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Damer A, Hamilton L, Tu A, Johnston DL, Ramphal R, Wilson N. Primary intramedullary extradural Ewing sarcoma. Radiol Case Rep 2024; 19:2381-2389. [PMID: 38572274 PMCID: PMC10987877 DOI: 10.1016/j.radcr.2024.02.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/15/2024] [Accepted: 02/27/2024] [Indexed: 04/05/2024] Open
Abstract
Ewing sarcoma is the second most frequent primary bone tumour of childhood and adolescence. The aim of this report is to describe the imaging, pathology, clinical findings, and treatment of a primary intradural extramedullary Ewing sarcoma with a unique intracranial metastatic component in a pediatric patient. A 14-year-old girl with a history of mood disorders presented to the emergency department with a 3-week history of neck torticollis, cervical pain, paresis, and paresthesia of the upper and lower extremities on the left side. Initially, non-organic causes such as somatization or conversion disorder were suspected. She returned 3 months later when her symptoms worsened. MRI of the head and spine was performed, and demonstrated the presence of a suprasellar, retro-chiasmatic mass lesion. There was also diffuse leptomeningeal enhancement, another well-defined intradural extramedullary lesion the sacral region and several multifocal cauda equina soft tissue nodules. The patient first underwent surgery. The patient was also treated with a combination of chemotherapy (vincristine, doxorubicin and cyclophosphamide alternating with ifosfamide and etoposide (VDC/IE)) and radiation as per the Children's Oncology Group AEWS1221 protocol. Most recent imaging conducted 22 months after the initial mass discovery revealed improvement of the suprasellar mass lesion with residual stable appearance of the prominence and enhancement of the pituitary stalk and tuber cinereum. There was interval improvement of the spinal lesions with no convincing residual. Clinically, at almost three years since initial imaging findings, and 25 months since completing treatment, she is stable from an oncology perspective.
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Affiliation(s)
- Alameen Damer
- University of Toronto, Department of Medical Imaging, Toronto, ON, Canada
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Leslie Hamilton
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Albert Tu
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Donna L. Johnston
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario (CHEO), Division of Hematology/Oncology, Ottawa ON, Canada
| | - Raveena Ramphal
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario (CHEO), Division of Hematology/Oncology, Ottawa ON, Canada
| | - Nagwa Wilson
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
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Rosa D, Villa G, Amigoni C, Rossetti AM, Guberti M, Ghirotto L, Manara DF. Role of emotions in the clinical decision-making process of the hospital nurse: A multicentre qualitative study. MethodsX 2024; 12:102590. [PMID: 38322133 PMCID: PMC10844854 DOI: 10.1016/j.mex.2024.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024] Open
Abstract
While for a long-time emotional reaction and moral distress, have been primarily investigated for the possible outcomes of the nursing decision-making process rather than in terms of their role as antecedents of the final decision taken. The primary study's aim is to explore how inpatient nurses' decision-making takes place in different care settings, with a special focus on the role played by emotions during decision-making. The secondary aim is to explore the subjective experience of hospital nurses in relation to successful and unsuccessful decision-making situations. Multicentre qualitative study, consisting of three phases with different designs: participatory study, grounded theory study, and phenomenological study. Participants will be nurses and may be doctors with various levels of professional experience working in hospital, outpatient, or ward settings. Participants will be recruited through different sampling (purposive and convenience). Data will be collected through focus groups and in-depth interviews with nurses working in different hospital care settings. The researchers expect to find themes that will contribute to a better understanding of the role of emotions in decision-making. The results of this study have the potential of providing important implications to support nurses in the recognition and management of their emotions during the decision-making process.
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Affiliation(s)
- Debora Rosa
- Center for Nursing Research and Innovation, Giulia VILLA, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Giulia VILLA, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Duilio Fiorenzo Manara
- Center for Nursing Research and Innovation, Giulia VILLA, Vita-Salute San Raffaele University, Milan, Italy
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Punnett G, Eastwood C, Green L, Yorke J. A systematic review of the effectiveness of decision making interventions on increasing perceptions of shared decision making occurring in advanced cancer consultations. Patient Educ Couns 2024; 123:108235. [PMID: 38492428 DOI: 10.1016/j.pec.2024.108235] [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] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To determine how decision making interventions for use in advanced cancer treatment consultations function and whether they increase perceptions of shared decision making (SDM) behaviours within consultations. METHODS A systematic search of five literature databases was conducted. Evaluations of decision making interventions where participants faced active treatment decisions for stage 4 or otherwise incurable cancer were included. Intervention descriptions were coded using Behaviour Change Techniques (BCTs) to provide a narrative of how the interventions function. A narrative synthesis of interventions effect on perceptions of SDM behaviours compared to usual care was conducted. RESULTS Four studies presenting different interventions were included. Education, training, modelling and enablement intervention functions were identified. Oncologist SDM training alone and combined with a patient communication aid demonstrated the only significant effect (p < 0.05) on SDM behaviours in advanced cancer consultations. CONCLUSION Healthcare professional (HCP) SDM training which includes modelling and enablement functions may be effective in increasing clinician motivation, capability and opportunity to facilitate SDM in advanced cancer consultations. PRACTICE IMPLICATIONS Implementing HCP SDM training into practice may encourage greater uptake of SDM which may lead to treatment decisions concordant with the goals of care of people with advanced cancer.
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Affiliation(s)
- Grant Punnett
- The Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK; University of Manchester, School of Nursing, Midwifery and Social Work, Manchester, UK.
| | - Charlotte Eastwood
- The Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
| | - Laura Green
- University of Manchester, School of Nursing, Midwifery and Social Work, Manchester, UK
| | - Janelle Yorke
- The Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK; University of Manchester, School of Nursing, Midwifery and Social Work, Manchester, UK
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Weishaar K, Shiu KB, Wright ZM. A Practical Guide to Clinical Studies in Veterinary Oncology. Vet Clin North Am Small Anim Pract 2024; 54:591-601. [PMID: 38176955 DOI: 10.1016/j.cvsm.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
This article explains the authors' experiences about opportunities, perspectives, and considerations required to initiate clinical studies in a veterinary oncology practice. These details include the infrastructure required for appropriate study training for all staff. Negotiation of scope of work and fees for service with study sponsors is also discussed. Finally, although generally similar, the article also describes management of clinical studies in academic and private practice settings.
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Affiliation(s)
- Kristen Weishaar
- Colorado State University Flint Animal Cancer Center, CSU Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO 80523, USA.
| | - Kai-Biu Shiu
- VCA VESVSC, 1612 North High Point Road, Middleton, WI 53562, USA
| | - Zachary M Wright
- VCA Animal Diagnostic Clinic, 4444 Trinity Mills Suite 100, Dallas, TX 75287, USA
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Tak D, Ye Z, Zapaischykova A, Zha Y, Boyd A, Vajapeyam S, Chopra R, Hayat H, Prabhu SP, Liu KX, Elhalawani H, Nabavizadeh A, Familiar A, Resnick AC, Mueller S, Aerts HJWL, Bandopadhayay P, Ligon KL, Haas-Kogan DA, Poussaint TY, Kann BH. Noninvasive Molecular Subtyping of Pediatric Low-Grade Glioma with Self-Supervised Transfer Learning. Radiol Artif Intell 2024; 6:e230333. [PMID: 38446044 DOI: 10.1148/ryai.230333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Purpose To develop and externally test a scan-to-prediction deep learning pipeline for noninvasive, MRI-based BRAF mutational status classification for pediatric low-grade glioma. Materials and Methods This retrospective study included two pediatric low-grade glioma datasets with linked genomic and diagnostic T2-weighted MRI data of patients: Dana-Farber/Boston Children's Hospital (development dataset, n = 214 [113 (52.8%) male; 104 (48.6%) BRAF wild type, 60 (28.0%) BRAF fusion, and 50 (23.4%) BRAF V600E]) and the Children's Brain Tumor Network (external testing, n = 112 [55 (49.1%) male; 35 (31.2%) BRAF wild type, 60 (53.6%) BRAF fusion, and 17 (15.2%) BRAF V600E]). A deep learning pipeline was developed to classify BRAF mutational status (BRAF wild type vs BRAF fusion vs BRAF V600E) via a two-stage process: (a) three-dimensional tumor segmentation and extraction of axial tumor images and (b) section-wise, deep learning-based classification of mutational status. Knowledge-transfer and self-supervised approaches were investigated to prevent model overfitting, with a primary end point of the area under the receiver operating characteristic curve (AUC). To enhance model interpretability, a novel metric, center of mass distance, was developed to quantify the model attention around the tumor. Results A combination of transfer learning from a pretrained medical imaging-specific network and self-supervised label cross-training (TransferX) coupled with consensus logic yielded the highest classification performance with an AUC of 0.82 (95% CI: 0.72, 0.91), 0.87 (95% CI: 0.61, 0.97), and 0.85 (95% CI: 0.66, 0.95) for BRAF wild type, BRAF fusion, and BRAF V600E, respectively, on internal testing. On external testing, the pipeline yielded an AUC of 0.72 (95% CI: 0.64, 0.86), 0.78 (95% CI: 0.61, 0.89), and 0.72 (95% CI: 0.64, 0.88) for BRAF wild type, BRAF fusion, and BRAF V600E, respectively. Conclusion Transfer learning and self-supervised cross-training improved classification performance and generalizability for noninvasive pediatric low-grade glioma mutational status prediction in a limited data scenario. Keywords: Pediatrics, MRI, CNS, Brain/Brain Stem, Oncology, Feature Detection, Diagnosis, Supervised Learning, Transfer Learning, Convolutional Neural Network (CNN) Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Divyanshu Tak
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Zezhong Ye
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Anna Zapaischykova
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Yining Zha
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Aidan Boyd
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Sridhar Vajapeyam
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Rishi Chopra
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Hasaan Hayat
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Sanjay P Prabhu
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Kevin X Liu
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Hesham Elhalawani
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Ali Nabavizadeh
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Ariana Familiar
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Adam C Resnick
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Sabine Mueller
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Hugo J W L Aerts
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Pratiti Bandopadhayay
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Keith L Ligon
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Daphne A Haas-Kogan
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Tina Y Poussaint
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Benjamin H Kann
- From the Artificial Intelligence in Medicine Program, Mass General Brigham, Harvard Medical School, Boston, Mass (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., H.J.W.L.A., B.H.K.); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (D.T., Z.Y., A.Z., Y.Z., A.B., R.C., H.H., K.X.L., H.E., H.J.W.L.A., D.A.H.K., B.H.K.); Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Mass (S.V., S.P.P., T.Y.P.); Center for Data-Driven Discovery in Biomedicine (A.N., A.F.) and Department of Neurosurgery (A.F., A.C.R.), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (A.N.); Departments of Neurology, Pediatrics, and Neurologic Surgery, University of California San Francisco, San Francisco, Calif (S.M.); Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass (H.J.W.L.A.); Department of Radiology and Nuclear Medicine, CalifRIM & GROW, Maastricht University, Maastricht, the Netherlands (H.J.W.L.A.); and Department of Pediatric Oncology (P.B.) and Department of Pathology (K.L.L.), Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass
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Chang VKO, Liang ES, Schmidt P. The diagnostic utility of computed tomography scans performed for febrile neutropenia in a single centre. Curr Probl Diagn Radiol 2024; 53:341-345. [PMID: 38309990 DOI: 10.1067/j.cpradiol.2024.01.003] [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: 07/11/2023] [Revised: 11/08/2023] [Accepted: 01/16/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Computed tomography (CT) imaging has become a first line investigation for most cases of febrile neutropenia (FN) which can be the only sign of infection in oncology patients undergoing active chemotherapy and bone marrow transplants. The utility of routine non-targeted imaging remains unclear. OBJECTIVE To assess and compare the diagnostic rate between targeted, non-targeted and pan-scan CT in identifying an acute source of infection in adult oncology patients with FN. MATERIALS AND METHODS A retrospective observational study was conducted between February 2019 and March 2023 on 417 consecutive CT examinations for the clinical indication of source identification in FN. Scans were noted for the anatomical regions that were imaged and reports were classified as positive, negative or equivocal for infection. Pre-existing pathology was also noted. Results were tabulated and statistical analyses for comparison between groups of scans was performed using chi-square test. RESULTS All targeted regional scans had statistically significant difference in positive rate compared to non-targeted scans of the respective region; chest (Χ²(1)=18.11, P<.001); sinus (Χ²(1)=15.36, P<.001); abdomen and pelvis (Χ²(1)=5.95, P=.01). Pneumonia (41.3 %) was much more likely to be the diagnosis compared to sinusitis (16.2 %) in concomitant CT chest to sinus examinations (Χ²(1)=45.3, P<.001). Pan-scans had a higher incidence of positive diagnosis compared to all-targeted scans (Χ²(1)=4.91, P=.03) but when compared to higher yield targeted scans (abdomen and chest), there was no statistical difference (Χ²(1)=2.43, P=.12). 20/54 patients had pan-scans despite having localising symptoms. CONCLUSION Imaging guided by presenting signs and symptoms can help to reduce unnecessary imaging and promote more judicious use of non-targeted and pan-scan CT in current practices.
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Affiliation(s)
- Victor K O Chang
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
| | - Ee Shern Liang
- Radiology and Imaging Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Paul Schmidt
- Radiology and Imaging Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Christine B, Daniel W, Florian L, Johannes H, Nina H, Ruth H, Frederike S, Daniel H, Anne HJ. "Uninformed consent" in clinical trials with cancer patients: A qualitative analysis of patients' and support persons' communication experiences and needs. Patient Educ Couns 2024; 122:108144. [PMID: 38306787 DOI: 10.1016/j.pec.2024.108144] [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] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Cancer patients are often overwhelmed when being informed about clinical trials. However, there is a lack of evidence-based strategies to improve physician-patient communication in this area. This study assessed the experiences and needs of cancer patients and their support persons (SPs) during the informed consent (IC) process prior to participation in clinical trials. METHODS 17 semi-structured interviews with cancer patients and their SP were conducted and analysed using a framework analysis. RESULTS Most respondents reported feeling well informed about the clinical trial. However, core aspects of the study were often not understood highlighting a dissonance between perceived and actual recall and understanding. Many participants trusted that the trial recommended was the best available care and only skimmed the consent form or did not read it at all. CONCLUSIONS This is the first German study to analyse both cancer patients' and SPs' perspectives on IC processes. Although many feel well informed, our results suggest a significant gap in recall and understanding of core components of clinical trials which hinders IC. PRACTICE IMPLICATIONS Further interventional research is required to improve the consent processes prior to clinical trials in order to provide optimal, patient-centred care.
