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George B, Michael P, Allen BG, Spitz DR, Caster JM. Enhanced Peroxide Fluxes and Radiosensitization in Colorectal Tumors but Not Normal Enterocytes from the Combination of Superoxide Dismutase Mimetics and Pharmacological Ascorbate. Int J Radiat Oncol Biol Phys 2023; 117:e231. [PMID: 37784928 DOI: 10.1016/j.ijrobp.2023.06.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Selective superoxide dismutase mimetics (DMs), including GC4419 and GC4711, are radiation (RT) modulators which induce opposite effects in tumors and normal tissues and may be ideally suited for locally advanced rectal cancer. However, their tumor radiosensitization effect is limited at RT doses relevant to rectal cancer (2-5 Gy). Over this dose range, they protect normal mucosal tissues, but we and others have shown they do not reliably enhance tumor radiosensitization at doses < 8-15 Gy. We hypothesize that combining DMs and other therapies which also target redox metabolism may effectively sensitize tumors to clinically relevant RT doses for rectal cancer while maintaining their normal tissue sparing effects. Like DMs, pharmacological ascorbate (P-AscH) selectively increases lethal hydrogen peroxide (H2O2) fluxes in tumors, but it does so through distinct mechanisms which are potentially complimentary with DMs (particularly at low RT doses). MATERIALS/METHODS Human HCT116, SW480, and HT29 colorectal tumor models and non-malignant FHs74 intestinal epithelial cells were used. Clonogenic survival was assessed following single-fraction RT (2-5 Gy) +/- P-AscH (5 pmol/cell) +/- GC4711 (20 µM). Dependency on H202 fluxes was tested by adding bovine catalase with drug and RT treatments. Oxygen consumption in culture media was measured using a Clark electrode. Rectal toxicity was assessed in vivo using IHC in fixed rectal tissues following fractionated, image-guided rectal RT (5-9 Gy x 3). Tumor growth delay was assessed following RT (5 Gy x 3) +/- P-AscH (4 g/kg) +/- GC4419 (10 mg/kg) in animals with unilateral HCT116 flank tumors. RESULTS Combination therapy with P-AscH and GC4711 potently radiosensitized all tumor lines in vitro whereas neither agent significantly decreased clonogenic survival as a monotherapy. Neither drug nor combination treatment sensitized FHs74 epithelial cells. P-AscH increased oxygen consumption and H2O2 production in culture media and the addition of GC4711 significantly increased both more than P-AscH alone. Co-treatment with exogenous catalase inhibited cancer cell killing with combination therapy +/- RT. In vivo, combination therapy significantly enhanced tumor growth delay and survival. Both agents significantly decreased markers of acute rectal RT injury as monotherapies. CONCLUSION Co-treatment with DMs and P-AscH selectively enhanced tumor radiosensitization by increasing oxygen consumption and H202 fluxes even in tumor models which are known to be resistant to oxidative stressors (HT29). In contrast, each agent conferred a radioprotective effect in the rectum. Combination therapy with DMs and P-AscH may represent a novel, potent approach to target dysregulated redox metabolism in colorectal tumors.
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Affiliation(s)
- B George
- University of Iowa, Iowa City, IA
| | | | - B G Allen
- Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - D R Spitz
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa Hospital and Clinics, Iowa City, IA
| | - J M Caster
- Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA
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Ponce SEB, Small CJ, Ahmad T, Patel K, Tsai S, Kamgar M, George B, Kharofa JR, Saeed H, Dua KS, Clarke C, Aldakkak M, Evans DB, Christians K, Paulson ES, de Choudens SO, Erickson BA, Hall WA. Patterns of Locoregional Pancreatic Cancer Recurrence after Total Neoadjuvant Therapy and Implications on Optimal Neoadjuvant Radiation Treatment Volumes. Int J Radiat Oncol Biol Phys 2023; 117:e284-e285. [PMID: 37785058 DOI: 10.1016/j.ijrobp.2023.06.1270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Neoadjuvant treatment for patients with localized pancreatic adenocarcinoma (PDAC) has improved survival duration. As survival increases, local disease control becomes even more important. We sought to understand the patterns of locoregional recurrence following total neoadjuvant therapy (TNT) and determine the impact of treatment volumes on recurrence. MATERIALS/METHODS Patients with PDAC managed with neoadjuvant chemotherapy and chemoradiation (TNT) followed by surgery who developed an isolated locoregional or simultaneously locoregional and distant recurrence were identified. Locoregional recurrences were individually contoured utilizing commercially available software. When available, original neoadjuvant dose distributions were registered to the scans on which the locoregional recurrences were contoured. Recurrences where then classified as in-field (> 95% of prescription dose), marginal (50-95% of prescription dose), or out of field (< 50% of prescription dose). Target volumes were created using four commonly utilized PDAC contouring guidelines to characterize the relationship of the local recurrence to the RT dose distribution. RESULTS Of 474 patients treated with TNT and surgery, 80 (17%) patients developed a locoregional recurrence with or without distant recurrence, visible on diagnostic imaging. Of the 80 patients, 56 (70%) had tumors in the pancreatic head; 46 (57.5%) were borderline resectable, 23 (28.8%) locally advanced, and 11 (13.6%) resectable. The most common initial neoadjuvant therapies were FOLFIRINOX (57.5%) and gemcitabine/nab-paclitaxel (18.8%). Chemoradiation included concurrent gemcitabine (47.5%) or 5-fluorouracil (26.3%). RT dose distributions were available for 38 patients; 