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Akanuwe J, Cooke S, Henderson H, Kane R. Exploring the perceptions and acceptability of an integrated lifestyle database for public health research and service commissioning: a qualitative study. Perspect Public Health 2022:17579139221136726. [PMID: 36377889 DOI: 10.1177/17579139221136726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
AIM Public health lifestyle databases at local authority level are currently poorly aligned across the UK. The integration of lifestyle databases at a regional level could provide a rich resource to support research and help inform public health leads and service commissioners in improving service delivery, facilitating decision-making and developing key public health policies. Prior to its implementation, the acceptability of an integrated lifestyle database should be explored. The aim of this study was to consult with public health stakeholders to explore the acceptability of developing and implementing a regional integrated lifestyle database across four key areas of public health: smoking cessation, diet, physical activity and alcohol consumption. METHOD Qualitative interviews were conducted with public health stakeholders recruited from across the East Midlands region of England. All interviews were conducted using video conferencing software and recorded, transcribed, and analysed using the Framework approach. Sixteen public health stakeholders were purposively identified and invited to participate in interviews. RESULTS Stakeholders viewed the integrated database as having potential to support research, service development and commissioning decisions. Barriers such as providers' reluctance to reveal their business strategies to rival organisations, cost of setting up and running the proposed database, complex information-sharing and governance were identified. CONCLUSION An integrated lifestyle database has the potential to support research and service commissioning regionally. However, several barriers were identified that must be addressed prior to the development and implementation of an integrated database.
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Affiliation(s)
- Jna Akanuwe
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - S Cooke
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - H Henderson
- School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - R Kane
- School of Health and Social Care, University of Lincoln, Lincoln, UK
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Cooke S, de Ruysscher D, Reymen B, Lambrecht M, Persson GF, Faivre-Finn C, Dieleman E, van Diessen J, Damen E, Sikorska K, Belderbos J, Sonke J. Whole Tumor vs. FDG-Directed Dose Escalation in Patients with Locally Advanced NSCLC: Evaluation of Isotoxic Treatment Plans from the Randomized ARTFORCE PET-Boost Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1501] [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]
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Crouch S, Painter D, Barrans S, Roman E, Beer P, Lacy S, Cooke S, Webster N, Glover P, Hoppe S, Campbell PJ, Hodson DJ, Patmore R, Burton C, Smith AG, Tooze R. MOLECULAR SUBCLUSTERS OF FOLLICULAR LYMPHOMA: A REPORT FROM THE UK'S HAEMATOLOGICAL MALIGNANCY RESEARCH NETWORK. Hematol Oncol 2021. [DOI: 10.1002/hon.40_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Crouch
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - D. Painter
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - S. Barrans
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - E. Roman
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - P. Beer
- University of Glasgow Glasgow Precision Oncology Laboratory Glasgow UK
| | - S. Lacy
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - S. Cooke
- University of Glasgow Glasgow Precision Oncology Laboratory Glasgow UK
| | - N. Webster
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - P. Glover
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - S. Hoppe
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - P. J. Campbell
- Wellcome Trust Sanger Institute, Cancer Ageing and Somatic Mutation Programme Cambridge UK
| | - D. J. Hodson
- University of Cambridge Wellcome–MRC CambridgeStem Cell Institute Cambridge UK
| | - R. Patmore
- Hull University Teaching Hospitals NHS Trust Queen's Centre for Oncology and Haematology Hull UK
| | - C. Burton
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - A. G. Smith
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - R. Tooze
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
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Loughrey PB, Baker G, Herron B, Cooke S, Iacovazzo D, Lindsay JR, Korbonits M. Invasive ACTH-producing pituitary gland neoplasm secondary to MSH2 mutation. Cancer Genet 2021; 256-257:36-39. [PMID: 33866195 DOI: 10.1016/j.cancergen.2021.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 03/11/2021] [Accepted: 03/30/2021] [Indexed: 02/05/2023]
Affiliation(s)
- P B Loughrey
- Regional Center for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast Health and Social Care Trust, UK; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, UK
| | - G Baker
- Cellular Pathology, Royal Victoria Hospital, Belfast Health and Social Care Trust, UK
| | - B Herron
- Cellular Pathology, Royal Victoria Hospital, Belfast Health and Social Care Trust, UK
| | - S Cooke
- Department of Neurosurgery, Royal Victoria Hospital, Belfast Health and Social Care Trust, UK
| | - D Iacovazzo
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - J R Lindsay
- Regional Center for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast Health and Social Care Trust, UK; Mater Infirmorum Hospital, Belfast Health and Social Care Trust, UK
| | - M Korbonits
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Cooke S, De Ruysscher D, Reymen B, Lambrecht M, Fredberg Persson G, Faivre-Finn C, Dieleman E, Van Diessen J, Sikorska K, Lalezari F, Sonke J, Belderbos J. OA02.05 Local, Regional and Pulmonary Failures in the Randomised PET-Boost Trial for NSCLC Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tran D, Cooke S, Illingworth PJ, Gardner DK. Reply: Can deep learning automatically predict fetal heart pregnancy with almost perfect accuracy? Hum Reprod 2021; 35:1474. [PMID: 32457996 DOI: 10.1093/humrep/deaa084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Tran
- Harrison AI, Barangaroo, NSW, Australia
| | - S Cooke
- IVF Australia, Greenwich, NSW, Australia
| | | | - D K Gardner
- Melbourne IVF, East Melbourne, VIC, Australia
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Tran D, Cooke S, Illingworth PJ, Gardner DK. Reply: Deep learning as a predictive tool for fetal heart pregnancy following time-lapse incubation and blastocyst transfer. Hum Reprod 2020; 35:483. [PMID: 32053191 DOI: 10.1093/humrep/dez264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Tran
- 8 Milton Ave, Eastwood, Sydney, NSW Australia
| | - S Cooke
- IVFAustralia Greenwich, Greenwich, NSW, Australia
| | | | - D K Gardner
- Melbourne IVF, East Melbourne, Victoria, Australia
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Evans TJ, Eatock MM, Lewsley LA, Kelly C, McCartney E, Duffton A, Houston P, Harrison C, Purcell C, Ashton M, Morton A, Graham J, Chalmers AJ, Thomson F, Pou C, Bilsland A, Cooke S, McIntosh D, Grose DB. A phase I study of olaparib in combination with capecitabine-based chemoradiation (CRT) in patients (pts) with locally advanced pancreatic cancer (LAPC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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
709 Background: Olaparib is a potent inhibitor of PARP-1, which has a critical role in signalling DNA single strand breaks (SSB) as part of the base excision repair pathway, and may have radio-sensitizing effects due to impaired resolution of radiation induced SSB. We hypothesize that O may potentiate the effects of X-CRT in pts with LAPC. Methods: Eligible pts with LAPC, ECOG < 1, tumor diameter < 6cm, with stable disease (SD) or response after 12 weeks’ induction chemotherapy, were treated with 1 of 4 escalating doses of O given bid po starting on day -3, and then in combination with X (830 mg/m2 bid) and radiation (50·4 Gy in 28 fractions) all administered Mon-Fri. Dose limiting toxicities (DLT) were determined on clinical and lab toxicity assessments (NCI-CTC AE v4.03) performed weekly from the start of O until completion of O plus X-CRT (i.e. 6 weeks). Dose escalation continued with a rolling-six design until the Maximum Tolerated Dose (MTD) was reached. Blood samples for PK analyses of O and PD measurement (inhibition of PARP activity) were collected on day -3 (O monotherapy) and during week 1 of O + X-CRT. Results: 18 pts, (9 m, 9 f, ECOG 0/1 [n=6/12]), age range 49-81 (median=70) years, with histologic (14) or cytologic (4) proven LAPC, had received induction chemotherapy with gemcitabine [GEM] (n=2), GEM + X (12), or FOLFIRINOX (3) with partial response (n=4) or stable disease (14). Pts received 50 (3), 100 (4), 150 (6), or 200 (5) mgs bid of O with X+CRT. DLTs were observed in 2 pts (both at 200mgs bid): 1 pt with grade 3 nausea (on optimal anti-emetics) and grade 3 fatigue, 1 pt with grade 3 anorexia. 6 pts were subsequently recruited at 150mgs bid with no DLTs. No pts had complete response, 2 pts had partial response (1 pt each at 100 and 150 mgs bid) and 1 pt (at 100 mgs bid) had progressive disease; the remaining 14 pts had SD. Conclusions: The recommended dose (RP2) of O is 150mgs bid when given in combination with X + CRT in LAPC. Recruitment of up to 12 pts with borderline operable LAPC at the RP2 is ongoing. PK analyses of O, PD studies (PARP inhibition – PBMCs; cytokeratin 18 – serum; γH2AX foci – hair follicles), and exploratory predictive marker studies (tumor – NGS; RNA exome sequencing) are ongoing. Clinical trial information: ISRCTN10361292.
