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Reenen AV, Berger M, Moreau E, Bekx E, Bruinink T, Kemper D, Lippen LV, Weusten J, Mrakovic A, Michielsen E, Vissers J, Theije FD, Nieuwenhuis J, Semjonow V, Mair J. Analytical performance of a single epitope B-type natriuretic peptide sandwich immunoassay on the Minicare platform for point-of-care diagnostics. Pract Lab Med 2019; 15:e00119. [PMID: 30984810 PMCID: PMC6444177 DOI: 10.1016/j.plabm.2019.e00119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 07/19/2018] [Revised: 01/23/2019] [Accepted: 03/14/2019] [Indexed: 12/17/2022] Open
Abstract
Point-of-care B-type natriuretic peptide (BNP) testing with adequate analytical performance has the potential to improve patient flow and provide primary care givers with easy-to-use advanced diagnostic tools in the management of heart failure. We present the analytical evaluation of the Minicare BNP immunoassay under development on the Minicare I-20 platform for point-of-care testing. Analytical performance was evaluated using EDTA venous whole blood, EDTA plasma and capillary whole blood. Method comparison with a lab-testing system was performed using samples from 187 patients. Normal values were determined based on 160 healthy adults, aging from 19 to 70 years. Limit of blank (LoB), limit of detection (LoD) were determined to be 3.3 ng/L, 5.8 ng/L. Limit of quantitation (LoQ) in whole blood at 20% and 10% coefficient of variation (CV) was found < 9 ng/L and <30 ng/L respectively without significant differences between EDTA whole blood and EDTA plasma. Total CV was found to be from 6.7% to 9.7% for BNP concentrations between 92.6 and 3984 ng/L. The sample type comparison study demonstrated correlation coefficients between 0.97 and 0.99 with slopes between 1.03 and 1.09 between the different samples. Method comparison between Minicare BNP and Siemens ADVIA Centaur BNP demonstrated a correlation coefficient of 0.92 with a slope of 1.06. The 97.5% URL of a healthy population was calculated to be 72.6 ng/L. The Minicare BNP assay is a robust, easy-to-use and sensitive test for rapid determination of BNP concentrations that can be used in a near-patient setting.
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Key Words
- Analytical performance
- B-type natriuretic peptide
- BNP, B-type Natriuretic Peptide
- CI, confidence interval
- CLSI, clinical laboratory standards institute
- CV, coefficient of variation
- Capillary blood
- Diagnosis
- EDTA, ethylene-diamine-tetraacetic acid
- HAMA, human anti-mouse antibody
- HF, heart failure
- Heart failure
- K2-EDTA, dipotassium ethylene-diamine-tetraacetic acid
- Li-heparin, lithium heparin
- LoB, limit of blank
- LoD, limit of detection
- LoQ, limit of quantitation
- NP, Natriuretic Peptide
- NYHA, New York Heart Association
- POC, point-of-care
- Point-of-care
- RF, rheumatoid factor
- RFID, radiofrequency identification
- RT, room temperature
- SD, standard deviation
- URL, upper reference limit
- fTIR, frustrated total internal reflection
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Affiliation(s)
- Alexander van Reenen
- Minicare BV, Eindhoven, the Netherlands.,Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Mario Berger
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | | | - Edwin Bekx
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Tom Bruinink
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | | | | | - Jos Weusten
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Anita Mrakovic
- Department of Internal Medicine III - Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Joost Vissers
- Future Diagnostics Solutions, Wijchen, the Netherlands
| | - Femke de Theije
- Minicare BV, Eindhoven, the Netherlands.,Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Jeroen Nieuwenhuis
- Minicare BV, Eindhoven, the Netherlands.,Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | | | - Johannes Mair
- Department of Internal Medicine III - Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
