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Chen S, McMiller TL, Soni A, Succaria F, Sidhom JW, Cappelli LC, Casciola-Rosen LA, Morales IR, Sankaran P, Berger AE, Deutsch JS, Zhu QC, Anders RA, Hooper JE, Pardoll DM, Lipson EJ, Taube JM, Topalian SL. Comparing anti-tumor and anti-self immunity in a patient with melanoma receiving immune checkpoint blockade. J Transl Med 2024; 22:241. [PMID: 38443917 PMCID: PMC10916264 DOI: 10.1186/s12967-024-04973-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/09/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Tumor regression following immune checkpoint blockade (ICB) is often associated with immune-related adverse events (irAEs), marked by inflammation in non-cancerous tissues. This study was undertaken to investigate the functional relationship between anti-tumor and anti-self immunity, to facilitate irAE management while promoting anti-tumor immunity. METHODS Multiple biopsies from tumor and inflamed tissues were collected from a patient with melanoma experiencing both tumor regression and irAEs on ICB, who underwent rapid autopsy. Immune cells infiltrating melanoma lesions and inflamed normal tissues were subjected to gene expression profiling with multiplex qRT-PCR for 122 candidate genes. Subsequently, immunohistochemistry was conducted to assess the expression of 14 candidate markers of immune cell subsets and checkpoints. TCR-beta sequencing was used to explore T cell clonal repertoires across specimens. RESULTS While genes involved in MHC I/II antigen presentation, IFN signaling, innate immunity and immunosuppression were abundantly expressed across specimens, irAE tissues over-expressed certain genes associated with immunosuppression (CSF1R, IL10RA, IL27/EBI3, FOXP3, KLRG1, SOCS1, TGFB1), including those in the COX-2/PGE2 pathway (IL1B, PTGER1/EP1 and PTGER4/EP4). Immunohistochemistry revealed similar proportions of immunosuppressive cell subsets and checkpoint molecules across samples. TCRseq did not indicate common TCR repertoires across tumor and inflammation sites, arguing against shared antigen recognition between anti-tumor and anti-self immunity in this patient. CONCLUSIONS This comprehensive study of a single patient with melanoma experiencing both tumor regression and irAEs on ICB explores the immune landscape across these tissues, revealing similarities between anti-tumor and anti-self immunity. Further, it highlights expression of the COX-2/PGE2 pathway, which is known to be immunosuppressive and potentially mediates ICB resistance. Ongoing clinical trials of COX-2/PGE2 pathway inhibitors targeting the major COX-2 inducer IL-1B, COX-2 itself, or the PGE2 receptors EP2 and EP4 present new opportunities to promote anti-tumor activity, but may also have the potential to enhance the severity of ICB-induced irAEs.
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Affiliation(s)
- Shuming Chen
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Tracee L McMiller
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Abha Soni
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Contra Costa Pathology Associates, Pleasant Hill, CA, USA
| | - Farah Succaria
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - John-William Sidhom
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Mount Sinai School of Medicine, New York, NY, USA
| | - Laura C Cappelli
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Livia A Casciola-Rosen
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Isaac R Morales
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Preethi Sankaran
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Crossbow Therapeutics, Cambridge, MA, USA
| | - Alan E Berger
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Julie Stein Deutsch
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Qingfeng C Zhu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Robert A Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Jody E Hooper
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
| | - Drew M Pardoll
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Evan J Lipson
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Janis M Taube
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Suzanne L Topalian
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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Arias-Stella EU, Campbell C, Pisapia DJ, Cocito C, McThenia S, Degliuomini M, Greenfield JP, Khakoo Y. Pediatric Postmortem Tissue Donation in the Confines of a Pandemic: A Model of Collaboration. Pediatr Neurol 2023; 148:138-141. [PMID: 37713977 DOI: 10.1016/j.pediatrneurol.2023.08.009] [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: 01/06/2023] [Revised: 07/21/2023] [Accepted: 08/08/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Obtaining postmortem tissue from pediatric oncology patients is critical to research and may help grieving families heal. Since 2019, the national Gift from a Child program has made significant progress in collecting postmortem tissue from pediatric patients with central nervous system tumors to advance research. This progress was at risk during the onset of the severe acute respiratory syndrome coronavirus 2 pandemic, when some autopsy programs came to a halt. METHODS We retrospectively reviewed autopsies of four patients treated at Memorial Sloan Kettering Cancer Center who underwent postmortem examination at Weill Cornell Medicine from June 2020 to March 2021. We collected patient demographics, Do not resuscitate status, time of death and procedure, restrictions due to the coronavirus disease 2019 (COVID-19) pandemic, and results of the tissue analysis. RESULTS Three of four specimens were processed within 12 hours of the time of death. Two families required interpreter services to obtain consent. In all cases, tumor aliquots were flash frozen for further study. Cell line generation was successful in one case. All families expressed gratitude both for the opportunity to participate and for the handling of the procedures. CONCLUSIONS Despite the sensitive nature of these cases and the challenges presented by COVID-19 restrictions, clinicians should offer the option of a rapid autopsy to caregivers of pediatric patients based on the scientific need and the positive effect it has on grieving families. This article outlines the logistic efforts required for these donations to take place and provides a framework for providers to offer rapid autopsy as an option for families through this program.