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Affiliation(s)
- Bernardi Christine
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
| | - Wolff Daniel
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Lüke Florian
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Hies Johannes
- Legal Department, University Hospital Regensburg, Regensburg, Germany
| | - Hallowell Nina
- Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Horn Ruth
- Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Seitz Frederike
- Ethics Committee, University of Regensburg, Regensburg, Germany
| | - Heudobler Daniel
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Hermann-Johns Anne
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany; School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Ostrowska M, Kacała P, Onolememen D, Vaughan-Lane K, Sisily Joseph A, Ostrowski A, Pietruszewska W, Banaszewski J, Wróbel MJ. To trust or not to trust: evaluating the reliability and safety of AI responses to laryngeal cancer queries. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08643-8. [PMID: 38652298 DOI: 10.1007/s00405-024-08643-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE As online health information-seeking surges, concerns mount over the quality and safety of accessible content, potentially leading to patient harm through misinformation. On one hand, the emergence of Artificial Intelligence (AI) in healthcare could prevent it; on the other hand, questions raise regarding the quality and safety of the medical information provided. As laryngeal cancer is a prevalent head and neck malignancy, this study aims to evaluate the utility and safety of three large language models (LLMs) as sources of patient information about laryngeal cancer. METHODS A cross-sectional study was conducted using three LLMs (ChatGPT 3.5, ChatGPT 4.0, and Bard). A questionnaire comprising 36 inquiries about laryngeal cancer was categorised into diagnosis (11 questions), treatment (9 questions), novelties and upcoming treatments (4 questions), controversies (8 questions), and sources of information (4 questions). The population of reviewers consisted of 3 groups, including ENT specialists, junior physicians, and non-medicals, who graded the responses. Each physician evaluated each question twice for each model, while non-medicals only once. Everyone was blinded to the model type, and the question order was shuffled. Outcome evaluations were based on a safety score (1-3) and a Global Quality Score (GQS, 1-5). Results were compared between LLMs. The study included iterative assessments and statistical validations. RESULTS Analysis revealed that ChatGPT 3.5 scored highest in both safety (mean: 2.70) and GQS (mean: 3.95). ChatGPT 4.0 and Bard had lower safety scores of 2.56 and 2.42, respectively, with corresponding quality scores of 3.65 and 3.38. Inter-rater reliability was consistent, with less than 3% discrepancy. About 4.2% of responses fell into the lowest safety category (1), particularly in the novelty category. Non-medical reviewers' quality assessments correlated moderately (r = 0.67) with response length. CONCLUSIONS LLMs can be valuable resources for patients seeking information on laryngeal cancer. ChatGPT 3.5 provided the most reliable and safe responses among the models evaluated.
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Affiliation(s)
- Magdalena Ostrowska
- Department of Otolaryngology and Laryngological Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, ul.Marie Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Paulina Kacała
- ENT Scientific Club, Department of Otolaryngology and Laryngological Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, ul.Marie Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Deborah Onolememen
- ENT Scientific Club, Department of Otolaryngology and Laryngological Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, ul.Marie Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Katie Vaughan-Lane
- ENT Scientific Club, Department of Otolaryngology and Laryngological Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, ul.Marie Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland.
| | - Anitta Sisily Joseph
- ENT Scientific Club, Department of Otolaryngology and Laryngological Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, ul.Marie Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Adam Ostrowski
- Department of Urology, Collegium Medicum, Nicolaus Copernicus University in Torun, ul.Marie Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Wioletta Pietruszewska
- Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, ul Żeromskiego 113, 90-549, Lodz, Poland
| | - Jacek Banaszewski
- Department of Otolaryngology, Head and Neck Oncology, Poznan University of Medical Science, ul Przybyszewskiego 49, 60-355, Poznań, Poland
| | - Maciej J Wróbel
- Department of Otolaryngology and Laryngological Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, ul.Marie Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
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Domblides C, Crampton S, Liu H, Bartleson JM, Nguyen A, Champagne C, Landy EE, Spiker L, Proffitt C, Bhattarai S, P Grawe A, Fuentealba Valenzuela M, Lartigue L, Mahouche I, Dupaul-Chicoine J, Nishimura K, Lefort F, Decraecker M, Velasco V, Netzer S, Pitard V, Roy C, Soubeyran I, Racine V, Blanco P, Déchanet-Merville J, Saleh M, Canna SW, Furman D, Faustin B. Human NLRC4 promotes cancer survival and is associated to type-I interferon signaling and immune infiltration. J Clin Invest 2024:e166085. [PMID: 38652550 DOI: 10.1172/jci166085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
The immune system can control cancer progression. However, even though some innate immune sensors of cellular stress are expressed intrinsically in epithelial cells, their potential role in cancer aggressiveness and subsequent overall survival in humans is mainly unknown. Here, we show that NLR family CARD Domain Containing 4 (NLRC4) is downregulated in epithelial tumor cells of colorectal cancer (CRC) patients by using spatial tissue imaging. Strikingly, only the loss of tumor NLRC4 but not stromal is associated with poor immune infiltration (mainly dendritic and CD4+/CD8+ T cells) and accurately predicts progression to metastatic Stage IV and decrease of overall survival. By combining multi-omics approaches, we show that restoring NLRC4 expression in human colorectal cancer cells triggers a broad inflammasome-independent immune reprogramming consisting of Type-I IFN signaling genes and the release of chemokines and myeloid growth factors involved in the tumor infiltration and activation of dendritic cells (DCs) and T cells. Consistently, such reprogramming in cancer cells is sufficient to directly mature human DCs towards a Th1 antitumor immune response through IL-12 production in vitro. In multiple human carcinomas (colorectal, lung, and skin), we confirmed that NLRC4 expression in patient tumors is strongly associated with Type-I IFN genes, immune infiltrates and high microsatellite instability. Thus, we shed light on the epithelial innate immune sensor NLRC4 as a novel therapeutic target to promote an efficient antitumor immune response against the aggressiveness of various carcinomas.
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Affiliation(s)
| | - Steven Crampton
- Immunology Discovery, Janssen Research and Development, San Diego, United States of America
| | - Hong Liu
- Takeda Pharmaceuticals, Cambridge, United States of America
| | | | - Annie Nguyen
- Immunology Discovery, Janssen Research and Development, San Diego, United States of America
| | | | - Emily E Landy
- Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, United States of America
| | - Lindsey Spiker
- Department of Genetics, University of Pittsburgh School of Public Health, Pittsburgh, United States of America
| | | | - Sunil Bhattarai
- Immunology Discovery, Janssen Research and Development, San Diego, United States of America
| | - Anissa P Grawe
- Buck Institute for Research on Aging, Novato, United States of America
| | | | | | | | | | | | - Félix Lefort
- ImmunoConcEpt, University of Bordeaux, Bordeaux, France
| | | | - Valérie Velasco
- Department of Biopathology, Institut Bergonié, Bordeaux, France
| | | | | | - Christian Roy
- Takeda Pharmaceuticals, Cambridge, United States of America
| | | | | | | | | | - Maya Saleh
- INRS Santé Biotechnologie, Laval, Canada
| | - Scott W Canna
- Pediatric Rheumatology, Children's Hospital of Philadelphia, Philadelphia, United States of America
| | - David Furman
- Buck Institute for Research on Aging, Novato, United States of America
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10
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Kumar D, Neeman E, Zhu S, Sun H, Kotak D, Liu R. Revisiting the Association of ECOG Performance Status With Clinical Outcomes in Diverse Patients With Cancer. J Natl Compr Canc Netw 2024:1-7. [PMID: 38653321 DOI: 10.6004/jnccn.2023.7111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/20/2023] [Indexed: 04/25/2024]
Abstract
BACKGROUND The ECOG performance status (PS) scale was developed to support national clinical trials, but the degree to which ECOG PS predicts clinical outcomes in patient subgroups outside of clinical trials is relatively unknown. This study examined associations between ECOG PS and adverse outcomes in a diverse community oncology population. PATIENTS AND METHODS In this retrospective cohort study, demographic and clinical characteristics, including the most recent ECOG PS between January 1, 2017, and December 31, 2019, were examined for patients receiving cancer treatment within Kaiser Permanente Northern California (KPNC). Proportional hazard models were used to evaluate the effect of ECOG PS on adverse outcomes. RESULTS A total of 21,730 patients were identified. Overall, most patients had an ECOG PS of 0 (42.5%) or 1 (42.5%). In multivariable analysis, an ECOG PS of 3 or 4 was associated with higher risk of 30-day emergency department visits (adjusted hazard ratio [aHR], 3.85; 95% CI, 3.47-4.26), 30-day hospitalizations (aHR, 4.70; 95% CI, 4.12-5.36), and 6-month mortality (aHR, 7.34; 95% CI, 6.64-8.11) compared with an ECOG PS of 0. Additionally, we found that upper gastrointestinal and stage IV cancers were associated with a higher risk of adverse outcomes compared with breast and stage I cancers, respectively. When adjusted for ECOG PS, African American race, Asian race, and female sex were associated with a lower risk of mortality than White race and male sex. An ECOG PS of 3 or 4 was more predictive of mortality in younger patients and those with breast cancer (P<.001). CONCLUSIONS ECOG PS and upper gastrointestinal and stage IV cancers were independently associated with increased risk of emergency department visits, hospitalizations, and mortality, whereas African American and Asian race and female sex were associated with decreased risk of mortality. An ECOG PS of 3 or 4 was more predictive of an increased risk of mortality in younger patients and patients with breast cancer. These findings can enhance the use of ECOG PS for clinical decision-making and defining eligibility for clinical trials.
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Affiliation(s)
- Deepika Kumar
- 1Hematology/Oncology Department, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
| | - Elad Neeman
- 2Department of Hematology-Oncology, The Permanente Medical Group (TPMG), Oakland, CA
| | - Shiyun Zhu
- 3Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Hongxin Sun
- 3Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Dinesh Kotak
- 2Department of Hematology-Oncology, The Permanente Medical Group (TPMG), Oakland, CA
| | - Raymond Liu
- 2Department of Hematology-Oncology, The Permanente Medical Group (TPMG), Oakland, CA
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11
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Fuller AM, Pruitt HC, Liu Y, Irizarry-Negron VM, Pan H, Song H, DeVine A, Katti RS, Devalaraja S, Ciotti GE, Gonzalez MV, Williams EF, Murazzi I, Ntekoumes D, Skuli N, Hakonarson H, Zabransky DJ, Trevino JG, Weeraratna A, Weber K, Haldar M, Fraietta JA, Gerecht S, Eisinger-Mathason TSK. Oncogene-induced matrix reorganization controls CD8+ T cell function in the soft-tissue sarcoma microenvironment. J Clin Invest 2024:e167826. [PMID: 38652549 DOI: 10.1172/jci167826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
CD8+ T cell dysfunction impedes anti-tumor immunity in solid cancers but the underlying mechanisms are diverse and poorly understood. Extracellular matrix (ECM) composition has been linked to impaired T cell migration and enhanced tumor progression; however, impacts of individual ECM molecules on T cell function in the tumor microenvironment (TME) are only beginning to be elucidated. Upstream regulators of aberrant ECM deposition and organization in solid tumors are equally ill-defined. Therefore, we investigated how ECM composition modulates CD8+ T cell function in undifferentiated pleomorphic sarcoma (UPS), an immunologically active desmoplastic tumor. Using an autochthonous murine model of UPS and data from multiple human patient cohorts, we discovered a multifaceted mechanism wherein the transcriptional co-activator YAP1 promotes collagen VI (COLVI) deposition in the UPS TME. In turn, COLVI induces CD8+ T cell dysfunction and immune evasion by remodeling fibrillar collagen and inhibiting T cell autophagic flux. Unexpectedly, collagen I (COLI) opposed COLVI in this setting, promoting CD8+ T cell function and acting as a tumor suppressor. Thus, CD8+ T cell responses in sarcoma depend upon oncogene-mediated ECM composition and remodeling.
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Affiliation(s)
- Ashley M Fuller
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Hawley C Pruitt
- Department of Chemical and Biomolecular Engineering, The Institute for Nano, Johns Hopkins University, Baltimore, United States of America
| | - Ying Liu
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Valerie M Irizarry-Negron
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Hehai Pan
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Hoogeun Song
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Ann DeVine
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Rohan S Katti
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Samir Devalaraja
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Gabrielle E Ciotti
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Michael V Gonzalez
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, United States of America
| | - Erik F Williams
- Department of Microbiology, Center for Cellular Immunotherapies, Parker Ins, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Ileana Murazzi
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Dimitris Ntekoumes
- Department of Biomedical Engineering, Duke University, Durham, United States of America
| | - Nicolas Skuli
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, United States of America
| | - Daniel J Zabransky
- Department of Oncology, The Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, Baltimore, United States of America
| | - Jose G Trevino
- Division of Surgical Oncology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, United States of America
| | - Ashani Weeraratna
- Department of Biochemistry and Molecular Biology, John Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Kristy Weber
- Penn Sarcoma Program, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Malay Haldar
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Joseph A Fraietta
- Department of Microbiology, Center for Cellular Immunotherapies, Parker Ins, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | - Sharon Gerecht
- Department of Biomedical Engineering, Duke University, Durham, United States of America
| | - T S Karin Eisinger-Mathason
- Department of Pathology and Laboratory Medicine, Penn Sarcoma Program, Abra, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
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12
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Zhao D, Guo Y, Wei H, Jia X, Zhi Y, He G, Nie W, Huang L, Wang P, Laster KV, Liu Z, Wang J, Lee MH, Dong Z, Liu K. Multi-omics characterization of esophageal squamous cell carcinoma identifies molecular subtypes and therapeutic targets. JCI Insight 2024:e171916. [PMID: 38652547 DOI: 10.1172/jci.insight.171916] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Esophageal squamous cell carcinoma (ESCC) is the predominant form of esophageal cancer and is characterized by an unfavorable prognosis. To elucidate the distinct molecular alterations in ESCC and investigate therapeutic targets, we performed a comprehensive analysis of transcriptomic, proteomic, and phosphoproteomic data derived from 60 paired treatment-naive ESCC and adjacent non-tumor tissue samples. Additionally, we conducted a correlation analysis to describe the regulatory relationship between transcriptomic and proteomic processes, revealing alterations in key metabolic pathways. Unsupervised clustering analysis of the proteomic data stratified ESCC patients into three subtypes with different molecular characteristics and clinical outcomes. Notably, subtype III exhibited the worst prognosis and enrichment in proteins associated with malignant processes, including glycolysis and DNA repair pathways. Furthermore, translocase of inner mitochondrial membrane domain containing 1 (TIMMDC1) was validated as a potential prognostic molecule for ESCC. Moreover, integrated kinase-substrate network analysis using the phosphoproteome nominated candidate kinases as potential targets. In vitro and in vivo experiments further confirmed casein kinase II subunit alpha (CSNK2A1) as a potential kinase target for ESCC. These underlying data represent a valuable resource for researchers, which may provide better insights into the biology and treatment of ESCC.
