1
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Pearson J, Khan A, Bhogal T, Wong H, Law A, Mills S, Santamaria N, Bishop J, Cliff J, Errington D, Hall A, Hart C, Malik Z, Sripadam R, Innes H, Flint H, Langton G, Ahmed E, Jackson R, Palmieri C. A comparison of the efficacy of trastuzumab deruxtecan in advanced HER2-positive breast cancer: active brain metastasis versus progressive extracranial disease alone. ESMO Open 2023; 8:102033. [PMID: 37866031 PMCID: PMC10774880 DOI: 10.1016/j.esmoop.2023.102033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/29/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Trastuzumab deruxtecan (T-DXd) has demonstrated efficacy in patients with brain metastasis (BM), a group historically with poor outcomes. The prevalence of BMs in patients commencing T-DXd is currently unknown. No direct comparisons have been made of the activity of T-DXd in patients with active BM versus those with extracranial progression alone. This real-world study explored the prevalence of BMs in patients commencing T-DXd, the efficacy of T-DXd in active BM versus extracranial progression alone and the safety of T-DXd. PATIENTS AND METHODS Patients with human epidermal growth factor receptor 2-positive advanced breast cancer treated with T-DXd between June 2021 and February 2023 at our specialist cancer hospital were identified and notes reviewed. Clinicopathological information, prior treatment, the presence or absence of central nervous system (CNS) disease, outcomes and treatment-emergent adverse events (TEAEs) were recorded. RESULTS Twenty-nine female patients, with a median age of 52 years (interquartile range 44-62 years), were identified; the prevalence of BM was 41%. Median number of lines of prior therapy was 2 (range 2-6). At a median follow-up of 13.8 months, median progression-free survival (PFS) for the overall population was 13.9 months [95% confidence interval (CI) 12.4 months-not estimable (NE)], 16.1 months (95% CI 15.1 months-NE) for active BMs and 12.4 months (95% CI 8.3 months-NE) for progressive extracranial disease alone. The 12-month overall survival (OS) rate was 74% (95% CI 59% to 95%) in the overall population, and 83% (95% CI 58% to 100%) and 66% (95% CI 45% to 96%) for active BMs and extracranial disease only, respectively. Most common TEAEs were fatigue, alopecia, and constipation. In nine patients (31%, including two deaths), pneumonitis occurred. CONCLUSION In this real-world population, we demonstrate T-DXd to be effective in patients with active BMs and those with progressive extracranial disease alone. PFS and OS were numerically longer in those with active BMs. These data demonstrate that patients with active BM treated with T-DXd have at least comparable outcomes to those with extracranial disease alone. The high rate of pneumonitis warrants further consideration.
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Affiliation(s)
- J Pearson
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool; Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool
| | - A Khan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - T Bhogal
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool; Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool
| | - H Wong
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - A Law
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - S Mills
- The Walton NHS Foundation Trust, Liverpool, UK
| | - N Santamaria
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - J Bishop
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - J Cliff
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - D Errington
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - A Hall
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - C Hart
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - Z Malik
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - R Sripadam
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - H Innes
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - H Flint
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - G Langton
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - E Ahmed
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - R Jackson
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool
| | - C Palmieri
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool; Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool.
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Chung B, Wang Y, Thiel M, Rostami F, Rogoll A, Hirsch VG, Malik Z, Bührke A, Bär C, Klintschar M, Schmitto JD, Vogt C, Werlein C, Jonigk D, Bauersachs J, Wollert KC, Kempf T. Pre-emptive iron supplementation prevents myocardial iron deficiency and attenuates adverse remodelling after myocardial infarction. Cardiovasc Res 2023; 119:1969-1980. [PMID: 37315201 DOI: 10.1093/cvr/cvad092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/20/2023] [Accepted: 04/08/2023] [Indexed: 06/16/2023] Open
Abstract
AIMS Heart failure (HF) after myocardial infarction (MI) is a major cause of morbidity and mortality. We sought to investigate the functional importance of cardiac iron status after MI and the potential of pre-emptive iron supplementation in preventing cardiac iron deficiency (ID) and attenuating left ventricular (LV) remodelling. METHODS AND RESULTS MI was induced in C57BL/6J male mice by left anterior descending coronary artery ligation. Cardiac iron status in the non-infarcted LV myocardium was dynamically regulated after MI: non-haem iron and ferritin increased at 4 weeks but decreased at 24 weeks after MI. Cardiac ID at 24 weeks was associated with reduced expression of iron-dependent electron transport chain (ETC) Complex I compared with sham-operated mice. Hepcidin expression in the non-infarcted LV myocardium was elevated at 4 weeks and suppressed at 24 weeks. Hepcidin suppression at 24 weeks was accompanied by more abundant expression of membrane-localized ferroportin, the iron exporter, in the non-infarcted LV myocardium. Notably, similarly dysregulated iron homeostasis was observed in LV myocardium from failing human hearts, which displayed lower iron content, reduced hepcidin expression, and increased membrane-bound ferroportin. Injecting ferric carboxymaltose (15 µg/g body weight) intravenously at 12, 16, and 20 weeks after MI preserved cardiac iron content and attenuated LV remodelling and dysfunction at 24 weeks compared with saline-injected mice. CONCLUSION We demonstrate, for the first time, that dynamic changes in cardiac iron status after MI are associated with local hepcidin suppression, leading to cardiac ID long term after MI. Pre-emptive iron supplementation maintained cardiac iron content and attenuated adverse remodelling after MI. Our results identify the spontaneous development of cardiac ID as a novel disease mechanism and therapeutic target in post-infarction LV remodelling and HF.
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Affiliation(s)
- Bomee Chung
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Yong Wang
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Marleen Thiel
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Fatemeh Rostami
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Anika Rogoll
- Institute for Analytical Chemistry, TU Bergakademie, Leipziger Straße 29, 09599 Freiberg, Germany
| | - Valentin G Hirsch
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Zulaikha Malik
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Anne Bührke
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Michael Klintschar
- Institute of Forensic Medicine, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Jan D Schmitto
- Department of Cardiac-, Thoracic-, Transplantation, and Vascular Surgery, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Carla Vogt
- Institute for Analytical Chemistry, TU Bergakademie, Leipziger Straße 29, 09599 Freiberg, Germany
| | - Christopher Werlein
- Institute of Pathology and German Centre for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Danny Jonigk
- Institute of Pathology and German Centre for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Kai C Wollert
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Tibor Kempf
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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Attard G, Murphy L, Clarke N, Cross W, Gillessen S, Amos C, Brawley C, Jones R, Pezaro C, Malik Z, Montazeri A, Millman R, Cook A, Gilbert D, Langley R, Parker C, Sydes M, Brown L, Parmar M, James N. LBA62 Comparison of abiraterone acetate and prednisolone (AAP) or combination enzalutamide (ENZ) + AAP for metastatic hormone sensitive prostate cancer (mHSPC) starting androgen deprivation therapy (ADT): Overall survival (OS) results of 2 randomised phase III trials from the STAMPEDE protocol. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.065] [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] Open
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4
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Malik Z, Mirza AI, Akram MA, Arshad A, Kiyani A. Mast Cells Released Inflammatory Markers Play a Vital Role in Mandibular Remodeling of Odontogenic Keratocyst Patients. Annals KEMU 2022. [DOI: 10.21649/akemu.v28i1.4991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Odontogenic Keratocyst (OKC) falls among the distinctive and rare odontogenic developmental cyst which is derivative of the dental lamina and contains clear fluid along with a cheesy material which resembles keratin debris. Treatment strategies for OKC are for the most part classified as conservative or aggressive. Mast Cells play an important role in the pathogenesis of inflammatory conditions. Objective: The goal of our study was to observe the participation of inflammatory mediators (RANKL, TNF-α, TGF-β and MMP-9) in the pathogenesis as well as the recovery process of OKC. Methods: Enrolled patients were divided into three groups while a fourth group was formed of the control individuals. Sampling of all groups was done once after required data collection. Blood samples were taken, mRNA extraction and cDNA was then subjected to qRT-PCR. IHC for mast cells was done on patient samples. Results: qRT-PCR showed higher expressions of inflammatory markers in patients undergoing treatment as compared to individuals with completed treatment procedure. Levels of RANKL were high in patients that were currently undergoing bone development as compared to other patients. The levels of TNF-α were comparatively higher in patients who showed visible signs of inflammation like swelling and pain. TGF-β and MMP-9 expression levels showed correlation with each other in all three groups. Both these cytokines were also found to be in association with mast cells. The results of histochemical staining of mast cells suggested the involvement of these cells in the pathogenesis of the cystic lesion via inflammation. Conclusions: The findings of the study suggest that the expressions of inflammatory mediators correlate with the presence of mast cells, therefore, application of mast cells stabilizers in addition to marsupialization in the treatment of OKC can be a prospective treatment strategy in future clinical settings.
