423 DOI: 10.1063/5.0023024] [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] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/13/2020] [Indexed: 06/12/2023]
Abstract
In this Note, we discuss the Helmholtz spacing for a pair of thin rectangular coils of arbitrary aspect ratio and consider how best to use such coils to compensate for Earth's magnetic field along the coils' Cartesian symmetry axes. Such coils are frequently used in conjunction with charged-particle beam machines. The Helmholtz spacing varies non-monotonically between that for square coils and that for four optimally spaced infinite wires. We consider other coil spacings that extend the length over which the field varies by less than some tolerance along the Cartesian symmetry axes. The calculations also provide a convenient means to evaluate when the length of the coils is sufficiently long to be considered infinite at the center point within a fixed tolerance.
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Affiliation(s)
- K J Ahrendsen
- Jorgensen Hall, University of Nebraska, Lincoln, Nebraska 68588-0299, USA
| | - S Reyes
- Jorgensen Hall, University of Nebraska, Lincoln, Nebraska 68588-0299, USA
| | - T J Gay
- Jorgensen Hall, University of Nebraska, Lincoln, Nebraska 68588-0299, USA
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17
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Baker D, Roberts CAK, Pryce G, Kang AS, Marta M, Reyes S, Schmierer K, Giovannoni G, Amor S. COVID-19 vaccine-readiness for anti-CD20-depleting therapy in autoimmune diseases. Clin Exp Immunol 2020; 202:149-161. [PMID: 32671831 PMCID: PMC7405500 DOI: 10.1111/cei.13495] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022] Open
Abstract
Although most autoimmune diseases are considered to be CD4 T cell- or antibody-mediated, many respond to CD20-depleting antibodies that have limited influence on CD4 and plasma cells. This includes rituximab, oblinutuzumab and ofatumumab that are used in cancer, rheumatoid arthritis and off-label in a large number of other autoimmunities and ocrelizumab in multiple sclerosis. Recently, the COVID-19 pandemic created concerns about immunosuppression in autoimmunity, leading to cessation or a delay in immunotherapy treatments. However, based on the known and emerging biology of autoimmunity and COVID-19, it was hypothesised that while B cell depletion should not necessarily expose people to severe SARS-CoV-2-related issues, it may inhibit protective immunity following infection and vaccination. As such, drug-induced B cell subset inhibition, that controls at least some autoimmunities, would not influence innate and CD8 T cell responses, which are central to SARS-CoV-2 elimination, nor the hypercoagulation and innate inflammation causing severe morbidity. This is supported clinically, as the majority of SARS-CoV-2-infected, CD20-depleted people with autoimmunity have recovered. However, protective neutralizing antibody and vaccination responses are predicted to be blunted until naive B cells repopulate, based on B cell repopulation kinetics and vaccination responses, from published rituximab and unpublished ocrelizumab (NCT00676715, NCT02545868) trial data, shown here. This suggests that it may be possible to undertake dose interruption to maintain inflammatory disease control, while allowing effective vaccination against SARS-CoV-29, if and when an effective vaccine is available.
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Affiliation(s)
- D. Baker
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - C. A. K. Roberts
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - G. Pryce
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - A. S. Kang
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- Centre for Oral Immunobiology and Regenerative MedicineInstitute of Dentistry, Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - M. Marta
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- Clinical Board: Medicine (Neuroscience)The Royal London HospitalBarts Health NHS TrustLondonUK
| | - S. Reyes
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- Clinical Board: Medicine (Neuroscience)The Royal London HospitalBarts Health NHS TrustLondonUK
| | - K. Schmierer
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- Clinical Board: Medicine (Neuroscience)The Royal London HospitalBarts Health NHS TrustLondonUK
| | - G. Giovannoni
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- Clinical Board: Medicine (Neuroscience)The Royal London HospitalBarts Health NHS TrustLondonUK
| | - S. Amor
- Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- Pathology DepartmentAmsterdam UMCVUmc siteAmsterdamThe Netherlands
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18
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Smets I, Reyes S, Giovannoni G. Distinguishing physiological versus pathological serum NfL levels in multiple sclerosis will require serial measurements. Mult Scler Relat Disord 2020; 46:102477. [PMID: 32889372 DOI: 10.1016/j.msard.2020.102477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Affiliation(s)
- I Smets
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom.
| | - S Reyes
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - G Giovannoni
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom; Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
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19
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Diaz M, Reyes S, Adur A, Cuartero V, Leon T, Raffa I, Sanchez P, Dioca M. P-7 Induction chemotherapy in locally advanced rectal cancer: Retrospective report of efficacy and safety in an Argentinean university institution, a feasibility perspective. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.089] [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: 10/23/2022] Open
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20
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Chaudhary SP, Goyal L, Chase ML, Zhu AX, Hashemi N, Reyes S, Corey KE, Misdraji J, Clark JW. Comparing clinicopathologic feature and treatment outcome of patients who underwent surgical resection or liver transplant for nonalcoholic fatty liver disease (NAFLD)-related and non-NAFLD related hepatocellular carcinoma (HCC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e16675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16675 Background: NAFLD associated HCC is rapidly increasing in frequency worldwide. In this study, we evaluated potential differences in clinical characteristics and outcomes of patients who underwent surgery or liver transplant for NAFLD-associated HCC compared to HCC from other etiologies. Methods: Demographic, clinicopathological features and outcomes of patients with HCC who underwent liver resection or liver transplant at Massachusetts General Hospital and Brigham and Women’s Hospital were collected (January 2004 - April 2018). Of 713 patients screened, 481were eligible: 260 underwent resection [NAFLD (n = 61), viral (n = 150), cryptogenic (CC) (n = 49)]. 221 underwent transplant [(NAFLD (n = 14), viral (n = 201), CC (n = 6)]. Results: In the Resected cohort, NAFLD patients presented with median age of (71.5 years) compared with Viral (63.4) and Cryptogenic (68.4). NAFLD patients had significantly higher Body Mass Index (BMI) > 28.8 39(66%) p = < 0.001, while patients with cryptogenic HCC presented with large tumor size (>5cm) 37(75%) p = 0.001. In multivariate analysis, tumor size 5cm (HR1.78,p = 0.002), R1 or R2 resection (HR 2.48, p = < 0.001and 2.8,p = 0.007), low platelet count (HR 2.8,p = 0.002) and diabetes (HR 1.5,p = 0.025) were poor prognostic factors in resection cohort. Median overall survival (OS) was not significantly different between NAFLD, Cryptogenic and Viral (47.2, 69.7 and 69.0 months, p = 0.18) etiologies, respectively. In the Transplant cohort, NAFLD patients had a median age of 65.5 and cryptogenic, viral (61.3 and 58.5 years) respectively. NAFLD and Cryptogenic HCC patients compared with viral HCC patients had low AFP median 3.7, 3.9 and 7.5 ng/mL(p = 0.012) respectively. In multivariate analysis patients with perineural invasion (HR 20.7,p = 0.009), disease recurrence (HR 2.5,p = 0.001) and high AFP (HR 2.1,p = 0.001) were at higher risk of death among transplant patients. No significant difference in median OS was seen between NAFLD, cryptogenic and viral (69.1,92.3 and 88.0 months, p = 0.38). Conclusions: NAFLD patients had higher BMI and had a lower AFP than viral and CC. NAFLD had similar median OS following resection and transplant when compared to those with Viral and CC.
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Affiliation(s)
| | | | | | - Andrew X. Zhu
- Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Nikroo Hashemi
- Gastroenterology and Hepatology, Brigham and Womens Hospital, Boston, MA
| | | | | | - Joseph Misdraji
- Department of Pathology, Massachusetts General Hospital, Boston, MA
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21
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Mateo-Casas M, Reyes S, O'Toole EA, De Trane S, Yildiz O, Allen-Philbey K, Mathews J, Baker D, Giovannoni G, Schmierer K. Severe skin reactions associated with cladribine in people with multiple sclerosis. Mult Scler Relat Disord 2020; 43:102140. [PMID: 32454296 DOI: 10.1016/j.msard.2020.102140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To report three cases of severe skin reactions in patients treated with cladribine for multiple sclerosis. METHODS Case study. RESULTS Patients developed severe rash 3-192 days after receiving cladribine. All were effectively treated with steroids and antihistamines. Additional doses of cladribine were administered after pretreatment with steroids and anti-histamines. One patient developed mild recurrence following re-exposure, which resolved within three days, whilst another patient tolerated re-exposure without further adverse reaction. CONCLUSION Severe skin reactions, well described in patients receiving cladribine for treatment of haematological conditions, may occur in patients treated with this compound for multiple sclerosis. Neurologists need to be aware of this rare, but significant adverse reaction. Re-exposure may be safe with standard pre-treatment against allergic reactions.