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Affiliation(s)
- T.R. Jeffry Evans
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | | | - Elaine McCartney
- Cancer Research UK Clinical Trials Unit, Glasgow, United Kingdom
| | - Aileen Duffton
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Peter Houston
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | - Colin Purcell
- Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - Miranda Ashton
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Alanna Morton
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Jill Graham
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | | | | | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - David McIntosh
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Derek B. Grose
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
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Ahmad M, Sekar V, Healy E, Rennie I, Cooke S. Case report: The unusual case of a sellar/suprasellar Extrarenal Rhabdoid tumour in an adult. Interdisciplinary Neurosurgery 2019. [DOI: 10.1016/j.inat.2019.01.014] [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: 10/27/2022] Open
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10
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Tran D, Cooke S, Illingworth PJ, Gardner DK. Deep learning as a predictive tool for fetal heart pregnancy following time-lapse incubation and blastocyst transfer. Hum Reprod 2019; 34:1011-1018. [PMID: 31111884 PMCID: PMC6554189 DOI: 10.1093/humrep/dez064] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [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: 02/26/2019] [Revised: 04/07/2019] [Indexed: 12/11/2022] Open
Abstract
STUDY QUESTION Can a deep learning model predict the probability of pregnancy with fetal heart (FH) from time-lapse videos? SUMMARY ANSWER We created a deep learning model named IVY, which was an objective and fully automated system that predicts the probability of FH pregnancy directly from raw time-lapse videos without the need for any manual morphokinetic annotation or blastocyst morphology assessment. WHAT IS KNOWN ALREADY The contribution of time-lapse imaging in effective embryo selection is promising. Existing algorithms for the analysis of time-lapse imaging are based on morphology and morphokinetic parameters that require subjective human annotation and thus have intrinsic inter-reader and intra-reader variability. Deep learning offers promise for the automation and standardization of embryo selection. STUDY DESIGN, SIZE, DURATION A retrospective analysis of time-lapse videos and clinical outcomes of 10 638 embryos from eight different IVF clinics, across four different countries, between January 2014 and December 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS The deep learning model was trained using time-lapse videos with known FH pregnancy outcome to perform a binary classification task of predicting the probability of pregnancy with FH given time-lapse video sequence. The predictive power of the model was measured using the average area under the curve (AUC) of the receiver operating characteristic curve over 5-fold stratified cross-validation. MAIN RESULTS AND THE ROLE OF CHANCE The deep learning model was able to predict FH pregnancy from time-lapse videos with an AUC of 0.93 [95% CI 0.92-0.94] in 5-fold stratified cross-validation. A hold-out validation test across eight laboratories showed that the AUC was reproducible, ranging from 0.95 to 0.90 across different laboratories with different culture and laboratory processes. LIMITATIONS, REASONS FOR CAUTION This study is a retrospective analysis demonstrating that the deep learning model has a high level of predictability of the likelihood that an embryo will implant. The clinical impacts of these findings are still uncertain. Further studies, including prospective randomized controlled trials, are required to evaluate the clinical significance of this deep learning model. The time-lapse videos collected for training and validation are Day 5 embryos; hence, additional adjustment would need to be made for the model to be used in the context of Day 3 transfer. WIDER IMPLICATIONS OF THE FINDINGS The high predictive value for embryo implantation obtained by the deep learning model may improve the effectiveness of previous approaches used for time-lapse imaging in embryo selection. This may improve the prioritization of the most viable embryo for a single embryo transfer. The deep learning model may also prove to be useful in providing the optimal order for subsequent transfers of cryopreserved embryos. STUDY FUNDING/COMPETING INTEREST(S) D.T. is the co-owner of Harrison AI that has patented this methodology in association with Virtus Health. P.I. is a shareholder in Virtus Health. S.C., P.I. and D.G. are all either employees or contracted with Virtus Health. D.G. has received grant support from Vitrolife, the manufacturer of the Embryoscope time-lapse imaging used in this study. The equipment and time for this study have been jointly provided by Harrison AI and Virtus Health.
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Affiliation(s)
- D Tran
- Medical AI, Harrison AI, Barangaroo, NSW, Australia
| | - S Cooke
- Embryology, IVF Australia, Greenwich, NSW, Australia
| | | | - D K Gardner
- Embryology, Melbourne IVF, East Melbourne, Victoria, Australia
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Grose DB, McKay CJ, Cooke S, Graham JS, Duthie F, Jamieson N, Ravikumar R, Duffton A, McIntosh D, Goody R, Radhakrishna G, Hawkins MA, Colville D, Willshire C, Stobo J, Paul J, Bradley S, Dixon-Hughes J, Biankin AV, Chang DKF. PRIMUS-002: A multicentre, open-label, phase II study examining FOLFOX and nab-paclitaxel (FA) and nab-paclitaxel and gemcitabine (AG) as neoadjuvant therapy for (borderline) resectable pancreatic cancer (PC), focusing on biomarker and liquid biopsy development. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps4166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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
TPS4166 Background: There is increasing evidence suggesting benefit from a neoadjuvant approach to PC. However, the optimal regimen is unclear and will likely require a precision medicine approach, where patient and tumor attributes define therapy. Platinum-containing regimens have shown survival benefit for PC, with occasional exceptional responders, but biomarkers (BM) of response are not well defined and treatment decisions are often based on patient performance status (PS) and co-morbidity. Tumors with defects in BRCA1/2and other Fanconi Anemia genes show defective DNA damage response (DDR), conferring potential selective sensitivity to DNA-damaging agents (e.g. platinum) and newer targeted agents. We have shown that DDR deficiency (DDRd) is present in up to 20% of PC. This study aims to exploit DDRd as a therapeutic vulnerability, with integrated analysis to define candidate BM for FA and AG response. Methods: PRIMUS-002 will enroll patients registered on the Precision-Panc Master Protocol who are molecularly profiled using the Precision-Panc Clinical Cancer Genome including a novel DDRd assay, and the transcriptome with longitudinal sampling (pre-, during, and post-treatment). Patients receive either FA ( nab-paclitaxel 150mg/m2IV,oxaliplatin 85mg/m2, folinic acid 350mg flat dose, fluorouracil infusion 2400mg/m2continuous IV infusion), orAG ( nab-paclitaxel 125mg/m2, gemcitabine 1000 mg/m2) for 3 months,based on patient age and PS.Following initial safety analysis, chemoradiation may be introduced. The primary endpoint is disease progression (DP) during neoadjuvant therapy. The study is designed to detect a 20% difference in DP between the BM+ve (10%) and BM –ve (30%) in patients treated with FA (90% power, 5% 1-sided level of statistical significance)., Exploratory translational endpoints include surrogate therapeutic response assessment using CA19.9, PET-CT SUV, DWI-MRI and ctDNA. Current Enrolment: 2 patients enrolled to date: 1 to receive FA and 1 to AG treatment. Clinical trial information: ISRCTN34129115.