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Affiliation(s)
- Dengyun Zhao
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yaping Guo
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Huifang Wei
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Xuechao Jia
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yafei Zhi
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Guiliang He
- China-US (Henan) Hormel Cancer Institute, Zhengzhou, China
| | - Wenna Nie
- China-US (Henan) Hormel Cancer Institute, Zhengzhou, China
| | - Limeng Huang
- China-US (Henan) Hormel Cancer Institute, Zhengzhou, China
| | - Penglei Wang
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | | | | | | | - Mee-Hyun Lee
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zigang Dong
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Kangdong Liu
- Department of Pathophysiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
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13
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Hu X, Wen Y, Lu M, Luo Y, Zhou Y, Yang X, Tu C, Min L. Biomechanical and clinical outcomes of 3D-printed versus modular hemipelvic prostheses for limb-salvage reconstruction following periacetabular tumor resection: a mid-term retrospective cohort study. J Orthop Surg Res 2024; 19:258. [PMID: 38654343 DOI: 10.1186/s13018-024-04697-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Debates persist over optimal pelvic girdle reconstruction after acetabular tumor resection, with surgeons grappling between modular and 3D-printed hemipelvic endoprostheses. We hypothesize superior outcomes with 3D-printed versions, yet scarce comparative research exists. This study fills the gap, examining biomechanics and clinical results retrospectively. METHODS From February 2017 to June 2021, we retrospectively assessed 32 patients undergoing en bloc resection for malignant periacetabular tumors at a single institution. PRIMARY OUTCOME limb function. SECONDARY OUTCOMES implant precision, hip joint rotation center restoration, prosthesis-bone osteointegration, and complications. Biomechanical characteristics were evaluated through finite element analysis on pelvic defect models. RESULTS In the 3D-printed group, stress distribution mirrored a normal pelvis, contrasting the modular group with elevated overall stress, unstable transitions, and higher stress peaks. The 3D-printed group exhibited superior functional scores (MSTS: 24.3 ± 1.8 vs. 21.8 ± 2.0, p < 0.05; HHS: 79.8 ± 5.2 vs. 75.3 ± 3.5, p < 0.05). Prosthetic-bone interface osteointegration, measured by T-SMART, favored 3D-printed prostheses, but surgery time (426.2 ± 67.0 vs. 301.7 ± 48.6 min, p < 0.05) and blood loss (2121.1 ± 686.8 vs. 1600.0 ± 505.0 ml, p < 0.05) were higher. CONCLUSIONS The 3D-printed hemipelvic endoprosthesis offers precise pelvic ring defect matching, superior stress transmission, and function compared to modular endoprostheses. However, complexity, fabrication expertise, and challenging surgical implantation result in prolonged operation times and increased blood loss. A nuanced consideration of functional outcomes, complexity, and patient conditions is crucial for informed treatment decisions. LEVEL OF EVIDENCE Level III, therapeutic study (Retrospective comparative study).
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Affiliation(s)
- Xin Hu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xang, Chengdu, 610041, Sichuan, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yang Wen
- Department of Orthopedics, Zigong Fourth People's Hospital, Zigong, 643000, People's Republic of China
| | - Minxun Lu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xang, Chengdu, 610041, Sichuan, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yi Luo
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xang, Chengdu, 610041, Sichuan, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yong Zhou
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xang, Chengdu, 610041, Sichuan, People's Republic of China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xiao Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, Sichuan, People's Republic of China.
- Provincial Engineering Research Center for Biomaterials Genome of Sichuan, Sichuan University, Chengdu, 610064, People's Republic of China.
| | - Chongqi Tu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xang, Chengdu, 610041, Sichuan, People's Republic of China.
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China.
| | - Li Min
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xang, Chengdu, 610041, Sichuan, People's Republic of China.
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China.
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14
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Barata P, Gulati S, Elliott A, Hammers HJ, Burgess EF, Gartrell BA, Darabi S, Bilen MA, Basu A, Geynisman DM, Dawson NA, Zibelman MR, Zhang T, Wei S, Ryan CJ, Heath EI, Poorman KA, Nabhan C, McKay RR. Renal cell carcinoma histologic subtypes exhibit distinct transcriptional profiles. J Clin Invest 2024:e178915. [PMID: 38652565 DOI: 10.1172/jci178915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Molecular profiling of clear cell RCC (ccRCC) tumors of clinical trial patients has identified distinct transcriptomic signatures with predictive value, yet data in non-clear cell variants (nccRCC) are lacking. We examined the transcriptional profiles of RCC tumors representing key molecular pathways, from a multi-institutional, real-world patient cohort, including ccRCC (n = 508) and centrally-reviewed nccRCC (n = 149) samples. ccRCC had increased angiogenesis signature scores compared to the heterogeneous group of nccRCC tumors (mean z-score 0.37 vs -0.99, P < 0.001), while cell cycle, fatty acid oxidation (FAO)/AMPK signaling, fatty acid synthesis (FAS)/pentose phosphate signature scores were increased in one or more nccRCC subtypes. Among both ccRCC and nccRCC tumors, T-effector scores statistically correlated with increased immune cell infiltration and were more commonly associated with immunotherapy-related markers (PD-L1+/TMB-High/MSI-High). In conclusion, this study provides evidence of differential gene transcriptional profiles among ccRCC vs nccRCC tumors, providing new insights for optimizing personalized and histology-specific therapeutic strategies for patients with advanced RCC.
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Affiliation(s)
- Pedro Barata
- Department of Internal Medicine, University Hospitals Seidman Cancer Center, Cleveland, United States of America
| | - Shuchi Gulati
- Division of Hematology and Oncology, Department of Internal Medicine, UC Davis Comprehensive Cancer Center, Sacramento, United States of America
| | - Andrew Elliott
- Clinical and Translational Research/Medical Affairs, Caris Life Sciences, Irving, United States of America
| | - Hans J Hammers
- UT Southwestern Kidney Cancer Program, UT Southwestern Medical Center, Dallas, United States of America
| | - Earle F Burgess
- Department of Internal Medicine, Levine Cancer Institute Atrium Health, Charlotte, United States of America
| | - Benjamin A Gartrell
- Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Bronx, United States of America
| | - Sourat Darabi
- Clinical Genomics, Hoag Memorial Hospital Presbyterian, Newport Beach, United States of America
| | - Mehmet A Bilen
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, United States of America
| | - Arnab Basu
- Department of Medical Oncology, University of Alabama, Birmingham, United States of America
| | - Daniel M Geynisman
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, United States of America
| | - Nancy A Dawson
- Department of Internal Medicine, Georgetown University Lombardi Comprehensive Cancer Center, Washington D.C., United States of America
| | - Matthew R Zibelman
- Department of Internal Medicine, Fox Chase Cancer Center, Philadelphia, United States of America
| | - Tian Zhang
- UT Southwestern Kidney Cancer Program, UT Southwestern Medical Center, Dallas, United States of America
| | - Shuanzeng Wei
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, United States of America
| | - Charles J Ryan
- Medical School, University of Minnesota, Minneapolis, United States of America
| | - Elisabeth I Heath
- Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, United States of America
| | - Kelsey A Poorman
- Department of Molecular Biology, Caris LifeSciences, Irving, United States of America
| | - Chadi Nabhan
- Chairman of the Caris Precision Oncology Alliance, Caris LifeSciences, Phoenix, United States of America
| | - Rana R McKay
- Moores Cancer Center, UCSD, San Diego, United States of America
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Pathak P, Abandeh L, Aboughalia H, Pooyan A, Mansoori B. Overview of F18-FDG uptake patterns in retroperitoneal pathologies: imaging findings, pitfalls, and artifacts. Abdom Radiol (NY) 2024:10.1007/s00261-023-04139-x. [PMID: 38652126 DOI: 10.1007/s00261-023-04139-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Retroperitoneum can be the origin of a wide variety of pathologic conditions and potential space for disease spread to other compartments of the abdomen and pelvis. Computed tomography (CT) and magnetic resonance imaging (MRI) are often the initial imaging modalities to evaluate the retroperitoneal pathologies, however given the intrinsic limitations, F18-FDG PET/CT provides additional valuable metabolic information which can change the patient management and clinical outcomes. We highlight the features of retroperitoneal pathologies on F18-FDG PET/CT and the commonly encountered imaging artifacts and pitfalls. The aim of this review is to characterize primary and secondary retroperitoneal pathologies based on their metabolic features, and correlate PET findings with anatomic imaging. CONCLUSION Retroperitoneal pathologies can be complex, ranging from oncologic to a spectrum of non-oncologic disorders. While crosse-sectional imaging (CT and MRI) are often the initial imaging modalities to localize and characterize pathologies, metabolic information provided by F18-FDG PET/CT can change the management and clinical outcome in many cases.
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Affiliation(s)
- Priya Pathak
- Abdominal Imaging and Nuclear Medicine Divisions, Department of Radiology, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Laith Abandeh
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Hassan Aboughalia
- Department of Radiology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Atefe Pooyan
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Bahar Mansoori
- Abdominal Imaging Division, Department of Radiology, University of Washington, Seattle, WA, USA
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Maki A, Narukawa M. Factors Associated with Inclusion of Japan in Phase I Multiregional Clinical Trials in Oncology. Ther Innov Regul Sci 2024:10.1007/s43441-024-00655-0. [PMID: 38652349 DOI: 10.1007/s43441-024-00655-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Early inclusion of Japan in the global development program could be a key factor in reducing the drug lag, making participation in phase I multiregional clinical trials (Ph. I MRCTs) an important consideration for oncology drug development in Japan. We aimed to investigate the factors associated with the inclusion of Japan in Ph. I MRCTs in oncology. METHODS We compared the trial design, target population, type of primary tested drug, trial conduct profile, and sponsor profile for Ph. I MRCTs with or without Japan conducted by the top 20 companies in more than two countries and started between January 1, 2011, and December 31, 2020. RESULTS One hundred and ninety-seven Ph. I MRCTs included Japan, and 697 did not. Detailed features of the Ph. I MRCTs in oncology were summarized, and several factors (trial design, target population, trial conduct profile, and sponsor profile) associated with inclusion of Japan in the Ph. I MRCTs were identified. CONCLUSIONS It is important for Japanese subsidiaries within global pharmaceutical companies to closely communicate with the headquarters based on medical practice and unmet needs in Japan to join global development from an early stage. In addition, further efforts to attract emerging biopharmaceutical companies to Japan from the regulatory and/or political perspectives would be needed, thereby preventing drug lag in Japan.
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Affiliation(s)
- Akio Maki
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, 108-8641, Tokyo, Japan.
| | - Mamoru Narukawa
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, 108-8641, Tokyo, Japan
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17
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Mohr R, Howard A, Townsend M. Immune-related adverse effects: Recognition and initiation of appropriate treatment in cancer patients on immunotherapy. J Oncol Pharm Pract 2024:10781552241247477. [PMID: 38646708 DOI: 10.1177/10781552241247477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
PURPOSE Delayed or improper identification of immune-related adverse events (IRAEs) during cancer treatment can impact time to receive proper treatment. This study describes rates of IRAE recognition and appropriate treatment in adult patients with cancer at a community teaching hospital. METHODS This single-center, retrospective, cohort study evaluated rates of proper IRAE treatment in conjunction with National Comprehensive Cancer Network (NCCN) guidelines. Secondary outcomes included time from presentation to IRAE diagnosis and hospital readmissions/repeat emergency department (ED) visits following initial admission for IRAE. Retrospective chart review assessed IRAE presentation including common terminology criteria for adverse event (CTCAE) grading and treatment choices. RESULTS Fifteen subjects included in this study contributed to 21 encounters with noted IRAE. Over half (52.4%) of the encounters received proper IRAE treatment (e.g. correct drug, dose, route, frequency, or therapy duration). Nearly 22% of total actionable components were improper, occurring more often in patients with colitis, pneumonitis, and hepatitis. Median time to IRAE diagnosis was approximately 3.5 days, with the longest being 24 days. There were eight all-cause rehospitalizations one year after initial IRAE presentation, with four directly IRAE-related. Most (75%) IRAE-related rehospitalizations occurred with colitis. Seven ED return visits were also noted. CONCLUSION Many IRAEs were misdiagnosed and/or received improper treatment resulting in increased rehospitalization/return ED visit rates. The importance of medical oncology involvement (e.g. medical oncology consult at time of admission and/or notification of primary oncologist) in IRAE management in the hospital or ED was also stressed. Organizations may benefit from systematic improvements and staff education to improve patient outcomes and prevent readmissions.
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Affiliation(s)
- Riley Mohr
- Pharmacy Department, Medical Center Blvd, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Anna Howard
- Pharmacy Department, Billings Clinic, Billings, MT, USA
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Elgamal OA, Fobare S, Vibhute S, Mehmood A, Vroom DC, Johnson ML, Stearns B, Lerma JR, Truxall J, Stahl E, Carmichael B, Orwick SJ, Mims AS, Curran E, Santhanam R, Tridandapani S, Phelps MA, Xie Z, Coss CC, Baker SD, Patrick J, Ezzell JK, Rai J, Pan J, Rai SN, Stillwell C, Wunderlich M, Abdulrahim M, Goodwin TE, Hilinski G, Bennett CE, Hertlein E, Byrd JC. Pyrimidine depletion enhances targeted and immune therapy combinations in acute myeloid leukemia. JCI Insight 2024; 9:e173646. [PMID: 38646934 DOI: 10.1172/jci.insight.173646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024] Open
Abstract
Acute myeloid leukemia (AML) is a fatal disease characterized by the accumulation of undifferentiated myeloblasts, and agents that promote differentiation have been effective in this disease but are not curative. Dihydroorotate dehydrogenase inhibitors (DHODHi) have the ability to promote AML differentiation and target aberrant malignant myelopoiesis. We introduce HOSU-53, a DHODHi with significant monotherapy activity, which is further enhanced when combined with other standard-of-care therapeutics. We further discovered that DHODHi modulated surface expression of CD38 and CD47, prompting the evaluation of HOSU-53 combined with anti-CD38 and anti-CD47 therapies, where we identified a compelling curative potential in an aggressive AML model with CD47 targeting. Finally, we explored using plasma dihydroorotate (DHO) levels to monitor HOSU-53 safety and found that the level of DHO accumulation could predict HOSU-53 intolerability, suggesting the clinical use of plasma DHO to determine safe DHODHi doses. Collectively, our data support the clinical translation of HOSU-53 in AML, particularly to augment immune therapies. Potent DHODHi to date have been limited by their therapeutic index; however, we introduce pharmacodynamic monitoring to predict tolerability while preserving antitumor activity. We additionally suggest that DHODHi is effective at lower doses with select immune therapies, widening the therapeutic index.