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5
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Meltzer A, Limkakeng A, Gentile N, Vargas N, Fleisher D, Malik Z, Kallus S, Borum M, Ma Y, Kumar A. 182 A Multi-Center Randomized Trial of Capsule Endoscopy to Reduce Admissions in Emergency Department Patients With Low Risk Upper Gastrointestinal Bleed. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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6
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Attard G, Brown L, Clarke N, Murphy L, Cross W, Jones R, Gillessen S, Russell J, Cook A, Bowen J, Lydon A, Pedley I, Parikh O, Chowdhury S, Malik Z, Matheson D, Parker C, Sydes M, Parmar M, James N. LBA4 Abiraterone acetate plus prednisolone (AAP) with or without enzalutamide (ENZ) added to androgen deprivation therapy (ADT) compared to ADT alone for men with high-risk non-metastatic (M0) prostate cancer (PCa): Combined analysis from two comparisons in the STAMPEDE platform protocol. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2098] [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: 10/20/2022] Open
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Abstract
In the absence of dental related guidelines available in Australia specific to obesity and minimal awareness of the clinical implications on local dental practice, bariatric dental care can be perceived as a 'silent disability crisis'. This opinion piece and brief clinical note aims to question and raise awareness amongst dental professionals surrounding the current limited availability of bariatric dental chairs, difficulties in access, the safety of dental care delivery and ethical considerations for the dental management of people with obesity.
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Affiliation(s)
- Z Malik
- Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Westmead Hospital, Sydney, NSW, Australia
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8
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Clarke NW, Ali A, Ingleby FC, Hoyle A, Amos CL, Attard G, Brawley CD, Calvert J, Chowdhury S, Cook A, Cross W, Dearnaley DP, Douis H, Gilbert D, Gillessen S, Jones RJ, Langley RE, MacNair A, Malik Z, Mason MD, Matheson D, Millman R, Parker CC, Ritchie AWS, Rush H, Russell JM, Brown J, Beesley S, Birtle A, Capaldi L, Gale J, Gibbs S, Lydon A, Nikapota A, Omlin A, O'Sullivan JM, Parikh O, Protheroe A, Rudman S, Srihari NN, Simms M, Tanguay JS, Tolan S, Wagstaff J, Wallace J, Wylie J, Zarkar A, Sydes MR, Parmar MKB, James ND. Corrigendum to Addition of docetaxel to hormonal therapy in low- and high-burden metastatic hormone sensitive prostate cancer: long-term survival results from the STAMPEDE trial: Ann Oncol 2019; 30: 1992-2003. Ann Oncol 2020; 31:442. [PMID: 32067690 PMCID: PMC8929236 DOI: 10.1016/j.annonc.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- N W Clarke
- Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester.
| | - A Ali
- Genito-Urinary Cancer Research Group, Division of Cancer Sciences, The University of Manchester, Manchester
| | - F C Ingleby
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London; London School of Hygiene and Tropical Medicine, London
| | - A Hoyle
- Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester
| | - C L Amos
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | | | - C D Brawley
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - J Calvert
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - S Chowdhury
- Guy's and Saint Thomas' NHS Foundation Trust, London
| | - A Cook
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - W Cross
- St James University Hospital, Leeds
| | | | - H Douis
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham
| | - D Gilbert
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - S Gillessen
- Division of Cancer Sciences, The University of Manchester, Manchester
| | - R J Jones
- Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow
| | - R E Langley
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - A MacNair
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - Z Malik
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | | | - D Matheson
- Faculty of Education Health and Wellbeing, University of Wolverhampton, Wolverhampton
| | - R Millman
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - C C Parker
- Institute of Cancer Research, Sutton-London; RoyalMarsden NHS Foundation Trust, London
| | - A W S Ritchie
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - H Rush
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - J M Russell
- Institute of Cancer Sciences, Beatson West of Scotland Cancer Centre, Glasgow
| | - J Brown
- University of Sheffield, Sheffield
| | | | - A Birtle
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston
| | - L Capaldi
- Worcestershire Acute Hospitals NHS Trust, Worcester
| | - J Gale
- Portsmouth Oncology Centre, Queen Alexandra Hospital, Portsmouth
| | | | - A Lydon
- Torbay and South Devon NHS Foundation Trust, Torbay
| | | | - A Omlin
- Department of Oncology and Haematology, Kantonsspital, St Gallen, Switzerland
| | - J M O'Sullivan
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK
| | - O Parikh
- East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - A Protheroe
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Rudman
- Guy's and Saint Thomas' NHS Foundation Trust, London
| | - N N Srihari
- Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - M Simms
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | | | - S Tolan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - J Wagstaff
- Swansea University College of Medicine, Swansea, UK
| | - J Wallace
- Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow
| | - J Wylie
- The Christie NHS Foundation Trust, Manchester, UK
| | - A Zarkar
- Heartlands Hospital, Birmingham, UK
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - M K B Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - N D James
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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9
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Clarke NW, Ali A, Ingleby FC, Hoyle A, Amos CL, Attard G, Brawley CD, Calvert J, Chowdhury S, Cook A, Cross W, Dearnaley DP, Douis H, Gilbert D, Gillessen S, Jones RJ, Langley RE, MacNair A, Malik Z, Mason MD, Matheson D, Millman R, Parker CC, Ritchie AWS, Rush H, Russell JM, Brown J, Beesley S, Birtle A, Capaldi L, Gale J, Gibbs S, Lydon A, Nikapota A, Omlin A, O'Sullivan JM, Parikh O, Protheroe A, Rudman S, Srihari NN, Simms M, Tanguay JS, Tolan S, Wagstaff J, Wallace J, Wylie J, Zarkar A, Sydes MR, Parmar MKB, James ND. Addition of docetaxel to hormonal therapy in low- and high-burden metastatic hormone sensitive prostate cancer: long-term survival results from the STAMPEDE trial. Ann Oncol 2019; 30:1992-2003. [PMID: 31560068 PMCID: PMC6938598 DOI: 10.1093/annonc/mdz396] [Citation(s) in RCA: 222] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND STAMPEDE has previously reported that the use of upfront docetaxel improved overall survival (OS) for metastatic hormone naïve prostate cancer patients starting long-term androgen deprivation therapy. We report on long-term outcomes stratified by metastatic burden for M1 patients. METHODS We randomly allocated patients in 2 : 1 ratio to standard-of-care (SOC; control group) or SOC + docetaxel. Metastatic disease burden was categorised using retrospectively-collected baseline staging scans where available. Analysis used Cox regression models, adjusted for stratification factors, with emphasis on restricted mean survival time where hazards were non-proportional. RESULTS Between 05 October 2005 and 31 March 2013, 1086 M1 patients were randomised to receive SOC (n = 724) or SOC + docetaxel (n = 362). Metastatic burden was assessable for 830/1086 (76%) patients; 362 (44%) had low and 468 (56%) high metastatic burden. Median follow-up was 78.2 months. There were 494 deaths on SOC (41% more than the previous report). There was good evidence of benefit of docetaxel over SOC on OS (HR = 0.81, 95% CI 0.69-0.95, P = 0.009) with no evidence of heterogeneity of docetaxel effect between metastatic burden sub-groups (interaction P = 0.827). Analysis of other outcomes found evidence of benefit for docetaxel over SOC in failure-free survival (HR = 0.66, 95% CI 0.57-0.76, P < 0.001) and progression-free survival (HR = 0.69, 95% CI 0.59-0.81, P < 0.001) with no evidence of heterogeneity of docetaxel effect between metastatic burden sub-groups (interaction P > 0.5 in each case). There was no evidence that docetaxel resulted in late toxicity compared with SOC: after 1 year, G3-5 toxicity was reported for 28% SOC and 27% docetaxel (in patients still on follow-up at 1 year without prior progression). CONCLUSIONS The clinically significant benefit in survival for upfront docetaxel persists at longer follow-up, with no evidence that benefit differed by metastatic burden. We advocate that upfront docetaxel is considered for metastatic hormone naïve prostate cancer patients regardless of metastatic burden.