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Affiliation(s)
- Derek B. Grose
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Colin J McKay
- West of Scotland Pancreatic Unit, Department of Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Fraser Duthie
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Nigel Jamieson
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary; Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Aileen Duffton
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - David McIntosh
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Rebecca Goody
- St James Institute of Oncology, Leeds, United Kingdom
| | | | - Maria A Hawkins
- CRUK/MRC Oxford Institute for Radiation Oncology, Oxford, United Kingdom
| | - Dave Colville
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | - Jon Stobo
- Cancer Research UK Clinical Trials Unit, University of Glasgow, Glasgow, United Kingdom
| | - James Paul
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Sarah Bradley
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Judith Dixon-Hughes
- Cancer Research UK Clinical Trials Unit, University of Glasgow, Glasgow, United Kingdom
| | | | - David Kuang-Fu Chang
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
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Dreyer SB, Jamieson NB, Evers L, Duthie F, Cooke S, Marshall J, Beraldi D, Knight S, Upstill-Goddard R, Dickson EJ, Carter CR, McKay CJ, Biankin AV, Chang DK. Feasibility and clinical utility of endoscopic ultrasound guided biopsy of pancreatic cancer for next-generation molecular profiling. Chin Clin Oncol 2019; 8:16. [PMID: 31070037 DOI: 10.21037/cco.2019.04.06] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 01/12/2023]
Abstract
Next-generation sequencing is enabling molecularly guided therapy for many cancer types, yet failure rates remain relatively high in pancreatic cancer (PC). The aim of this study is to investigate the feasibility of genomic profiling using endoscopic ultrasound (EUS) biopsy samples to facilitate personalised therapy for PC. Ninty-five patients underwent additional research biopsies at the time of diagnostic EUS. Diagnostic formalin-fixed (FFPE) and fresh frozen EUS samples underwent DNA extraction, quantification and targeted gene sequencing. Whole genome (WGS) and RNA sequencing was performed as proof of concept. Only 2 patients (2%) with a diagnosis of PC had insufficient material for targeted sequencing in both FFPE and frozen specimens. Targeted panel sequencing (n=54) revealed mutations in PC genes (KRAS, GNAS, TP53, CDKN2A, SMAD4) in patients with histological evidence of PC, including potentially actionable mutations (BRCA1, BRCA2, ATM, BRAF). WGS (n=5) of EUS samples revealed mutational signatures that are potential biomarkers of therapeutic responsiveness. RNA sequencing (n=35) segregated patients into clinically relevant molecular subtypes based on transcriptome. Integrated multi-omic analysis of PC using standard EUS guided biopsies offers clinical utility to guide personalized therapy and study the molecular pathology in all patients with PC.
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Affiliation(s)
- Stephan B Dreyer
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - Nigel B Jamieson
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - Lisa Evers
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - Fraser Duthie
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - John Marshall
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Dario Beraldi
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Stephen Knight
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Rosanna Upstill-Goddard
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Euan J Dickson
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - C Ross Carter
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - Colin J McKay
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - Andrew V Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - David K Chang
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK.
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Dreyer S, Paulus-Hock V, Upstill-Goddard R, Lampraki E, Jamieson N, Cooke S, Bailey P, Biankin A, Chang DKF. Defining DNA damage repair deficiency and replication stress in pancreatic cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.285] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
285 Background: Integrated multi-omic analyses revealed 24% of pancreatic cancer (PC) harbor defects in DNA damage response (DDR) and a subgroup demonstrate upregulation in replication stress pathways. DDR defective tumors preferentially respond to DNA damaging agents, and clinical responses to cell cycle inhibitors are seen in undefined subgroups, representing novel therapeutic strategies for PC. The aim of this study is to define and refine therapeutic segments for agents targeting DDR and replication stress in PC. Methods: We performed whole genome and RNA sequencing (RNAseq) on 48 patient-derived cell lines (PDCL) generated and characterized as part of the International Cancer Genome Initiative (ICGC). This identified increased replication stress in a sub-group of tumours, correlating with previously defined molecular subtypes of PC, irrespective of DDR status. Cytotoxic viability assays were performed using agents targeting the DDR pathway and cell cycle checkpoints, including Cisplatin, and inhibitors of PARP, ATR, WEE1, CHK1, CDK4/6 and PLK4. Subcutaneous patient derived xenografts (PDX) were generated to test therapeutic regimens in vivo. Results: DDR defective models, as defined by signatures of homologous recombination deficiency (HRD) were highly sensitive to Cisplatin and PARP inhibitors. Replication stress predicted differential responses to cell cycle inhibitors of WEE1, CHK1, CDK4/6 and PLK4. A novel mRNA signature of ATR inhibitor sensitivity was generated and correlated with response. Response to cell cycle checkpoint inhibitors were independent of DDR status, but strongly associated with replication stress. Conclusions: This proof of concept data demonstrates DDR deficiency and increased Replication Stress to be attractive targets in PC. Therapeutic vulnerabilities extend beyond platinum chemotherapy and can be targeted with novel small molecule inhibitors, with independent biomarkers predicting response to agents targeting either DDR or cell cycle checkpoints. This has led to the design and development of several personalized medicine trials via the Precision Panc platform targeting DDR and Replication stress, and will allow clinical testing of signatures of HRD and replication stress.
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Affiliation(s)
- Stephan Dreyer
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Viola Paulus-Hock
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Rosie Upstill-Goddard
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Eirini Lampraki
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Nigel Jamieson
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary; Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Peter Bailey
- Beatson Institute of Cancer Research, Glasgow, United Kingdom
| | - Andrew Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - David Kuang-Fu Chang
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
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Valle JW, Evans TJ, McKay CJ, Dixon-Hughes J, Paul J, Stobo J, Cooke S, Willshire C, Williams N, Duthie F, Biankin A, Chang DKF. Precision-Panc Master Protocol: Personalizing treatment for pancreatic cancer ISRCTN14879538—Part of Precision-Panc United Kingdom. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.tps460] [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
TPS460 Background: A major challenge of lower incidence cancer types is that to make significant advances a network approach is required to coordinate research, generate greater clinical capacity and recruit sufficient patients. This is particularly the case for pancreatic cancer (PC). To address this, we established Precision-Panc, a synergistic and dynamic platform aligning “discovery”, “preclinical” and “clinical” therapeutic development. Methods: Central to the clinical development is the Precision-Panc Master Protocol, a multi-centre “portal” protocol recruiting patients with known or suspected PC, to enable enrolment into PRIMUS (Pancreatic canceR Individualised Multi-arm Umbrella Study), examining different treatment regimens and/or biomarker development. Eligible patients are identified prior to the diagnostic biopsy to obtain Stage 1 (Screening) Consent for extra tissue to be taken in the same biopsy setting. Patients who already have a diagnosis are asked to provide additional research biopsy. Once the PC diagnosis is made, Stage 2 (Registration) Consent is obtained for molecular profiling at the central reference laboratory using Precision-Panc NGS Diagnostic (bespoke clinical grade assay), including germline testing of 12 PC predisposition genes. The results may inform eligibility for a PRIMUS study. There is no sample size calculation due to the nature of the Master Protocol; however, individual PRIMUS studies will be appropriately powered according to their study design and primary endpoint. Results: Adults (aged >16 years) with either a hypodense pancreatic mass highly suspicious of PC (+/- distant metastases) or histologically/cytologically confirmed PC and its variants; willing and able to undergo tumour biopsy to obtain sufficient tissue for molecular profiling; deemed suitable to receive chemotherapy and/or radiotherapy and/or surgery pending stage of disease; must give both Stage 1 and 2 informed consent. Conclusions: The study opened on 28 Dec 2017; by 25 Sep 2018, 67 patients have been screened for Precision-Panc, 43 of whom have gone on to be registered and 19 have then been randomised to the PRIMUS-001 study (first-line metastatic). Clinical trial information: ISRCTN14879538.