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Affiliation(s)
- Ola A Elgamal
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Sydney Fobare
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Sandip Vibhute
- Medicinal Chemistry Shared Resource, Comprehensive Cancer Center
| | - Abeera Mehmood
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Dennis C Vroom
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Mariah L Johnson
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Blaise Stearns
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - James R Lerma
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jean Truxall
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Emily Stahl
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Bridget Carmichael
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Shelley J Orwick
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Alice S Mims
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Emily Curran
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ramasamy Santhanam
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | | | - Mitch A Phelps
- College of Pharmacy and Comprehensive Cancer Center; and
| | - Zhiliang Xie
- College of Pharmacy and Comprehensive Cancer Center; and
| | - Christopher C Coss
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Sharyn D Baker
- College of Pharmacy and Comprehensive Cancer Center; and
| | - Jeffrey Patrick
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Janel K Ezzell
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Jayesh Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine
- Cancer Data Science Center, College of Medicine; and
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jianmin Pan
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine
- Cancer Data Science Center, College of Medicine; and
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Shesh N Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine
- Cancer Data Science Center, College of Medicine; and
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Cody Stillwell
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Mark Wunderlich
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | | | - Gerard Hilinski
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Chad E Bennett
- Medicinal Chemistry Shared Resource, Comprehensive Cancer Center
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Erin Hertlein
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - John C Byrd
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
- College of Pharmacy and Comprehensive Cancer Center; and
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Okamura N, Kubo E, Ishida A, Noda S, Harada M, Ishizuka K, Inoue Y, Kosugi K, Miura T. Differences in discharge letter content: oncologists' vs. home care physicians' needs. Support Care Cancer 2024; 32:299. [PMID: 38644420 DOI: 10.1007/s00520-024-08507-1] [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: 11/26/2023] [Accepted: 04/15/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To compare the details, oncologists include in discharge letters with what home care physicians need. Although discharge letters are important to share patients' information for home palliative care, few studies have compared the details, especially patients' emotions, regarding what oncologists include in discharge letters and home care physicians' needs. METHODS This cross-sectional study was conducted by sending anonymous, self-administered questionnaires to 500 certified oncologists (OCs) and 500 directors of home care supporting clinics (HCs) in Japan between March and May 2023. The survey considered 20 potential items found in discharge letters, and compared rates of OCs including these items and HCs needs. RESULTS Of 310 valid responses, 186 were from OCs (average age: 47.7; 29 females) and 124 from HCs (average age: 55.4; 9 females). Major items with lower inclusion rates for OCs included patients' emotions regarding medical conditions (58.4% in OCs vs. 92.6% in HCs, p < 0.001), families' emotions regarding medical conditions (60.0 vs. 92.6%, respectively, p < 0.001), patients' perceptions regarding medical conditions (84.9 vs. 94.3%, respectively, p = 0.011), families' perceptions regarding medical conditions (84.3 vs. 95.1%, respectively, p = 0.004), and potential late-onset treatment-related adverse events (79.3 vs. 92.6%, respectively, p = 0.002). Conversely, OCs included patients' activities of daily living more frequently (96.2 vs. 90.2%, respectively, p = 0.031). CONCLUSION Transitioning to home-based palliative care may necessitate accurate information and consideration of patients' and families' perceptions and emotions regarding medical conditions in discharge letters for continuous provision of high-quality care.
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Affiliation(s)
- Nozomi Okamura
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
- Department of Nephrology, Aso Iizuka Hospital, Iizuka, Japan
| | - Emi Kubo
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Ayaka Ishida
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Sakiho Noda
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Mariko Harada
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Keisuke Ishizuka
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Yujiro Inoue
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Tomofumi Miura
- Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan.
- Division of Biomarker Discovery, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Kashiwa, Japan.
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Kulkarni A, Singh J. Predicting drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors and forward planning. Expert Opin Drug Metab Toxicol 2024:1-9. [PMID: 38600865 DOI: 10.1080/17425255.2024.2341810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Cyclin-dependent kinase (CDK) 4/6 inhibitors are cornerstones in the treatment of Hormone Receptor (HR) positive and Human Epidermal Growth factor (HER2) negative metastatic breast cancer. Given their widespread use in the metastatic setting and emerging use in the adjuvant setting, studying drug-drug interactions (DDI) of these medications is of utmost importance. AREAS COVERED This review provides key background information on the CDK4/6 inhibitors, palbociclib, ribociclib, and abemaciclib. We discuss drug-drug interactions including those with proton pump inhibitors as well as CYP3A substrates, inhibitors, and inducers. We describe the effect of these drugs on membrane transporters and their substrates as well as those drugs that increase risk of CDK4/6 toxicities. Finally, we explore future directions for strategies to minimize drug-drug interactions. EXPERT OPINION It is crucial to be mindful of medications that may interfere with drug absorption, such as proton pump inhibitors, as well as those that interfere with drug metabolism, such as CYP3A4 inhibitors and inducers. Additionally, special consideration should be given to populations at higher risk for polypharmacy, such as older patients with greater comorbidities. These interactions and patient characteristics should be considered when developing individual treatment plans with CDK4/6 inhibitors.
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Affiliation(s)
- Abha Kulkarni
- Department of Medicine, New York Presbyterian Weill Cornell, New York, NY USA
| | - Jasmeet Singh
- Department of Breast Medicine, Memorial Sloan Kettering Cancer Center, West Harrison, NY USA
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21
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Kim U, Debnath R, Maiz JE, Rico J, Sinha S, Blanco MA, Chakrabarti R. ΔNp63 regulates MDSC survival and metabolism in triple-negative breast cancer. iScience 2024; 27:109366. [PMID: 38510127 PMCID: PMC10951988 DOI: 10.1016/j.isci.2024.109366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 03/22/2024] Open
Abstract
Triple-negative breast cancer (TNBC) contributes greatly to mortality of breast cancer, demanding new targetable options. We have shown that TNBC patients have high ΔNp63 expression in tumors. However, the function of ΔNp63 in established TNBC is yet to be explored. In current studies, targeting ΔNp63 with inducible CRISPR knockout and Histone deacetylase inhibitor Quisinostat showed that ΔNp63 is important for tumor progression and metastasis in established tumors by promoting myeloid-derived suppressor cell (MDSC) survival through tumor necrosis factor alpha. Decreasing ΔNp63 levels are associated with decreased CD4+ and FOXP3+ T-cells but increased CD8+ T-cells. RNA sequencing analysis indicates that loss of ΔNp63 alters multiple MDSC properties such as lipid metabolism, chemotaxis, migration, and neutrophil degranulation besides survival. We further demonstrated that targeting ΔNp63 sensitizes chemotherapy. Overall, we showed that ΔNp63 reprograms the MDSC-mediated immunosuppressive functions in TNBC, highlighting the benefit of targeting ΔNp63 in chemotherapy-resistant TNBC.
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Affiliation(s)
- Ukjin Kim
- Department of Surgery, Sylvester Comprehensive Cancer, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Rahul Debnath
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Javier E. Maiz
- Department of Surgery, Sylvester Comprehensive Cancer, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joshua Rico
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Satrajit Sinha
- Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA
| | - Mario Andrés Blanco
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rumela Chakrabarti
- Department of Surgery, Sylvester Comprehensive Cancer, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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22
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Fernández-Sánchez J, Trujillo-Colmena D, Rodríguez-Castaño A, Lavín-Pérez AM, Del Coso J, Casado A, Collado-Mateo D. Effects of exercise on life satisfaction of people diagnosed with cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:297. [PMID: 38637349 PMCID: PMC11026230 DOI: 10.1007/s00520-024-08486-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE A cancer diagnosis is commonly associated with a decline in patient's life satisfaction and more pessimistic expectations about the future. The identification of strategies to improve life satisfaction in patients with cancer is of great interest to health practitioners since it may be associated with a better prognosis of cancer and higher survival rates. Previous meta-analyses and reviews concluded that exercise could significantly improve health-related quality of life in this population, but the effects of exercise on life satisfaction are still not well-known. This review aims to analyse the effects of exercise programs on life satisfaction in people with cancer and individuals who have overcome cancer. METHODS The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A thorough search of databases including Web of Science and PubMed/MEDLINE was carried out. Six studies (535 participants) in which the effect of an exercise program was compared to a non-exercise program control condition in patients with cancer were considered eligible. A subsequent meta-analysis was performed using the random effects model to calculate the standardized mean differences (SMD) and 95% confidence intervals (CI). RESULTS Exercise intervention improved satisfaction with life compared with a control condition (SMD = 1.28; p = 0.02 with a 95% CI of 0.22 to 2.34). CONCLUSION Exercise could be considered an effective tool to improve life satisfaction in patients with cancer. Hence, professionals might consider the possibility of integrating physical exercise into strategies aimed at enhancing the low life satisfaction often experienced by patients. PROSPERO CRD42023438146.
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Affiliation(s)
| | | | | | - Ana Myriam Lavín-Pérez
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain.
- GO fitLAB, Ingesport, Madrid, Spain.
| | - Juan Del Coso
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Arturo Casado
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Daniel Collado-Mateo
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
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Kelkar SS, Prabhu VS, Zhang J, Ogando YM, Roney K, Verma RP, Miles N, Marth C. Real-world prevalence of microsatellite instability testing and related status in women with advanced endometrial cancer in Europe. Arch Gynecol Obstet 2024:10.1007/s00404-024-07504-3. [PMID: 38634898 DOI: 10.1007/s00404-024-07504-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To assess the real-world prevalence of microsatellite instability (MSI)/mismatch repair (MMR) testing and related tumor status in recurrent/advanced endometrial cancer patients in Europe. METHODS Data were from two multi-center, retrospective patient chart review studies conducted in the United Kingdom, Germany, Italy, France and Spain: The Endometrial Cancer Health Outcomes-Europe-First-Line (ECHO-EU-1L) study and the ECHO-EU-Second-Line (ECHO-EU-2L) study. ECHO-EU-1L included recurrent/advanced endometrial cancer patients who received first-line systemic therapy between 1/JUN/2016 and 31/MAR/2020 after recurrent/advanced diagnosis. ECHO-EU-2L included patients with recurrent/advanced endometrial cancer who progressed between 1/JUN/2016 and 30/JUN/2019 following prior first-line systemic therapy. Data collected included patient demographics, MSI/MMR tumor testing and results, and clinical/treatment characteristics. RESULTS ECHO-EU-1L included 242 first-line patients and ECHO-EU-2L included 475 s-line patients. For all patients, median age at recurrent/advanced diagnosis was 69 years, roughly half had endometrioid carcinoma histology and over 75% had Stage IIIB-IV disease at initial diagnosis. The prevalence of MSI/MMR testing in the first-line and second-line cohorts was similar (36.4 and 34.9%, respectively). Among those tested, a majority had non-MSI-high/MMR proficient tumors (80.7 and 74.7% among first- and second-line patients, respectively). About 15% had MSI-high/MMR deficient tumors in both cohorts, and a few patients had discordant results (3.4 and 10.8% among first- and second-line patients, respectively). CONCLUSION Prior to the approvals of biomarker-directed therapies for recurrent/advanced endometrial cancer patients in Europe, there were low MSI/MMR testing rates for these patients of just over one-third. Given the availability of biomarker-directed therapies, increased MSI/MMR testing may help inform treatment decisions for recurrent/advanced endometrial cancer patients in Europe.
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Affiliation(s)
| | - Vimalanand S Prabhu
- Merck & Co., Inc., 126 East Lincoln Ave, P.O. Box 2000, Rahway, NJ, 07065, USA.
| | | | | | | | | | | | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
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Geese F, Bryant-Lukosius D, Zwakhalen S, Hahn S. Advanced Practice Nurses and Their Roles in Swiss Cancer Care: A Cross-Sectional Study. Semin Oncol Nurs 2024:151626. [PMID: 38641521 DOI: 10.1016/j.soncn.2024.151626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/25/2024] [Accepted: 03/08/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVES To examine the advanced practice nurse workforce in Swiss cancer care and how their roles are being implemented (eg, role structures, processes) to achieve optimal outcomes for patients and their families, care organizations, and the broader health care system. METHODS A cross-sectional study was conducted. The sample included master-prepared advanced practice nurses in cancer care, who completed an online questionnaire from December 2021 to January 2022. Thirty-nine items assessed structures (eg, role characteristics, utilization), processes (eg, role activities, interventions), and perceived outcomes (eg, for patients, the health care system) of advanced practice nurses in Swiss cancer care. Data from closed questions were analyzed using descriptive statistics. Data from open-ended questions were organized and summarized into categories related to domains of advanced practice nursing and its reported frequency by the advanced practice nurses. RESULTS The participating advanced practice nurses (n = 53), worked in half of the 26 Swiss cantons. Interventions were identified within nine categories, of which most were targeted to patients and their families (n = 7), followed by health care professionals (n = 2). Perceived positive outcomes were patient symptom management, length of hospital stay, and health care costs. Participants felt less confident in cancer care (eg, autonomous practice) and reported 15 professional development needs (eg, medical interventions, teaching). CONCLUSIONS This study provides a comprehensive examination of 53 advanced practice nurses, detailing the characteristics of their roles and utilization across various jurisdictions and health care settings. The results highlight the diverse dimensions of advanced practice nursing and its potential to enhance cancer services and outcomes in Switzerland. Opportunities for role development support and expansion are identified. IMPLICATIONS FOR NURSING PRACTICE More systematic health human resource planning is needed to expand the deployment of advanced practice nurses across jurisdictions, practice settings, and more diverse patient populations. Role development needs show the desire for specialized educational preparation in cancer care.