22 (57.9%) had in-field failures, 9 (23.7%) marginal failures, and 7 (18.4%) out of field failures. Each published contouring atlas covered a relatively low percentage of recurrences, which are summarized in Table 1. Regions at particularly high likelihood of recurrence that were under covered on existing atlases included: aortic-diaphragmic junction, retro-pancreatic duodenal nodal basin, and the region to the right of the superior mesenteric artery (SMA). CONCLUSION We present the largest series (to our knowledge) of mapped locoregional recurrences for patients being treated with TNT in PDAC. These recurrences differ substantially from established atlases and highlight anatomical regions of highest priority for RT coverage. A novel visual contouring volume highlighting these regions will be presented which will strive to advance the use of RT in the TNT setting.
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Affiliation(s)
- S E Beltran Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - C J Small
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - T Ahmad
- Medical College of Wisconsin, Milwaukee, WI
| | - K Patel
- Medical College of Wisconsin, Milwaukee, WI
| | - S Tsai
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - M Kamgar
- Department of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - B George
- Department of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - J R Kharofa
- University of Cincinnati, Department of Radiation Oncology, University of Cincinnati Cancer Center, Cincinnati, OH
| | - H Saeed
- Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida, Boca Raton, FL
| | - K S Dua
- Department of Gastroenterology, Medical College of Wisconsin, Milwaukee, WI
| | - C Clarke
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - M Aldakkak
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - D B Evans
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - K Christians
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - E S Paulson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - S Ortiz de Choudens
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI; Department of Radiation Oncology, Froedtert & the Medical College of Wisconsin, Milwaukee, WI
| | - B A Erickson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - W A Hall
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
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Thalji S, Aldakkak M, Christians K, Clarke C, George B, Kamgar M, Erickson B, Hall W, Chisholm P, Kulkarni N, Doucette S, Evans D, Tsai S. Neoadjuvant Chemotherapy for Pancreatic Cancer: Quality over Quantity. J Surg Oncol 2023. [PMID: 36960919 DOI: 10.1002/jso.27265] [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: 10/09/2022] [Revised: 02/19/2023] [Accepted: 02/26/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND AND OBJECTIVES The ideal duration of neoadjuvant chemotherapy (NACT) in patients with localized pancreatic adenocarcinoma (PDAC) treated with curative intent is unclear. We sought to determine the prognostic significance of both duration of NACT and Carbohydrate Antigen 19-9 (CA19-9) normalization to NACT. METHODS We examined patients with resectable and borderline resectable PDAC treated with NACT and chemoradiation. Patients were compared by NACT duration (2 vs 4 months) and by CA19-9 normalization after NACT. RESULTS Among 171 patients, 83 (49%) received two months of NACT and 88 (51%) received four months. After NACT completion, 115 (67%) patients had persistently elevated CA19-9 and 56 (33%) had normalized. Of the 125 patients who had successful surgery, 73 (58%) had normalized CA19-9 postoperatively. Duration of NACT was not associated with overall survival (OS) while CA19-9 normalization after NACT (regardless of duration) was associated with improved OS (HR 0.56, 95% CI 0.35-0.89, p=0.02). Adjuvant chemotherapy was associated with improved OS among patients without CA19-9 normalization after NACT (HR 0.42, CI 0.20-0.86, p=0.02) but not among those that normalized, independent of duration. CONCLUSIONS CA19-9 normalization after NACT is a clinically significant endpoint of treatment; patients without CA19-9 normalization may benefit from additional therapy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sz Thalji
- Department of Surgery, Division of Surgical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Aldakkak
- Department of Surgery, Division of Surgical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kk Christians
- Department of Surgery, Division of Surgical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Cn Clarke
- Department of Surgery, Division of Surgical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - B George
- Department of Medicine, Division of Medical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Kamgar
- Department of Medicine, Division of Medical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ba Erickson
- Department of Radiation Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Wa Hall
- Department of Radiation Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - P Chisholm
- Department of Medicine, Division of Gastroenterology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - N Kulkarni
- Department of Radiology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - S Doucette
- Department of Pathology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Db Evans
- Department of Surgery, Division of Surgical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - S Tsai
- Department of Surgery, Division of Surgical Oncology, LaBahn Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