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Affiliation(s)
- N W Clarke
- Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester.
| | - A Ali
- Genito-Urinary Cancer Research Group, Division of Cancer Sciences, The University of Manchester, Manchester
| | - F C Ingleby
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London; London School of Hygiene and Tropical Medicine, London
| | - A Hoyle
- Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester
| | - C L Amos
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | | | - C D Brawley
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - J Calvert
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - S Chowdhury
- Guy's and Saint Thomas' NHS Foundation Trust, London
| | - A Cook
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - W Cross
- St James University Hospital, Leeds
| | | | - H Douis
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham
| | - D Gilbert
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - S Gillessen
- Division of Cancer Sciences, The University of Manchester, Manchester
| | - R J Jones
- Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow
| | - R E Langley
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - A MacNair
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - Z Malik
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | | | - D Matheson
- Faculty of Education Health and Wellbeing, University of Wolverhampton, Wolverhampton
| | - R Millman
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - C C Parker
- Institute of Cancer Research, Sutton-London; Royal Marsden NHS Foundation Trust, London
| | - A W S Ritchie
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - H Rush
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - J M Russell
- Institute of Cancer Sciences, Beatson West of Scotland Cancer Centre, Glasgow
| | - J Brown
- University of Sheffield, Sheffield
| | | | - A Birtle
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston
| | - L Capaldi
- Worcestershire Acute Hospitals NHS Trust, Worcester
| | - J Gale
- Portsmouth Oncology Centre, Queen Alexandra Hospital, Portsmouth
| | | | - A Lydon
- Torbay and South Devon NHS Foundation Trust, Torbay
| | | | - A Omlin
- Department of Oncology and Haematology, Kantonsspital, St Gallen, Switzerland
| | - J M O'Sullivan
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast
| | - O Parikh
- East Lancashire Hospitals NHS Trust, Blackburn
| | - A Protheroe
- Oxford University Hospitals NHS Foundation Trust, Oxford
| | - S Rudman
- Guy's and Saint Thomas' NHS Foundation Trust, London
| | - N N Srihari
- Shrewsbury and Telford Hospital NHS Trust, Shrewsbury
| | - M Simms
- Hull and East Yorkshire Hospitals NHS Trust, Hull
| | | | - S Tolan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - J Wagstaff
- Swansea University College of Medicine, Swansea
| | - J Wallace
- Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow
| | - J Wylie
- The Christie NHS Foundation Trust, Manchester
| | | | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - M K B Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - N D James
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham
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Clarke N, Ali A, Ingleby F, Hoyle A, Calvert J, Attard G, Chowdhury S, Dearnaley D, Douis H, Gillessen S, Jones R, Malik Z, Mason M, Millman R, Parker C, Rush H, Omlin A, Sydes M, Parmar M, James N. Docetaxel for hormone-naïve prostate cancer: Results from long-term follow-up of metastatic (M1) patients in the STAMPEDE randomised trial (NCT00268476) and sub-group analysis by metastatic burden. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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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Vogelzang N, Gabrail N, Malik Z, Volterra F, Nordquist L, Levin R, Zhang P, Zhou K. The extended/phase II study of safety and tolerability of proxalutamide (GT0918) in subjects with metastatic castrate resistant prostate cancer (mCRPC) who failed either abiraterone (Abi) or enzalutamide (Enza). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Smith MS, Cash B, Konda V, Trindade AJ, Gordon S, DeMeester S, Joshi V, Diehl D, Ganguly E, Mashimo H, Singh S, Jobe B, McKinley M, Wallace M, Komatsu Y, Thakkar S, Schnoll-Sussman F, Sharaiha R, Kahaleh M, Tarnasky P, Wolfsen H, Hawes R, Lipham J, Khara H, Pleskow D, Navaneethan U, Kedia P, Hasan M, Sethi A, Samarasena J, Siddiqui UD, Gress F, Rodriguez R, Lee C, Gonda T, Waxman I, Hyder S, Poneros J, Sharzehi K, Di Palma JA, Sejpal DV, Oh D, Hagen J, Rothstein R, Sawhney M, Berzin T, Malik Z, Chang K. Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry. Dis Esophagus 2019; 32:5481776. [PMID: 31037293 PMCID: PMC6853704 DOI: 10.1093/dote/doz029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/08/2019] [Indexed: 12/11/2022]
Abstract
Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291.
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Affiliation(s)
- M S Smith
- Mount Sinai West & Mount Sinai St. Luke's Hospitals, New York, New York,Address correspondence to: Michael S. Smith, M.D., M.B.A., Chief of Gastroenterology and Hepatology, Mount Sinai West & Mount Sinai St. Luke's Hospitals, Ambulatory Care Center, Floor 13, 440 W. 114th Street, New York, NY 10025, USA.
| | - B Cash
- University of Texas Health Science Center at Houston, Houston, Texas
| | - V Konda
- Baylor University Medical Center, Dallas, Texas
| | - A J Trindade
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York
| | - S Gordon
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - V Joshi
- University Medical Center at LSU, New Orleans, Louisiana
| | - D Diehl
- Geisinger Medical Center, Danville, Pennsylvania
| | - E Ganguly
- University of Vermont Medical Center, Burlington, Vermont
| | - H Mashimo
- VA Boston Health Care System, Boston, Massachusetts
| | - S Singh
- VA Boston Health Care System, Boston, Massachusetts
| | - B Jobe
- Allegheny Health Network, Pittsburgh, Pennsylvania
| | - M McKinley
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York,ProHEALTHcare Associates, Lake Success, New York, New York
| | | | - Y Komatsu
- Allegheny Health Network, Pittsburgh, Pennsylvania
| | - S Thakkar
- Allegheny Health Network, Pittsburgh, Pennsylvania
| | | | - R Sharaiha
- Weill Cornell Medicine, New York, New York
| | - M Kahaleh
- Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| | | | | | - R Hawes
- Florida Hospital, Orlando, Florida
| | - J Lipham
- University of Southern California, Keck School of Medicine, Los Angeles, California
| | - H Khara
- Geisinger Medical Center, Danville, Pennsylvania
| | - D Pleskow
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - P Kedia
- Methodist Health System, Dallas, Texas
| | - M Hasan
- Florida Hospital, Orlando, Florida
| | - A Sethi
- Columbia University Medical Center, New York, New York
| | | | | | - F Gress
- Columbia University Medical Center, New York, New York
| | - R Rodriguez
- University of South Alabama, Mobile, Alabama
| | - C Lee
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York
| | - T Gonda
- Columbia University Medical Center, New York, New York
| | - I Waxman
- Chicago Medicine, Chicago, Illinois
| | - S Hyder
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - J Poneros
- Columbia University Medical Center, New York, New York
| | - K Sharzehi
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - J A Di Palma
- University of Texas Health Science Center at Houston, Houston, Texas
| | - D V Sejpal
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York
| | - D Oh
- University of Southern California, Keck School of Medicine, Los Angeles, California
| | - J Hagen
- University of Southern California, Keck School of Medicine, Los Angeles, California
| | - R Rothstein
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - M Sawhney
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - T Berzin
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Z Malik
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - K Chang
- UC Irvine Medical Center, Irvine, California
