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Mekha M, Joshi A, Maniar V, Maheshwari U, Joshi K, Kalaskar P, Sheth S, Kendre P, Morzaria D, Korgavkar R, Pethe C, Dhande S. The Efficacy of Paxman Scalp Cooling System in Preventing Hair Loss in Breast Cancer Patients Receiving Chemotherapy in Western India - Multi-centre Retrospective Cohort Study. Indian J Dermatol 2024; 69:16-23. [PMID: 38572038 PMCID: PMC10986862 DOI: 10.4103/ijd.ijd_345_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Aim Chemotherapy-induced alopecia (CIA) is the most common side effect of systemic treatment in breast cancer patients. Scalp cooling gained worldwide acceptance in preventing or mitigating CIA in patients undergoing chemotherapy. The objective of this study was to evaluate the efficacy and safety of the Paxman scalp cooling system (PSCS) in Indian breast cancer patients. Materials and Methods This is a multi-centre, retrospective-observational study including patients registered from 1st March, 2019 to 30th April, 2021 undergoing chemotherapy for breast cancer by using PSCS. The primary end-point was the incidence of CIA after completing cycles of chemotherapy. Results A total of 91 female patients were enrolled in the study, with a median age of 53 years (IQR: 44-62 years). The prevention of alopecia (grade 0 and grade I) was seen in 81%, while more than 50% hair loss (grade 2) was seen in 16.48% after completion of treatment. The univariate analysis results showed that CIA was significantly higher in patients who received anthracyclines (OR: 2.69; 95% CI: 1.04-6.958; P = 0.041) and in patients with a post-infusion cooling time of >150 minutes (OR: 8.409; 95% CI: 2.295-30.787; P = 0.001). The incidence of grade 2 (>50% hair loss) alopecia was 81.3% in patients <6 weeks and was 18.8% at >6 weeks of start of chemotherapy (P < 0.0001). No adverse events were reported in 71.4% of patients, and the most common adverse event was headache (18.7%). Conclusion PSCS is an effective and well-tolerated treatment modality for preventing CIA among breast cancer patients undergoing chemotherapy.
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Affiliation(s)
- Mangesh Mekha
- From the Department of Medical Oncology, Mumbai Oncocare Centre, Pune, India
| | - Ashish Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Vashishth Maniar
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Udip Maheshwari
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Kshitij Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Pritam Kalaskar
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Smit Sheth
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Pradip Kendre
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Disha Morzaria
- Department of Clinical Research, Mumbai Oncocare Centre, Mumbai, India
| | - Reshma Korgavkar
- Department of Clinical Research, Mumbai Oncocare Centre, Mumbai, India
| | | | - Sonal Dhande
- Department of Medical Oncology, Mumbai Oncocare Centre, Nashik, India
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Joshi A, Korgavkar R, Joshi K, Maniar V, Kalaskar P, Kendre P, Maheshwari UD, Pethe C, Sheth S, Dhande S. A Real-World Molecular Epidemiological Study of Non-Small-Cell Lung Cancer (NSCLC) Patients from Western India. South Asian J Cancer 2023; 12:263-265. [PMID: 38047052 PMCID: PMC10691910 DOI: 10.1055/s-0042-1743425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Ashish JoshiBackground The molecular characterization of advanced non-small-cell lung cancer (NSCLC) has unveiled genomic alterations such as EGFR gene mutations, KRAS gene mutations, ROS1 gene rearrangements, EML4-ALK rearrangements, and altered MET signaling. The objective of this molecular epidemiological study was to report the clinical, pathological, and molecular profile of NSCLC patients from western India. Materials and Methods This real-world study of NSCLC patients was performed at a chemotherapy day-care center in western India. The clinical, pathological, and molecular data were collected from the patient's medical records after obtaining the Ethics Committee permission for the study. The study was conducted according to the ethical principles stated in the latest version of Helsinki Declaration, and the applicable guidelines for good clinical practice. Results A total of 182 (58.7%) men and 128 (41.3%) women with a median age of 63 years (range: 22-93 years) were included in the study. Of the total 310 patients, 195 (62.9%) were nonsmokers whereas 81 (26.1%) had a past history of smoking. EGFR , EML4-ALK Fusion Gene, KRAS , ROS1 gene rearrangement, and PD-L1 were positive in 42 (22.3%), 12 (9%), 2 (28.6%), 3 (12.5%), and 3 (25%) patients, respectively. One patient had concurrent EGFR mutation along with ROS1 gene rearrangement. Conclusion Oncogenic driver mutations are present in Indian NSCLC patients. Molecular testing should be performed for all patients of advanced NSCLC to identify those that can benefit from newer generation of targeted or immunotherapies.