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Affiliation(s)
- Franziska Geese
- Academic Practice Partnership, School of Health Professions, Bern University of Applied Sciences, Switzerland; University Hospital Bern, Inselspital, Insel Gruppe, Freiburgstrasse, Switzerland.
| | - Denise Bryant-Lukosius
- School of Nursing and Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sandra Zwakhalen
- Department of Health Services Research, Maastricht University, Netherlands
| | - Sabine Hahn
- Division of Nursing, School of Health Professions, Bern University of Applied Sciences, Switzerland
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Pagès L, Gouin-Barré E, Bourgier C. [Onco'sport testing by patients: Lived experience of patients with cancer practicing adapted physical activity as part of the Onco'sport program, a qualitative study]. Bull Cancer 2024:S0007-4551(24)00120-6. [PMID: 38631986 DOI: 10.1016/j.bulcan.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Physical activity is a major determinant in the prevention of chronic diseases, equally on the side effects of treatments and the consequences of the disease. It improves quality of life, but also reduces morbidity and mortality, and therefore health expenses. A sedentary lifestyle is the fourth cause of premature death in the world, in the context of chronic non-communicable diseases. In France, the prescription for adapted physical activity (APA) has been included in the law since 2016. With the development of "Maisons Sport santé", the Onco'sport program was developed to enable people affected by cancer to participate in adapted physical activity. The objective of our work is to explore the lived experience of cancer patients practicing adapted physical activity as part of the Onco'sport program. METHODS This is a qualitative study of 10 semi-directed individual interviews with patients participating in the Onco'sport program, recruited from the "Maison Sport Santé" from Nîmes and the association "Les Roses du Gard". A phenomenological analysis was carried out with a semiopragmatic approach. RESULTS For all participants, the APA through a program provides professional supervision of Physical Activity, influences adherence and builds confidence. This program is at the origin of changes in lifestyle habits and improves the relationship with illness and their cancer thanks to the physical and psychological benefits felt. Thus, APA appears as a full-fledged supportive care which requires informing patients and promoting it so that access is facilitated and becomes a standard. Health professionals including general practitioners do not currently have an important place in the promotion of APA, and patients most often obtain documentation on their own or through associations of patient. CONCLUSION An APA program like Onco'sport is often the cause of a return to physical activity in patients, brings overall well-being and changes lifestyle habits. It seems important to promote physical activity to patients but also to the general population, given the benefits. This promotion involves easier access to this type of supervised program, financial support and better training of health professionals.
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Affiliation(s)
- Loïc Pagès
- Université de Montpellier, 38, rue Roussy, 30000 Nîmes, France.
| | | | - Céline Bourgier
- Institut régional du cancer Montpellier, 208, avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier cedex 5, France
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Panther EJ, Lyons H, Shychuk AJ. Dedifferentiated liposarcoma of the spermatic cord. BMJ Case Rep 2024; 17:e258954. [PMID: 38627046 PMCID: PMC11029294 DOI: 10.1136/bcr-2023-258954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
A man in his 60s presented to an outside hospital with persistent groin pain and a scrotal mass which was thought to be a recurrent hernia. Three months after initial presentation, the patient was found to have dedifferentiated liposarcoma (LPS) of the spermatic cord. LPS of the spermatic cord is a rare entity; however, clinicians should have LPS on the differential diagnosis especially in men with recurrent scrotal pain and mass. If unrecognised, LPS is associated with a high degree of morbidity and mortality. LPS can be subdivided into well-differentiated LPS, dedifferentiated LPS, myxoid LPS and pleomorphic LPS. In patients with advanced or metastatic LPS, chemotherapy consisting of Adriamycin, ifosfamide and mesna is used despite LPS being relatively chemoresistant. Therapies inhibiting mouse double minute 2 homologue, an oncoprotein that is a negative regulator of the tumour suppressor p53, appear to be promising in preclinical trials.
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Affiliation(s)
- Eric James Panther
- Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Hannah Lyons
- Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Andrew Jacob Shychuk
- Internal Medicine, University of Florida, Gainesville, Florida, USA
- Internal Medicine, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida, USA
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27
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Lafront C, Germain L, Campolina-Silva GH, Weidmann C, Berthiaume L, Hovington H, Brisson H, Jobin C, Frégeau-Proulx L, Cotau R, Gonthier K, Lacouture A, Caron P, Ménard C, Atallah C, Riopel J, Latulippe É, Bergeron A, Toren P, Guillemette C, Pelletier M, Fradet Y, Belleannée C, Pouliot F, Lacombe L, Lévesque É, Audet-Walsh É. The estrogen signaling pathway reprograms prostate cancer cell metabolism and supports proliferation and disease progression. J Clin Invest 2024:e170809. [PMID: 38625747 DOI: 10.1172/jci170809] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Just as the androgen receptor (AR), the estrogen receptor α (ERα) is expressed in the prostate and is thought to influence prostate cancer (PCa) biology. Yet, the incomplete understanding of ERα functions in PCa hinders our ability to fully comprehend its clinical relevance and restricts the repurposing of estrogen-targeted therapies for the treatment of this disease. Using two human PCa tissue microarray cohorts, we first demonstrated that nuclear ERα expression was heterogeneous among patients, being only detected in half of tumors. Positive nuclear ERα levels were correlated with disease recurrence, progression to metastatic PCa, and patient survival. Using in vitro and in vivo models of the normal prostate and PCa, bulk and single-cell RNA-Seq analyses revealed that estrogens partially mimic the androgen transcriptional response and induce specific biological pathways linked to proliferation and metabolism. Bioenergetic flux assays and metabolomics confirmed the regulation of cancer metabolism by estrogens, supporting proliferation. Using cancer cell lines and patient-derived organoids, selective estrogen receptor modulators, a pure anti-estrogen, and genetic approaches impaired cancer cell proliferation and growth in an ERα-dependent manner. Overall, our study revealed that, when expressed, ERα functionally reprograms PCa metabolism, is associated with disease progression, and could be targeted for therapeutic purposes.
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Affiliation(s)
- Camille Lafront
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | - Lucas Germain
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | | | - Cindy Weidmann
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Line Berthiaume
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Hélène Hovington
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Hervé Brisson
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Cynthia Jobin
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | | | - Raul Cotau
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Kevin Gonthier
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | - Aurélie Lacouture
- Department of Molecular Medicine, Université Laval, Québec City, Canada
| | - Patrick Caron
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Claire Ménard
- Department of Medicine, Université Laval, Québec City, Canada
| | - Chantal Atallah
- Department of Medicine, Université Laval, Québec City, Canada
| | - Julie Riopel
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Éva Latulippe
- Department of Pathology, CHU de Québec-Université Laval, Québec City, Canada
| | - Alain Bergeron
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Paul Toren
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Chantal Guillemette
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
| | - Martin Pelletier
- Department of Microbiology-Infectious Diseases and Immunology, Université Laval, Québec City, Canada
| | - Yves Fradet
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Clémence Belleannée
- Department of Obstetrics, Gynecology, and Reproduction, Université Laval, Québec City, Canada
| | - Frédéric Pouliot
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Louis Lacombe
- Cancer Research Center (CRC) of Université Laval, Québec City, Canada
| | - Éric Lévesque
- Endocrinology and Nephrology Division, CHU de Québec-Université Laval Research Center, Québec City, Canada
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28
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Wolf MM, Madden MZ, Arner EN, Bader JE, Ye X, Vlach L, Tigue ML, Landis MD, Jonker PB, Hatem Z, Steiner KK, Gaines DK, Reinfeld BI, Hathaway ES, Xin F, Tantawy MN, Haake SM, Jonasch E, Muir A, Weiss VL, Beckermann KE, Rathmell WK, Rathmell JC. VHL loss reprograms the immune landscape to promote an inflammatory myeloid microenvironment in renal tumorigenesis. J Clin Invest 2024; 134:e173934. [PMID: 38618956 PMCID: PMC11014672 DOI: 10.1172/jci173934] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/24/2024] [Indexed: 04/16/2024] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) is characterized by dysregulated hypoxia signaling and a tumor microenvironment (TME) highly enriched in myeloid and lymphoid cells. Loss of the von Hippel Lindau (VHL) gene is a critical early event in ccRCC pathogenesis and promotes stabilization of HIF. Whether VHL loss in cancer cells affects immune cells in the TME remains unclear. Using Vhl WT and Vhl-KO in vivo murine kidney cancer Renca models, we found that Vhl-KO tumors were more infiltrated by immune cells. Tumor-associated macrophages (TAMs) from Vhl-deficient tumors demonstrated enhanced in vivo glucose consumption, phagocytosis, and inflammatory transcriptional signatures, whereas lymphocytes from Vhl-KO tumors showed reduced activation and a lower response to anti-programmed cell death 1 (anti-PD-1) therapy in vivo. The chemokine CX3CL1 was highly expressed in human ccRCC tumors and was associated with Vhl deficiency. Deletion of Cx3cl1 in cancer cells decreased myeloid cell infiltration associated with Vhl loss to provide a mechanism by which Vhl loss may have contributed to the altered immune landscape. Here, we identify cancer cell-specific genetic features that drove environmental reprogramming and shaped the tumor immune landscape, with therapeutic implications for the treatment of ccRCC.
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Affiliation(s)
- Melissa M. Wolf
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Graduate Program in Cancer Biology and
| | - Matthew Z. Madden
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Medical Scientist Training Program, Vanderbilt University, Nashville, Tennessee, USA
| | - Emily N. Arner
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
| | - Jackie E. Bader
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
| | - Xiang Ye
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
| | - Logan Vlach
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Graduate Program in Cancer Biology and
| | - Megan L. Tigue
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Graduate Program in Cancer Biology and
- Medical Scientist Training Program, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Patrick B. Jonker
- Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois, USA
| | - Zaid Hatem
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
| | - KayLee K. Steiner
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Graduate Program in Cancer Biology and
| | - Dakim K. Gaines
- Department of Radiation Oncology
- Vanderbilt-Ingram Cancer Center
| | - Bradley I. Reinfeld
- Graduate Program in Cancer Biology and
- Medical Scientist Training Program, Vanderbilt University, Nashville, Tennessee, USA
- Department of Medicine, VUMC, Nashville, Tennessee, USA
| | - Emma S. Hathaway
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Graduate Program in Cancer Biology and
| | - Fuxue Xin
- Department of Radiology and Radiological Sciences, and
- Vanderbilt University Institute of Imaging Science, VUMC, Nashville, Tennessee, USA
| | - M. Noor Tantawy
- Department of Radiology and Radiological Sciences, and
- Vanderbilt University Institute of Imaging Science, VUMC, Nashville, Tennessee, USA
| | - Scott M. Haake
- Department of Medicine, VUMC, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center
| | - Eric Jonasch
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alexander Muir
- Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois, USA
| | - Vivian L. Weiss
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Vanderbilt-Ingram Cancer Center
| | - Kathryn E. Beckermann
- Department of Medicine, VUMC, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center
| | - W. Kimryn Rathmell
- Department of Medicine, VUMC, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center
- Vanderbilt Center for Immunobiology, VUMC, Nashville, Tennessee, USA
| | - Jeffrey C. Rathmell
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville (VUMC), Tennessee, USA
- Vanderbilt-Ingram Cancer Center
- Vanderbilt Center for Immunobiology, VUMC, Nashville, Tennessee, USA
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29
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Gao P, Zhang W. Adaptive sequential design for phase II single-arm oncology trials: an expansion of Simon's design. J Biopharm Stat 2024:1-15. [PMID: 38619921 DOI: 10.1080/10543406.2024.2341673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
Single-arm phase II trials are very common in oncology. A fixed sample trial may lack sufficient power if the true efficacy is less than the assumed one. Adaptive designs have been proposed in the literature. We propose a Simon's design based, adaptive sequential design. Simon's design is the most used fixed sample design for single-arm phase II oncology trials. A prominent feature of Simon's design is that it minimizes the sample size when there is no clinically meaningful efficacy. We identify Simon's trial as a special group sequential design. Established methods for sample size re-estimation (SSR) can be readily applied to Simon's design. Simulations show that simply adding SSR to Simon's design may still not provide desirable power. We propose some expansions to Simon's design. The expanded design with SSR can provide even more power.
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Affiliation(s)
- Ping Gao
- Biostatistics, Innovatio Statistics, Inc, Bridgewater, New Jersey, USA
| | - Weidong Zhang
- Biostatistics, Sana Biotechnology, Inc. Cambridge, Massachusetts, USA
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30
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Zhang C, Yu M, Hepperla AJ, Zhang Z, Raj R, Zhong H, Zhou J, Hu L, Fang J, Liu H, Liang Q, Jia L, Liao C, Xi S, Simon JM, Xu K, Liu Z, Nam Y, Kapur P, Zhang Q. Von Hippel Lindau tumor suppressor controls m6A-dependent gene expression in renal tumorigenesis. J Clin Invest 2024; 134:e175703. [PMID: 38618952 PMCID: PMC11014668 DOI: 10.1172/jci175703] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/01/2024] [Indexed: 04/16/2024] Open
Abstract
N6-Methyladenosine (m6A) is the most abundant posttranscriptional modification, and its contribution to cancer evolution has recently been appreciated. Renal cancer is the most common adult genitourinary cancer, approximately 85% of which is accounted for by the clear cell renal cell carcinoma (ccRCC) subtype characterized by VHL loss. However, it is unclear whether VHL loss in ccRCC affects m6A patterns. In this study, we demonstrate that VHL binds and promotes METTL3/METTL14 complex formation while VHL depletion suppresses m6A modification, which is distinctive from its canonical E3 ligase role. m6A RNA immunoprecipitation sequencing (RIP-Seq) coupled with RNA-Seq allows us to identify a selection of genes whose expression may be regulated by VHL-m6A signaling. Specifically, PIK3R3 is identified to be a critical gene whose mRNA stability is regulated by VHL in a m6A-dependent but HIF-independent manner. Functionally, PIK3R3 depletion promotes renal cancer cell growth and orthotopic tumor growth while its overexpression leads to decreased tumorigenesis. Mechanistically, the VHL-m6A-regulated PIK3R3 suppresses tumor growth by restraining PI3K/AKT activity. Taken together, we propose a mechanism by which VHL regulates m6A through modulation of METTL3/METTL14 complex formation, thereby promoting PIK3R3 mRNA stability and protein levels that are critical for regulating ccRCC tumorigenesis.