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Affiliation(s)
- Juan W. Valle
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - T.R. Jeffry Evans
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Colin J McKay
- West of Scotland Pancreatic Unit, Department of Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Judith Dixon-Hughes
- Cancer Research UK Clinical Trials Unit, University of Glasgow, Glasgow, United Kingdom
| | - James Paul
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Jamie Stobo
- Cancer Research UK Clinical Trials Unit, University of Glasgow, Glasgow, United Kingdom
| | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Nicola Williams
- Laboratory Medicine, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Fraser Duthie
- Laboratory Medicine, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | | | - David Kuang-Fu Chang
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
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Graham JS, Valle JW, Evans TJ, Grose DB, Paul J, Stobo J, Cooke S, Dixon-Hughes J, Weir H, Mohan S, Biankin A, Chang DKF. PRIMUS-001: An adaptive phase II study of FOLFOX-A (FOLFOX and nab-paclitaxel) versus AG ( nab-paclitaxel and gemcitabine) in patients with metastatic pancreatic cancer, with integrated biomarker evaluation (ISRCTN75002153) – Part of Precision-Panc. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps4158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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)
| | - Juan W. Valle
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | | | - Derek B Grose
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - James Paul
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Jamie Stobo
- Cancer Research UK Clinical Trials Unit, University of Glasgow, Glasgow, United Kingdom
| | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Judith Dixon-Hughes
- Cancer Research UK Clinical Trials Unit, University of Glasgow, Glasgow, United Kingdom
| | - Hannah Weir
- CRUK Clinical Trials Unit, Glasgow, United Kingdom
| | - Sumitra Mohan
- Clinical and Experimental Pharmacology, Cancer Research UK Manchester Institute, Cheshire, United Kingdom
| | - Andrew Biankin
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - David Kuang-Fu Chang
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
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Perry DC, Wright JG, Cooke S, Roposch A, Gaston MS, Nicolaou N, Theologis T. A consensus exercise identifying priorities for research into clinical effectiveness among children's orthopaedic surgeons in the United Kingdom. Bone Joint J 2018; 100-B:680-684. [PMID: 29701090 DOI: 10.1302/0301-620x.100b5.bjj-2018-0051] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. Results A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes' disease (4.5) and bone infection (4.5). Conclusion This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children's orthopaedic surgery and encourage the development of multicentre clinical trials. Cite this article: Bone Joint J 2018;100-B:680-4.
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Affiliation(s)
- D C Perry
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK and University of Oxford, Oxford, UK
| | - J G Wright
- University of Oxford, Botnar Research Centre, Oxford, UK
| | - S Cooke
- University Hospital Coventry and Warwick, Coventry, UK
| | - A Roposch
- UCL GOS Institute of Child Health, University College London, London, UK
| | - M S Gaston
- Royal Hospital for Sick Children, Edinburgh, UK
| | - N Nicolaou
- Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - T Theologis
- University of Oxford, Botnar Research Centre, Oxford, UK
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Elder KJ, Nickson C, Cooke S, Machalek D, Rose A, Mou A, Collins JP, Park A, De Boer R, Phillips C, Pridmore V, Farrugia H, Mann GB. Abstract PD2-13: Benefits to breast screening beyond mortality reduction. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd2-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The value of population-based mammographic screening has been questioned by those who believe that the reduction in mortality from earlier diagnosis is outweighed by harms including overdiagnosis and overtreatment. Much of these commentaries assume that all Early-Stage Breast Cancer (ESBC) is treated the same way after diagnosis; with extensive therapies including surgery, radiotherapy and chemotherapy being standard.
Intensity of treatment received is rarely mentioned in the debate. We hypothesised that those diagnosed through a screening program (Active Screeners (AS)) would receive less extensive surgical treatment and less intense adjuvant therapies than those not recently screened (NRS). If demonstrated, these differences would form an important component of the debate over the role of mammographic screening.
Methods
Retrospective analysis of a consecutive cohort of female patients aged 50-69 and managed for ESBC (invasive or DCIS) during 2007-2013 within a large metropolitan Breast Service, diagnosed either via a population screening program (AS) or outside of the program (NRS). Data on patient characteristics, symptoms, mode of detection, tumour pathology, surgical intervention and adjuvant treatment recommendations were derived from prospectively collected Multi-Disciplinary Meeting (MDM) records. Patients with metastatic disease or prior treatment for breast cancer were excluded.
Results
791 cases were identified (569 with screen-detected cancer, 53 with interval cancers and 169 cancers diagnosed in women not recently screened). Invasive cancers in the AS group were much smaller than in the NRS group – mean 17mm versus 26mm. The AS group had lower grade invasive cancer – grade 1, 2 and 3 were 27%, 42%, 31% - compared with 10%, 39% and 52% in the NRS group. The AS group were more likely to have ER+ve cancers (88% vs 80%) and less likely to have nodal involvement (26% vs 48%). For invasive breast cancer, the NRS group were more than twice as likely to undergo mastectomy than cancers in the AS group (35% vs 16%). Axillary dissections were more common in the NRS than the AS group (43% vs 19%). Adjuvant chemotherapy was recommended more frequently for the NRS group compared to the AS group (65% vs 37%), as was post mastectomy radiotherapy (58% vs 39%). Endocrine therapy was less often recommended to the NRS group (86% versus 77%).
Conclusion
Women diagnosed with early stage breast cancer who are participating in a population based screening program are less likely to receive mastectomy and/or axillary dissection, less likely to receive adjuvant chemotherapy and less likely to receive post-mastectomy radiotherapy. These differences in treatment intensity should be considered in the debate surrounding mammographic screening.
Citation Format: Elder KJ, Nickson C, Cooke S, Machalek D, Rose A, Mou A, Collins JP, Park A, De Boer R, Phillips C, Pridmore V, Farrugia H, Mann GB. Benefits to breast screening beyond mortality reduction [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD2-13.
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Affiliation(s)
- KJ Elder
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - C Nickson
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - S Cooke
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - D Machalek
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - A Rose
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - A Mou
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - JP Collins
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - A Park
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - R De Boer
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - C Phillips
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - V Pridmore
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - H Farrugia
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
| | - GB Mann
- Royal Women's Hospital, Melbourne, Victoria, Australia; University of Melbourne; The Royal Melbourne Hospital; BreastScreen Victoria; Victorian Cancer Registry
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Dreyer S, Jamieson N, Evers L, Jones M, Martin S, Duthie F, Musgrove L, Cooke S, Bailey P, McKay C, Chang DKF, Biankin A. Feasibility and clinical utility of EUS guided biopsy of pancreatic cancer for next-generation genomic sequencing. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
296 Background: Next-generation sequencing technology has made genomic profiling guided therapy a reality for many cancer types. The aim of this study is to investigate the feasibility of genomic profiling using standard clinical endoscopic ultrasound (EUS) core biopsy samples of Pancreatic Cancer (PC) to allow personalised cancer care. Methods: 78 patients underwent additional research biopsy at the time of diagnostic EUS biopsy. En-face frozen section was performed to enable targeted macro-dissection prior to DNA extraction, quantification and targeted gene sequencing (Agilent Comprehensive Cancer Gene Panel). Matching formalin-fixed (FFPE) diagnostic EUS biopsies and fresh frozen surgical resection specimens also underwent genomic profiling for comparison. Whole genome (WGS) and RNA sequencing was performed in selected patients. Results: Targeted panel sequencing ( n = 61) revealed known PC genes ( KRAS, GNAS, TP53, CDKN2A, SMAD4) in 36 patients with histological evidence of PC. Potentially actionable somatic mutations (BRCA1, BRCA2, ATM, BRAF, JAK3) were found in 6 (17%) patients. WGS ( n = 5) of EUS samples confirmed mutations identified on panel sequencing and revealed relevant mutational signatures and structural variation patterns that can act as putative biomarkers of therapeutic responsiveness. RNA sequencing ( n = 54) segregated patients into key clinically relevant molecular PC subtypes based on transcriptome and reveals novel molecular insights into advanced, unresectable PC ( n = 38). Conclusions: We demonstrate here novel multi-omic analysis of pancreatic cancer using standard clinical EUS guided fine needle biopsies. Multi-omic analysis of EUS biopsies offers potential clinical utility to guide personalized therapy of PC in both the neoadjuvant and advanced settings.