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Qammar M, Malik Z, Malik F, Baig T, Chaudhary AJ. Antibacterial activity of Mg1-xNixO(x=0.5) nano-solid solution; experimental and computational approach. J Mol Struct 2019. [DOI: 10.1016/j.molstruc.2018.11.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Bhojwani A, Flint H, Hall B, Wong H, Innes H, Cliff J, Ahmed E, Malik Z, O'Hagan J, Tolan S, Hall A, Hyatt K, Errington D, Alam F, Robson P, Thorp N, O'Reilly S, Law A, Cicconi S, Jackson R, Palmieri C. Abstract P6-18-32: Profiling the early haematological dynamics and treatment modifications with palbociclib when used as first line treatment for ER-positive, HER2-negative metastatic breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-32] [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: Palbociclib plus endocrine therapy (ET) significantly increases progression free survival compared to ET alone. Within PALOMA2 neutropenia was the most common AE and reason for dose reductions. No real data exists regarding dose reductions (DRs), dose interruptions (DIs), toxicities and benefits of palbociclib. Objective: To describe the early haematological dynamics, DRs/DIs with 1st line palbociclib in the context of a routine UK clinical practice. Methods: A prospective record was maintained of all patients with ER-positive, HER2-negative metastatic BC registered on the Pfizer patient programme at the Clatterbridge Cancer Centre NHS Foundation Trust. The clinical records of all patients commenced on treatment between April and December 2017 were reviewed, and clinico-pathological information, haematological data & toxicity data recorded. Data lock was 31st March 2018. Results: 48 patients received at least one cycle of treatment. The median age was 58, 29% (14/48) premenopausal & 71% (34/48) postmenopausal. 43% (21/48) had bone only disease with 42% (20/48) having visceral disease. The median number of cycles delivered 8 (range 2-11). DRs: 18/48 (38%) patients had a total of 21 DRs; 14/18 (78%) had 1 DR to 100mg; 1/18 (5%) 1 DR to 75mg; & 3/18 (17%) 2 DRs to 75mg. Reasons for DRs: 13 neutropenia, 2 leukopenia, 1 thrombocytopenia, 2 fatigue, 1 poor appetite, 1 sore mouth & 1 non-specially unwell. DIs: occurred in 24/48 patients (50%). Details of DRs/DIs by cycle will be presented. 85% (41 of 48) patients remain on treatment with 59% (24/41) on 125mg; 34% (14/41) on 100mg & 7% (3/41) on 75mg. FBC were available for 41/48 (85%) cases & dynamics considered over the first 6 cycles using FBC at the time of planned treatment delivery. Hb Baseline all patients (AP):129 (121 – 138), patients; patients with no dose reductions (NDR) 127 (123 – 139) & patient dose reduction (DR): 130 (118 – 136). Hb changes to cycles 2, 4 and 6 AP: 122 (115 – 131), 121 (116 – 127) and 125 (116 – 134); NDR:122 (110 - 135), 125 (117 - 127) and 131 (116 – 135); DR: 115 (112 - 120), 120 (115 - 124) and 122 (115 – 129). WCC Baseline AP: 6.8 (5.6 – 7.7); NDR: 7.2 (6.3 – 7.7); DR: 6.7 (5.2 – 7.7). WCC changes to cycles 2, 4 and 6 AP: 3.7 (2.9 – 4.4), 3.7 (3.1 – 4.4) and 3.3 (3 – 3.9); NDR: 3.5 (2.9 – 4.1), 3.6 (3.2 – 4.3) and 3.6 (3.1 – 4.1); DR: 2.1 (1.7 – 2.5), 4.3 (3 – 4.6) and 3.3 (2.8 – 3.5). ANC Baseline AP: 4.0 (3.2 – 5.1); NDR: 4.4 (3.4 – 5.0); DR: 3.6 (2.9 – 5.2). ANC changes to cycles 2, 4 and 6 AP: 1.5 (1.2 – 2.1), 1.7 (1.3 – 2.0) and 1.4 (1.2 – 1.9) NDR: 1.5 (1.1 – 2.1), 1.7 (1.4 – 2.0) and 1.3 (1.2 – 2.0); DR: 0.8 (0.6 – 0.8), 1.7 (1.2 – 2.3) and 1.4 (1.3 – 1.6). Plts Baseline AP: 298 (226 – 339), NDR: 252 (211 – 336); DR: 299 (253 – 339). Plt changes to cycles 2, 4 and 6 AP: 252 (198 – 310), 221 (186 – 259) and 200 (169 – 243). NDR: 249 (185 – 334), 229 (171 – 267) and 205 (177 – 263);DR: 208 (199 – 210), 216 (199 – 243) and 194 (162 -210). Conclusion: These initial real world data are consistent with the PALOMA2 data. Baseline WCC & ANC show no significant difference between NDR and DR cases. Updated data will be presented as well as outcome data for first time.
Citation Format: Bhojwani A, Flint H, Hall B, Wong H, Innes H, Cliff J, Ahmed E, Malik Z, O'Hagan J, Tolan S, Hall A, Hyatt K, Errington D, Alam F, Robson P, Thorp N, O'Reilly S, Law A, Cicconi S, Jackson R, Palmieri C. Profiling the early haematological dynamics and treatment modifications with palbociclib when used as first line treatment for ER-positive, HER2-negative metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-32.
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Affiliation(s)
- A Bhojwani
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - H Flint
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - B Hall
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - H Wong
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - H Innes
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - J Cliff
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - E Ahmed
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - Z Malik
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - J O'Hagan
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - S Tolan
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - A Hall
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - K Hyatt
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - D Errington
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - F Alam
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - P Robson
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - N Thorp
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - S O'Reilly
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - A Law
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - S Cicconi
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - R Jackson
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - C Palmieri
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, Merseyside, Switzerland; University of Liverpool, Liverpool, Merseyside, United Kingdom
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Hall B, Bhojwani A, Innes H, Ahmed E, Cliff J, Malik Z, O'Hagan J, Tolan S, Hall A, Hayat K, Errington D, Alam F, Thorp N, Flint H, Law A, Wong H, O'Reilly S, Jackson R, Cicconi S, Palmieri C. Abstract P6-17-27: Real world experience of the medical and surgical management of HER2 positive early breast cancer treated with neoadjuvant trastuzumab and pertuzumab via the NHS England cancer drug fund. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-27] [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: Studies of neoadjuvant (NA) dual HER2 blockade with trastuzumab (T) and pertuzumab (P) in combination with chemotherapy (CT) for early breast cancer (BC) have reported pathological complete response (pCR) rates of 39 to 62%. These studies also report manageable toxicity with diarrhoea reported in up to 73% of cases. To date no real-world studies have explored the efficacy and toxicity of this treatment. The objective of this study was to describe the medical and surgical management of women treated with neoadjuvant T-P in combination with CT (NAT-P-CT). As well as to determine the efficacy toxicity of NAT-P-CT in the context of a routine UK NHS clinical practice.
Methods: Patients with HER2+ BC treated neoadjuvantly with T-P accessed via the NHS England Cancer Drug Fund (CDF) at the Clatterbridge Cancer Centre NHS Foundation Trust between October 2016 and January 2018 were retrospectively identified. Clinico-pathological information, treatment data, nurse led toxicity review and echocardiographic were reviewed. Data lock was 19th June 2018.
Results: 78 female patients were identified with a median age of 50 years (IQR: 44.4-60.2). At diagnosis: median tumour size 30mm (23.0-47.5mm), 62% (48/78) were LN positive & 56% (44/78) ER+. CT regimens: 81% (63/78) FEC-DHP of these 30% (19/63) switched to weekly paclitaxel (wP). or nab-paclitaxel; 5% (4/78); AC/EC-DHP; 9% (8/78) TCHP with 13% (1/8) switched to wP. At time of analysis, 88% (69/78) had undergone definitive surgery. Surgical details: Breast: 52% (36/69) mastectomy & 48% (33/69) WLE, Axillary management: 51% (35/69) axillary dissection (Ax Dx) & 49% (34/69) sentinel node biopsy (4 performed prior to NA treatment). 91% (32/35) of those undergoing Ax Dx were LN+ at presentation, of these 59% (19/32) had no evidence of axillary involvement at surgery. pCR rate (ypT0/is, N0) was 46% (32/69) [pCR by HR: ER+ 43% (21/49) & ER- 55% (11/20]. pCR for 20 patients switched to wP was 60% (12/20). 7% (5/69) achieved pCR in the breast alone (in these LN status ITCx1, micrometsx3 & macrometsx1). Of the 54% (37/69) with residual breast tumour median size was 13mm (1-22mm). Toxicity Data: Ejection fraction (EF) did not decline beyond 10% of baseline in any patients. Diarrhoea (any grade) occurred in 74% of cases, and CTCAE grade 3-4 toxicity occurring in >2% of patients: diarrhoea, fatigue, and infection. Updated analysis regarding pCR rate and toxicity, as well as initial outcome data will be presented.
Conclusion: These results (1) confirm the efficacy of NA T-P in a real world population; (2) support the use of NA wP; (3) indicate significant proportion of patients axilla are downstaged & (4) reveal diarrhoea rates in keeping with the literature. Currently, NHS England rules do not allow wP to be used routinely in NA setting with T-P this should be reviewed in light of these data and those of the BERENICE study. Measures to identify patients who can avoid axillary dissection as well as to mitigate diarrhoea should be considered.