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Affiliation(s)
- Ashish Joshi
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Reshma Korgavkar
- Department of Research and Clinical Trials, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Kshitij Joshi
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Vashishth Maniar
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Pritam Kalaskar
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Pradip Kendre
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Udip Dilip Maheshwari
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Chandrashekhar Pethe
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Smith Sheth
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
| | - Sonal Dhande
- Department of Oncology and Hematology, Mumbai Oncocare Center, Borivali and Vile Parle, Mumbai, Maharashtra, India
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Bakshi G, Tongaonkar H, Addla S, Menon S, Pradhan A, Kumar A, Bapat A, Gore A, Joshi A, Raja A, Bradoo A, Ramesh A, Kumar A, Agrawal A, Ambekar A, Joshi A, Singh A, Singh BP, Dabkara D, Khadakban D, Gautam G, Prakash G, Pahwa HS, Goel HK, Kulkarni J, Mishra JJ, Patel K, Pal M, Chibber PJ, Tiwari P, Naik R, Raghunath SK, Krishnatry R, Shimpi R, Sharma R, Taran R, Trivedi S, Nabar S, Surekha S, Kumar S, Sawaimoon SK, Raina S, Narasimha S, Advani S, Ghouse SM, Muddu VK, Maniar V, Venkat V, Murthy V. Expert survey on management of prostate cancer in India: Real-world insights into practice patterns. Indian J Cancer 2022; 59:S19-S45. [PMID: 35343189 DOI: 10.4103/ijc.ijc_1145_21] [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: 06/14/2023]
Abstract
To gain insights on the diverse practice patterns and treatment pathways for prostate cancer (PC) in India, the Urological Cancer Foundation convened the first Indian survey to discuss all aspects of PC, with the objective of guiding clinicians on optimizing management in PC. A modified Delphi method was used, wherein a multidisciplinary panel of oncologists treating PC across India developed a questionnaire related to screening, diagnosis and management of early, locally advanced and metastatic PC and participated in a web-based survey (WBS) (n = 62). An expert committee meeting (CM) (n = 48, subset from WBS) reviewed the ambiguous questions for better comprehension and reanalyzed the evidence to establish a revote for specific questions. The threshold for strong agreement and agreement was ≥90% and ≥75% agreement, respectively. Sixty-two questions were answered in the WBS; in the CM 31 questions were revoted and 4 questions were added. The panelists selected answers based on their best opinion and closest to their practice strategy, not considering financial constraints and access challenges. Of the 66 questions, strong agreement was reached for 17 questions and agreement was achieved for 22 questions. There were heterogeneous responses for 27 questions indicative of variegated management approaches. This is one of the first Indian survey, documenting the diverse clinical practice patterns in the management of PC in India. It aims to provide guidance in the face of technological advances, resource constraints and sparse high-level evidence.
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Affiliation(s)
- Ganesh Bakshi
- Department of Uro-Oncology, P D Hinduja National Hospital, Mumbai, India
| | - Hemant Tongaonkar
- Director of Surgical Oncology and Uro-Oncology, Max Nanavati Hospital, Mumbai, India
| | - Sanjai Addla
- Department of Uro-Oncology, Apollo Hospital, Hyderabad, India
| | - Santosh Menon
- Department of Uro-Onco Pathology, Tata Memorial Hospital & HBNI, Mumbai, India
| | - Aditya Pradhan
- Department of Uro-Oncology, BL Kapoor Hospital, Delhi, India
| | - Abhay Kumar
- Department of Uro-Oncology, Narayana Health, Kolkata, India
| | - Abhijit Bapat
- Department of Urology, Bapat Urology Hospital, Mumbai, India
| | - Adwaita Gore
- Department of Medical Oncology, Prince Aly Khan Hospital, Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Anand Raja