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Affiliation(s)
- Stephan Dreyer
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Nigel Jamieson
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Lisa Evers
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Marc Jones
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sancha Martin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Fraser Duthie
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Liz Musgrove
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Peter Bailey
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Colin McKay
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - David Kuang-Fu Chang
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Andrew Biankin
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom
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Ahmad M, Sekar V, Healy E, Rennie I, Cooke S. A Rare Case of an Extrarenal Rhabdoid Tumour in the Sellar and Suprasellar Region. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sandhu A, Cooke S, Barnard C. A QUALITATIVE STUDY OF COMMUNICATION CRISES IN THE PEDIATRIC IN-PATIENT SETTING: A 360O PERSPECTIVE. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dreyer S, Jamieson N, Evers L, Jones M, Martin S, Duthie F, Musgrove L, Cooke S, Bailey P, McKay CJ, Chang DKF, Biankin A. Feasibility and clinical utility of EUS guided biopsy of pancreatic cancer for next-generation genomic sequencing. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e15755] [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
e15755 Background: Next-generation sequencing (NGS) has made genomic profiling to guide therapy a reality for many cancer types. The aim of this study is to investigate the feasibility of genomic profiling using standard clinical endoscopic ultrasound (EUS) core biopsy samples of Pancreatic Cancer (PC) to allow personalised cancer care. Methods:Patients undergoing EUS and biopsy for suspicion of PC underwent additional biopsies which was snap frozen. En-face frozen section enabled targeted macro-dissection prior to DNA extraction, quantification and targeted sequencing using a commercially available 151 gene ClearSeq Comprehensive Cancer Panel. Matching formalin-fixed (FFPE) diagnostic EUS biopsy and fresh frozen surgical resection specimens underwent genomic profiling for comparison. Whole genome sequencing (WGS) was performed in 2 patients. RNA sequencing was performed in samples with sufficient RNA yield. Results: Known PC genes ( KRAS, GNAS, TP53, CDKN2A, SMAD4) were identified in 27 out of 30 (90%) patients with histological diagnosis of PC. Potentially actionable somatic mutations (BRCA1, BRCA2, ATM, BRAF, JAK3) were found in 6 (20%) patients. In the 2 samples selected, WGS of the EUS samples confirmed point mutations identified on panel sequencing and revealed relevant mutational signatures and structural variation patterns. Targeted panel sequencing was successful in all FFPE samples. In 1 chemotherapy naïve patient, sequencing of a matching trio of fresh frozen and FFPE EUS biopsies, and resection sample revealed evidence of spatial intra-tumoral heterogeneity. In another patient, pre-treatment biopsy revealed a somatic BRCA1 mutation, and patient had a near complete pathological response to platinum containing neoadjuvant therapy in the resected specimen. RNA sequencing segregated patients into key clinically relevant molecular PC subtypes based on transcriptome as recently described. Conclusions: We demonstrate here novel multi-omic analysis of pancreatic cancer using standard clinical EUS guided fine needle biopsies. Multi-omic analysis of EUS biopsies offers potential clinical utility to guide personalized therapy of PC in the neoadjuvant and advanced settings.
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Affiliation(s)
- Stephan Dreyer
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Nigel Jamieson
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Lisa Evers
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Marc Jones
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sancha Martin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Fraser Duthie
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Liz Musgrove
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Susie Cooke
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Peter Bailey
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Colin J McKay
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - David Kuang-Fu Chang
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Andrew Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
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Jordan RW, Aquilina A, Westacott DJ, Cooke S. A comparison of ketamine sedation and general anaesthesia for manipulation of paediatric forearm fractures. Acta Orthop Belg 2016; 82:836-842. [PMID: 29182126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of the study was to compare the use of ketamine sedation and general anaesthesia for manipulation of paediatric wrist and forearm fractures. A retrospective analysis was performed of patients under 16 years treated at our centre between October 2014 and October 2015. Exclusion criteria were open fractures and fractures with complete displacement. Outcomes measured were fracture reduction, the quality of the cast, fracture redisplacement, further surgical intervention and use of theatre time. 66 children were manipulated over the study period; 31 received ketamine sedation and 35 general anaesthesia. No statistically significant difference was found in the rate of re-intervention (p=0.48), quality of reduction (p=0.39), quality of cast (p=0.14 and p=0.21), or redisplacement (p=0.87). Those undergoing general anaesthesia used on average 50 minutes of theatre time and one third required an overnight admission. We conclude that ketamine sedation achieves comparable treatment outcomes to general anaesthesia whilst using fewer resources.
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Softley I, Kier E, Cooke S, Bowes M, Watkeys L, Gale N, Cockcroft J, McDonnell B. P6.4 THE DIFFERENTIAL EFFECTS OF RESISTANCE TRAINING AND ENDURANCE TRAINING ON AUGMENTATION INDEX: A PILOT STUDY. Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Christensen JH, Kvistgaard H, Knudsen J, Shaikh G, Tolmie J, Cooke S, Pedersen S, Corydon TJ, Gregersen N, Rittig S. A novel deletion partly removing the AVP gene causes autosomal recessive inheritance of early-onset neurohypophyseal diabetes insipidus. Clin Genet 2012; 83:44-52. [PMID: 22168581 DOI: 10.1111/j.1399-0004.2011.01833.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Familial neurohypophyseal diabetes insipidus (FNDI) typically presents with age-dependent penetrance and autosomal dominant inheritance caused by missense variations in one allele of the AVP gene encoding the arginine vasopressin (AVP) prohormone. We present the molecular genetic characteristics underlying an unusual form of FNDI occurring with very early onset and seemingly autosomal recessive inheritance. By DNA amplification and sequencing, we identified a novel variant allele of the AVP gene carrying a 10,396 base pair deletion involving the majority of the AVP gene as well as its regulatory sequences in the intergenic region between the AVP and the OXT gene, encoding the oxytocin prohormone. We found two chromosomes carrying the deletion in affected family members and one in unaffected family members suspected to transmit the deleted allele. Whole-genome array analysis confirmed the results and excluded the presence of any additional major pathogenic abnormalities. The deletion is predicted to abolish the transcription of the AVP gene, thus the fact that family members heterozygous for the deletion remain healthy argues, in general, against haploinsufficiency as the pathogenic mechanism FNDI. Accordingly, our data is strong support to the prevailing idea that dominant inheritance of FNDI is due to a dominant-negative effect exerted by variant AVP prohormone.
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Welling A, Cooke S, Dewey A, Archer M, Higgins B, Carss G. 006 Tuning fork testing on ankle injuries: does it improve the accuracy of the Ottawa ankle rules? Arch Emerg Med 2011. [DOI: 10.1136/emermed-2011-200617.6] [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: 11/03/2022]
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Jones L, Braithwaite BD, Selwyn D, Cooke S, Earnshaw JJ. Reprinted article "Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein". Eur J Vasc Endovasc Surg 2011; 42 Suppl 1:S57-60. [PMID: 21855024 DOI: 10.1016/j.ejvs.2011.06.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/1996] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine whether routine stripping of the long saphenous vein reduces recurrence after varicose vein surgery. DESIGN Randomised controlled trial. All operations done by a consultant vascular surgeon. Two year follow-up. MATERIALS AND METHODS One hundred patients with primary long saphenous varicose veins (133 legs) were randomised. Two year follow-up in 81 patients (113 legs) with questionnaire, clinical examination and Duplex scanning. RESULTS Some 89% remained satisfied with the results of their surgery, though 35% had recurrent veins on clinical examination. Recurrence was reduced from 43 to 25% in patients who had their long saphenous vein stripped (p = 0.04, χ(2)). Neovascularisation (serpentine tributaries arising from the ligated saphenofemoral junction) was detected in 52% of limbs and was the commonest cause of recurrence. Most tributaries were less than 3 mm in diameter and only caused recurrence if the long saphenous vein or a major thigh vein was intact. Twelve patients had tributaries greater than 3 mm diameter and all had recurrent varicose veins. CONCLUSIONS Recurrence is common after varicose vein surgery and in this study was caused principally by neovascularisation at the ligated saphenofemoral junction. Clinical recurrence is reduced by routine stripping of the long saphenous vein.