Citation Format: Hall B, Bhojwani A, Innes H, Ahmed E, Cliff J, Malik Z, O'Hagan J, Tolan S, Hall A, Hayat K, Errington D, Alam F, Thorp N, Flint H, Law A, Wong H, O'Reilly S, Jackson R, Cicconi S, Palmieri C. Real world experience of the medical and surgical management of HER2 positive early breast cancer treated with neoadjuvant trastuzumab and pertuzumab via the NHS England cancer drug fund [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-27.
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Affiliation(s)
- B Hall
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - A Bhojwani
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - H Innes
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - E Ahmed
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - J Cliff
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Z Malik
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - J O'Hagan
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - S Tolan
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - A Hall
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - K Hayat
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - D Errington
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - F Alam
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - N Thorp
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - H Flint
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - A Law
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - H Wong
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - S O'Reilly
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - R Jackson
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - S Cicconi
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - C Palmieri
- University of Liverpool, Liverpool, Hammersmith and Fulham, United Kingdom; Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
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Malik Z, Pichler A, Di Lorenzo G, De Giorgi U, Hitier S, Ecstein-Fraisse E, Ozatilgan A, Carles J. Post hoc analysis of the effect of baseline characteristics on treatment duration in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving cabazitaxel in the compassionate use (CUP)/expanded access programs (EAP) and CAPRISTANA registry. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.027] [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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Saadi M, Yu D, Malik Z, Parkman HP, Schey R. Pyloric sphincter characteristics using EndoFLIP ® in gastroparesis. Rev Gastroenterol Mex (Engl Ed) 2018; 83:375-384. [PMID: 29709494 DOI: 10.1016/j.rgmx.2018.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/19/2018] [Accepted: 02/02/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION AND AIMS Pyloric sphincter abnormalities may be detected in gastroparesis. Botulinum toxin A (BoNT/A) injection into the pylorus has been used to treat gastroparesis with varying results. The aim of the present article was to assess whether pyloric sphincter characteristics using the endoscopic functional lumen imaging probe (EndoFLIP®) with impedance planimetry in patients with gastroparesis correlated with symptoms, gastric emptying, and therapeutic response to pyloric sphincter BoNT/A injection. METHODS EndoFLIP® study was performed on patients undergoing gastroparesis treatment with BoNT/A. The gastroparesis cardinal symptom index (GCSI) was applied prior to treatment and at post-treatment weeks 2, 4, 8, and 12. RESULTS Forty-four patients were enrolled (30 with idiopathic gastroparesis, 14 with diabetic gastroparesis). Smaller pyloric diameter, cross-sectional area (CSA), and distensibility correlated with worse vomiting and retching severity at baseline. Greater gastric retention tended to correlate with decreased CSA and pyloric distensibility. BoNT/A treatment resulted in a significant decrease in the GCSI score at 2 and 4 weeks after treatment, but not at post-treatment weeks 8 or 12. Nausea, early satiety, postprandial fullness, and upper abdominal pain improved up to 12 weeks, whereas loss of appetite, stomach fullness, and stomach visibly larger improved only up to 4 weeks. Retching and vomiting failed to improve. Greater pyloric compliance at baseline correlated with greater improvement in early satiety and náusea at 8 weeks and greater pyloric distensibility correlated with improvement in upper abdominal pain. CONCLUSIONS EndoFLIP® characteristics of the pylorus provided important pathophysiologic information in patients with gastroparesis, in relation to symptoms, gastric emptying, and predicting the response to treatment directed at the pylorus.
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Affiliation(s)
- M Saadi
- Área de Gastroenterología, Departamento de Medicina, Temple University School of Medicine, Filadelfia, PA, Estados Unidos
| | - D Yu
- Temple Clinical Research Institute, Departamento de Ciencias Clínicas, Temple University School of Medicine, Filadelfia, PA, Estados Unidos
| | - Z Malik
- Área de Gastroenterología, Departamento de Medicina, Temple University School of Medicine, Filadelfia, PA, Estados Unidos
| | - H P Parkman
- Área de Gastroenterología, Departamento de Medicina, Temple University School of Medicine, Filadelfia, PA, Estados Unidos
| | - R Schey
- Área de Gastroenterología, Departamento de Medicina, Temple University School of Medicine, Filadelfia, PA, Estados Unidos.
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Abstract
Formation of highly organized dental hard tissues is a complex process involving sequential and ordered deposition of an extracellular scaffold, followed by its mineralization. Odontoblast and ameloblast differentiation involves reciprocal and sequential epithelial-mesenchymal interactions. Similar to early tooth development, various Bmps are expressed during this process, although their functions have not been explored in detail. Here, we investigated the role of odontoblast-derived Bmp2 for tooth mineralization using Bmp2 conditional knockout mice. In developing molars, Bmp2LacZ reporter mice revealed restricted expression of Bmp2 in early polarized and functional odontoblasts while it was not expressed in mature odontoblasts. Loss of Bmp2 in neural crest cells, which includes all dental mesenchyme, caused a delay in dentin and enamel deposition. Immunohistochemistry for nestin and dentin sialoprotein (Dsp) revealed polarization defects in odontoblasts, indicative of a role for Bmp2 in odontoblast organization. Surprisingly, pSmad1/5/8, an indicator of Bmp signaling, was predominantly reduced in ameloblasts, with reduced expression of amelogenin ( Amlx), ameloblastin ( Ambn), and matrix metalloproteinase ( Mmp20). Quantitative real-time polymerase chain reaction (RT-qPCR) analysis and immunohistochemistry showed that loss of Bmp2 resulted in increased expression of the Wnt antagonists dickkopf 1 ( Dkk1) in the epithelium and sclerostin ( Sost) in mesenchyme and epithelium. Odontoblasts showed reduced Wnt signaling, which is important for odontoblast differentiation, and a strong reduction in dentin sialophosphoprotein ( Dspp) but not collagen 1 a1 ( Col1a1) expression. Mature Bmp2-deficient teeth, which were obtained by transplanting tooth germs from Bmp2-deficient embryos under a kidney capsule, showed a dentinogenesis imperfecta type II-like appearance. Micro-computed tomography and scanning electron microscopy revealed reduced dentin and enamel thickness, indistinguishable primary and secondary dentin, and deposition of ectopic osteodentin. This establishes that Bmp2 provides an early temporal, nonredundant signal for directed and organized tooth mineralization.
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Affiliation(s)
- Z Malik
- 1 School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - M Alexiou
- 1 School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - B Hallgrimsson
- 2 Department of Cell Biology and Anatomy, Faculty of Medicine, University of Calgary, AB, Canada
| | | | - H U Luder
- 4 Institute of Oral Biology, Centre for Dental Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - D Graf
- 1 School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,5 Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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James N, de Bono J, Spears M, Clarke N, Mason M, Dearnaley D, Ritchie A, Russell M, Gilson C, Jones R, Gillessen S, Matheson D, Aung S, Birtle A, Chowdhury S, Gale J, Malik Z, O'Sullivan J, Parmar M, Sydes M. Adding abiraterone for patients (pts) with high-risk prostate cancer (PCa) starting long-term androgen deprivation therapy (ADT): Outcomes in non-metastatic (M0) patients from STAMPEDE (NCT00268476). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Alamshah A, Spreckley E, Norton M, Kinsey-Jones JS, Amin A, Ramgulam A, Cao Y, Johnson R, Saleh K, Akalestou E, Malik Z, Gonzalez-Abuin N, Jomard A, Amarsi R, Moolla A, Sargent PR, Gray GW, Bloom SR, Murphy KG. l-phenylalanine modulates gut hormone release and glucose tolerance, and suppresses food intake through the calcium-sensing receptor in rodents. Int J Obes (Lond) 2017; 41:1693-1701. [PMID: 28792489 PMCID: PMC5678004 DOI: 10.1038/ijo.2017.164] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 05/26/2017] [Accepted: 06/21/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE High-protein diets (HPDs) are associated with greater satiety and weight loss than diets rich in other macronutrients. The exact mechanisms by which HPDs exert their effects are unclear. However, evidence suggests that the sensing of amino acids produced as a result of protein digestion may have a role in appetite regulation and satiety. We investigated the effects of l-phenylalanine (L-Phe) on food intake and glucose homeostasis in rodents. METHODS We investigated the effects of the aromatic amino-acid and calcium-sensing receptor (CaSR) agonist l-phenylalanine (L-Phe) on food intake and the release of the gastrointestinal (GI) hormones peptide YY (PYY), glucagon-like peptide-1 (GLP-1) and ghrelin in rodents, and the role of the CaSR in mediating these effects in vitro and in vivo. We also examined the effect of oral l-Phe administration on glucose tolerance in rats. RESULTS Oral administration of l-Phe acutely reduced food intake in rats and mice, and chronically reduced food intake and body weight in diet-induced obese mice. Ileal l-Phe also reduced food intake in rats. l-Phe stimulated GLP-1 and PYY release, and reduced plasma ghrelin, and also stimulated insulin release and improved glucose tolerance in rats. Pharmacological blockade of the CaSR attenuated the anorectic effect of intra-ileal l-Phe in rats, and l-Phe-induced GLP-1 release from STC-1 and primary L cells was attenuated by CaSR blockade. CONCLUSIONS l-Phe reduced food intake, stimulated GLP-1 and PYY release, and reduced plasma ghrelin in rodents. Our data provide evidence that the anorectic effects of l-Phe are mediated via the CaSR, and suggest that l-Phe and the CaSR system in the GI tract may have therapeutic utility in the treatment of obesity and diabetes. Further work is required to determine the physiological role of the CaSR in protein sensing in the gut, and the role of this system in humans.