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Affiliation(s)
- M Mateo-Casas
- The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology, Hospital General Universitario de Castellón, Castellón de la Plana, Spain
| | - S Reyes
- The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - E A O'Toole
- The Blizard Institute (Cell Biology & Cutaneous Research), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - S De Trane
- The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - O Yildiz
- The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - K Allen-Philbey
- Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - J Mathews
- Pathology and Pharmacy, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - D Baker
- The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - G Giovannoni
- The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - K Schmierer
- The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK.
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Pappas L, Reyes S, Lanka A, Shroff RT, Le TM, Rahma OE, Bocobo AG, Borad MJ, DeLeon T, Mody K, Roth MT, Peters MLB, Goff LW, Boyhen K, VanCott C, Horick N, Zhu AX, Javle MM, Kelley RK, Goyal L. Comparison of the clinical features, treatment patterns, and tumor mutations of patients with intrahepatic (ICC) and extrahepatic (ECC) cholangiocarcinoma. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
580 Background: Though studies indicate that the genomic profiles of ICC and ECC are distinct, the clinical features that differentiate them still remain to be well characterized. The purpose of this study was to further analyze these differences and patient treatment patterns in a multi-center cohort. Methods: A retrospective chart review was performed at 8 institutions on patients (pts) with ICC or ECC diagnosed after June 2009. Data on demographics, risk factors, treatments, pathology and overall survival (OS) were collected. Tumor genotyping results from CLIA-certified tissue assays were analyzed. Fisher’s exact, Wilcoxon rank sum and log-rank tests were used to compare sub-groups. Results: In a database of 737 pts with cholangiocarcinoma, 538(73%) had ICC and 199(27%) had ECC. Pts with ICC more often presented in later stages, had tumors > 5cm at resection (p < 0.0001) and had metastases to the liver, lymph nodes, lung and/or bone (p < 0.01). Pts with ICC more often received liver directed therapy, targeted therapy and multiple lines of systemic therapy and they more often enrolled in a clinical trial (all p < 0.01). Pts with ECC were more likely to be male, undergo surgery, receive adjuvant chemotherapy and/or chemoradiation (all p < 0.05). Mutation profiling performed in 381 (52%) pts (ICC/ECC = 301/80) showed that pts with ICC were more likely to have IDH1 mutations and FGFR2 fusions, whereas pts with ECC were more likely to have KRAS, APC, SMAD4, WNT, TGFb and TP53 mutations (all < 0.05). Factors that did not differ significantly between pts with ICC and ECC include race, rates of primary sclerosing cholangitis, median diagnosis CA19-9 levels and R1 resection rate. Median OS from diagnosis was 18.9 months in ICC and 17.3 months in ECC (p = 0.8471). Conclusions: While pts with ICC and ECC have some similarities in their clinical features, differences in metastases patterns and molecular profiling significantly impact their management such that pts with ICC receive more liver-directed therapy, targeted therapy and more lines of systemic therapy. Further prospective studies are needed as referral patterns to tertiary care centers may have impacted these results.
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Affiliation(s)
| | | | | | | | | | | | - Andrea Grace Bocobo
- UC San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | | | | | | | | | | | | | | | | | - Nora Horick
- Massachusetts General Hospital Biostatistics Center, Boston, MA
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Lawless ME, Anderson S, Reyes S, Mead E, Leon J, Martin S, Seeholzer E, Bardaro S, Gasiewski R. A476 Prolonged lead times may impact steps required for Weight Loss Surgery (WLS). Surg Obes Relat Dis 2019. [DOI: 10.1016/j.soard.2019.08.414] [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: 10/25/2022]
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24
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Pimenov OY, Galimova MH, Evdokimovskii EV, Averin AS, Nakipova OV, Reyes S, Alekseev AE. Myocardial α2-Adrenoceptors as Therapeutic Targets to Prevent Cardiac Hypertrophy and Heart Failure. Biophysics (Nagoya-shi) 2019. [DOI: 10.1134/s000635091905021x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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25
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Goyal L, Shi L, Liu LY, Fece de la Cruz F, Lennerz JK, Raghavan S, Leschiner I, Elagina L, Siravegna G, Ng RWS, Vu P, Patra KC, Saha SK, Uppot RN, Arellano R, Reyes S, Sagara T, Otsuki S, Nadres B, Shahzade HA, Dey-Guha I, Fetter IJ, Baiev I, Van Seventer EE, Murphy JE, Ferrone CR, Tanabe KK, Deshpande V, Harding JJ, Yaeger R, Kelley RK, Bardelli A, Iafrate AJ, Hahn WC, Benes CH, Ting DT, Hirai H, Getz G, Juric D, Zhu AX, Corcoran RB, Bardeesy N. TAS-120 Overcomes Resistance to ATP-Competitive FGFR Inhibitors in Patients with FGFR2 Fusion-Positive Intrahepatic Cholangiocarcinoma. Cancer Discov 2019; 9:1064-1079. [PMID: 31109923 DOI: 10.1158/2159-8290.cd-19-0182] [Citation(s) in RCA: 230] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/16/2019] [Accepted: 05/15/2019] [Indexed: 02/07/2023]
Abstract
ATP-competitive fibroblast growth factor receptor (FGFR) kinase inhibitors, including BGJ398 and Debio 1347, show antitumor activity in patients with intrahepatic cholangiocarcinoma (ICC) harboring activating FGFR2 gene fusions. Unfortunately, acquired resistance develops and is often associated with the emergence of secondary FGFR2 kinase domain mutations. Here, we report that the irreversible pan-FGFR inhibitor TAS-120 demonstrated efficacy in 4 patients with FGFR2 fusion-positive ICC who developed resistance to BGJ398 or Debio 1347. Examination of serial biopsies, circulating tumor DNA (ctDNA), and patient-derived ICC cells revealed that TAS-120 was active against multiple FGFR2 mutations conferring resistance to BGJ398 or Debio 1347. Functional assessment and modeling the clonal outgrowth of individual resistance mutations from polyclonal cell pools mirrored the resistance profiles observed clinically for each inhibitor. Our findings suggest that strategic sequencing of FGFR inhibitors, guided by serial biopsy and ctDNA analysis, may prolong the duration of benefit from FGFR inhibition in patients with FGFR2 fusion-positive ICC. SIGNIFICANCE: ATP-competitive FGFR inhibitors (BGJ398, Debio 1347) show efficacy in FGFR2-altered ICC; however, acquired FGFR2 kinase domain mutations cause drug resistance and tumor progression. We demonstrate that the irreversible FGFR inhibitor TAS-120 provides clinical benefit in patients with resistance to BGJ398 or Debio 1347 and overcomes several FGFR2 mutations in ICC models.This article is highlighted in the In This Issue feature, p. 983.