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Affiliation(s)
- L Jones
- Department of Surgery, Gloucestershire Royal Hospital, Gloucester, UK
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Hallowell N, Cooke S, Crawford G, Lucassen A, Parker M, Snowdon C. An investigation of patients' motivations for their participation in genetics-related research. J Med Ethics 2010; 36:37-45. [PMID: 20026692 DOI: 10.1136/jme.2009.029264] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
DESIGN Qualitative interview study. PARTICIPANTS Fifty-nine patients with a family history of cancer who attend a regional cancer genetics clinic in the UK were interviewed about their current and previous research experiences. FINDINGS Interviewees gave a range of explanations for research participation. These were categorised as (a) social--research participation benefits the wider society by progressing science and improving treatment for everyone; (b) familial--research participation may improve healthcare and benefit current or future generations of the participant's family; and (c) personal--research participation provides therapeutic or non-therapeutic benefits for oneself. CONCLUSIONS We discuss the distinction drawn between motives for research participation focused upon self (personal) and others (familial/social), and observe that personal, social and familial motives can be seen as interdependent. For example, research participation that is undertaken to benefit others, particularly relatives, may also offer a number of personal benefits for self, such as enabling participants to feel that they have discharged their social or familial obligations. We argue for the need to move away from simple, static, individualised notions of research participation to a more complex, dynamic and inherently social account.
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Affiliation(s)
- N Hallowell
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG.
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Hallowell N, Cooke S, Crawford G, Parker M, Lucassen A. Healthcare professionals' and researchers' understanding of cancer genetics activities: a qualitative interview study. J Med Ethics 2009; 35:113-119. [PMID: 19181885 DOI: 10.1136/jme.2008.024224] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIMS To describe individuals' perceptions of the activities that take place within the cancer genetics clinic, the relationships between these activities and how these relationships are sustained. DESIGN Qualitative interview study. PARTICIPANTS Forty individuals involved in carrying out cancer genetics research in either a clinical (n = 28) or research-only (n = 12) capacity in the UK. FINDINGS Interviewees perceive research and clinical practice in the subspecialty of cancer genetics as interdependent. The boundary between research and clinical practice is described as vague or blurred, and this ambiguity is regarded as being sustained by a range of methodological, ethical and economic factors. The implications of these findings for the "therapeutic misconception" are explored. It is argued that while research participation is seen as having therapeutic benefit for individual patients, the interviewees are not labouring under any misconceptions about the relationship between research and clinical care. It is suggested that concepts such as the "therapeutic misconception" may have less relevance in highly technological specialities that are characterised by a developing evidence base.
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Affiliation(s)
- N Hallowell
- Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, UK.
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Graham E, Ahmed A, Kane L, Cooke S, Longman C, Stewart W, Petty R. G.P.12.02 Asymmetric hypertrophy and contractures in an adult male due to somatic mosaicism for a DMD stop mutation. Neuromuscul Disord 2008. [DOI: 10.1016/j.nmd.2008.06.274] [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: 11/26/2022]
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Howarth K, Blood K, Ng B, Beavis J, Chua Y, Cooke S, Pole J, Chin S, Ichimura K, Collins VP, Ellis I, Caldas C, Carter N, Edwards PAW. Chromosome translocations in breast cancer. Breast Cancer Res 2008. [PMCID: PMC3300709 DOI: 10.1186/bcr1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Morrow CMK, Hostetler CE, Griswold MD, Hofmann MC, Murphy KM, Cooke S, Hess RA. ETV5 is required for continuous spermatogenesis in adult mice and may mediate blood testes barrier function and testicular immune privilege. Ann N Y Acad Sci 2007; 1120:144-51. [PMID: 17911411 PMCID: PMC2733827 DOI: 10.1196/annals.1411.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The transcription factor Ets-variant gene 5 (ETV5) is essential for spermatogonial stem cell (SSC) self-renewal, as the targeted deletion of the Etv5 gene in mice (Etv5(-/-)) results in only the first wave of spermatogenesis. Reciprocal transplants of neonatal germ cells from wild-type (WT) and Etv5(-/-) testes were performed to determine the role of ETV5 in Sertoli cells and germ cells. ETV5 appears to be needed in both cell types for normal spermatogenesis. In addition, Etv5(-/-) recipients displayed increased interstitial inflammation and tubular involution after transplantation. Preliminary studies suggest that the blood-testis barrier (Sertoli-Sertoli tight junctional complex) is abnormal in the Etv5(-/-) mouse.
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Affiliation(s)
- Carla M. K. Morrow
- Department of Veterinary Bioscience, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Chris E. Hostetler
- School of Molecular Biosciences, College of Sciences, Washington State University, Pullman, WA 99164
| | - Mike D. Griswold
- School of Molecular Biosciences, College of Sciences, Washington State University, Pullman, WA 99164
| | - Marie-Claude Hofmann
- Department of Veterinary Bioscience, University of Illinois at Urbana-Champaign, Urbana, IL 61802
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Kenneth M. Murphy
- Department of Pathology and Immunology, School of Medicine, Washington University, St. Louis, MO 63110
- Howard Hughes Medical Institute
| | - S. Cooke
- Department of Veterinary Bioscience, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Rex A. Hess
- Department of Veterinary Bioscience, University of Illinois at Urbana-Champaign, Urbana, IL 61802
- Corresponding Author: Dr. Rex A. Hess, Vet. Biosciences, 2001 S Lincoln Ave, Urbana, IL 61802; Phone: (217); Fax: (217) 244-1652; e-mail:
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Croese J, O'neil J, Masson J, Cooke S, Melrose W, Pritchard D, Speare R. A proof of concept study establishing Necator americanus in Crohn's patients and reservoir donors. Gut 2006; 55:136-7. [PMID: 16344586 PMCID: PMC1856386 DOI: 10.1136/gut.2005.079129] [Citation(s) in RCA: 193] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Howarth K, Blood K, Cooke S, Ng BL, Edwards P. P39: Use of array painting to detect balanced translocations in breast cancer. Eur J Med Genet 2005. [DOI: 10.1016/j.ejmg.2005.10.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cooke S, Tyler JPP, Driscoll GL. Meiotic spindle location and identification and its effect on embryonic cleavage plane and early development. Hum Reprod 2004; 18:2397-405. [PMID: 14585893 DOI: 10.1093/humrep/deg447] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To examine the relationship between the meiotic spindle, the first cleavage plane and any resulting influence on embryonic development parameters. METHODS Sibling oocytes (n = 246) were allocated to either a control [polar body (PB)-aligned] or a treatment (spindle-aligned) microinjection group by use of a random numbers table. Spindles were identified by PolScope((R)) and the early embryo development parameters, and angle of first cleavage plane in relation to a defined animal-vegetal pole were analysed. RESULTS Most oocytes (92.7%) had a visible spindle at the time of microinjection; however, 62.6% of first PBs (1PBs) were not located above the spindle (average deviation 37.3 +/- 33.2 degrees; range 0-176.6), with 6.9% of 1PBs in the opposite hemisphere to the spindle. The second PBs (2PBs) can also have an unpredictable deviation from the position of the meiotic spindle (12.5 +/- 16.7 degrees; range 0-91.8). This increased when the 1PB was above the spindle, forming a physical barrier to extrusion (average 24.7 +/- 16.1 degrees; range 7.9-91.8). Embryos developing from the spindle-aligned microinjection group had significantly more blastomeres per embryo (P = 0.044), a higher morphology score per embryo (P = 0.008) and a significantly higher average embryo score parameter (P = 0.003), with more embryos developing without any detectable fragmentation (P < 0.05) than the PB-aligned control group. Non-fragmented embryos undergo meridional cleavage, with a small angle between the spindle location and first cleavage plane (16.4 +/- 14.0 degrees ) compared with embryos with some degree of fragmentation (P = 0.002). This angle increased with the degree of fragmentation, with worst quality embryos having a spindle:cleavage angle of 45.1 +/- 17.7 degrees. CONCLUSIONS The 1PB and, to a lesser degree, the 2PB can be unreliable predictors of the exact meiotic spindle location in human oocytes. Embryos from spindle-aligned oocytes have an increase in all measured development parameters over control siblings. When the animal pole is defined as the meiotic spindle location, non-fragmented embryos tend to develop from a meridional cleavage; with the most fragmented embryos developing from a more equatorial initial cleavage plane. This study proposes that the spindle accurately marks the animal pole in human oocytes, and provides evidence linking the meiotic spindle location to the first cleavage plane and resulting early embryo development parameters in human embryos.