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Affiliation(s)
- A Alamshah
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - E Spreckley
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - M Norton
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - J S Kinsey-Jones
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - A Amin
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - A Ramgulam
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - Y Cao
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - R Johnson
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - K Saleh
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - E Akalestou
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - Z Malik
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - N Gonzalez-Abuin
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - A Jomard
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - R Amarsi
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - A Moolla
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK.,Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | | | | | - S R Bloom
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - K G Murphy
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
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Iluz N, Maor Y, Keller N, Malik Z. The synergistic antimicrobial activity of tetrapyrroles and PDT on antibiotic resistant clinical isolates of Staph. aureus. Photodiagnosis Photodyn Ther 2017. [DOI: 10.1016/j.pdpdt.2017.01.032] [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: 11/27/2022]
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Malik Z, Bayman L, Valestin J, Rizvi-Toner A, Hashmi S, Schey R. Dronabinol increases pain threshold in patients with functional chest pain: a pilot double-blind placebo-controlled trial. Dis Esophagus 2017; 30:1-8. [PMID: 26822791 DOI: 10.1111/dote.12455] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Noncardiac chest pain is associated with poor quality of life and high care expenditure. The majority of noncardiac chest pain is either gastresophageal reflux disease related or due to esophageal motility disorders, and the rest are considered functional chest pain (FCP) due to central and peripheral hypersensitivity. Current treatment of FCP improves 40-50% of patients. Cannabinoid receptors 1 (CB1) and 2 (CB2) modulate release of neurotransmitters; CB1 is located in the esophageal epithelium and reduces excitatory enteric transmission and potentially could reduce esophageal hypersensitivity. We performed a prospective study to evaluate its effects on pain threshold, frequency, and intensity in FCP. Subjects with FCP received dronabinol (5 mg, twice daily; n = 7; average age, 44 years; mean body mass index, 26.7) or placebo (n = 6; average age, 42 years; mean body mass index, 25.9) for 28 days (4 weeks). Chest pain, general health, and anxiety/depression questionnaires were assessed at baseline and at 4 weeks. Subjects underwent an esophageal balloon distention test prior to treatment and on last day of the study. Dronabinol increased pain thresholds significantly (3.0 vs. 1.0; P = 0.03) and reduced pain intensity and odynophagia compared to placebo (0.18 vs. 0.01 and 0.12 vs. 0.01, respectively, P = 0.04). Depression and anxiety scores did not differ between the groups at baseline or after treatment. No significant adverse effects were observed. In this novel study, dronabinol increased pain threshold and reduced frequency and intensity of pain in FCP. Further, large scale studies are needed to substantiate these findings.
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Affiliation(s)
- Z Malik
- Section of Gastroenterology, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - L Bayman
- Division of Gastroenterology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - J Valestin
- Division of Gastroenterology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - A Rizvi-Toner
- Division of Gastroenterology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - S Hashmi
- Division of Gastroenterology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - R Schey
- Section of Gastroenterology, Temple University Hospital, Philadelphia, Pennsylvania, USA.,Division of Gastroenterology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Fizazi K, Hotte S, Saad F, Alekseev B, Matveev V, Flechon A, Gravis G, Joly F, Chi K, Malik Z, Stewart P, Jacobs C, Beer T. genitourinary tumours, prostate Final overall survival (OS) from the AFFINITY phase 3 trial of custirsen and cabazitaxel/prednisone in men with previously treated metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.20] [Citation(s) in RCA: 2] [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: 11/14/2022] Open
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Jayasena C, Abbara A, Comninos A, Narayanaswamy S, Gonzalez Maffe J, Izzi-Engbeaya C, Oldham J, Lee T, Sarang Z, Malik Z, Dhanjal M, Williamson C, Regan L, Bloom S, Dhillo W. Novel circulating placental markers prokineticin-1, soluble fms-like tyrosine kinase-1, soluble endoglin and placental growth factor and association with late miscarriage. Hum Reprod 2016; 31:2681-2688. [DOI: 10.1093/humrep/dew225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 08/02/2016] [Accepted: 08/11/2016] [Indexed: 11/14/2022] Open
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Pan S, Bahl A, Gee A, Butt M, Malik Z, Dew R, Birtle A. 2552 Real Life treatment sequences and survival of men with metastatic castrate-resistant prostate cancer (mCRPC) receiving cabazitaxel in UK clinical practice. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31371-5] [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: 11/28/2022]
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Jayasena CN, Abbara A, Narayanaswamy S, Comninos AN, Ratnasabapathy R, Bassett P, Mogford JT, Malik Z, Calley J, Ghatei MA, Bloom SR, Dhillo WS. Direct comparison of the effects of intravenous kisspeptin-10, kisspeptin-54 and GnRH on gonadotrophin secretion in healthy men. Hum Reprod 2015; 30:1934-41. [PMID: 26089302 PMCID: PMC4507333 DOI: 10.1093/humrep/dev143] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/22/2015] [Indexed: 12/16/2022] Open
Abstract
STUDY QUESTION How potently does the novel hypothalamic stimulator of reproduction, kisspeptin, increase gonadotrophin secretion when compared with GnRH in healthy men? SUMMARY ANSWER At the doses tested, intravenous administration of either of two major kisspeptin isoforms, kisspeptin-10 and -54, was associated with similar levels of gonadotrophin secretion in healthy men; however, GnRH was more potent when compared with either kisspeptin isoform. WHAT IS KNOWN ALREADY Kisspeptin-10 and -54 are naturally occurring hormones in the kisspeptin peptide family which potently stimulates endogenous GnRH secretion from the hypothalamus, so have the potential to treat patients with reproductive disorders. Rodent studies suggest that kisspeptin-54 is more potent when compared with kisspepitn-10; however, their effects have not previously been directly compared in humans, or compared with direct pituitary stimulation of gonadotrophin secretion using GnRH. STUDY DESIGN, SIZE AND DURATION A single-blinded placebo controlled physiological study was performed from January to December 2013. Local ethical approval was granted, and five participants were recruited to each dosing group. PARTICIPANTS/MATERIALS, SETTING, METHODS Healthy men were administered vehicle, kisspeptin-10, kisspeptin-54 and GnRH intravenously for 3 h on different study days. Each hormone was administered at 0.1, 0.3 and 1.0 nmol/kg/h doses (n = 5 subjects per group). Regular blood sampling was conducted throughout the study to measure LH and FSH. Study visits were conducted at least a week apart. MAIN RESULTS AND THE ROLE OF CHANCE Serum LH and FSH levels were ∼3-fold higher during GnRH infusion when compared with kisspeptin-10 and ∼2-fold higher when compared with kisspeptin-54 [mean area under the curve serum LH during infusion (in hours times international units per litre, h.IU/l): 10.81 ± 1.73, 1.0 nmol/kg/h kisspeptin-10; 14.43 ± 1.27, 1.0 nmol/kg/h kisspeptin-54; 34.06 ± 5.18, 1.0 nmol/kg/h GnRH, P < 0.001 versus kisspeptin-10, P < 0.01 versus kisspeptin-54]. LIMITATIONS, REASONS FOR CAUTION This study had a small sample size. WIDER IMPLICATIONS OF THE FINDINGS Kisspeptin offers a novel means of stimulating the reproductive axis. Our data suggest that kisspeptin stimulates gonadotrophin secretion less potently when compared with GnRH; however, kisspeptin may stimulate gonadotrophins in a more physiological manner when compared with current therapies. Kisspeptin is emerging as a future therapeutic agent, so it is important to establish which kisspeptin hormones could be used to treat patients with infertility. Results of this study suggest that either isoform has similar effects on reproductive hormone secretion in healthy men when administered intravenously. STUDY FUNDING/COMPETING INTERESTS This work is funded by grants from the MRC and NIHR and is supported by the NIHR Imperial Biomedical Research Centre Funding Scheme. C.N.J. is supported by an NIHR Clinical Lectureship. A.A. is supported by Wellcome Trust Research Training Fellowships. A.N.C. is supported by Wellcome Trust Translational Medicine Training Fellowship. W.S.D. is supported by an NIHR Career Development Fellowship.