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Affiliation(s)
| | - Cindy Campbell
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York
| | - David J Pisapia
- Department of Pathology, Weill Cornell Medical College, New York, New York
| | - Carolina Cocito
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York
| | - Sheila McThenia
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Melanie Degliuomini
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jeffrey P Greenfield
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York; Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yasmin Khakoo
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York.
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3
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Tutty E, Horsley P, Forbes Shepherd R, Forrest LE. The art and science of recruitment to a cancer rapid autopsy programme: A qualitative study exploring patient and clinician experiences. Palliat Med 2021; 35:437-446. [PMID: 33126839 DOI: 10.1177/0269216320967595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND CASCADE is a successful, Australia-first cancer rapid autopsy programme. Patients are recruited to the programme by their clinician once they understand that further treatment has only palliative intent. Despite its value, rapid autopsy is a rare research method owing partly to recruitment challenges. AIM This research aimed to explore (1) how, in practice, clinicians select and recruit patients to the programme and (2) patient experiences of this process. DESIGN This was a qualitative study grounded in phenomenology. CASCADE team members (clinicians and researchers) and patients participated in semi-structured interviews. Data were analysed using an inductive, team-based approach to thematic analysis. PARTICIPANTS Interviews were conducted with 31 participants (11 patients and 20 CASCADE team members). RESULTS Patient selection and recruitment to a rapid autopsy programme is both an art and science. In practice, patient selection is a subjective process that involves assessing a patient's psychosocial suitability for the programme. Trust and rapport are necessary for informing this assessment and to create an environment conducive to discussing rapid autopsy. Clinicians have also crafted their own ways of delivering information about CASCADE, with both clinicians and patients acknowledging that, if not handled sensitively, recruitment could cause distress. Overall, patients were satisfied with the way in which they were recruited. CONCLUSION Findings provide insight into how clinicians successfully select and recruit patients to a rapid autopsy programme and suggests that discussing such topics are acceptable to end-of-life patients. This research also raises thought-provoking questions about the 'gatekeeping' role of clinicians in recruitment.
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Affiliation(s)
- Erin Tutty
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Philomena Horsley
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rowan Forbes Shepherd
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Laura E Forrest
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
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4
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Mannan R, Wang X, Bawa PS, Spratt DE, Wilson A, Jentzen J, Chinnaiyan AM, Reichert ZR, Mehra R. Polypoidal giant cancer cells in metastatic castration-resistant prostate cancer: observations from the Michigan Legacy Tissue Program. Med Oncol 2020; 37:16. [PMID: 32030484 DOI: 10.1007/s12032-020-1341-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 01/27/2020] [Indexed: 11/26/2022]
Abstract
Despite early diagnosis and established protocols, a subset of prostate cancer patients will eventually be categorized as castration-resistant prostate cancer. Recently, it has been reported that these multi-modal therapy cases may harbor a special subset of cancer cells termed as polypoidal giant cancer cells (PGCC). These cells are phenotypically described either as possessing highly irregular polylobated nuclei or multiple pleomorphic nuclei. To identify and characterize the distribution of these cells, we created a cohort of 5 randomly selected cases of multi-modal therapy failure prostate cancer (16 selected non-osseous and osseous tumor sites) enrolled in Michigan Legacy Tissue Program. In all cases, specific "regions of interest" or "hot spots" within tumor areas showing an increased proportion of these multi-nucleated/polylobated cells under light microscopy were labeled as PGCC-rich area. On microscopic evaluation, overall mean count of PGCC was 42.4 ± 3.91 with case 2 in the study cohort with the highest number of average PGCC count of 17 ± 4.04. Site wise analysis showed retroperitoneal lymph node as the tissue with highest number of average PGCC number/site (5.0 ± 0.32). On correlating the average number of PGCC recorded with the time elapsed from last dose of chemotherapy administered to autopsy, the spearman correlation value (R) was 0.67, but the result was not statistically significant (p = 0.22). A systematic assessment of PGCC in a large stratified cohort of prostate cancer patients integrated with various histopathological and clinical parameters along with discovery of specific biomarkers for PGCC are the future studies suggested.