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Affiliation(s)
- S Cooke
- IVFAustralia-Western Sydney, 12 Caroline Street, Westmead, NSW 2145, Australia.
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Cooke S, Brenner JL, Perkin L, Jordan CN. Development And Implementation Of A Hospitalist Inpatient Care Program In A Tertiary Care Pediatric Centre: A Description Of Impacts After Two Years Experience With Hospital Pediatricans At The Alberta Children's Hospital. Paediatr Child Health 2003. [DOI: 10.1093/pch/8.suppl_b.28b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maskell NA, Cooke S, Meecham Jones DJ, Prior JG, Butland RJA. The use of automated strain gauge plethysmography in the diagnosis of deep vein thrombosis. Br J Radiol 2002; 75:648-51. [PMID: 12153937 DOI: 10.1259/bjr.75.896.750648] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The venometer is a nurse- or technician-operated machine that uses automated strain gauge plethysmography to detect deep vein thrombosis (DVT). We compared the venometer with contrast venography to determine its accuracy, and also used it to triage patients between admission with subsequent anticoagulation and out-patient investigation without anticoagulation. We enrolled 307 consecutive patients presenting to the medical admissions unit with suspected DVT, of whom 270 underwent both plethysmography and venography. Plethysmography produced a negative predictive value (NPV) of 97% and a sensitivity of 90% for proximal DVT. It also produced a false negative rate of 10% for proximal DVT, For distal DVT, sensitivity was 66%, specificity 80%, positive predictive value 36% and NPV 93%. We conclude that the automated venometer report is a quick, non-invasive and easy to use initial screening test. However, it is not sufficiently accurate in a medical admissions unit to be a definitive diagnostic test for DVT and may, therefore, be best used in combination with clinical risk assessment and D-dimer assay with more definitive radiological investigations as necessary.
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Affiliation(s)
- N A Maskell
- Medical Directorate, Gloucestershire Royal NHS Trust, Gloucester, UK
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Graham LE, Flynn P, Cooke S, Patterson V. The interdisciplinary management of cerebral haemorrhage using telemedicine--a case report from Nepal. J Telemed Telecare 2002; 7:304-6. [PMID: 11571086 DOI: 10.1258/1357633011936570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- L E Graham
- Department of Medicine, Patan Hospital, GPO Box 252, Kathmandu, Nepal.
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Abstract
BACKGROUND Since the condition was first described in 1965, the syndrome of normal pressure hydrocephalus (NPH) has conventionally been managed by placement of a cerebrospinal fluid (CSF) shunt. OBJECTIVES To determine the effectiveness of shunting procedures in promoting stability or improvement in the neurological symptoms and signs of NPH. SEARCH STRATEGY The trials were identified from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 26 June 2001 using the terms 'shunt*' and 'normal pressure hydrocephalus'. SELECTION CRITERIA Studies included for analysis were those involving the placement of a CSF shunt for the treatment of NPH as part of a randomized controlled trial. DATA COLLECTION AND ANALYSIS No data matching the selection criteria were found. MAIN RESULTS No randomized controlled trials of shunt placement versus no shunt were found. REVIEWER'S CONCLUSIONS There is no evidence to indicate whether placement of a shunt is effective in the management of NPH.
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Affiliation(s)
- T Esmonde
- Dept of Neurology, Royal Victoria Hospital, Dept of Neurology, Royal Victoria Hospital, Belfast, UK, BT12 6BA.
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Li J, Cooke S, Tyler JP, Bentley MJ, Kime L, Driscoll GL. Oocyte morphology and early zygote cleavage does not appear to be related to intrafollicular concentrations of inhibin-A or -B. J Assist Reprod Genet 2000; 17:425-30. [PMID: 11062852 PMCID: PMC3455567 DOI: 10.1023/a:1009461117779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The aim was to investigate the relationship of intrafollicular inhibin dimers A and B with human oocyte morphology and subsequent embryo potential. METHODS Sixty-eight oocytes were isolated from 31 women undertaking intracytoplasmic sperm injection (ICSI). Estradiol, progesterone, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, sex hormone-binding globulin, inhibin-A and inhibin-B was assayed in corresponding follicular fluid. RESULTS The mean (+/- SD) concentration for inhibin-A was 9.7 +/- 9.8 ng/ml (range, 1.1-60.0 ng/ml) and for inhibin-B was 269.4 +/- 185.2 ng/ml (range, 33.1-811.0 ng/ml). In a correlation matrix there were no marked relationships (r < 0.556) between inhibin and steroid or gonadotropin concentrations. Similarly, when inhibin concentrations were divided according to whether the oocytes had mature or immature cumulous complexes, were viable or necrotic, were meiotically immature or mature, became fertilized or not, or had different embryo gradings after cleavage, no statistically significant difference could be seen between groupings. CONCLUSIONS Because the range of values was large and the data often skewed, neither inhibin dimer has discriminatory power to reflect the potential of the oocyte.
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Affiliation(s)
- J Li
- ART Centre, First Affiliated Hospital, Sun Yat-Sen University of Medical Sciences, Guang Zhou, China
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Cooke S, Grant G, McLauchlan C, Lotto RB, Price DJ. Basic fibroblast growth factor promotes subplate cell survival in explant cultures of embryonic mouse cortex. Neurosci Lett 1999; 271:143-6. [PMID: 10507689 DOI: 10.1016/s0304-3940(99)00546-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Subplate neurons form a transient layer immediately below the embryonic cortex and die early in postnatal life. It has been suggested that trophic factors, perhaps coming from cortical afferents, maintain the initial survival of these cells. Later withdrawal of these factors may cause subplate cell death. We tested whether basic fibroblast growth factor (bFGF) has survival-promoting effects on subplate cells in organotypic cultures from the late embryonic mouse cortex. We found that the survival of subplate cells was promoted by adding bFGF to the cultures. By contrast, there was no effect of bFGF on the survival of overlying cortical neurons. These results indicate that bFGF may have a role in the regulation of subplate cell survival and death in vivo.
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Affiliation(s)
- S Cooke
- Department of Biomedical Sciences, University of Edinburgh Medical School, UK
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Borrello I, Sotomayor EM, Cooke S, Levitsky HI. A universal granulocyte-macrophage colony-stimulating factor-producing bystander cell line for use in the formulation of autologous tumor cell-based vaccines. Hum Gene Ther 1999; 10:1983-91. [PMID: 10466632 DOI: 10.1089/10430349950017347] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Irradiated tumor cells transduced with the gene encoding the cytokine GM-CSF have been extensively studied as a vaccine formulation capable of priming systemic antitumor immune responses in the tumor-bearing host. In spite of the therapeutic promise of this vaccine strategy demonstrated in both animal models and early-phase clinical trials, clinical development has been limited by difficulties pertaining to the need to establish in culture the tumor of each patient and to perform individualized gene transfer. To circumvent these issues, we generated an HLA-negative human cell line producing large quantities of human GM-CSF for use as a universal bystander cell to be mixed with unmodified autologous tumor cells in the formulation of a vaccine. This line is easily propagated as a suspension culture in defined, serum-free medium. In a mouse model, we find that vaccination with a mixture of autologous tumor cells and an MHC-negative allogeneic GM-CSF-producing bystander cell primes antitumor immune responses that are equivalent or better than those achieved using autologous tumor cells directly transduced to secrete GM-CSF. This strategy greatly simplifies further clinical development of autologous tumor cell-based vaccines.