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Affiliation(s)
- Lipika Goyal
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lei Shi
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Leah Y Liu
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ferran Fece de la Cruz
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jochen K Lennerz
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Srivatsan Raghavan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | | | | | - Giulia Siravegna
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino, Candiolo, Torino, Italy
| | - Raymond W S Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Phuong Vu
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Krushna C Patra
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Supriya K Saha
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Raul N Uppot
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ron Arellano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stephanie Reyes
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Takeshi Sagara
- Tsukuba Research Institute, Taiho Pharmaceutical Co., Ltd., Japan
| | - Sachie Otsuki
- Tsukuba Research Institute, Taiho Pharmaceutical Co., Ltd., Japan
| | - Brandon Nadres
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Heather A Shahzade
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ipsita Dey-Guha
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Isobel J Fetter
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Islam Baiev
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emily E Van Seventer
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Janet E Murphy
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cristina R Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kenneth K Tanabe
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Vikram Deshpande
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - James J Harding
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rona Yaeger
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robin K Kelley
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Alberto Bardelli
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino, Candiolo, Torino, Italy
| | - A John Iafrate
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - William C Hahn
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Cyril H Benes
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David T Ting
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hiroshi Hirai
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gad Getz
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Dejan Juric
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew X Zhu
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Ryan B Corcoran
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Nabeel Bardeesy
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. .,Broad Institute of Harvard and MIT, Cambridge, Massachusetts
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Brice S, Jabouley A, Reyes S, Machado C, Rogan C, Gastellier N, Chabriat H, Tezenas du Montcel S. Profil évolutif cognitif au cours de l’angiopathie Cadasil. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.085] [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: 11/25/2022] Open
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27
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McCauley JL, Reyes S, Meyerowitz C, Gordan VV, Rindal DB, Gilbert GH, Leite RS, Fillingim RB, Brady KT. Training experiences regarding pain management, addiction, and drug diversion of dentists enrolled in the National Dental Practice-Based Research Network. Subst Abus 2019; 40:344-349. [PMID: 30829128 DOI: 10.1080/08897077.2019.1576085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/27/2022]
Abstract
Background: The purpose of this study was to describe dentists' training experiences relevant to pain management, addiction, and prescription opioid drug diversion and examine associations between these training experiences and dentists' opioid prescribing practices. Methods: A Web-based, cross-sectional survey was conducted among practicing dentist members of the National Dental Practice-Based Research Network (PBRN; N = 822). The survey assessed pain management prescribing practices and training experiences related to pain management and assessment for addiction and drug diversion. Survey data were linked with National Dental PBRN Enrollment Questionnaire data regarding practitioner demographics and practice characteristics. Results: The majority of dentists (67%) reported prior training in pain management; however, a minority of dentists reported prior training regarding identification and assessment of drug abuse or addiction (48%) or identification of prescription drug diversion (25%). The majority of training experiences across all topics occurred through continuing dental education participation. Dental school training relevant to pain management, addiction, and identification of drug diversion was more prevalent among more recent dental school graduates. Training experiences were associated with prescribing practices. Conclusions: Results suggest that across multiple levels of training, many dentists are not receiving training specific to addiction assessment and identification of drug diversion. Such training is associated with greater consistency of risk mitigation implementation in practice.
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Affiliation(s)
- Jenna L McCauley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Stephanie Reyes
- Department of Periodontics, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Valeria V Gordan
- Department of Restorative Dental Sciences, University of Florida, Gainesville, Florida, USA
| | - D Brad Rindal
- HealthPartners Institute, Bloomington, Minnesota, USA
| | - Gregg H Gilbert
- Department of Clinical & Community Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Renata S Leite
- Department of Stomatology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Sciences, University of Florida, Gainesville, Florida, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, USA
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Martín M, Barrios CH, Torrecillas L, Ruiz-Borrego M, Bines J, Segalla J, Ruiz A, García-Sáenz JA, Torres R, de la Haba J, García E, Gómez HL, Llombart A, Rodríguez de la Borbolla M, Baena JM, Barnadas A, Calvo L, Pérez-Michel L, Ramos M, Castellanos J, Rodríguez-Lescure A, Cárdenas J, Vinholes J, Martínez de Dueñas E, Godes MJ, Seguí MA, Antón A, López-Álvarez P, Moncayo J, Amorim G, Villar E, Reyes S, Sampaio C, Cardemil B, Escudero MJ, Bezares S, Carrasco E, Lluch A. Abstract GS2-04: Efficacy results from CIBOMA/2004-01_GEICAM/2003-11 study: A randomized phase III trial assessing adjuvant capecitabine after standard chemotherapy for patients with early triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs2-04] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Triple negative breast cancers (TNBC) have a greater risk of relapse than non-TNBC. New therapeutic approaches are needed for these patients (pts). CIBOMA/2004-01_GEICAM/2003-11 is a multinational, randomized phase III trial exploring adjuvant capecitabine (X) after completion of standard treatment in early TNBC pts.
Materials and Methods: Patients with operable, node-positive (or node-negative with tumor size ≥ 1 cm), centrally confirmed hormone receptor-negative, HER2-negative early BC, who had received 6–8 cycles (cy) of standard anthracycline and/or taxane-containing chemotherapy or 4 cy of doxorubicin-cyclophosphamide (for node-negative disease) in the (neo)adjuvant setting, were eligible. Patients were randomized to either 8 cy of X (1,000 mg/m2 bid, days 1–14, every 3 weeks) or observation. Stratification factors included center, prior taxane-based therapy, number of involved axillary lymph nodes and phenotype (basal vs non-basal, according to cytokeratins 5/6 and/or EGFR positivity). The primary objective was to compare the disease-free survival (DFS) between both treatment arms, and secondary objectives included the comparison in terms of 5-year DFS, overall survival (OS) and safety. Assuming a 30% risk reduction in DFS rate at 5 years (from 64.7% to 73.7%, hazard ratio 0.70) with 80% power and a two-tailed log-rank test at 0.05, 834 evaluable pts were needed. 876 pts had to be finally enrolled considering a drop-out rate of 5%.
Results: Recruitment of 876 pts from 8 countries was completed in September 2011. Median age was 49 years; 68.5% of pts were postmenopausal, 55.5% were lymph node negative, 71.7% had a basal phenotype, 67.5% received chemotherapy based on anthracyclines and taxanes. Median follow-up was 7.3 years (range 0.0 to 11.1). DFS was not significantly prolonged with X vs observation (hazard ratio (HR) 0.82; 95% confidence interval (CI), 0.63 to 1.06; P=0.1353). Five-year DFS was 79.6% (95% CI, 75.8% to 83.4%) with X and 76.8% (95% CI, 72.7% to 80.9%) with observation. OS was not statistically different between treatment arms (HR 0.92; 95% CI, 0.66 to 1.28; P=0.6228). In subgroup analysis for DFS, we found no statistically significant interaction between X treatment and different subgroups, with the exception of basal vs non-basal phenotypes (basal HR 0.97, 95% CI 0.72 to 1.32, P=0.8620; non-basal HR 0.51, 95% CI, 0.31 to 0.86, P=0.0101; interaction P=0.0357). Similar results were found for OS (basal HR 1.20, 95% CI 0.81 to 1.77, P=0.3684; non-basal HR 0.48, 95% CI, 0.26 to 0.91, P=0.0205; interaction P=0.0155). 75.2% of pts completed 8 cy of X, with a median relative dose intensity of 86.3%. Grade (G) 3 or higher adverse events (AEs) were observed in 40.4% of pts in X arm. In 9.6% of pts the AEs were related with X. Hand-foot syndrome was the most common AE in X arm (G3 on 18.8% of pts).
Conclusions: In our study, the addition of adjuvant X after standard (neo) adjuvant anthracycline and/or taxane-containing chemotherapy was not associated with a statistically significant improvement of DFS or OS compared to observation in pts with early TNBC. However, in a subgroup analysis a significant DFS and OS improvement was observed with X in pts with non-basal phenotype.
Sponsor: CIBOMA.
Citation Format: Martín M, Barrios CH, Torrecillas L, Ruiz-Borrego M, Bines J, Segalla J, Ruiz A, García-Sáenz JA, Torres R, de la Haba J, García E, Gómez HL, Llombart A, Rodríguez de la Borbolla M, Baena JM, Barnadas A, Calvo L, Pérez-Michel L, Ramos M, Castellanos J, Rodríguez-Lescure A, Cárdenas J, Vinholes J, Martínez de Dueñas E, Godes MJ, Seguí MA, Antón A, López-Álvarez P, Moncayo J, Amorim G, Villar E, Reyes S, Sampaio C, Cardemil B, Escudero MJ, Bezares S, Carrasco E, Lluch A. Efficacy results from CIBOMA/2004-01_GEICAM/2003-11 study: A randomized phase III trial assessing adjuvant capecitabine after standard chemotherapy for patients with early triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS2-04.