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Affiliation(s)
- Rahul Mannan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Xiaoming Wang
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Pushpinder S Bawa
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Daniel E Spratt
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA
- Department of Radiation Oncology, Michigan Medicine, Ann Arbor, MI, USA
| | - Allecia Wilson
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jeffrey Jentzen
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Arul M Chinnaiyan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
- Howard Hughes Medical Institute, Ann Arbor, MI, USA
| | - Zachery R Reichert
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA
- Division of Hematology/Oncology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA.
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA.
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5
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Simon CT, Skala SL, Killen PD, Siddiqui J, Cao X, Qiao Y, Al-Ahmadie H, Camelo-Piragua SI, Jentzen J, Chinnaiyan AM, Dhanasekaran SM, Reichert ZR, Mehra R. Plasmacytoid urothelial carcinoma: a rapid autopsy case report with unique clinicopathologic and genomic profile. Diagn Pathol 2019; 14:113. [PMID: 31638990 PMCID: PMC6802321 DOI: 10.1186/s13000-019-0896-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/25/2019] [Indexed: 12/18/2022] Open
Abstract
Background Rapid (“warm”) autopsies of patients with advanced metastatic cancer provide important insight into the natural history, pathobiology and histomorphology of disease in treatment-resistant tumors. Plasmacytoid urothelial carcinoma (PUC) is a rare variant of urothelial carcinoma characterized by neoplastic cells morphologically resembling plasma cells. PUC is typically aggressive, high-stage at presentation, and associated with poor outcomes. Recurrence is common in PUC, with the majority of recurrences occurring in the peritoneum. Case presentation Here, we report rapid autopsy findings from a patient with recurrent PUC. The patient had persistent pain after cystoprostatectomy, although initial post-operative imaging showed no evidence of disease. Imaging obtained shortly before his death showed only subtle growth along vascular tissue planes; however, extensive disease was seen on autopsy. Plasmacytoid tumor cells formed sheets involving many serosal surfaces. Molecular interrogation confirmed a mutation in CDH1 exon 12 leading to early truncation of the CDH1 protein in the tumor cells. Conclusions The sheet-like growth pattern of PUC makes early phases of disease spread much more difficult to capture on cross-sectional imaging. Alternative forms of surveillance may be required for detection of recurrent PUC, and providers may need to treat based on symptoms and clinical suspicion.
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Affiliation(s)
- Caroline T Simon
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Rd, Building 35, Ann Arbor, MI, 48109, USA
| | - Stephanie L Skala
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Rd, Building 35, Ann Arbor, MI, 48109, USA
| | - Paul D Killen
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Rd, Building 35, Ann Arbor, MI, 48109, USA
| | - Javed Siddiqui
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Xuhong Cao
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Yuanyuan Qiao
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Hikmat Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sandra I Camelo-Piragua
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Rd, Building 35, Ann Arbor, MI, 48109, USA
| | - Jeffrey Jentzen
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Rd, Building 35, Ann Arbor, MI, 48109, USA
| | - Arul M Chinnaiyan
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Rd, Building 35, Ann Arbor, MI, 48109, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA.,Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA.,Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA.,Howard Hughes Medical Institute, Ann Arbor, MI, USA
| | | | - Zachery R Reichert
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA.,Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Rd, Building 35, Ann Arbor, MI, 48109, USA. .,Michigan Center for Translational Pathology, Ann Arbor, MI, USA. .,Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA.