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Affiliation(s)
- C N Jayasena
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - A Abbara
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - S Narayanaswamy
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - A N Comninos
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - R Ratnasabapathy
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - P Bassett
- Statsconsultancy Ltd, 40 Longwood Lane, Amersham, Bucks HP7 9EN, UK
| | - J T Mogford
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - Z Malik
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - J Calley
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - M A Ghatei
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - S R Bloom
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - W S Dhillo
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
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Reddy SM, Kopetz S, Morris J, Parikh N, Qiao W, Overman MJ, Fogelman D, Shureiqi I, Jacobs C, Malik Z, Jimenez CA, Wolff RA, Abbruzzese JL, Gallick G, Eng C. Phase II study of saracatinib (AZD0530) in patients with previously treated metastatic colorectal cancer. Invest New Drugs 2015; 33:977-84. [PMID: 26062928 DOI: 10.1007/s10637-015-0257-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/02/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Src has a critical role in tumor cell migration and invasion. Increased Src activity has been shown to correlate with disease progression and poor prognosis, suggesting Src could serve as a therapeutic target for kinase inhibition. Saracatinib (AZD0530) is a novel selective oral Src kinase inhibitor. METHODS Metastatic colorectal cancer patients who had received one prior treatment and had measurable disease were enrolled in this phase 2 study. Saracatinib was administered at 175 mg by mouth daily for 28 day cycles until dose-limiting toxicity or progression as determined by staging every 2 cycles. The primary endpoint was improvement in 4 month progression-free survival. Design of Thall, Simon, and Estey was used to monitor proportion of patients that were progression free at 4 months. The trial was opened with plan to enroll maximum of 35 patients, with futility assessment every 10 patients. RESULTS A total of 10 patients were enrolled between January and November 2007. Further enrollment was stopped due to futility. Median progression-free survival was 7.9 weeks, with all 10 patients showing disease progression following radiographic imaging. Median overall survival was 13.5 months. All patients were deceased by time of analysis. Observed adverse events were notable for a higher than expected number of patients with grade 3 hypophosphatemia (n = 5). CONCLUSION Saracatinib is a novel oral Src kinase inhibitor that was well tolerated but failed to meet its primary endpoint of improvement in 4 month progression-free survival as a single agent in previously treated metastatic colorectal cancer patients.
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Affiliation(s)
- S M Reddy
- Hematology-Oncology Fellow, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 463, Houston, TX, 77030, USA,
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Malik Z, Sankineni A, Parkman HP. Assessing pyloric sphincter pathophysiology using EndoFLIP in patients with gastroparesis. Neurogastroenterol Motil 2015; 27:524-31. [PMID: 25712043 DOI: 10.1111/nmo.12522] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 01/07/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pyloric dysfunction has been associated with gastroparesis, particularly diabetic gastroparesis. Endoscopic functional luminal imaging probe (EndoFLIP) uses 16 sensors inside a balloon that is inflated inside a sphincter to assess physiologic characteristics. The aim of this study was to measure the pressure, diameter, cross-sectional area (CSA), and distensibility of the pylorus using EndoFLIP in patients with gastroparesis. In addition, the relationship between pyloric pathophysiology with gastroparesis etiology, symptoms, and gastric emptying was assessed. METHODS EndoFLIP was performed in 54 patients (39 idiopathic gastroparesis, 15 diabetic gastroparesis). The EndoFLIP catheter was passed endoscopically so that the balloon straddled the pylorus. Pressure, diameter, CSA, and distensibility of the pylorus were measured at 20, 30, 40, and 50 cc balloon volume. KEY RESULTS Pyloric sphincter contour was seen best at 40 cc balloon distension (diameter 12.2 ± 0.44 mm, CSA 125.2 ± 9.15 mm(2), pressure 18.0 ± 1.23 mmHg, length 1.59 ± 0.34 cm, distensibility 10.7 ± 2.57 mm(2)/mmHg). There was a wide range seen in diameter (5.6-22.1 mm) and distensibility (1-55 mm(2)/mmHg) of the pylorus. Symptoms of early satiety and postprandial fullness were inversely correlated with pyloric sphincter diameter and CSA. No significant difference was seen between diabetic and idiopathic gastroparetics. CONCLUSIONS & INFERENCES EndoFLIP is a novel technique that can be used to assess pyloric physiologic characteristics. Early satiety and postprandial fullness were inversely correlated with diameter and CSA of the pyloric sphincter. No significant differences were seen comparing diabetic and idiopathic gastroparetics. This technology may be of benefit to help select patients with pyloric sphincter abnormalities.
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Affiliation(s)
- Z Malik
- Gastroenterology Section, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA
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Mullard AP, Misra V, Sumra P, Ali Z, O’Reilly SM, Malik Z. Reducing febrile neutropenia rates in early breast cancer. Experience of two UK cancer centres. Support Care Cancer 2014; 22:2033-7. [DOI: 10.1007/s00520-014-2141-3] [Citation(s) in RCA: 3] [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] [Received: 11/30/2013] [Accepted: 01/22/2014] [Indexed: 11/29/2022]
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Garcia JR, Laughton AM, Malik Z, Parker BJ, Trincot C, S L Chiang S, Chung E, Gerardo NM. Partner associations across sympatric broad-headed bug species and their environmentally acquired bacterial symbionts. Mol Ecol 2014; 23:1333-1347. [PMID: 24384031 DOI: 10.1111/mec.12655] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 12/12/2013] [Accepted: 12/13/2013] [Indexed: 12/01/2022]
Abstract
Many organisms have intimate associations with beneficial microbes acquired from the environment. These host-symbiont associations can be specific and stable, but they are prone to lower partner specificity and more partner-switching than vertically transmitted mutualisms. To investigate partner specificity in an environmentally acquired insect symbiosis, we used 16S rRNA gene and multilocus sequencing to survey the bacterial population in the bacteria-harbouring organ (crypts) of 49 individuals across four sympatric broad-headed bug species (Alydus calcaratus, A. conspersus, A. tomentosus and Megalotomus quinquespinosus). Similar to other insect-bacteria associations, Burkholderia spp. were the most common residents of the crypts in all four insect species (77.2% of recovered sequences). Burkholderia presence was associated with prolonged survival to adulthood in A. tomentosus, suggesting a beneficial role of these specialized associations. Burkholderia were also found in environmental reservoirs in the insects' habitat, which may facilitate acquisition by insects by increasing Burkholderia-insect encounters. Symbiont establishment could also be facilitated by resistance to insect defences; zone of inhibition assays demonstrated that Burkholderia and other bacteria isolated from crypts are resistant to insect defences that limit growth of Escherichia coli. Alternatively, the insects' defences may not efficiently kill a broad range of bacteria. Although the symbiosis is targeted to Burkholderia, the insects' crypts housed other bacteria, including non-Burkholderiaceae species. There is no significant effect of host insect species on Burkholderia distribution, suggesting a lack of strong partner specificity at finer scales. The presence of frequent partner-switching between sympatric insects and their symbionts likely prevents tight co-evolutionary dynamics.