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Affiliation(s)
- M Martín
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - CH Barrios
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - L Torrecillas
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - M Ruiz-Borrego
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - J Bines
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - J Segalla
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - A Ruiz
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - JA García-Sáenz
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - R Torres
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - J de la Haba
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - E García
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - HL Gómez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - A Llombart
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - M Rodríguez de la Borbolla
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - JM Baena
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - A Barnadas
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - L Calvo
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - L Pérez-Michel
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - M Ramos
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - J Castellanos
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - A Rodríguez-Lescure
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - J Cárdenas
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - J Vinholes
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - E Martínez de Dueñas
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - MJ Godes
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - MA Seguí
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - A Antón
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - P López-Álvarez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - J Moncayo
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - G Amorim
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - E Villar
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - S Reyes
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - C Sampaio
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - B Cardemil
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - MJ Escudero
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - S Bezares
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - E Carrasco
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
| | - A Lluch
- Hospital General Universitario Gregorio Marañón, Madrid, Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Universidad Complutense, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre/RS, Brazil; Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico DF, Mexico; Hospital Universitario Virgen del Rocío, Seville, Spain; Instituto Nacional de Câncer (INCA) José Alencar Gomes da Silva, Rio de Janeiro, Brazil; Hospital Amaral Carvalho, Chácara Braz Miraglia, Jaú - SP, Brazil; Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico San Carlos, Madrid, Spain; Instituto Nacional del Cáncer, Santiago, Chile; Hospital Universitario Reina Sofía, Córdoba, Spain; Hospital General Universitario Morales Messeguer, Murcia, Spain; In
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Cho P, Reyes S, Boost M. Microbiocidal characterization of a novel povidone-iodine based rigid contact lens disinfecting solution. Cont Lens Anterior Eye 2018; 41:542-546. [DOI: 10.1016/j.clae.2018.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/02/2018] [Accepted: 08/02/2018] [Indexed: 01/09/2023]
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Rojo V, Vázquez P, Reyes S, Puente Fuertes L, Cervero M. [Risk factors and clinical evolution of carbapenemase-producing Klebsiella pneumoniae infections in a university hospital in Spain. Case-control study]. Rev Esp Quimioter 2018; 31:427-434. [PMID: 30229644 PMCID: PMC6194862] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 12/04/2022]
Abstract
OBJECTIVE Carbapenemase-producing Enterobacterias is a global health hazard due to their ease of transmission, difficulty of treatment, and their personal and economic impact. We analyze the factors associated with an increased risk of infection by Klebsiella pneumoniae carbapenemase-producing bacteria (KPC) and factors related to poor prognosis. METHODS We designed a case-control study. KPC isolates were taken during an outbreak in a hospital in Madrid. A logistic regression was performed with the main variables. RESULTS Sixteen cases of clinically documented infections were isolated. Overall mortality rates in the cases group was 25%. The most frequent location was blood (37.5%) followed by urine (25%). All but one were OXA-48. Regarding factors related to an increased risk of developing infection, only previous exposure to antibiotics presented statistical significance difference OR 13 (2.40-70.46). With respect to the overall mortality, the presence of pneumonia OR 25 (1.93-323.55) or the use of invasive mechanical ventilation was associated with greater risk 15 OR 33 (1.92-122.8) For attributable mortality only invasive ventilation had a significant association OR 18 (1.48-218.95). CONCLUSIONS Exposure to previous antibiotics is an independent risk factor for developing KPC infection, adjusted for all other clinical and demographic variables. Risk factors such as the presence of pneumonia or the use of invasive mechanical ventilation were associated with a worse prognosis in terms of overall and attributable mortality.
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Affiliation(s)
- V Rojo
- Víctor Rojo, Servicio de Urgencias, Hospital Central de La Defensa Gómez Ulla. Madrid. Spain.
| | - P Vázquez
- Pedro Vázquez, Servicio de Urgencias, Hospital Universitario Severo Ochoa, Leganés, Madrid. Spain.
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Hervé D, Kossorotoff M, Bresson D, Blauwblomme T, Carneiro M, Touze E, Proust F, Desguerre I, Alamowitch S, Bleton JP, Borsali A, Brissaud E, Brunelle F, Calviere L, Chevignard M, Geffroy-Greco G, Faesch S, Habert MO, De Larocque H, Meyer P, Reyes S, Thines L, Tournier-Lasserve E, Chabriat H. French clinical practice guidelines for Moyamoya angiopathy. Rev Neurol (Paris) 2018. [PMID: 29519672 DOI: 10.1016/j.neurol.2017.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Goyal L, Zheng H, Abrams TA, Miksad RA, Bullock AJ, Allen JN, Yurgelun MB, Sheehan S, Lynch P, Afflitto AJ, Dinicola C, Maurer JR, Reyes S, Knowles M, Galway A, Clark JW, Birnbaum E, Khachatryan A, Duda GD, Zhu AX. A phase 2 and biomarker study of sorafenib combined with FOLFOX in patients with advanced hepatocellular carcinoma (HCC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
270 Background: Sorafenib is the standard first line treatment for advanced HCC and showed a median time to progression (TTP) of 5.5 months and an overall response rate (ORR) of 2% in the phase III SHARP trial. FOLFOX has shown modest activity in HCC with a progression free survival (PFS) of 2.9 months and ORR of 8% in a phase III trial. In this single-arm, multicenter phase 2 and biomarker study, sorafenib plus FOLFOX was evaluated in the first line treatment of advanced HCC. Methods: Patients with histologically proven advanced HCC, Child Pugh A liver function, and no prior systemic therapies received sorafenib 400mg orally twice daily during a 2-week lead-in, followed by concurrent modified FOLFOX (5-FUCI 1200mg/m2/day for 46 hours and LV 400mg/m2 bolus, Oxaliplatin 85mg/m2) on day 1 and 15 of each 28-day cycle. The primary endpoint was TTP, calculated from date of study entry to date of radiological or clinical disease progression. Serial plasma anti-angiogenic and anti-inflammatory biomarkers were evaluated. Results: The study enrolled 40 patients with advanced HCC: median age, 65 years; male 85%; Child Pugh A5, 70%; BCLC stage C, 95%; HCC etiology, HCV 40%, HBV 13%, alcohol 13%. Grade 3/4 adverse events were notable for AST (23%), ALT (15%), bilirubin (10%), diarrhea (10%), anemia (10%), hypertension (5%), hand-foot syndrome (5%), and thrombocytopenia (5%). Dose reductions for sorafenib and FOLFOX were done in 73% and 65% of patients, respectively. The median TTP was 8.8 months (95%CI, 6.5-11.2). The ORR was 18%, and the stable disease rate was 55%. Among 36 patients with a baseline AFP ≥ 5 ng/mL, 10 (28%) had a ≥ 50% drop in AFP. Low baseline plasma levels of sVEGFR1, VEGF-C, and bFGF and high levels of s-cMET and IL-12 tended to associate with longer TTP (p < 0.10). Decreased s-cMET at day 15 and decreased s-cMET and IL-2 at day 43 were associated with longer TTP (p < 0.05). Conclusions: Sorafenib+FOLFOX demonstrated encouraging clinical efficacy with moderate toxicity in the first line treatment of advanced HCC. Initial biomarker evaluation suggested a correlation between TTP and baseline angiogenic markers as well as changes in IL-2 and s-cMET. Complete biomarker analysis will be presented at the meeting. Clinical trial information: NCT01775501.