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Affiliation(s)
- Cheng Zhang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Miaomiao Yu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Austin J. Hepperla
- Lineberger Comprehensive Cancer Center, University of North Carolina (UNC) School of Medicine, Chapel Hill, North Carolina, USA
- Department of Genetics, Neuroscience Center and
- UNC Neuroscience Center, Carolina Institute for Developmental Disabilities, UNC, Chapel Hill, North Carolina, USA
| | - Zhao Zhang
- Department of Molecular Medicine, Mays Cancer Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Rishi Raj
- Department of Biochemistry, Department of Biophysics, Simmons Comprehensive Cancer Center and
| | - Hua Zhong
- Department of Pathology, Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jin Zhou
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Lianxin Hu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jun Fang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hongyi Liu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Qian Liang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Liwei Jia
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chengheng Liao
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sichuan Xi
- Thoracic Epigenetics Section, Thoracic Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeremy M. Simon
- Lineberger Comprehensive Cancer Center, University of North Carolina (UNC) School of Medicine, Chapel Hill, North Carolina, USA
- Department of Genetics, Neuroscience Center and
- UNC Neuroscience Center, Carolina Institute for Developmental Disabilities, UNC, Chapel Hill, North Carolina, USA
| | - Kexin Xu
- Department of Molecular Medicine, Mays Cancer Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Zhijie Liu
- Department of Molecular Medicine, Mays Cancer Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Yunsun Nam
- Department of Biochemistry, Department of Biophysics, Simmons Comprehensive Cancer Center and
| | - Payal Kapur
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, Department of Urology
| | - Qing Zhang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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31
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Lopes SR, Martins C, Santos IC, Teixeira M, Gamito É, Alves AL. Colorectal cancer screening: A review of current knowledge and progress in research. World J Gastrointest Oncol 2024; 16:1119-1133. [DOI: 10.4251/wjgo.v16.i4.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/16/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide, being the third most commonly diagnosed malignancy and the second leading cause of cancer-related deaths globally. Despite the progress in screening, early diagnosis, and treatment, approximately 20%-25% of CRC patients still present with metastatic disease at the time of their initial diagnosis. Furthermore, the burden of disease is still expected to increase, especially in individuals younger than 50 years old, among whom early-onset CRC incidence has been increasing. Screening and early detection are pivotal to improve CRC-related outcomes. It is well established that CRC screening not only reduces incidence, but also decreases deaths from CRC. Diverse screening strategies have proven effective in decreasing both CRC incidence and mortality, though variations in efficacy have been reported across the literature. However, uncertainties persist regarding the optimal screening method, age intervals and periodicity. Moreover, adherence to CRC screening remains globally low. In recent years, emerging technologies, notably artificial intelligence, and non-invasive biomarkers, have been developed to overcome these barriers. However, controversy exists over the actual impact of some of the new discoveries on CRC-related outcomes and how to effectively integrate them into daily practice. In this review, we aim to cover the current evidence surrounding CRC screening. We will further critically assess novel approaches under investigation, in an effort to differentiate promising innovations from mere novelties.
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Affiliation(s)
- Sara Ramos Lopes
- Department of Gastroenterology, Centro Hospitalar de Setúbal, Setúbal 2910-446, Portugal
| | - Claudio Martins
- Department of Gastroenterology, Centro Hospitalar de Setúbal, Setúbal 2910-446, Portugal
| | - Inês Costa Santos
- Department of Gastroenterology, Centro Hospitalar de Setúbal, Setúbal 2910-446, Portugal
| | - Madalena Teixeira
- Department of Gastroenterology, Centro Hospitalar de Setúbal, Setúbal 2910-446, Portugal
| | - Élia Gamito
- Department of Gastroenterology, Centro Hospitalar de Setúbal, Setúbal 2910-446, Portugal
| | - Ana Luisa Alves
- Department of Gastroenterology, Centro Hospitalar de Setúbal, Setúbal 2910-446, Portugal
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32
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Vencill JA, Kirsch JL, McPherson K, Sprankle E, Patten CA, Campana K, Brockman T, Bronars C, Hughes C, Gastineau D, Ehlers SL. Prospective Association of Psychological Distress and Sexual Quality of Life Among Hematopoietic Stem Cell Transplant Survivors. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10013-9. [PMID: 38615280 DOI: 10.1007/s10880-024-10013-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/15/2024]
Abstract
Sexual health concerns are one of the most common late effects facing hematopoietic stem cell transplant (HSCT) survivors. The current study tested whether self-reported depression and anxiety symptoms before transplant were associated with embedded items assessing two specific areas of sexual health-sexual interest and sexual satisfaction-one year post-HSCT. Of the 158 study participants, 41% were diagnosed with a plasma cell disorder (n = 60) and most received autologous transplantation (n = 128; 81%). At post-HSCT, 21% of participants reported they were not at all satisfied with their sex life, and 22% were not at all interested in sex. Greater pre-HSCT depressive symptomology was significantly predictive of lower sexual interest (β = -.27, p < .001) and satisfaction (β = -.39, p < .001) at post-HSCT. Similarly, greater pre-HSCT trait anxiety was significantly predictive of lower sexual interest (β = -.19, p = .02) whereas higher levels of state and trait anxiety were both predictive of lower satisfaction (β = -.22, p = .02 and β = -.29, p = .001, respectively). Participant sex significantly moderated the relationship between state anxiety and sexual satisfaction (b = -.05, t = -2.03, p = .04). Additional research examining the factors that contribute to sexual health post-HCST is needed to inform and implement clinical interventions to address these commonly overlooked survivorship concerns.
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Affiliation(s)
- Jennifer A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Janae L Kirsch
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Keagan McPherson
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
- Minnesota State University, Mankato, MN, USA
| | | | - Christi A Patten
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | | | - Tabetha Brockman
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Carrie Bronars
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Christine Hughes
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Dennis Gastineau
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Shawna L Ehlers
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA.
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33
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Miaris N, Kasinos N. The role of cardiovascular magnetic resonance in cancer therapy-related cardiotoxicity. Int J Cardiovasc Imaging 2024:10.1007/s10554-024-03090-2. [PMID: 38613606 DOI: 10.1007/s10554-024-03090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 03/21/2024] [Indexed: 04/15/2024]
Affiliation(s)
- Nikolaos Miaris
- Imaging Department, Harefield Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, Harefield, UK.
- 'Dimitrios Belntekos' Department of Echocardiography Training, 'Tzaneio' General Hospital of Piraeus, Piraeus, Greece.
| | - Nearchos Kasinos
- 'Dimitrios Belntekos' Department of Echocardiography Training, 'Tzaneio' General Hospital of Piraeus, Piraeus, Greece
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34
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Van Hecke A, Decoene E, Courtens A, Coolbrandt A, Decadt I, Pape E. The Role of Researcher for Advanced Practice Nurses in Oncology: Challenges and Lessons Learned. Semin Oncol Nurs 2024:151634. [PMID: 38604927 DOI: 10.1016/j.soncn.2024.151634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES To reflect on current practice analyses regarding the role of advanced practice nurse (APN) researcher in oncology, and report on the challenges that were faced and lessons we have learned when intensively working with APNs on doing research within the domain of oncology. METHODS Discussions with APNs supervised by or who collaborated with academics in nursing science during the past 10 years on doing research within the domain of oncology. RESULTS Several misconceptions exist regarding the role of APNs as researchers. During the research process, APNs are confronted with a wide range of topics based on evidence gaps and unmet needs, challenges linked to specific research designs, and ethical issues. APNs also face challenges related to the dissemination of research. This step in the research process is often overlooked due to APNs' lack of time, limited financial resources, insufficient support for academic writing, or lower priority for APNs and other healthcare providers. CONCLUSION The APN role of researcher in oncology is fundamental for the advancement of oncology nursing care, implementation of evidence-based practice and innovations in oncology patient care, and further development of the nursing profession and nursing science. Participation in research is considered a main function that differentiates APNs from nurses in other clinical roles, such as specialized nurses. By embracing the role of researcher, oncology APNs can achieve professional growth that will stimulate them as an APN, open new opportunities, and keep them challenged. IMPLICATIONS FOR NURSING PRACTICE In addition to APN, organizational and structural related factors, support by relevant stakeholders, partnering with (nursing) research units and professional and patient organizations, and dedicated time for research can positively influence uptake of the APN researcher role.
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Affiliation(s)
- Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care - University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff member Center of Expertise in Nursing, Ghent University Hospital, Ghent, Belgium.
| | - Elsie Decoene
- Staff member Center of Expertise in Nursing, Ghent University Hospital, Ghent, Belgium
| | - Annelies Courtens
- Advanced Practice Nurse in Oncology, AZ Groeninge Hospital, Kortrijk, Belgium
| | - Annemarie Coolbrandt
- Advanced Practice Nurse in Oncology, University Hospitals Leuven, Leuven, Belgium; Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Ine Decadt
- Advanced Practice Nurse in Oncology, AZ Groeninge Hospital, Kortrijk, Belgium
| | - Eva Pape
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care - University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium; Advanced Practice Nurse Digestive Oncology, Ghent University Hospital, Ghent, Belgium
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35
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Bernal D, Nugent K, Abdelnabi M. Atypical chest pain and haemoptysis as the initial presentation of spindle rhabdomyosarcoma in elderly smoker man. BMJ Case Rep 2024; 17:e260472. [PMID: 38589242 PMCID: PMC11015322 DOI: 10.1136/bcr-2024-260472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
- Diego Bernal
- Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Kenneth Nugent
- Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Mahmoud Abdelnabi
- Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Berg T, Jensen MB, Celik A, Talman ML, Misiakou MA, Knoop AS, Nielsen FC, Ejlertsen B, Rossing M. Molecular subtyping improves breast cancer diagnosis in the Copenhagen Breast Cancer Genomics Study. JCI Insight 2024; 9:e178114. [PMID: 38587073 DOI: 10.1172/jci.insight.178114] [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: 11/30/2023] [Accepted: 02/16/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUNDIntrinsic molecular subtypes define distinct biological breast cancers and can be used to further improve diagnosis and risk allocation.METHODSThe Copenhagen Breast Cancer Genomics Study (CBCGS) prospectively included women diagnosed with breast cancer at Rigshospitalet from 2014 to 2021. Eligible patients were females with a primary invasive breast cancer (T1c, if N0M0; otherwise, any T, any N, or any M stage) and no prior malignancy. All patients underwent molecular profiling with the CIT256 and PAM50 molecular profile.RESULTSIn the study period, 2,816 patients were included in the CBCGS. Molecular subtyping showed an increase in nonluminal (molecular-apocrine, luminal C, and Basal-like) as compared with luminal (luminal A, luminal B, and Normal-like) subtypes with increasing stage from I to IV. Across all stages, we found a significant difference in survival among subtypes; 91% of patients with LumA were alive at 5 years compared with 91% for LumB, 84% for LumC, 82% for mApo, and 80% for Basal-like. We identified 442 tumors (16%) that were discordant in subtype between CIT256 and IHC. Discordant subtype proved to be a risk factor of death among patients with IHC luminal breast cancer (hazard ratio [HR], 2.08; 95% CI, 1.51-2.86) in a multivariable Cox regression analysis. Discordance occurred more often among patients with N3, stage IV, or grade III disease.CONCLUSIONOur findings indicate that molecular subtypes are a predominant classification for survival. Assessment is particularly crucial for patients with IHC luminal breast cancer with known high-risk factors, since they are at an increased risk of harboring an aggressive molecular subtype.
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Affiliation(s)
- Tobias Berg
- Danish Breast Cancer Group
- Department of Clinical Oncology
- Center for Genomic Medicine, and
| | | | | | - Maj-Lis Talman
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Finn Cilius Nielsen
- Center for Genomic Medicine, and
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bent Ejlertsen
- Danish Breast Cancer Group
- Department of Clinical Oncology
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maria Rossing
- Center for Genomic Medicine, and
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Mao Z, Dong S, Yan Y, Wang C, Li W, Wang L, Qian C, Song Y, Tong L, Yu W. Diagnosis of malignant body fluids via cancer-universal methylation in cell-free DNA. JCI Insight 2024; 9:e175482. [PMID: 38587071 DOI: 10.1172/jci.insight.175482] [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: 09/07/2023] [Accepted: 02/14/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUNDDifferentiating malignant from nonmalignant body fluids remains a clinical challenge because of the unsatisfying performance of conventional cytology. We aimed to improve the sensitivity and ubiquity of cancer cell detection by assaying universal cancer-only methylation (UCOM) markers in supernatant cell-free DNA (cfDNA).METHODSAn observational prospective cohort including 1,321 nonmalignant and malignant body fluids of multiple cancers was used to develop and validate a cfDNA UCOM methylation diagnostic assay. All samples were divided into 2 portions for cytology and supernatant cfDNA methylation analysis.RESULTSThe significant hypermethylation of a potentially novel UCOM marker, TAGMe, together with the formerly reported PCDHGB7, was identified in the cfDNA of malignant body fluid samples. The combined model, cell-free cancer-universal methylation (CUE), was developed and validated in a prospective multicancer cohort with markedly elevated sensitivity and specificity, and was further verified in a set containing additional types of malignant body fluids and metastases. In addition, it remained hypersensitive in detecting cancer cells in cytologically negative malignant samples.CONCLUSIONcfDNA methylation markers are robust in detecting tumor cells and are applicable to diverse body fluids and tumor types, providing a feasible complement to current cytology-based diagnostic analyses.TRIAL REGISTRATIONThis study was registered at Chictr.org.cn (ChiCTR2200060532).FUNDINGNational Natural Science Foundation of China (32270645, 31872814, 32000505, 82170088), the National Key R&D Program of Ningxia Hui Autonomous region (2022BEG01003), Shanghai Municipal Key Clinical Specialty (shslczdzk02201), Science and Technology Commission of Shanghai Municipality (20DZ2261200, 20DZ2254400), and Major Special Projects of Basic Research of Shanghai Science and Technology Commission (18JC1411101).
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Affiliation(s)
- Zhanrui Mao
- Institutes of Biomedical Sciences, Shanghai Public Health Clinical Center, Cancer Metastasis Institute, and Department of General Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shihua Dong
- Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai, China
| | - Yu Yan
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chengyang Wang
- Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai, China
| | - Wei Li
- Institutes of Biomedical Sciences, Shanghai Public Health Clinical Center, Cancer Metastasis Institute, and Department of General Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lu Wang
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chengchen Qian
- Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai, China
| | - Yuanlin Song
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Respiratory Research Institute, Shanghai, China
| | - Lin Tong
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Respiratory Research Institute, Shanghai, China
| | - Wenqiang Yu
- Institutes of Biomedical Sciences, Shanghai Public Health Clinical Center, Cancer Metastasis Institute, and Department of General Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Colomer-Lahiguera S, Gentizon J, Christofis M, Darnac C, Serena A, Eicher M. Achieving Comprehensive, Patient-Centered Cancer Services: Optimizing the Role of Advanced Practice Nurses at the Core of Precision Health. Semin Oncol Nurs 2024:151629. [PMID: 38584046 DOI: 10.1016/j.soncn.2024.151629] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES The field of oncology has been revolutionized by precision medicine, driven by advancements in molecular and genomic profiling. High-throughput genomic sequencing and non-invasive diagnostic methods have deepened our understanding of cancer biology, leading to personalized treatment approaches. Precision health expands on precision medicine, emphasizing holistic healthcare, integrating molecular profiling and genomics, physiology, behavioral, and social and environmental factors. Precision health encompasses traditional and emerging data, including electronic health records, patient-generated health data, and artificial intelligence-based health technologies. This article aims to explore the opportunities and challenges faced by advanced practice nurses (APNs) within the precision health paradigm. METHODS We searched for peer-reviewed and professional relevant studies and articles on advanced practice nursing, oncology, precision medicine and precision health, and symptom science. RESULTS APNs' roles and competencies align with the core principles of precision health, allowing for personalized interventions based on comprehensive patient characteristics. We identified educational needs and policy gaps as limitations faced by APNs in fully embracing precision health. CONCLUSION APNs, including nurse practitioners and clinical nurse specialists, are ideally positioned to advance precision health. Nevertheless, it is imperative to overcome a series of barriers to fully leverage APNs' potential in this context. IMPLICATIONS FOR NURSING PRACTICE APNs can significantly contribute to precision health through their competencies in predictive, preventive, and health promotion strategies, personalized and collaborative care plans, ethical considerations, and interdisciplinary collaboration. However, there is a need to foster education in genetics and genomics, encourage continuous professional development, and enhance understanding of artificial intelligence-related technologies and digital health. Furthermore, APNs' scope of practice needs to be reflected in policy making and legislation to enable effective contribution of APNs to precision health.