- Department of Uro-Oncology, Cancer Institute (WIA), Adyar, Chennai, India
| | - Anil Bradoo
- Department of Urology, Excel Urology Centre, Mumbai, India
| | - Anita Ramesh
- Department of Medical Oncology, Apollo Hospital, Chennai, India
| | - Anup Kumar
- Department of Urology, Safdarjung Hospital, Delhi, India
| | - Archi Agrawal
- Department of Nuclear Medicine, Tata Memorial Hospital & HBNI, Mumbai, India
| | | | - Ashish Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, India
| | | | - Deepak Dabkara
- Department of Medical Oncology, Tata Memorial Centre, Kolkata, India
| | - Dhiraj Khadakban
- Department of Surgical Oncology, Oncolife Hospital, Satara, India
| | - Gagan Gautam
- Department of Uro-Oncology, Max Healthcare, Delhi, India
| | - Gagan Prakash
- Department of Uro-Oncology, Tata Memorial Hospital & HBNI, Mumbai, India
| | | | | | | | | | - Kaushal Patel
- Department of Medical Oncology, Tristar Hospital, Surat, India
| | - Mahendra Pal
- Department of Uro-Oncology, Tata Memorial Hospital & HBNI, Mumbai, India
| | | | - Priya Tiwari
- Department of Medical Oncology, Artemis Hospital, Delhi, India
| | - Radheshyam Naik
- Department of Medical Oncology, HCG Hospital, Bangalore, India
| | - S K Raghunath
- Department of Uro-Oncology, HCG Hospital, Bangalore, India
| | - Rahul Krishnatry
- Department of Radiation Oncology, Tata Memorial Hospital & HBNI, Mumbai, India
| | | | - Rakesh Sharma
- Department of Uro-Oncology, Indo-American Hospital, Hyderabad, India
| | - Rakesh Taran
- Department of Medical Oncology, CHL Hospital, Indore, India
| | - Sameer Trivedi
- Department of Urology, Institute of Medical Science, Varanasi, India
| | - Sanjay Nabar
- Department of Urology, Nanavati Hospital, Mumbai, India
| | | | - Satish Kumar
- Department of Surgical Oncology, Mohan's Medicity Hospital, Madurai, India
| | | | | | | | - Suresh Advani
- Department of Medical Oncology, SL Raheja Hospital, Mumbai, India
| | | | | | - Vashishth Maniar
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | - Vivek Venkat
- Department of Urology, Nanavati Hospital, Mumbai, India
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Hospital & HBNI, Mumbai, India
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Shivchhand A, Joshi A, Maheshwari U, Maniar V, Joshi K, Kalaskar P, Sheth S, Kendre P, Korgavkar R, Morzaria D, Pethe C, Dhande S, Mekha M, Rane D, Jagiasi S. 35P NSCLC: Real-world data analysis from a chain of oncology centres in Western India. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.044] [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: 11/01/2022] Open
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Abstract
Standard therapy for advanced ovarian cancer (OC) consists of radical debulking cytoreductive surgery followed by adjuvant chemotherapy. An important risk factor for OC is genetic predisposition, with BRCA1 or BRCA2 mutations accounting for the majority of hereditary OC. Mutation in BRCA ultimately causes accumulation of genetic alterations because of the failure of cells to arrest and repair DNA damage or to undergo apoptosis, resulting in tumorigenesis. Poly (ADP-ribose) polymerase (PARP) inhibitors have emerged as a promising approach for managing BRCA-associated cancers, especially high-grade OC and breast cancers. They lead to synthetic lethality in BRCA-mutated cells by stalling the replication forks in homologous recombination-deficient (HR) cells. Four PARP inhibitors (olaparib, niraparib, rucaparib, and talazoparib) are currently approved by the Food and Drug Administration for OC, breast, and pancreatic cancer indications and are being evaluated for other BRCA-associated cancers. Despite their clinical efficacy, cancer cells generally develop resistance to them through several mechanisms. Understanding these mechanisms is crucial for developing strategies to counter resistance and identify the basic mechanisms of DNA damage response. This review focuses on the mechanism of action of PARP inhibitors, understanding various causes of resistance, and building strategies to overcome PARP inhibitor resistance.