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Affiliation(s)
- Lipika Goyal
- Massachusetts General Hospital/ Harvard Medical School, Boston, MA
| | - Hui Zheng
- Massachusetts General Hospital, Boston, MA
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Delorme S, De Guio F, Reyes S, Jabouley A, Chabriat H, Jouvent E. Reaction Time Is Negatively Associated with Corpus Callosum Area in the Early Stages of CADASIL. AJNR Am J Neuroradiol 2017; 38:2094-2099. [PMID: 28912283 DOI: 10.3174/ajnr.a5378] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/23/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Reaction time was recently recognized as a marker of subtle cognitive and behavioral alterations in the early clinical stages of CADASIL, a monogenic cerebral small-vessel disease. In unselected patients with CADASIL, brain atrophy and lacunes are the main imaging correlates of disease severity, but MR imaging correlates of reaction time in mildly affected patients are unknown. We hypothesized that reaction time is independently associated with the corpus callosum area in the early clinical stages of CADASIL. MATERIALS AND METHODS Twenty-six patients with CADASIL without dementia (Mini-Mental State Examination score > 24 and no cognitive symptoms) and without disability (modified Rankin Scale score ≤ 1) were compared with 29 age- and sex-matched controls. Corpus callosum area was determined on 3D-T1 MR imaging sequences with validated methodology. Between-group comparisons were performed with t tests or χ2 tests when appropriate. Relationships between reaction time and corpus callosum area were tested using linear regression modeling. RESULTS Reaction time was significantly related to corpus callosum area in patients (estimate = -7.4 × 103, standard error = 3.3 × 103, P = .03) even after adjustment for age, sex, level of education, and scores of depression and apathy (estimate = -12.2 × 103, standard error = 3.8 × 103, P = .005). No significant relationship was observed in controls. CONCLUSIONS Corpus callosum area, a simple and robust imaging parameter, appears to be an independent correlate of reaction time at the early clinical stages of CADASIL. Further studies will determine whether corpus callosum area can be used as an outcome in future clinical trials in CADASIL or in more prevalent small-vessel diseases.
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Affiliation(s)
- S Delorme
- From the University Paris Diderot (S.D., F.D.G., H.C., E.J.), Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France
| | - F De Guio
- From the University Paris Diderot (S.D., F.D.G., H.C., E.J.), Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France.,DHU NeuroVasc Sorbonne Paris Cité (F.D.G., H.C., E.J.), Paris, France
| | - S Reyes
- Department of Neurology (S.R., A.J., H.C., E.J.), AP-HP, Lariboisière Hospital, Paris, France
| | - A Jabouley
- Department of Neurology (S.R., A.J., H.C., E.J.), AP-HP, Lariboisière Hospital, Paris, France
| | - H Chabriat
- From the University Paris Diderot (S.D., F.D.G., H.C., E.J.), Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France.,DHU NeuroVasc Sorbonne Paris Cité (F.D.G., H.C., E.J.), Paris, France.,Department of Neurology (S.R., A.J., H.C., E.J.), AP-HP, Lariboisière Hospital, Paris, France
| | - E Jouvent
- From the University Paris Diderot (S.D., F.D.G., H.C., E.J.), Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France .,DHU NeuroVasc Sorbonne Paris Cité (F.D.G., H.C., E.J.), Paris, France.,Department of Neurology (S.R., A.J., H.C., E.J.), AP-HP, Lariboisière Hospital, Paris, France
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Goyal L, Saha SK, Liu LY, Siravegna G, Leshchiner I, Ahronian LG, Lennerz JK, Vu P, Mussolin B, Reyes S, Furet P, Iafrate AJ, Getz G, Porta DG, Tiedt R, Bardelli A, Juric D, Corcoran RB, Bardeesy N, Zhu AX. Abstract 4114: Polyclonal secondary FGFR2 mutations drive acquired resistance to FGFR inhibition in FGFR2 fusion-positive cholangiocarcinoma patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Genetic alterations in the fibroblast growth factor receptor (FGFR) pathway are promising therapeutic targets in a broad range of cancers and occur in ~20% of ICCs. As seen with other targeted therapies, however, acquired resistance has limited the efficacy of selective FGFR kinase inhibitors such as BGJ398. In a phase II trial of patients with advanced refractory cholangiocarcinoma harboring an FGFR gene alteration, BGJ398 displayed an overall response rate of 22%, but the durability of response was short in some patients. We report the molecular basis of acquired resistance in 4 patients with advanced FGFR2-fusion positive ICC via integrative genomic characterization of cell-free circulating tumor DNA (cfDNA), the primary tumor, and metastases. Each patient enjoyed an initial response, but all subsequently progressed within 10 months. Serial analysis of cfDNA revealed multiple point mutations in the FGFR2 kinase domain at progression (Table 1). The gatekeeper mutation, p. V564F, sterically hinders drug binding and was identified in 3 of 4 patients. In patient #1, five different FGFR2 mutations were detected in the post-progression cfDNA but only one, p. K641R, was identified in the post-progression biopsy. A rapid autopsy was performed, and genomic characterization of 12 metastatic lesions revealed marked inter- and intra-lesional heterogeneity, with different FGFR2 mutations in individual resistant clones. Molecular modeling and in vitro studies indicated that each mutation lead to BGJ398 resistance that was surmountable by structurally distinct FGFR inhibitors. Thus, our report provides the first genetic evidence of clinical acquired resistance to FGFR inhibitor therapy in patients and informs future strategies for detecting mechanisms of resistance and promoting more durable remissions.
Clinical and Molecular Data on Patients with Advanced Refractory CCA treated with BGJ398Patient IDSexAge at Diagnosis (years)FGFR2 Fusion partnerMaximum ResponseProgression Free Survival on BGJ398 (months)Overall Survival since Diagnosis (months)FGFR2 Mutations on cfDNA at progression1F47OPTN28%3.632V564F, N549H, K641R, E565A, L617V2F59ZMYMY450%5.631V564F, N549H/K, E565A, K659M3F69SORBS168%12.650K659M, K714R4M43BICC137%7.418V564F
Note: This abstract was not presented at the meeting.
Citation Format: Lipika Goyal, Supriya K. Saha, Leah Y. Liu, Giulia Siravegna, Ignaty Leshchiner, Leanne G. Ahronian, Jochen K. Lennerz, Phuong Vu, Benedetta Mussolin, Stephanie Reyes, Pascal Furet, A. John Iafrate, Gad Getz, Diana G. Porta, Ralph Tiedt, Alberto Bardelli, Dejan Juric, Ryan B. Corcoran, Nabeel Bardeesy, Andrew X. Zhu. Polyclonal secondary FGFR2 mutations drive acquired resistance to FGFR inhibition in FGFR2 fusion-positive cholangiocarcinoma patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4114. doi:10.1158/1538-7445.AM2017-4114
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Affiliation(s)
| | | | | | | | | | | | | | - Phuong Vu
- 1Massachusetts General Hospital, Boston, MA
| | | | | | - Pascal Furet
- 5Novartis Institutes for BioMedical Research, Switzerland
| | | | | | - Diana G. Porta
- 5Novartis Institutes for BioMedical Research, Switzerland
| | - Ralph Tiedt
- 5Novartis Institutes for BioMedical Research, Switzerland
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Reyes S, Horick N, Clark J, Murphy J, Blaszkowsky L, Allen J, Ryan DP, Hong T, Wo J, Nipp R, Parikh A, Faris J, Kwak E, Galway A, Knowles M, Oklu R, John IA, Lennerz J, Finkelstein D, Borger D, Zhu A, Goyal L. Frequency and impact of tumor genotyping in clinical practice of patients with advanced biliary tract cancers (ABTCs). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx262.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Reyes S, Latkowski JF, Cadwallader LC, Moir RW, Río JGD, Sanz J. Safety Issues of Hg and Pb as IFE Target Materials: Radiological Versus Chemical Toxicity. Fusion Science and Technology 2017. [DOI: 10.13182/fst03-a367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Reyes
- Lawrence Livermore National Laboratory, P. O. Box 808, Mailstop L-641, Livermore, CA 94550
| | - J. F. Latkowski
- Lawrence Livermore National Laboratory, P. O. Box 808, Mailstop L-641, Livermore, CA 94550
| | - L. C. Cadwallader
- Idaho National Engineering and Environmental Laboratory, P.O. Box 1625, Idaho Falls, ID 83415-3860
| | - R. W. Moir
- Lawrence Livermore National Laboratory, P. O. Box 808, Mailstop L-641, Livermore, CA 94550
| | - J. Gómez del Río
- UNED/ETSII, Dpto. Ingeniería Energética, Madrid, Spain. Instituto Fusión Nuclear, Madrid, Spain
| | - J. Sanz
- UNED/ETSII, Dpto. Ingeniería Energética, Madrid, Spain. Instituto Fusión Nuclear, Madrid, Spain