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Affiliation(s)
- Sara Colomer-Lahiguera
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland.
| | - Jenny Gentizon
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Melissa Christofis
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Célia Darnac
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Andrea Serena
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
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Cranstoun D, Baliousis M, Merdian HL, Rennoldson M. Nurse-led psychological interventions for depression in adult cancer patients: A systematic review and meta-analysis of Randomised Controlled Trials. J Pain Symptom Manage 2024:S0885-3924(24)00706-1. [PMID: 38583500 DOI: 10.1016/j.jpainsymman.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES Depression, frequently associated with cancer, significantly impacts health outcomes, necessitating effective treatments. This systematic review and meta-analysis aim to synthesise and critically evaluate the evidence from Randomised Controlled Trials (RCTs) for the efficacy of nurse-led psychological interventions in managing depression among adult cancer patients. It focuses on the unique contribution of these interventions to improving depression management in oncology care, an underrepresented area in the existing literature. METHODS We conducted a comprehensive search in databases including Scopus, Medline, CINAHL, and PsycINFO, applying strict criteria to select RCTs assessing nurse-led psychological interventions for depression in cancer patients. We used the Cochrane Risk of Bias 2 tool to assess study quality. RESULTS Out of 425 screened abstracts, nine papers describing seven distinct interventions involving 1,463 participants were selected. The overall effect size estimate of -0.75 (95% confidence interval: -1.23 to -0.27) indicates significant effectiveness of these interventions in reducing depression compared to treatment as usual. Additionally, the calculated prediction interval highlights the variability in effectiveness across different settings, suggesting that contextual factors play a crucial role in the success of these interventions. CONCLUSION The findings advocate for the integration of nurse-led psychological interventions into standard cancer care, highlighting their efficacy in improving depressive symptoms in adult cancer patients. These interventions show promise but require further refinement and research to optimise their effectiveness across diverse patient groups and healthcare settings. This review underscores the potential of nurse-led psychological interventions in enriching oncology care and addresses a critical gap in the existing body of research.
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Nofi CP, Roberts BK, Kallis MP, Koo D, Glick RD, Rich BS. Management of Persistent Low-Suspicion Cervical Lymphadenopathy in Pediatric Patients. J Surg Res 2024; 298:71-80. [PMID: 38581765 DOI: 10.1016/j.jss.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/25/2024] [Accepted: 03/12/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Cervical lymphadenopathy in children is typically self-limited; however, the management of persistent lymphadenopathy remains unclear. This study aimed to evaluate the management and outcomes of patients with persistent cervical lymphadenopathy. METHODS Single-institution, retrospective review of children <18 years undergoing ultrasound (US) for cervical lymphadenopathy from 2013 to 2021 was performed. Patients were stratified into initial biopsy, delayed biopsy, or no biopsy groups. Clinical characteristics and workup were compared, and multivariate analyses were performed to assess predictors of delayed biopsy. RESULTS 568 patients were identified, with 493 patients having no biopsy, 41 patients undergoing initial biopsy, and 34 patients undergoing delayed biopsy. Presenting symptoms differed: no biopsy patients were younger, were more likely to present to the emergency department, and had clinical findings often associated with acute illness. Patients with USs revealing abnormal vascularity or atypical architecture were more likely to be biopsied. History of malignancy, symptoms >1 week but <3 months, and atypical or change in architecture on US was associated with delayed biopsy. Patients with long-term follow-up (LTF) were followed for a median of 99.0 days. Malignancies were identified in 12 patients (2.1%). All malignancies were diagnosed within 14 days of presentation, and no malignancies were identified in LTF. CONCLUSIONS Patients with persistent low suspicion lymphadenopathy are often followed for long durations; however, in this cohort, no malignancies were diagnosed during LTF. We propose an algorithm of forgoing a biopsy and employing primary care surveillance and education, which may be appropriate for these patients in the proper setting.
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Affiliation(s)
- Colleen P Nofi
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York; Division of Pediatric Surgery, Cohen Children's Medical Center at Hofstra/Northwell, Queens, New York
| | - Bailey K Roberts
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York; Division of Pediatric Surgery, Cohen Children's Medical Center at Hofstra/Northwell, Queens, New York
| | - Michelle P Kallis
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York; Division of Pediatric Surgery, Cohen Children's Medical Center at Hofstra/Northwell, Queens, New York
| | - Donna Koo
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York
| | - Richard D Glick
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York; Division of Pediatric Surgery, Cohen Children's Medical Center at Hofstra/Northwell, Queens, New York
| | - Barrie S Rich
- Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York; Division of Pediatric Surgery, Cohen Children's Medical Center at Hofstra/Northwell, Queens, New York.
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Hench J, Hultschig C, Brugger J, Mariani L, Guzman R, Soleman J, Leu S, Benton M, Stec IM, Hench IB, Hoffmann P, Harter P, Weber KJ, Albers A, Thomas C, Hasselblatt M, Schüller U, Restelli L, Capper D, Hewer E, Diebold J, Kolenc D, Schneider UC, Rushing E, Della Monica R, Chiariotti L, Sill M, Schrimpf D, von Deimling A, Sahm F, Kölsche C, Tolnay M, Frank S. EpiDiP/NanoDiP: a versatile unsupervised machine learning edge computing platform for epigenomic tumour diagnostics. Acta Neuropathol Commun 2024; 12:51. [PMID: 38576030 PMCID: PMC10993614 DOI: 10.1186/s40478-024-01759-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
DNA methylation analysis based on supervised machine learning algorithms with static reference data, allowing diagnostic tumour typing with unprecedented precision, has quickly become a new standard of care. Whereas genome-wide diagnostic methylation profiling is mostly performed on microarrays, an increasing number of institutions additionally employ nanopore sequencing as a faster alternative. In addition, methylation-specific parallel sequencing can generate methylation and genomic copy number data. Given these diverse approaches to methylation profiling, to date, there is no single tool that allows (1) classification and interpretation of microarray, nanopore and parallel sequencing data, (2) direct control of nanopore sequencers, and (3) the integration of microarray-based methylation reference data. Furthermore, no software capable of entirely running in routine diagnostic laboratory environments lacking high-performance computing and network infrastructure exists. To overcome these shortcomings, we present EpiDiP/NanoDiP as an open-source DNA methylation and copy number profiling suite, which has been benchmarked against an established supervised machine learning approach using in-house routine diagnostics data obtained between 2019 and 2021. Running locally on portable, cost- and energy-saving system-on-chip as well as gpGPU-augmented edge computing devices, NanoDiP works in offline mode, ensuring data privacy. It does not require the rigid training data annotation of supervised approaches. Furthermore, NanoDiP is the core of our public, free-of-charge EpiDiP web service which enables comparative methylation data analysis against an extensive reference data collection. We envision this versatile platform as a useful resource not only for neuropathologists and surgical pathologists but also for the tumour epigenetics research community. In daily diagnostic routine, analysis of native, unfixed biopsies by NanoDiP delivers molecular tumour classification in an intraoperative time frame.
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Affiliation(s)
- Jürgen Hench
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland.
| | - Claus Hultschig
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland
| | - Jon Brugger
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland
| | - Luigi Mariani
- Klinik für Neurochirurgie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Raphael Guzman
- Klinik für Neurochirurgie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Jehuda Soleman
- Klinik für Neurochirurgie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Severina Leu
- Klinik für Neurochirurgie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Miles Benton
- Human Genomics, Institute of Environmental Science and Research (ESR), 5022, Porirua, Wellington, New Zealand
| | - Irenäus Maria Stec
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland
| | - Ivana Bratic Hench
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland
| | - Per Hoffmann
- Life&Brain GmbH, Venusberg-Campus 1, Gebäude 76, 53127, Bonn, Germany
| | - Patrick Harter
- Institute of Neuropathology, Center for Neuropathology and Prion Research, Feodor- Lynen-Str. 23, 81377, München, Germany
| | - Katharina J Weber
- Neurological Institute (Edinger Institute), University Hospital, Heinrich-Hoffmann- Straße 7, 60528, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Anne Albers
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
| | - Christian Thomas
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
| | - Ulrich Schüller
- Forschungsinstitut Kinderkrebszentrum, Martinistrasse 52, 20251, Hamburg, Germany
- Department of Pediatric Hematology and Oncology, University Hospital Hamburg- Eppendorf, Hamburg, Germany
- Institute of Neuropathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
- Department of Neuropathology, Department of Neuropathology, Charité- Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Lisa Restelli
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland
| | - David Capper
- , 15. Luzerner Kantonsspital, Pathologie, Haus 27, 6000, Spitalstrasse, Luzern 16, Switzerland
| | - Ekkehard Hewer
- Institut universitaire de pathologie, Lausanne University Hospital (CHUV), University of Lausanne, Rue du Bugnon 25, 1011, Lausanne, Switzerland
| | - Joachim Diebold
- , 15. Luzerner Kantonsspital, Pathologie, Haus 27, 6000, Spitalstrasse, Luzern 16, Switzerland
| | - Danijela Kolenc
- , 15. Luzerner Kantonsspital, Pathologie, Haus 27, 6000, Spitalstrasse, Luzern 16, Switzerland
| | - Ulf C Schneider
- Klinik für Neurochirurgie, Luzerner Kantonsspital, Haus 31, 6000, 16, Spitalstrasse, Luzern, Switzerland
| | - Elisabeth Rushing
- , 15. Luzerner Kantonsspital, Pathologie, Haus 27, 6000, Spitalstrasse, Luzern 16, Switzerland
- Medica Pathologie Zentrum Zürich, Hottingerstrasse 9 / 11, 8032, Zürich, Switzerland
| | - Rosa Della Monica
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore, 486 - 80145, Napoli, Italy
| | - Lorenzo Chiariotti
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore, 486 - 80145, Napoli, Italy
| | - Martin Sill
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Consortium for Translational Cancer Research (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Daniel Schrimpf
- Department of Neuropathology, Institute of Neuropathology, University Hospital Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Institute of Neuropathology, University Hospital Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Institute of Neuropathology, University Hospital Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- CCU Neuropathology, German Consortium for Translational Cancer Research (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- , 23. DKFZ, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Christian Kölsche
- Pathologisches Institut der LMU, Thalkirchner Str. 36, 80337, München, Germany
| | - Markus Tolnay
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland
| | - Stephan Frank
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstr. 40, 4031, Basel, Switzerland.
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Almeida AM, Lima L, Martins T. Understanding quality of life's challenges in sarcoma patients: A mixed-methods study. Eur J Oncol Nurs 2024; 70:102585. [PMID: 38631125 DOI: 10.1016/j.ejon.2024.102585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Sarcoma, a highly aggressive form of cancer, profoundly affects patients both physically and psychologically. This study aimed to assess sarcoma patients' health-related quality of life and explore their experiences of living with the disease and their specific care requirements. METHODS This research employed a convergent parallel mixed-methods design. Fifty-two sarcoma patients completed the European Portuguese version of the EORTC QLQ-C30 questionnaire, and seven of them participated in semi-structured interviews. Descriptive measures, Cronbach alpha for internal consistency, t-teste-Anova and stepwise regression were employed in the quantitative analysis. Qualitative data was analysed thematically. RESULTS The most affected Quality of life (QoL) dimensions were role functioning and global health, areas of functioning that were also described as impacted in patients' experiences. Symptoms like insomnia, pain, and fatigue were frequently reported. Symptoms such as fatigue, pain, and financial difficulty explain QoL variance. No significant differences in QoL were found according to the different forms of treatment. Analysis of the interviews revealed three overarching themes: (1) disruption of daily life, (2) adaptation to life with sarcoma, and (3) the demand for more personalized care, allowing to gain a deeper understanding of living with sarcoma. CONCLUSION The results underscore the significance of delivering care that enhances the quality of life for sarcoma patients, addressing both their physical and psychosocial needs, and providing personalized support throughout all stages of the disease.
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Affiliation(s)
- Ana Maria Almeida
- ICBAS/UP - Institute for the Biomedical Sciences Abel Salazar / Porto University, Porto, Portugal; Francisco Gentil Portuguese Institute for Oncology of Porto, Portugal.
| | - Lígia Lima
- Nursing School of Porto, Porto, Portugal; CINTESIS@RISE, Portugal
| | - Teresa Martins
- Nursing School of Porto, Porto, Portugal; CINTESIS@RISE, Portugal
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Bahadur A, Mundhra R, Gill P, Singh A. Aggressive precursor B cell ALL of cervix with obstructive uropathy. BMJ Case Rep 2024; 17:e258313. [PMID: 38569729 PMCID: PMC10989100 DOI: 10.1136/bcr-2023-258313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Involvement of the cervix with acute lymphoblastic leukaemia (ALL) is extremely rare. In this case report, we discuss an unmarried woman in her early 20s, who presented in the emergency with lower abdominal pain and irregular vaginal bleeding for 1 month. Clinical examination and imaging revealed a large cervical mass probably neoplastic with obstructive uropathy. On evaluation, she was diagnosed incidentally with CALLA-positive precursor B cell ALL in peripheral blood flow cytometry. Involvement of B cell ALL in cervical mass was confirmed by histopathological examination of cervical biopsy and immunohistochemistry markers. Her history was not suggestive of signs and symptoms pertaining to leukaemia. Literature is sparse with only a few cases reporting cervical leukaemic infiltration. The present case report is a rarest case where the primary/initial presentation of precursor B cell ALL was seen with cervical involvement and obstructive uropathy mimicking characteristics of advanced cervical malignancy.