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Bangar S, Mohan U, Kumar S, Mahapatra A, Singh SK, Kohli R, Verma A, Katendra TL, Rahane G, Shewale SP, Yenbhar N, Verma V, Saravanamurthy P, George B, Kushwaha BS, Das C, Rajan S, Sahay S. Exploring access to HIV-related services and programmatic gaps for Men having Sex with Men (MSM) in rural India- a qualitative study. PLoS One 2023; 18:e0284901. [PMID: 37141198 PMCID: PMC10159193 DOI: 10.1371/journal.pone.0284901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 04/02/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Despite the Link Worker Scheme to address the HIV risk and vulnerabilities in rural areas, reaching out to unreached men having sex with men (MSM) remains a challenge in rural India. This study explored issues around health care access and programmatic gaps among MSM in rural settings of India. METHODS We conducted eight Focused Group Discussions (FGDs), 20 Key Informant Interviews (KIIs), and 20 In-Depth Interviews (IDIs) in four rural sites in Maharashtra, Odisha, Madhya Pradesh, and Uttar Pradesh between November 2018 and September 2019. The data in the local language were audio-recorded, transcribed, and translated. Data were analyzed in NVivo version 11.0 software using the grounded theory approach. RESULTS Primary barriers to health care access were lack of knowledge, myths and misconceptions, not having faith in the quality of services, program invisibility in a rural setting, and anticipated stigma at government health facilities. Government-targeted intervention services did not seem to be optimally advertised in rural areas as MSM showed a lack of information about it. Those who knew reported not accessing the available government facilities due to lack of ambient services, fear of the stigma transforming into fear of breach of confidentiality. One MSM from Odisha expressed, "…they get fear to go to the hospital because they know that hospital will not maintain confidentiality because they are local people. If society will know about them, then family life will be disturbed" [OR-R-KI-04]. Participants expressed the desire for services similar to those provided by the Accredited Social Health Activists (ASHA), frontline health workers for MSM. CONCLUSION Programme invisibility emerges as the most critical issue for rural and young MSM. Adolescent and panthis emerged as Hidden MSM and they need focused attention from the programme. The need for village-level workers such as ASHA specifically for the MSM population emerged. MSM-friendly health clinics would help to improve healthcare access in rural MSMs under Sexual and Reproductive Health Care.
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Affiliation(s)
- Sampada Bangar
- Epidemiology Division, ICMR-National AIDS Research Institute, Pune, India
| | - Uday Mohan
- Upgraded Department of Community Medicine and Public Health, King George's Medical University, Lucknow, India
| | - Sanjeev Kumar
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Amarendra Mahapatra
- Epidemiology Division, ICMR-Regional Medical Research Center, Bhubaneswar, India
| | - Shivendra Kumar Singh
- Upgraded Department of Community Medicine and Public Health, King George's Medical University, Lucknow, India
| | - Rewa Kohli
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, India
| | - Archana Verma
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, India
| | - Tuman Lal Katendra
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, India
| | - Girish Rahane
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, India
| | - Suhas P Shewale
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, India
| | - Nayana Yenbhar
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, India
| | - Vinita Verma
- National AIDS Control Organization, New Delhi, India
| | | | | | | | - Chinmoyee Das
- National AIDS Control Organization, New Delhi, India
| | - Shobini Rajan
- National AIDS Control Organization, New Delhi, India
| | - Seema Sahay
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, India
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Chibbaro S, Cornelius JF, Mallereau CH, Bruneau M, Zaed I, Visocchi M, Maduri R, Todeschi J, Bruno C, George B, Froelich S, Ganau M. Lateral Approach to the Cervical Spine to Manage Degenerative Cervical Myelopathy and Radiculopathy. Acta Neurochir Suppl 2023; 135:339-343. [PMID: 38153490 DOI: 10.1007/978-3-031-36084-8_51] [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] [Indexed: 12/29/2023]
Abstract
BACKGROUND The cervical lateral approach can enlarge the spinal canal and foramen to achieve an effective neural decompression without needing spine stabilization. For this review, the authors' main objective was to illustrate the rationale, advantages, disadvantages, complications, and pitfalls of this technique, highlighting also areas for future development. MATERIALS AND METHODS A Medline via PubMed database search was carried out by using both keywords, namely "cervical oblique corpectomy," "multilevel oblique corpectomy and foraminotomy," and "lateral vertebrectomy," and Medical Subject Headings (MeSH) terms from 1 January 1991, up to 31 December 2021. RESULTS The analyzed articles suggested that the use of such a technique has declined over time; only 29 clinical studies met all the inclusion criteria and were retained for data analysis, including 1200 patients undergoing such an approach for the management of degenerative cervical myelopathies (DCMs) or of radiculopathies. The main etiopathogeneses were cervical stenosis, degenerative disk disease, or a mix of them-78% of which had a favorable outcome; the most frequent complications were transient and permanent Horner syndrome in 13.6% and 9.2% of cases, respectively. Long-term stability was reported in 97% of patients. CONCLUSION Multilevel cervical oblique vertebrectomy and/or lateral foraminotomy allow wide neural structure decompression and optimal stability given that the physiological spinal motion is preserved.