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Petti DA, Reyes S, Cadwallader LC, Latkowski JF. Status of Safety and Environmental Activities in the U.S. Fusion Program. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- D. A. Petti
- Idaho National Engineering and Environmental Laboratory, PO Box 1625, Idaho Falls, ID 83415,
| | - S. Reyes
- Lawrence Livermore National Laboratory, PO Box 808, Livermore, CA 94551
| | - L. C. Cadwallader
- Idaho National Engineering and Environmental Laboratory, PO Box 1625, Idaho Falls, ID 83415,
| | - J. F. Latkowski
- Lawrence Livermore National Laboratory, PO Box 808, Livermore, CA 94551
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Dunne M, Moses EI, Amendt P, Anklam T, Bayramian A, Bliss E, Debs B, Deri R, Rubia TDDL, El-Dasher B, Farmer JC, Flowers D, Kramer KJ, Lagin L, Latkowski JF, Lindl J, Meier W, Miles R, Moses GA, Reyes S, Roberts V, Sawicki R, Spaeth M, Storm E. Timely Delivery of Laser Inertial Fusion Energy (LIFE). Fusion Science and Technology 2017. [DOI: 10.13182/fst10-316] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Dunne
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - E. I. Moses
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - P. Amendt
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - T. Anklam
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - A. Bayramian
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - E. Bliss
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - B. Debs
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - R. Deri
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | | | - B. El-Dasher
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - J. C. Farmer
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - D. Flowers
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - K. J. Kramer
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - L. Lagin
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | | | - J. Lindl
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - W. Meier
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - R. Miles
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - G. A. Moses
- Department of Engineering Physics, University of Wisconsin-Madison, WI 53706
| | - S. Reyes
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - V. Roberts
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - R. Sawicki
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - M. Spaeth
- Lawrence Livermore National Laboratory, Livermore, CA 94550
| | - E. Storm
- Lawrence Livermore National Laboratory, Livermore, CA 94550
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Olson C, Rochau G, Slutz S, Morrow C, Olson R, Cuneo M, Hanson D, Bennett G, Sanford T, Bailey J, Stygar W, Vesey R, Mehlhorn T, Struve K, Mazarakis M, Savage M, Pointon T, Kiefer M, Rosenthal S, Cochrane K, Schneider L, Glover S, Reed K, Schroen D, Farnum C, Modesto M, Oscar D, Chhabildas L, Boyes J, Vigil V, Keith R, Turgeon M, Cipiti M, Lindgren E, Dandini V, Tran H, Smith D, McDaniel D, Quintenz J, Matzen MK, VanDevender JP, Gauster W, Shephard L, Walck M, Renk T, Tanaka T, Ulrickson M, Meier W, Latkowski J, Moir R, Schmitt R, Reyes S, Abbott R, Peterson R, Pollock G, Ottinger P, Schumer J, Peterson P, Kammer D, Kulcinski G, El-Guebaly L, Moses G, Sviatoslavsky I, Sawan M, Anderson M, Bonazza R, Oakley J, Meekunasombat P, De Groot J, Jensen N, Abdou M, Ying A, Calderoni P, Morley N, Abdel-Khalik S, Dillon C, Lascar C, Sadowski D, Curry R, McDonald K, Barkey M, Szaroletta W, Gallix R, Alexander N, Rickman W, Charman C, Shatoff H, Welch D, Rose D, Panchuk P, Louie D, Dean S, Kim A, Nedoseev S, Grabovsky E, Kingsep A, Smirnov V. Development Path for Z-Pinch IFE. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a757] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C. Olson
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - G. Rochau
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - S. Slutz
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - C. Morrow
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - R. Olson
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Cuneo
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - D. Hanson
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - G. Bennett
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - T. Sanford
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - J. Bailey
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - W. Stygar
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - R. Vesey
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - T. Mehlhorn
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - K. Struve
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Mazarakis
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Savage
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - T. Pointon
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Kiefer
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - S. Rosenthal
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - K. Cochrane
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - L. Schneider
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - S. Glover
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - K. Reed
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - D. Schroen
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - C. Farnum
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Modesto
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - D. Oscar
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - L. Chhabildas
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - J. Boyes
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - V. Vigil
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - R. Keith
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Turgeon
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Cipiti
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - E. Lindgren
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - V. Dandini
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - H. Tran
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - D. Smith
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - D. McDaniel
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - J. Quintenz
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. K. Matzen
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | | | - W. Gauster
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - L. Shephard
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Walck
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - T. Renk
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - T. Tanaka
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - M. Ulrickson
- Sandia National Laboratories, Albuquerque, NM 87107 USA
| | - W. Meier
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
| | - J. Latkowski
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
| | - R. Moir
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
| | - R. Schmitt
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
| | - S. Reyes
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
| | - R. Abbott
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
| | - R. Peterson
- Los Alamos National Laboratories, Los Alamos, NM 87545, USA
| | - G. Pollock
- Los Alamos National Laboratories, Los Alamos, NM 87545, USA
| | - P. Ottinger
- Naval Research Laboratory, Washington, DC 20375, USA
| | - J. Schumer
- Naval Research Laboratory, Washington, DC 20375, USA
| | - P. Peterson
- University of California, Berkeley, CA 94720, USA
| | - D. Kammer
- University of Wisconsin, Madison, WI 53706, USA
| | | | | | - G. Moses
- University of Wisconsin, Madison, WI 53706, USA
| | | | - M. Sawan
- University of Wisconsin, Madison, WI 53706, USA
| | - M. Anderson
- University of Wisconsin, Madison, WI 53706, USA
| | - R. Bonazza
- University of Wisconsin, Madison, WI 53706, USA
| | - J. Oakley
- University of Wisconsin, Madison, WI 53706, USA
| | | | - J. De Groot
- University of California, Davis, Davis, CA 95616, USA
| | - N. Jensen
- University of California, Davis, Davis, CA 95616, USA
| | - M. Abdou
- University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - A. Ying
- University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - P. Calderoni
- University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - N. Morley
- University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - S. Abdel-Khalik
- Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - C. Dillon
- Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - C. Lascar
- Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - D. Sadowski
- Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - R. Curry