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Affiliation(s)
- Chirag Desai
- Medical Oncology, Vedanta Institute of Medical Sciences, Ahmedabad, Gujarat, India
| | - Anand Pathak
- Medical Oncology, National Cancer Institute, Nagpur, Maharashtra, India
| | - Sewanti Limaye
- Medical Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
| | - Vashishth Maniar
- Medical Oncology, Mumbai Oncocare Centre, Mumbai, Maharashtra, India
| | - Archita Joshi
- Medical Affairs, AstraZeneca Pharma India Ltd, Bangalore, Karnataka, India
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Joshi A, Korgavkar R, Joshi K, Maniar V, Kalaskar P, Kendre P, Sehgal K, Seth N. Dasatinib-Induced Lymphocytosis and Pleural Effusion in a Patient of Chronic Myeloid Leukemia: A Rare Indian Case Report. Indian J Med Paediatr Oncol 2020. [DOI: 10.4103/ijmpo.ijmpo_109_19] [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: 11/04/2022] Open
Affiliation(s)
- Ashish Joshi
- Mumbai Oncocare Centre, Vile Parle (West), Mumbai, Maharashtra, India
| | - Reshma Korgavkar
- Mumbai Oncocare Centre, Vile Parle (West), Mumbai, Maharashtra, India
| | - Kshitij Joshi
- Mumbai Oncocare Centre, Vile Parle (West), Mumbai, Maharashtra, India
| | - Vashishth Maniar
- Mumbai Oncocare Centre, Ghatkopar (West), Mumbai, Maharashtra, India
| | - Pritam Kalaskar
- Mumbai Oncocare Centre, Thane (West), Mumbai, Maharashtra, India
| | - Pradip Kendre
- Mumbai Oncocare Centre, Borivali (East), Mumbai, Maharashtra, India
| | - Kunal Sehgal
- Hematopathologist, Sehgal Path Lab., Mumbai, Maharashtra, India
| | - Neha Seth
- Pathologist, Sehgal Path Lab., Andheri (West), Mumbai, Maharashtra, India
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Mehta P, Dhabhar B, Bhatt A, Dattatreya P, Maru A, Vijayakumar R, Maniar V, Basade M, Patel K, Alurkar S, Bahl C, Todur S. P1.04-56 Landscape of Tumor Mutational Burden in Indian NSCLC Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.959] [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]
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Iyer S, Prajapati R, Ramesh A, Basavalingegowda M, Todur S, Kavishvar S, Vijaykumar R, Naik R, Kulkarni P, Bhatt AD, Maniar V, Maka V, Thungappa SC, Singhal M, Ranade A, Shafi G. The future of lung cancer therapy: Striding beyond conventional EGFR and ALK treatments. Mol Clin Oncol 2019; 10:469-475. [PMID: 30931120 DOI: 10.3892/mco.2019.1811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 10/16/2018] [Indexed: 12/13/2022] Open
Abstract
Lung cancer, one of the most frequently diagnosed cancers worldwide has long relied on testing for the molecular biomarkers EGFR/ALK. However, achieving superior clinical outcomes for patients with lung cancer requires developing comprehensive techniques beyond contemporary EGFR/ALK testing. Current technologies are on par with molecular testing for EGFR/ALK in terms of efficacy, most of them failing to offer improvements perhaps primarily due to skepticism among clinicians, despite being recommended in the NCCN guidelines. The present study endeavored to minimize chemotherapy-dependence in EGFR/ALK-negative patient cohorts, and use evidence-based methods to identify ways to improve clinical outcomes. In total, 137 lung cancer cases obtained from 'PositiveSelect NGS data', comprising 91 males and 46 females, were investigated. EGFR- and ALK-positivity was used for data dichotomization to understand the therapeutic utility of rare gene alterations beyond just EGFR/ALK. Statistics obtained from PositiveSelect were collated with data from international studies to construct a meta-analysis intended to achieve better clinical outcomes. Upon dichotomization, 23% of cases harbored EGFR variants indicating that treating with EGFR TKIs would be beneficial; the remaining 77% exhibited no EGFR variants that would indicate favorable results using specific currently available chemotherapy practices. Similarly, 28% of cases had EGFR+ALK variants favoring EGFR/ALK-based targeted therapeutics; the remaining 72% harbored no EGFR/ALK variants with known beneficial chemotherapy routes. The present study aimed to overcome current inadequacies of targeted therapies in patients with a conventional EGFR/ALK-positive diagnosis and those in EGFR+ALK-negative cohorts. Upon analysis of the negative cohorts, significant and clinically relevant single nucleotide variants were identified in KRAS, ERBB2, MET and RET, with frequencies of 7, 1, 2 and 3% in patients who were EGFR-negative and 6, 1, 1, and 3% in patients who were EGFR and ALK-negative, respectively, enabling the use of targeted therapeutics aside from EGFR/ALK TKIs. From the results of the current study only 35% of the two negative arms (EGFR negative and EGFR+ALK negative) would be recommended NCCN or off-label chemotherapy; prior to the current study, the entire cohorts would have been recommended this treatment. The present study emphasizes the potential of comprehensive genomics in identifying hallmarks of lung cancer beyond EGFR/ALK, using broad-spectrum genetic testing and data-sharing among medical professionals to circumvent ineffective chemotherapy.
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Affiliation(s)
- Sandhya Iyer
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Mumbai 400002, India
| | - Rambaksh Prajapati
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Mumbai 400002, India
| | - Aarthi Ramesh
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Mumbai 400002, India
| | | | - Seema Todur
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Mumbai 400002, India
| | - Shubham Kavishvar
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Mumbai 400002, India
| | | | - Radhesyam Naik
- Department of Medical Oncology, HCG, Bangalore 560020, India
| | | | | | | | - Vinayak Maka
- Department of Medical Oncology, HCG, Bangalore 560020, India
| | | | | | | | - Gowhar Shafi
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Mumbai 400002, India
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