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6
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Quinn GP, Pentz RD, Muñoz-Antonia T, Boyle TA, Schabath MB, Pratt CL, Shaffer A, Duarte LF, Bowman-Curci M, Antonia SJ, Chiappori AA, Creelan BC, Gray JE, Williams CC, Haura EB. Patient, caregiver and physician perspectives on participating in a thoracic rapid tissue donation program. Patient Educ Couns 2018; 101:703-710. [PMID: 29195718 PMCID: PMC5878993 DOI: 10.1016/j.pec.2017.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/18/2017] [Accepted: 11/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The collection of posthumous tissue from advanced stage lung cancer patients is beneficial to medical science. Recruiting living patients to a Rapid Tissue Donation Program (RTD) poses several psychosocial challenges and little is known about perceptions of joining this type of program. This study qualitatively examined perceptions of advanced stage lung cancer patients (n=14) participating in a lung cancer RTD program, their NoK (n=11), and physicians (n=6) at the Thoracic Oncology Clinic at H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida USA. METHODS Semi-structured interviews were conducted with participants and interview transcripts were analyzed using the constant comparison method. RESULTS Majority of patients joined to give back to research, discussed participation with family members, and desired for family to receive information about the use of the tissue after their death. All participating NoK were supportive of their family member's decision. Physicians described the program as running smoothly, but provided suggestions for process improvements. CONCLUSION Participants joined with intention to give back to research community and families were supportive of loved one's participation in RTD. Physicians agreed with overall process. PRACTICE IMPLICATIONS Key factors for a successful RTD program is tailoring to institutional and individual needs.
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Affiliation(s)
- Gwendolyn P Quinn
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States; New York University School of Medicine, 500 1st Ave, New York, NY 10012, United States.
| | - Rebecca D Pentz
- Winship Cancer Institute, Emory University School of Medicine, 1365 Clifton Rd., Atlanta, GA 30322, United States
| | - Teresita Muñoz-Antonia
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Tumor Biology Department, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Theresa A Boyle
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Anatomic Pathology Department, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Matthew B Schabath
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States; Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States
| | - Christie L Pratt
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Andrea Shaffer
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Luisa F Duarte
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Meghan Bowman-Curci
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Scott J Antonia
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Alberto A Chiappori
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Benjamin C Creelan
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Jhanelle E Gray
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Charles C Williams
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Eric B Haura
- Morsani College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States; Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States
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7
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McIntyre J, Pratt C, Pentz RD, Haura EB, Quinn GP. Stakeholder perceptions of thoracic rapid tissue donation: An exploratory study. Soc Sci Med 2013; 99:35-41. [PMID: 24355468 DOI: 10.1016/j.socscimed.2013.08.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 01/31/2013] [Revised: 06/19/2013] [Accepted: 08/27/2013] [Indexed: 12/01/2022]
Abstract
Rapid autopsy or rapid tissue donation (RTD) is a novel method of tissue procurement in which 'fresh' tissue is collected within 2-6 h following the death of a patient. While the use of RTD offers many opportunities to develop new therapies for lung cancer patients, it raises ethical concerns. The purpose of this study was to examine knowledge, perceptions and ethical concerns about recruiting patients for an RTD program. To achieve research goals, we conducted six focus groups, each containing 5-10 participants (N = 38). Participants were cancer patients (n = 17) their caregivers (n = 6), physicians (n = 6) and clinic staff (n = 9) from the Thoracic Oncology Program at Moffitt Cancer Center, in Tampa, Florida, USA. All focus groups were audio-recorded and conducted using a semi-structured focus group guide. The transcripts were analyzed using hand-coding methods. Data were coded independently by at least two researchers, and an inter-rater reliability rate of ≥90% was achieved. Knowledge about RTD was low among all groups, with physicians having slightly higher knowledge; all groups agreed that RTD offered major benefits to cancer research; physicians and clinic staff were mainly concerned about making a patient feel uncomfortable and reducing hope, while, patients and family members were more concerned about logistics and how the family would be affected during tissue retrieval. All groups agreed the physician was the appropriate person to begin a discussion about RTD and that recruitment should be individualized. All groups reported that physician training is necessary, as well as an awareness campaign for patients and families to be more receptive about RTD. The results of this study suggested more education is needed for all stakeholders to learn about RTD prior to the initiation of a research program. Our approach of querying all stakeholders provides a firm foundation for future training modules regarding RTD programs in lung cancer.
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Affiliation(s)
- Jessica McIntyre
- Cancer Prevention and Control, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Christie Pratt
- Thoracic Oncology Program, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Rebecca D Pentz
- Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA 30322, USA
| | - Eric B Haura
- Thoracic Oncology Program, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA; College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC 44, Tampa, FL 33612, USA
| | - Gwendolyn P Quinn
- Cancer Prevention and Control, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA; College of Medicine, Department of Oncologic Science, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC 44, Tampa, FL 33612, USA.
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