- University of Missouri-Columbia, Columbia, MO 65211, USA
| | - K. McDonald
- University of Missouri-Columbia, Columbia, MO 65211, USA
| | - M. Barkey
- University of Alabama, Tuscaloosa, AL 35487, USA
| | - W. Szaroletta
- University of New Mexico, Albuquerque, NM 87106, USA
| | - R. Gallix
- General Atomics, San Diego, CA 92121, USA
| | | | - W. Rickman
- General Atomics, San Diego, CA 92121, USA
| | - C. Charman
- General Atomics, San Diego, CA 92121, USA
| | - H. Shatoff
- General Atomics, San Diego, CA 92121, USA
| | - D. Welch
- ATK Mission Research, Albuquerque, NM 87110, USA
| | - D. Rose
- ATK Mission Research, Albuquerque, NM 87110, USA
| | | | - D. Louie
- Omicron, Albuquerque, NM 87110, USA
| | - S. Dean
- Fusion Power Associates, Gaithersburg, MD 20879, USA
| | - A. Kim
- Institute of High Current Electronics, Tomsk, Russia
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Reyes S, Anklam T, Babineau D, Becnel J, Davis R, Dunne M, Farmer J, Flowers D, Kramer K, Martinez-Frias J, Miles R, Taylor C. LIFE Tritium Processing: A Sustainable Solution for Closing the Fusion Fuel Cycle. Fusion Science and Technology 2017. [DOI: 10.13182/fst12-529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Reyes
- Lawrence Livermore National Laboratory, Livermore, CA USA
| | - T. Anklam
- Lawrence Livermore National Laboratory, Livermore, CA USA
| | - D. Babineau
- Savannah River National Laboratory, Aiken, SC, USA
| | - J. Becnel
- Savannah River National Laboratory, Aiken, SC, USA
| | - R. Davis
- Savannah River Site, Aiken, SC, USA
| | - M. Dunne
- Lawrence Livermore National Laboratory, Livermore, CA USA
| | - J. Farmer
- Lawrence Livermore National Laboratory, Livermore, CA USA
| | - D. Flowers
- Lawrence Livermore National Laboratory, Livermore, CA USA
| | - K. Kramer
- Lawrence Livermore National Laboratory, Livermore, CA USA
| | | | - R. Miles
- Lawrence Livermore National Laboratory, Livermore, CA USA
| | - C. Taylor
- Los Alamos National Laboratory, Los Alamos, NM, USA
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42
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Green MA, Willis M, Fernandez-Kong K, Reyes S, Linkhart R, Johnson M, Thorne T, Lindberg J, Kroska E, Woodward H. A Controlled Randomized Preliminary Trial of a Modified Dissonance-Based Eating Disorder Intervention Program. J Clin Psychol 2017; 73:1612-1628. [DOI: 10.1002/jclp.22468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 01/17/2017] [Accepted: 01/29/2017] [Indexed: 11/10/2022]
Affiliation(s)
- M. A. Green
- Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory
| | - M. Willis
- Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory
| | - K. Fernandez-Kong
- Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory
| | - S. Reyes
- Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory
| | - R. Linkhart
- Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory
| | - M. Johnson
- Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory
| | - T. Thorne
- Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory
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43
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Goyal L, Reyes S, Jain A, Shroff RT, Le TM, Rahma OE, Kelley RK, Bocobo AG, Kanakamedala A, Boyhen K, VanCott C, Lindsey S, Zheng H, Zhu AX, Javle MM. Clinical features and tumor mutational profile of younger versus older patients with cholangiocarcinoma (CCA). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
240 Background: As seen in lung cancer, young patients with cancer can have different risk factors, presentation, and tumor genotype than older patients with the same disease. The clinical and molecular features of young patients with CCA have yet to be well characterized. Methods: Retrospective chart review was performed on patients with intrahepatic (ICC) or extrahepatic cholangiocarcinoma (ECC) across 5 institutions. Data on demographics, risk factors, treatments, pathology, and overall survival (OS) were collected. Tumor genotyping results from MGH SNaPShot and Foundation Medicine were analyzed. Log-rank tests and Kaplan-Meier survival curves were used for statistical analysis. Results: Of 567 patients analyzed, 134 (23.6%) were < 50 years old (yo) and 455 (80.2%) had ICC. When assessed for risk factors, younger patients ( < 50yo) were more likely to have primary sclerosing cholangitis (PSC) (p < 0.001) and less likely to have diabetes (p = 0.05), compared to older patients ( ≥ 50yo). Surgical resection rates were similar in younger vs older patients (41.9 vs 42.6%, p = 0.890), but younger patients had larger tumors (median size 7.1 vs 5.3cm p = 0.012). Younger patients were also more likely to receive palliative systemic chemotherapy (p < 0.001) and more lines of therapy (median, 2 vs 1 line, p < 0.001). Frequency of treatment with liver directed therapy did not differ between the two groups. Molecular testing was performed on 222/567 (39.1%) patients of which 84/134 (62.7%) were younger patients and 138/433 (31.9%) were older patients. FGFR aberrations were more common in younger patients versus older patients (17.6 vs. 5.7%, p = 0.002). Targeted therapy was given to 15/84 (17.9%) younger and 28/138 (20.3%) older patients based on results of mutational profiling. Finally, no significant difference was seen in OS between younger and older patients (22.9 vs 22.7 months, p = 0.89). Conclusions: Younger patients with CCA may have different risk factors, tumor biology, and tolerance of systemic therapy compared to older patients. Further study is needed as referral patterns to tertiary care centers and motivation of younger patients to seek tertiary care may impact these results.
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Affiliation(s)
| | | | - Apurva Jain
- Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rachna T. Shroff
- GI Medical Oncology Department, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | | | | | - Hui Zheng
- Massachusetts General Hospital, Boston, MA
| | - Andrew X. Zhu
- Massachusetts General Hospital Cancer Center, Boston, MA
| | - Milind M. Javle
- Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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44
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Goyal L, Saha SK, Liu LY, Siravegna G, Leshchiner I, Ahronian LG, Lennerz JK, Vu P, Deshpande V, Kambadakone A, Mussolin B, Reyes S, Henderson L, Sun JE, Van Seventer EE, Gurski JM, Baltschukat S, Schacher-Engstler B, Barys L, Stamm C, Furet P, Ryan DP, Stone JR, Iafrate AJ, Getz G, Porta DG, Tiedt R, Bardelli A, Juric D, Corcoran RB, Bardeesy N, Zhu AX. Polyclonal Secondary FGFR2 Mutations Drive Acquired Resistance to FGFR Inhibition in Patients with FGFR2 Fusion-Positive Cholangiocarcinoma. Cancer Discov 2016; 7:252-263. [PMID: 28034880 DOI: 10.1158/2159-8290.cd-16-1000] [Citation(s) in RCA: 345] [Impact Index Per Article: 43.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/21/2016] [Accepted: 12/27/2016] [Indexed: 12/16/2022]
Abstract
Genetic alterations in the fibroblast growth factor receptor (FGFR) pathway are promising therapeutic targets in many cancers, including intrahepatic cholangiocarcinoma (ICC). The FGFR inhibitor BGJ398 displayed encouraging efficacy in patients with FGFR2 fusion-positive ICC in a phase II trial, but the durability of response was limited in some patients. Here, we report the molecular basis for acquired resistance to BGJ398 in three patients via integrative genomic characterization of cell-free circulating tumor DNA (cfDNA), primary tumors, and metastases. Serial analysis of cfDNA demonstrated multiple recurrent point mutations in the FGFR2 kinase domain at progression. Accordingly, biopsy of post-progression lesions and rapid autopsy revealed marked inter- and intralesional heterogeneity, with different FGFR2 mutations in individual resistant clones. Molecular modeling and in vitro studies indicated that each mutation led to BGJ398 resistance and was surmountable by structurally distinct FGFR inhibitors. Thus, polyclonal secondary FGFR2 mutations represent an important clinical resistance mechanism that may guide the development of future therapeutic strategies.Significance: We report the first genetic mechanisms of clinical acquired resistance to FGFR inhibition in patients with FGFR2 fusion-positive ICC. Our findings can inform future strategies for detecting resistance mechanisms and inducing more durable remissions in ICC and in the wide variety of cancers where the FGFR pathway is being explored as a therapeutic target. Cancer Discov; 7(3); 252-63. ©2016 AACR.See related commentary by Smyth et al., p. 248This article is highlighted in the In This Issue feature, p. 235.