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Kushner BH, Ostrovnaya I, Cheung IY, Kuk D, Kramer K, Modak S, Yataghene K, Cheung NK. Prolonged progression-free survival after consolidating second or later remissions of neuroblastoma with Anti-G D2 immunotherapy and isotretinoin: a prospective Phase II study. Oncoimmunology 2015; 4:e1016704. [PMID: 26140243 DOI: 10.1080/2162402x.2015.1016704] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 01/30/2015] [Accepted: 01/30/2015] [Indexed: 10/23/2022] Open
Abstract
Relapse of high-risk neuroblastoma (HR-NB) is deemed invariably fatal yet increasing numbers of HR-NB patients achieve a second complete/very good partial remission (CR/VGPR), hence the urgency to find a successful consolidative therapy. Identifying efficacy in patients without assessable disease, however, is problematic. We report the first study providing outcome data for this group of patients with poor prognosis. To prevent another relapse, HR-NB patients in second or later CR/VGPR received the anti-GD2 murine antibody 3F8 plus granulocyte-macrophage colony-stimulating factor plus isotretinoin in a Phase II trial. Upon meeting the target aim for progression-free survival (PFS) in the initial cohort of 33 patients, the trial was amended to allow patients who developed human anti-mouse antibody (HAMA) to receive rituximab to ablate HAMA with or without low-dose maintenance chemotherapy until immunotherapy could resume. For the total of 101 study patients, 5-year PFS and overall survival (OS) rates were 33% ± 5% and 48% ± 5%, respectively. Among the 33 long-term progression-free survivors, 19 had MYCN amplification, 19 had previously received anti-GD2 immunotherapy plus isotretinoin (as first-line therapy), and 15 never received maintenance chemotherapy. In a multivariate analysis of prognostic factors, only absence of minimal residual disease in bone marrow after 2 cycles of immunotherapy and before initiation of isotretinoin or anti-HAMA therapy was significantly favorable for both PFS and OS. Therefore, long-term PFS is possible for HR-NB patients who achieve at least a second CR/VGPR and receive consolidation that includes anti-GD2 immunotherapy plus isotretinoin, even if the patients received these biological treatments before relapse. Results from this prospective study will aid in the development of future Phase II studies for this growing ultra high-risk patient population.
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Key Words
- ASCT, autologous stem-cell transplantation
- BM, bone marrow
- CNS, central nervous system
- CR, complete remission
- GM-CSF, granulocyte-macrophage colony-stimulating factor
- HAMA, human anti-mouse antibody
- HR-NB: high-risk neuroblastoma
- INRC, International Neuroblastoma Response Criteria
- INRG, International Neuroblastoma Risk Group
- MIBG, metaiodobenzylguanidine
- MRD, minimal residual disease
- OS, overall survival
- PD, progressive disease
- PFS, progression-free survival
- VGPR, very good partial remission
- anti-GD2 antibody
- immunotherapy
- mAb, monoclonal antibody
- minimal residual disease
- salvage
- second remission
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Affiliation(s)
- Brian H Kushner
- Department of Pediatrics; Memorial Sloan-Kettering Cancer Center ; New York, NY USA
| | - Irina Ostrovnaya
- Department of Epidemiology and Biostatistics; Memorial Sloan Kettering Cancer Center ; New York, NY USA
| | - Irene Y Cheung
- Department of Pediatrics; Memorial Sloan-Kettering Cancer Center ; New York, NY USA
| | - Deborah Kuk
- Department of Epidemiology and Biostatistics; Memorial Sloan Kettering Cancer Center ; New York, NY USA
| | - Kim Kramer
- Department of Pediatrics; Memorial Sloan-Kettering Cancer Center ; New York, NY USA
| | - Shakeel Modak
- Department of Pediatrics; Memorial Sloan-Kettering Cancer Center ; New York, NY USA
| | - Karima Yataghene
- Department of Pediatrics; Memorial Sloan-Kettering Cancer Center ; New York, NY USA
| | - N K Cheung
- Department of Pediatrics; Memorial Sloan-Kettering Cancer Center ; New York, NY USA
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