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Affiliation(s)
- I Borrello
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21205-2196, USA
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Guo S, Wilson SW, Cooke S, Chitnis AB, Driever W, Rosenthal A. Mutations in the zebrafish unmask shared regulatory pathways controlling the development of catecholaminergic neurons. Dev Biol 1999; 208:473-87. [PMID: 10191060 DOI: 10.1006/dbio.1999.9204] [Citation(s) in RCA: 186] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The mechanism by which pluripotent progenitors give rise to distinct classes of mature neurons in vertebrates is not well understood. To address this issue we undertook a genetic screen for mutations which affect the commitment and differentiation of catecholaminergic (CA) [dopaminergic (DA), noradrenergic (NA), and adrenergic] neurons in the zebrafish, Danio rerio. The identified mutations constitute five complementation groups. motionless and foggy affect the number and differentiation state of hypothalamic DA, telencephalic DA, retinal DA, locus coeruleus (LC) NA, and sympathetic NA neurons. The too few mutation leads to a specific reduction in the number of hypothalamic DA neurons. no soul lacks arch-associated NA cells and has defects in pharyngeal arches, and soulless lacks both arch-associated and LC cell groups. Our analyses suggest that the genes defined by these mutations regulate different steps in the differentiation of multipotent CA progenitors. They further reveal an underlying universal mechanism for the control of CA cell fates, which involve combinatorial usage of regulatory genes.
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Affiliation(s)
- S Guo
- Department of Neuroscience, Genentech, Inc., 1 DNA Way, South San Francisco, California, 94080, USA
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Driscoll GL, Tyler JP, Knight DC, Cooke S, Kime L, Clark L, Bernstein J. Failure to collect oocytes in assisted reproductive technology: a retrospective. Hum Reprod 1998; 13:84-7. [PMID: 9512234 DOI: 10.1093/humrep/13.1.84] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
While there is much information and discussion on pregnancy failure after assisted reproductive technologies, less emphasis is placed on the failure to collect oocytes after apparently successful ovarian stimulation. This retrospective survey reviewed 4973 treatment cycles in order to obtain information about the likelihood of this event. Overall 42 women (43 treatment cycles) failed to have oocytes collected [0.86% of treatments started and 0.92% of women given human chorionic gonadotrophin (HCG)]. However, in only six cases was this failure unexpected (0.1%) with no obvious potential clinical reason (i.e. all six cases had: HCG administered; more than two follicles >15 mm in diameter; oestradiol values >2000 pmol/l; <38 years old; normal body mass index). Indifference concerning uncommon events is fraught with peril, as although rare, the particular outcome may be devastating to the individual, both economically and psychologically. Eighteen of the 42 women did not return for on-going treatment suggesting increased contact by clinic staff may be required when oocyte retrieval is not achieved. These data suggest that the failure to collect oocytes after apparently successful ovarian stimulation is rare and random. The information has proved useful in allaying the fears of couples contemplating assisted reproductive technologies.
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Wong WK, Wieringa GE, Stec Z, Russell J, Cooke S, Keevil BG, Lockhart S. A comparison of three procedures for the detection of Bence-Jones proteinuria. Ann Clin Biochem 1997; 34 ( Pt 4):371-4. [PMID: 9247668 DOI: 10.1177/000456329703400406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A traditional electrophoretic procedure for detection of Bence-Jones proteinuria, employing Amido black stain on 200-fold concentrated urine, has been compared to two procedures employing highly sensitive protein stains not requiring prior urine concentration. All three procedures were carried out on 80 random urine samples screened for Bence-Jones proteinuria and 10 samples were provided by patients attending a myeloma clinic. A new procedure employing modified Coomassie brilliant blue stain on unconcentrated urine showed comparable sensitivity to the established procedure (82% versus 88%, respectively) and specificity (77% versus 74%, respectively), when assessed against immunofixation as a reference method. However, the new method is considerably quicker and cheaper. A second method, employing Gold stain, showed enhanced sensitivity (94% versus 88% for Amido black) but lower specificity (62% versus 74% for Amido black). However, this method is labour intensive and relatively expensive. Our data suggest that the procedure employing modified Coomassie brilliant blue may be a suitable alternative to the traditional procedure commonly used in many clinical laboratories.
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Affiliation(s)
- W K Wong
- Department of Biochemistry, Christie Hospital NHS Trust, Manchester UK
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Affiliation(s)
- K Coates
- Department of Veterinary Pathology, University of Glasgow, Scotland, UK
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Jones L, Braithwaite BD, Selwyn D, Cooke S, Earnshaw JJ. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. Eur J Vasc Endovasc Surg 1996; 12:442-5. [PMID: 8980434 DOI: 10.1016/s1078-5884(96)80011-6] [Citation(s) in RCA: 249] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To determine whether routine stripping of the long saphenous vein reduces recurrence after varicose vein surgery. DESIGN Randomised controlled trial. All operations done by a consultant vascular surgeon. Two year follow-up. MATERIALS AND METHODS One hundred patients with primary long saphenous varicose veins (133 legs) were randomised. Two year follow-up in 81 patients (113 legs) with questionnaire, clinical examination and Duplex scanning. RESULTS Some 89% remained satisfied with the results of their surgery, though 35% had recurrent veins on clinical examination. Recurrence was reduced from 43 to 25% in patients who had their long saphenous vein stripped (p = 0.04, chi 2). Neovascularisation (serpentine tributaries arising from the ligated saphenofemoral junction) was detected in 52% of limbs and was the commonest cause of recurrence. Most tributaries were less than 3 mm in diameter and only caused recurrence if the long saphenous vein or a major thigh vein was intact. Twelve patients had tributaries greater than 3 mm diameter and all had recurrent varicose veins. CONCLUSIONS Recurrence is common after varicose vein surgery and in this study was caused principally by neovascularisation at the ligated saphenofemoral junction. Clinical recurrence is reduced by routine stripping of the long saphenous vein.
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Affiliation(s)
- L Jones
- Department of Surgery, Gloucestershire Royal Hospital, Gloucester, U.K
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Abstract
Times have been defined for the handling of 0.25 ml embryo cryostraws and semen, in either 0.5 ml cryostraws or 1.0 ml cryovials containing 0.5 ml material, before potentially detrimental changes in temperature take place. When handling cryovials the time lag is relatively long, with 78.8 +/- 2.6 s being available to manipulate the vials before -80 degrees C is reached and 335.4 +/- 3. 8 s until the eutectic point (approximately -7 degrees C) is reached. However the situation with cryostraws is less tolerant. Both 0.25 and 0.5 ml versions reach temperatures >-80 degrees C within 40 s, and the eutectic point is reached in 79.0 +/- 2.0 s in 0.25 ml cryostraws. These time/temperature data have proved useful in educating new technicians, as well as clinicians and nurses who may also handle frozen human material, in the need to minimize the ambient temperature exposure time of stored specimens so as to maintain optimal post-thaw viability.
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Affiliation(s)
- J P Tyler
- City West IVF, 12 Caroline Street, Westmead, NSW, Australia 2145
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Cooke S, Glenis S, Chen X, Lin CL, Labes MM. New preparation of superconducting alkali-metal fullerides utilizing monomethylamine as solvent. ACTA ACUST UNITED AC 1996. [DOI: 10.1039/jm9960600001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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