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Affiliation(s)
- Lipika Goyal
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Supriya K Saha
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Leah Y Liu
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Giulia Siravegna
- Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino, Torino, Italy.,Fondazione Italiana per la Ricerca sul Cancro (FIRC) Institute of Molecular Oncology (IFOM), Milano, Italy
| | - Ignaty Leshchiner
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Leanne G Ahronian
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Jochen K Lennerz
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Phuong Vu
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Vikram Deshpande
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Avinash Kambadakone
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Stephanie Reyes
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Laura Henderson
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Jiaoyuan Elisabeth Sun
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Emily E Van Seventer
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Joseph M Gurski
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Sabrina Baltschukat
- Novartis Institutes for BioMedical Research, Oncology Translational Research, Basel, Switzerland
| | | | - Louise Barys
- Novartis Institutes for BioMedical Research, Oncology Translational Research, Basel, Switzerland
| | - Christelle Stamm
- Novartis Institutes for BioMedical Research, Oncology Translational Research, Basel, Switzerland
| | - Pascal Furet
- Novartis Institutes for BioMedical Research, Global Discovery Chemistry, Basel, Switzerland
| | - David P Ryan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - James R Stone
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - A John Iafrate
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Gad Getz
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.,Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Diana Graus Porta
- Novartis Institutes for BioMedical Research, Oncology Translational Research, Basel, Switzerland
| | - Ralph Tiedt
- Novartis Institutes for BioMedical Research, Oncology Translational Research, Basel, Switzerland
| | - Alberto Bardelli
- Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino, Torino, Italy
| | - Dejan Juric
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Ryan B Corcoran
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
| | - Nabeel Bardeesy
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
| | - Andrew X Zhu
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
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45
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Nettles M, Pishgou M, Solares C, Brown J, Salgueiro M, Byrd J, Groves M, Shaaban S, Reyes S, Ciarrocca K, Mott F, Postma G, DeRossi S, Kountakis S, Mourad W, Rabatic B. Head and Neck Lymphedema: Reducing a Growing Problem. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chase ML, Hashemi N, Reyes S, Corey KE, Misdraji J, Zhu AX, Goyal L. Clinicopathologic and prognostic features of hepatocellular carcinoma (HCC) due to metabolic syndrome (MS) compared to chronic liver disease (CLD) and cryptogenic causes (CC). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Nikroo Hashemi
- Gastroenterology and Hepatology, Brigham and Womens Hospital, Boston, MA
| | | | | | - Joseph Misdraji
- Department of Pathology, Massachusetts General Hospital, Boston, MA
| | - Andrew X. Zhu
- Massachusetts General Hospital Cancer Center, Boston, MA
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47
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Wyles SP, Hrstka SC, Reyes S, Terzic A, Olson TM, Nelson TJ. Pharmacological Modulation of Calcium Homeostasis in Familial Dilated Cardiomyopathy: An In Vitro Analysis From an RBM20 Patient-Derived iPSC Model. Clin Transl Sci 2016; 9:158-67. [PMID: 27105042 PMCID: PMC4902766 DOI: 10.1111/cts.12393] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/22/2016] [Indexed: 12/16/2022] Open
Abstract
For inherited cardiomyopathies, abnormal sensitivity to intracellular calcium (Ca(2+) ), incurred from genetic mutations, initiates subsequent molecular events leading to pathological remodeling. Here, we characterized the effect of β-adrenergic stress in familial dilated cardiomyopathy (DCM) using human-induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (CMs) from a patient with RBM20 DCM. Our findings suggest that β-adrenergic stimulation accelerated defective Ca(2+) homeostasis, apoptotic changes, and sarcomeric disarray in familial DCM hiPSC-CMs. Furthermore, pharmacological modulation of abnormal Ca(2+) handling by pretreatment with β-blocker, carvedilol, or Ca(2+) -channel blocker, verapamil, significantly decreased the area under curve, reduced percentage of disorganized cells, and decreased terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL)-positive apoptotic loci in familial DCM hiPSC-CMs after β-adrenergic stimulation. These translational data provide patient-based in vitro analysis of β-adrenergic stress in RBM20-deficient familial DCM hiPSC-CMs and evaluation of therapeutic interventions to modify heart disease progression, which may be personalized, but more importantly generalized in the clinic.
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Affiliation(s)
- S P Wyles
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, Minnesota, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - S C Hrstka
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - S Reyes
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - A Terzic
- Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,Department of Medical Genetics, Mayo Clinic, Rochester, Minnesota, USA
| | - T M Olson
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA.,Cardiovascular Genetics Research Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - T J Nelson
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, Minnesota, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,Transplant Center, Mayo Clinic, Rochester, Minnesota, USA
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48
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Mungia R, Buchberg M, Hayes H, Dolan C, Reyes S, Rankin K, Oates T. Connecting and Collaborating: Developing National Dental PBRN Study Concepts Through POD Engagement. Health Promot Pract 2015; 17:278-84. [PMID: 26715696 DOI: 10.1177/1524839915621546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This article illustrates the process by which the Southwest Region of the National Dental Practice-Based Research Network (www.NationalDentalPBRN.org) fosters collaboration among practitioners and researchers in study concept development through protocol development groups (PODs). The Southwest Region begins this process by engaging PODs, which comprise dentists, hygienists, and/or academic faculty who share research interests related to improving dental care. METHOD The PODs use the Tuckman four-stage model of group development (forming, storming, norming, and performing) to develop study concepts. This well-structured model encourages engagement among group members and enables quality discussion through organized sessions. This model provides milestones for the group's progression and for the members' interactions. The Southwest Region Directors play a crucial role in guiding and directing the development of PODs by aligning the members' research interests with the goals of the National Network. RESULTS POD engagement using Tuckman's stages has been successful in developing study concepts for submission to the National Network. Between 2012 and 2014, the Southwest Region has developed 14 PODs from 275 research ideas. Five of these study concepts have been submitted to the National Network for approval, including the Novel Tobacco Products POD, which showcases the applicability of Tuckman's model. CONCLUSION Overall, the POD concept is a collaborative effort that brings together practitioners and academicians through shared research interests and capitalizes on participants' expertise and experiences. The Southwest Region will continue to develop PODs to foster new ideas for future studies in the Network.
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Affiliation(s)
- Rahma Mungia
- University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Holly Hayes
- University of South Carolina, Columbia, SC, USA
| | - Colleen Dolan
- University of Texas Health Science Center, San Antonio, TX, USA
| | - Stephanie Reyes
- University of Texas Health Science Center, San Antonio, TX, USA
| | - Kathleen Rankin
- Texas A&M University, Baylor College of Dentistry, Dallas, TX, USA
| | - Thomas Oates
- University of Texas Health Science Center, San Antonio, TX, USA
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Mungia R, Hayes H, Reyes S, Theisen S, Buchberg M, Dolan C, Oates T. Generating National Dental PBRN Research Ideas Through the ToP Consensus Method Workshop. Prog Community Health Partnersh 2015; 9:447-56. [PMID: 26548797 DOI: 10.1353/cpr.2015.0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE The purpose of this article is to illustrate the research idea generation process employed by the Southwest Region of the National Dental Practice-Based Research Network (PBRN; www.NationalDentalPBRN.org) based on the Technology of Participation (ToP) Consensus Method Workshop. This method encourages a high level of participation in the decision-making process through individual, small group, and large group discussions. This approach to idea generation has predominately been used by nonprofit organizations and community groups both nationally and internationally, but offers great potential to study concept development for PBRNs. METHOD Five independent workshops were designed over a 12-month period. Workshops were held at three academic institutions, one National Dental PBRN meeting, and one as part of a continuing education program. The sessions were directed at general dentists, dental hygienists, and dental researchers to identify research ideas appropriate for examination through the PBRN mechanism. RESULT Five groups ranging in size from 11 to 53 (197 participants total) participated in the consensus workshops and generated 205 research ideas. Ideas across the five sessions were collated into novel and common categories of interest, and identified key participants interested in developing research concepts. Participant reaction to the sessions was positive based on evaluation comments and personal interactions. IMPLICATIONS Practitioners effectively generated research ideas based on their current needs and daily clinical experience. The experiences presented in this article suggest continued use of the ToP consensus workshop methods within the PBRNs may help bridge the gap between research and practice.
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Orellana G, Held CM, Estevez PA, Perez CA, Reyes S, Algarin C, Peirano P. A balanced sleep/wakefulness classification method based on actigraphic data in adolescents. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:4188-91. [PMID: 25570915 DOI: 10.1109/embc.2014.6944547] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Several research groups have developed automated sleep-wakefulness classifiers for night wrist actigraphic (ACT) data. These classifiers tend to be unbalanced, with a tendency to overestimate the detection of sleep, at the expense of poorer detection of wakefulness. The reason for this is that the measure of success in previous works was the maximization of the overall accuracy, disregarding the balance between sensitivity and specificity. The databases were usually sleep recordings, hence the over-representation of sleep samples. In this work an Artificial Neural Network (ANN), sleep-wakefulness classifier is presented. ACT data was collected every minute. An 11-min moving window was used as observing frame for data analysis, as applied in previous sleep ACT studies. However, our feature set adds new variables such as the time of the day, the median and the median absolute deviation. Sleep and Wakefulness data were balanced to improve the system training. A comparison with previous studies can still be done, by choosing the point in the ROC curve associated with the corresponding data balance. Our results are compared with a polysomnogram-based hypnogram as golden standard, rendering an accuracy of 92.8%, a sensitivity of 97.6% and a specificity of 73.4%. Geometric mean between sensitivity and specificity is 84.9%.
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