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Affiliation(s)
- J R Garcia
- Biology Department, Emory University, O. Wayne Rollins Research Center, 1510 Clifton Rd, Atlanta, GA, 30322, USA
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Saipillai M, Haridass A, Brunt J, Temple S, Wong H, Malik Z, Eswar C. PO-0931: RapidArcTM in prostate cancer patients with metallic hip prosthesis at a UK cancer centre. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33237-0] [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: 11/24/2022]
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Berkovitch-Luria G, Yakobovitch S, Weitman M, Nudelman A, Rozic G, Rephaeli A, Malik Z. A multifunctional 5-aminolevulinic acid derivative induces erythroid differentiation of K562 human erythroleukemic cells. Eur J Pharm Sci 2012; 47:206-14. [DOI: 10.1016/j.ejps.2012.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 05/30/2012] [Accepted: 05/31/2012] [Indexed: 01/05/2023]
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Lester J, Nixon L, Mayles P, Mayles H, Tsang Y, Ionescu A, Courtier N, Nahum A, Fenwick J, Eswar C, Malik Z, Mohammed N, Griffiths G. 156 The I-START trial: ISoToxic Accelerated RadioTherapy in locally advanced non-small cell lung cancer. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70157-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nahum A, Uzan J, Jain P, Malik Z, Fenwick J, Baker C. SU-E-T-657: Quantitative Tumour Control Predictions for the Radiotherapy of Non-Small-Cell Lung Tumours. Med Phys 2011. [DOI: 10.1118/1.3612620] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mai Z, Malik Z, Spring B, Hasan T. A novel mutual prodrug-induced, and quantitatively and selectively enhanced PpIX accumulation in brain tumors. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.293] [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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Malik Z. History and current situation of PD/PDT with porphyrin precursors. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Malik Z. The roles heme oxygenase-1 in activation of cellular rescue mechanism during PDT oxidative stress and cell death protection. Photodiagnosis Photodyn Ther 2011. [DOI: 10.1016/j.pdpdt.2011.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Panettieri V, Fenwick J, Malik Z, Landau D, Mayles P, Nahum A, Jain P. 399 poster ISOTOXIC DOSE-ESCALATION IN NSCLC RADIOTHERAPY: TARGET DOSE COVERAGE AS A FUNCTION OF DOSE-CALCULATION ALGORITHM, MULTILEAF PENUMBRA MARGIN, AND BREATHING MOTION. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70521-7] [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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Jain P, McKay M, Wong H, Alam F, Littler J, Maguire J, Malik Z, Ramani V, Schofield P, Whitmarsh K. The Role of Radiotherapy in Extensive Stage Small Cell Lung Cancer (ED SCLC): Prophylactic Cranial Irradiation (PCI) and Consolidation Thoracic Radiotherapy. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Krywonos J, Fenwick J, Elkut F, Jenkinson I, Liu Y, Brunt J, Scott A, Malik Z, Eswar C, Ren X. MRI image-based FE modelling of the pelvis system and bladder filling. Comput Methods Biomech Biomed Engin 2010; 13:669-76. [DOI: 10.1080/10255840903446961] [Citation(s) in RCA: 14] [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: 12/15/2022]
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Wardley AM, Stein R, McCaffrey J, Crown J, Malik Z, Rea D, Barrett-Lee PJ, Lee GT. Phase II data for entinostat, a class 1 selective histone deacetylase inhibitor, in patients whose breast cancer is progressing on aromatase inhibitor therapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1052] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wardley A, McCaffrey J, Crown J, Stein R, Malik Z, Rea D, Barrett-Lee P, Lee G. Preliminary Phase II Data Suggest That Entinostat (SNDX275), a Class 1 Selective Histone Deacetylase Inhibitor (HDACi), May Resensitize Breast Cancer Patients Progressing on Aromataste Inhibitor (AI) Therapy to Their AI Therapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6111] [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: Aromatase inhibitors (AI), reduce peripheral conversion of androgen to estrogen, and are standard treatment for ER+ breast cancer (BCA); however, despite initial benefit, the disease eventually progresses. Once patients become resistant to AI, cytotoxic chemotherapy is often used for palliation. Histone deacetylase inhibitors (HDACi) have been shown preclinically to reverse AI resistance and sensitize tumor to AI. Entinostat, an oral selective HDACi, reverses both de novo and acquired hormone resistance in BCA in cell lines and xenograph models and has been well-tolerated, in humans, as a single agent and in combination with other agents tested to date.Methods: Postmenopausal women with ER+ BCA progressing while receiving AI for > 3 months were enrolled. Eligibility criteria included: measurable disease by RECIST criteria, PS 0 or 1, and ≤ 1 chemotherapy for metastatic disease. Exclusion criteria included: rapidly-progressing BCA, life-threatening metastases, chemotherapy within 3 months, and previous exposure to epigenetic modulating agents. Patients continued the AI therapy on which the cancer was progressing, with the addition of entinostat 5 mg weekly in 28-day cycles. Primary objective was to determine clinical benefit rate during the first 6 cycles, defined as the proportion of patients achieving CR, PR or SD lasting > 6 months. Secondary objectives included ORR and PFS. Exploratory biomarkers for anti-tumor activities and entinostat pharmacology were also measured.Results: To date, 24 patients have been enrolled from October 2008 – May 2009. Interim results from 20 patients are described here. The median age is 69 yrs. Eight (40%) and 12 (60%) patients had ECOG scores of 0 and 1, respectively. Fifteen patients (80%) had received tamoxifen; 12 (60%) had prior chemotherapy or immunotherapy. Nine patients (45%) had visceral involvement (lung, pleura, and liver), and 10 had metastases to bone, 3 to breast, and 1 to skin. Among the 10 patients who have completed ≥ 2 cycles, preliminary analysis indicates that the longest durations of SD thus far are > 6 months in 1 and > 5 months in 2 patients. Preliminary analysis of biomarkers in paired samples from 6 patients indicates that HDAC inhibition correlates with changes in cellular molecular targets. Entinostat has been well-tolerated. The majority of AEs were mild to moderate in severity, and the character of AEs was generally consistent with that seen with AI therapy.Conclusion: Entinostat in combination with AI was well-tolerated in patients with progressive BCA. Disease stabilization in several patients was observed. At dose administered, expected pharmacological effects were achieved.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6111.
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Affiliation(s)
| | - J. McCaffrey
- 2Mater Misericordiae University Hospital, Ireland
| | - J. Crown
- 3St. Vincent's University Hospital, Ireland
| | - R. Stein
- 4University College London Hospitals, United Kingdom
| | - Z. Malik
- 5Clatterbridge Centre for Oncology, United Kingdom
| | - D. Rea
- 6University of Birmingham, United Kingdom
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Haridass A, Brunt J, Malik Z, Vee CE. FEASIBILITY OF DOSE ESCALATED EXTERNAL BEAM RADIOTHERAPY IN PROSTATE CANCER PATIENTS WITH UNILATERAL AND BILATERAL HIP PROSTHESES. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)73157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Brunt J, Haridass A, Malik Z, Vee CE. CT/MRI IMAGE REGISTRATION IN PROSTATE RADIOTHERAPY PLANNING OF PATIENTS WITH UNI- AND BI-LATERAL HIP PROSTHESES. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)73075-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Eswar C, Malik Z, Kirk J, Nahum A, Mayles H, Littler J, Maguire J. Intensity modulated radiotherapy (IMRT) in right sided malignant mesothelioma following extrapleural pneumonectomy. Lung Cancer 2008. [DOI: 10.1016/s0169-5002(08)70023-0] [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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Moan J, Berg K, Kvam E, Western A, Malik Z, Rück A, Schneckenburger H. Intracellular localization of photosensitizers. Ciba Found Symp 2007; 146:95-107; discussion 107-11. [PMID: 2697539 DOI: 10.1002/9780470513842.ch7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The intracellular localization of photosensitizers can be studied by different methods. One method involves homogenization of the cells followed by differential ultracentrifugation which leads to fractions enriched in nuclear, mitochondrial, and microsomal material as well as a supernatant fraction. More detailed information can be obtained by electron microscopy of cells exposed to light in the presence of photosensitizers. This method is based on the assumption that damage is primarily induced at intracellular sites where the concentration of photosensitizer is high. By irradiating the cells at 6 degrees C, where biochemical reactions are slow, and then incubating them for different times at 37 degrees C, it is possible to follow the development of damage. The amount of photosensitized damage to enzymes or cell functions whose localization in the cells is known gives information about the intracellular localization of the sensitizer. Fluorescence microscopy is the most direct method and is widely applicable because most photosensitizers fluoresce. Lipophilic dyes generally localize in membrane structures. In future more attention should be paid to the localization of dyes in lysosomes, as suggested by early reports. Mitochondria, the endoplasmic reticulum and nuclear membrane are other important loci for intracellular localization of sensitizers.
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Affiliation(s)
- J Moan
- Institute for Cancer Research, Montebello, Oslo, Norway
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