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Affiliation(s)
- Anupama Bahadur
- Obstetrics and Gynaecology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
| | - Rajlaxmi Mundhra
- Obstetrics and Gynaecology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
| | - Poonam Gill
- Obstetrics and Gynaecology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
| | - Ashok Singh
- Pathology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
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Quiralte M, Barquín A, Yagüe Fernández M, Navarro P, Grazioso TP, Sevillano E, Rodriguez Moreno JF, Balarezo-Saldivar A, Peinado H, Izquierdo E, Millán C, López Carrasco I, Prieto M, Madurga de Lacalle R, Fernández-Miranda I, Ruiz-Llorente S, García-Donas J. Proteomic profiles of peritoneal-derived small extracellular vesicles correlate with outcome in ovarian cancer patients. J Clin Invest 2024:e176161. [PMID: 38564289 DOI: 10.1172/jci176161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Cancer-derived small extracellular vesicles (sEVs) are capable of modifying tumor microenvironment and promoting tumor progression. Ovarian cancer (OvCa) is a lethal malignancy that preferentially spreads through the abdominal cavity. Thus, the secretion of such vesicles into the peritoneal fluid could be a determinant factor in the dissemination and behavior of this disease. We designed a prospective observational study to assess the impact of peritoneal fluid-derived sEVs (PFD-sEVs) in OvCa clinical outcome. For this purpose, two patient cohorts were enrolled, including OvCa cases who underwent a diagnostic or cytoreductive surgery, and non-oncological patients as controls, who underwent abdominal surgery for benign gynecological conditions. PFD-sEVs systematic extraction from surgical samples enabled us to observe significant quantitative and qualitative differences associated with cancer diagnosis, disease stage and platinum chemosensitivity. Proteomic profiling of PFD-sEVs led to the identification of molecular pathways and proteins of interest and to the biological validation of S100A4 and STX5. In addition, unsupervised analysis of PFD-sEVs proteomic profiles in high-grade serous ovarian carcinomas (HGSOC) revealed two clusters with different outcomes in terms of overall survival. In conclusion, comprehensive characterization of the PFD-sEVs content provided a prognostic value with potential implications in HGSOC clinical management.
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Affiliation(s)
- Miguel Quiralte
- Laboratory of Innovation in Oncology, HM Sanchinarro University Hospital, Madrid, Spain
| | - Arantzazu Barquín
- Laboratory of Innovation in Oncology, HM Sanchinarro University Hospital, Madrid, Spain
| | | | - Paloma Navarro
- Laboratory of Innovation in Oncology, HM Sanchinarro University Hospital, Madrid, Spain
| | - Tatiana P Grazioso
- Laboratory of Innovation in Oncology, HM Sanchinarro University Hospital, Madrid, Spain
| | - Elena Sevillano
- Laboratory of Innovation in Oncology, HM Sanchinarro University Hospital, Madrid, Spain
| | | | | | - Héctor Peinado
- Microenvironment and Metastasis Laboratory, Molecular Oncology Program, Spanish National Cancer Research Centre, Madrid, Spain
| | - Elena Izquierdo
- Institute of Applied Molecular Medicine, Faculty of Medicine, CEU San Pablo University, Boadilla del Monte, Madrid, Spain
| | - Carlos Millán
- Gynecologic Unit, HM Montepríncipe University Hospital, Boadilla del Monte, Madrid, Spain
| | - Irene López Carrasco
- Gynecologic Unit, HM Montepríncipe University Hospital, Boadilla del Monte, Madrid, Spain
| | - Mario Prieto
- Department of Pathological Anatomy - Therapeutic Targets Laboratory, HM Sanchinarro University Hospital, Madrid, Spain
| | | | - Ismael Fernández-Miranda
- R&D Oncology Business Unit, Pharmacogenomic & Cell Biology Departments, Pharmamar, Colmenar Viejo, Spain
| | - Sergio Ruiz-Llorente
- Laboratory of Innovation in Oncology, HM Sanchinarro University Hospital, Madrid, Spain
| | - Jesús García-Donas
- Laboratory of Innovation in Oncology, HM Sanchinarro University Hospital, Madrid, Spain
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Hall MJ, D'Avanzo PA, Chertock Y, Kelly PJA, Brajuha J, Singley K, Luck CC, Bass SB. Oncologists' perceptions of tumor genomic profiling and barriers to communicating secondary hereditary risks to African American cancer patients. BMC Cancer 2024; 24:412. [PMID: 38566032 PMCID: PMC10988900 DOI: 10.1186/s12885-024-12184-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Tumor genomic profiling (TGP) identifies targets for precision cancer treatments, but also secondary hereditary risks. Oncologists are poorly trained to communicate the results of TGP, especially among patients with lower health literacy, poorer genetics knowledge, and higher mistrust. African American (AA) patients are especially vulnerable to poor understanding due to significant cancer disparities and lower uptake of TGP. The goal of this research is to inform the development of an internet-based brief educational support for oncologists to prepare them to provide better decisional support related to TGP for their AA cancer patients. METHODS This mixed-methods study used semi-structured interviews of oncologists to inform development of an online survey with a convenience sample of US-based oncologists (n = 50) to assess perceptions of the challenges of TGP and communicating results to AA patients. RESULTS Most interviewed oncologists felt it was important to consider racial/cultural differences when communicating about hereditary risks. Cost, family dynamics, discrimination concerns, and medical mistrust were identified as particularly salient. Survey respondents' views related to AAs and perceptions of TGP were strongly associated with years since completing training, with recent graduates expressing stronger agreement with statements identifying barriers/disadvantages to TGP for AA patients. CONCLUSIONS Oncologists who had more recently completed training expressed more negative perceptions of TGP and more perceived challenges in communicating about TGP with their AA patients. Focused training for oncologists that addresses barriers specific to AAs may be helpful in supporting improved communication about TGP and improved decisional support for AA patients with cancer considering TGP to evaluate their tumors.
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Affiliation(s)
- Michael J Hall
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA.
| | - Paul A D'Avanzo
- College of Public Health, Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Yana Chertock
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Patrick J A Kelly
- College of Public Health, Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Jesse Brajuha
- College of Public Health, Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Katie Singley
- College of Public Health, Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Caseem C Luck
- College of Public Health, Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Sarah B Bass
- College of Public Health, Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
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Yarlagadda S, Mandava A, Fonseca D, Koppula V. Mucoepidermoid Carcinoma of the Lung in Intralobar Bronchopulmonary Sequestration. Radiol Cardiothorac Imaging 2024; 6:e230365. [PMID: 38602467 DOI: 10.1148/ryct.230365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Sneha Yarlagadda
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Anitha Mandava
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Daphne Fonseca
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Veeraiah Koppula
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
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Ibrahim El-Sayed AA, Ramadan Asal MG, Farghaly Abdelaliem SM, Alsenany SA, Elsayed BK. The moderating role of just culture between nursing practice environment and oncology nurses' silent behaviors toward patient safety: A multicentered study. Eur J Oncol Nurs 2024; 69:102516. [PMID: 38402719 DOI: 10.1016/j.ejon.2024.102516] [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: 07/08/2023] [Revised: 01/10/2024] [Accepted: 01/24/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Patient safety is a critical part of healthcare delivery that must be prioritized to guarantee optimal patient outcomes. Oncology nursing is a specialized area of nursing that demands great focus on patient safety because of the high-risk nature of this patient group. Nurses play an important role in ensuring that patients receive safe and effective care. However, the nursing practice environment can have a substantial impact on how nurses respond to patient safety problems. A just culture can promote open communication and identify potential safety issues, whereas a culture of silence can have a negative impact on patient outcomes. OBJECTIVE Firstly, assess the relationship between the nursing practice environment and oncology nurses' silent behavior towards patient safety. Secondly, the interaction effect of just culture as a moderator in this relationship. METHOD A cross-sectional, correctional research design was employed. Data was collected from 303 nurses working at the oncology departments of five hospitals in Egypt using three questionnaires. Data was analyzed using SPSS-PROCESS Macro (v4.2). RESULTS There was a moderate, negative, and significant correlation between the nurse practice environment and silent behavior of nurses towards patient safety. The interaction effect of just culture with nurse practice environment strengthens this relationship, thus enhancing errors reporting. CONCLUSIONS This study emphasized on the importance of creating a just culture that facilitates open communication and eliminating the potential hazards result from nurses' silence. Thus, oncology nurses must be encouraged to report issues related to patient safety.
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Affiliation(s)
| | | | - Sally Mohammed Farghaly Abdelaliem
- Associate Professor of Nursing Management and Education Department, College of Nursing, Princess Nourah bint Abdulrahman University Riyadh, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Samira Ahmed Alsenany
- Associate Professor, Community Health Nursing Department, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Boshra Karem Elsayed
- Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
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Ke Y, Zhou H, Chan RJ, Chan A. Decision aids for cancer survivors' engagement with survivorship care services after primary treatment: a systematic review. J Cancer Surviv 2024; 18:288-317. [PMID: 35798994 PMCID: PMC10960885 DOI: 10.1007/s11764-022-01230-y] [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: 03/31/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To elucidate existing decision aids (DAs) in supporting cancer survivors' decisions to engage in cancer survivorship care services after primary treatment. Secondary objectives are to assess the DA acceptability, impact of DAs, and implementation barriers. METHODS Databases (PubMed, Embase, PsycINFO, CINAHL) were searched to collect publications from inception through September 2021. Studies describing the development or evaluation of DAs used for survivorship care services after primary cancer treatment were included. Article selection and critical appraisal were conducted independently by two authors. RESULTS We included 16 studies that described 13 DAs and addressed multiple survivorship care domains: prevention of recurrence/new cancers in Hodgkin lymphoma survivors and breast cancer gene mutation carriers, family building options, health insurance plans, health promotion (substance use behavior, cardiovascular disease risk reduction), advanced care planning, and post-treatment follow-up intensity. The electronic format was used to design most DAs for self-administration. The content presentation covered decisional context, options, and value clarification exercises. DAs were acceptable and associated with higher knowledge but presented inconclusive decisional outcomes. Implementation barriers included lack of design features for connectivity to care, low self-efficacy, and low perceived DA usefulness among healthcare professionals. Other survivor characteristics included age, literacy, preferred timing, and setting. CONCLUSIONS A diverse range of DAs exists in survivorship care services engagement with favorable knowledge outcomes. Future work should clarify the impact of DAs on decisional outcomes. IMPLICATIONS FOR CANCER SURVIVORS DA characterization and suggestions for prospective developers could enhance support for cancer survivors encountering complex decisions throughout the survivorship continuum.
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Affiliation(s)
- Yu Ke
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Hanzhang Zhou
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA5042, Australia
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, QLD, Australia
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California Irvine, Irvine, CA, USA.
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Feeney G, Waldron R, Miller N, Malone C, Sweeney K, McLaughlin R, Lowery A, Barry K, Kerin M. Association of clinical biomarkers and response to neoadjuvant therapy in breast cancer. Ir J Med Sci 2024; 193:605-613. [PMID: 37673801 PMCID: PMC10961274 DOI: 10.1007/s11845-023-03489-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Neoadjuvant therapy is an essential component of multimodality therapy for locally advanced breast adenocarcinoma (BC). Complete pathologic response (pCR) is a useful surrogate for long-term oncologic outcome. AIM To assess the association between clinicopathologic, molecular and immunological markers and treatment response to neoadjuvant therapy in BC. METHODS BC patients undergoing neoadjuvant therapy were identified from a prospectively maintained institutional database. Serum haematological/biochemical values, histopathologic, immunohistochemical data and TNM stage were obtained from electronic records. Patients were categorised into complete responders vs non-complete responders and responders vs non-responders. Statistical analysis was performed via SPSS. RESULTS Overall, 299 BC patients were included. The average age was 49.8 ± 11.5 years. A pCR was evident in 22.6% (n = 69). pCR was associated with early T stage and non-luminal subtypes (HER2 enriched [HER2 +] and triple negative [TNBC]). The neutrophil-lymphocyte ratio (NLR) pre-operatively was lower in patients with a pCR (p = 0.02). The lymphocyte-CRP ratio (LCR) was also slightly reduced in responders (p = 0.049) at diagnosis. A pre-op NLR greater than 2 was not found to be a significant predictive factor (p = 0.071) on multivariable logistic regression analysis. T stage at diagnosis (p = 0.024), N stage (p = 0.001) and breast cancer subtype (p = 0.0001) were also determined to be significant predictive factors of complete response. CONCLUSION pCR was more likely in patients with less advanced disease in BC. The presence of HER2 + or TNBC in BC also increases the likelihood of pCR. Neoadjuvant therapy stimulates the systemic inflammatory response; however, a reduced baseline NLR may be associated with increased pCR. Confirmation with larger datasets is required.
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Affiliation(s)
- Gerard Feeney
- Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
| | - Ronan Waldron
- Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - Nicola Miller
- Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - Carmel Malone
- Department of General Surgery, Galway University Hospital, Newcastle, Galway, Ireland
| | - Karl Sweeney
- Department of General Surgery, Galway University Hospital, Newcastle, Galway, Ireland
| | - Raymond McLaughlin
- Department of General Surgery, Galway University Hospital, Newcastle, Galway, Ireland
| | - Aoife Lowery
- Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
- Department of General Surgery, Galway University Hospital, Newcastle, Galway, Ireland
| | - Kevin Barry
- Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
- Department of General Surgery, Galway University Hospital, Newcastle, Galway, Ireland
| | - Michael Kerin
- Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
- Department of General Surgery, Galway University Hospital, Newcastle, Galway, Ireland
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Kırca K, Özveren H, Bağcı S. Evaluation of the Spiritual Care Needs of Patients with Cancer in a Chemotherapy Unit in Turkey. J Relig Health 2024; 63:1457-1474. [PMID: 37794297 DOI: 10.1007/s10943-023-01876-7] [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] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 10/06/2023]
Abstract
This study was conducted to determine the spiritual care needs of cancer patients receiving chemotherapy. A cross-sectional descriptive design was used to analyze a total of 104 patients at a university hospital in Turkey. The data were collected using the Spiritual Care Needs Scale. The mean age of the patients participating in the study was 61.0 (10.2). It was determined that 31.7% of the patients stated that the concepts of spirituality and spiritual care are related to religion and worship. As a result, it was found that the patients receiving chemotherapy had high-spiritual care needs. The dimensions in which the spiritual needs of the patients were remarkably high were belief and spiritual practices, being in peace and security, the love and support of their relatives and being informed about health. The spiritual care need score of the patients increased significantly with marital status (p = 0.001), having children (p = 0.002), having a chronic disease (p = 0.04) and having an undergraduate/graduate level education (p = 0.01). Nurses should be aware of patient's spiritual needs, plan patient-specific spiritual care practices, conduct more studies on the effects of spiritual care on the patient and family and create guidelines for spiritual care practices in patients receiving chemotherapy in Turkey.
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Affiliation(s)
- Kamile Kırca
- Faculty of Health Sciences, Nursing Department, Kırıkkale University, Kırıkkale, Turkey
| | - Hüsna Özveren
- Faculty of Health Sciences, Nursing Department, Kırıkkale University, Kırıkkale, Turkey.
| | - Sema Bağcı
- Medical Oncology Clinic, Chemotherapy Unit, Kırıkkale University Faculty of Medicine Hospital, Kırıkkale, Turkey
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