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Affiliation(s)
- S Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - J F Cornelius
- Department of Neurosurgery, Duesseldorf University Hospital, Duesseldorf, Germany
| | - C H Mallereau
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - M Bruneau
- Department of Neurosurgery, UZ Hospital Brussel, Jette, Belgium
| | - I Zaed
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - M Visocchi
- Department of Neurosurgery, Catholic University of Rome, Rome, Italy
| | - R Maduri
- Genolier Spine Care Center, Swiss Medical Network, Genolier, Switzerland
| | - J Todeschi
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
| | - C Bruno
- Department of Neurosurgery, Andria Bonomo Hospital, Andria, Italy
| | - B George
- Department of Neurosurgery, Lariboisiere University Hospital, Paris, France
| | - S Froelich
- Department of Neurosurgery, Lariboisiere University Hospital, Paris, France
| | - M Ganau
- Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
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Van Cutsem E, Hochster H, Shitara K, Mayer R, Ohtsu A, Falcone A, Yoshino T, Doi T, Ilson D, Arkenau HT, George B, Benhadji K, Makris L, Tabernero J. Pooled safety analysis from phase III studies of trifluridine/tipiracil in patients with metastatic gastric or gastroesophageal junction cancer and metastatic colorectal cancer. ESMO Open 2022; 7:100633. [PMID: 36455504 PMCID: PMC9808443 DOI: 10.1016/j.esmoop.2022.100633] [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: 08/10/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Trifluridine/tipiracil (FTD/TPI) showed clinical benefit, including improved survival and manageable safety in previously treated patients with metastatic colorectal (mCRC) or gastric/gastroesophageal junction (mGC/GEJC) cancer in the phase III RECOURSE and TAGS trials, respectively. A pooled analysis was conducted to further characterize FTD/TPI safety, including management of haematologic toxicities and use in patients with renal or hepatic impairment. PATIENTS AND METHODS Adults with ≥2 prior regimens for advanced mGC/GEJC or mCRC were randomized (2 : 1) to FTD/TPI [35 mg/m2 twice daily days 1-5 and 8-12 (28-day cycle); same dosage in both trials] or placebo plus best supportive care. Adverse events (AEs) were summarized in the safety population (patients who received ≥1 dose) and analysed by renal/hepatic function. RESULTS TAGS and RECOURSE included 335 and 533 FTD/TPI-treated and 168 and 265 placebo-treated patients, respectively. Overall safety of FTD/TPI was similar in TAGS and RECOURSE. Haematologic (neutropenia, anaemia) and gastrointestinal (nausea, diarrhoea) AEs were most commonly observed. Laboratory-assessed grade 3-4 neutropenia occurred in 37% (TAGS)/38% (RECOURSE) of FTD/TPI-treated patients (median onset: 29 days/55 days), and 96% (TAGS)/97% (RECOURSE) of cases resolved regardless of renal/hepatic function. Supportive medications for neutropenia were received by 17% (TAGS) and 9% (RECOURSE); febrile neutropenia was reported in 2% and 4%, respectively. Overall grade ≥3 AEs were more frequent in patients with moderate renal impairment [81% (TAGS); 85% (RECOURSE)] versus normal renal function (74%; 67%); anaemia and neutropenia were more common in patients with renal impairment. FTD/TPI safety (including haematologic AEs) was consistent across patients with normal and mildly impaired hepatic function. CONCLUSIONS These results support FTD/TPI as a well-tolerated treatment in patients with mGC/GEJC or mCRC, with a consistent safety profile. Safety was largely similar in patients with normal or mildly impaired renal/hepatic function; however, patients with renal impairment should be monitored for haematologic toxicities.
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Affiliation(s)
- E. Van Cutsem
- University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium,Correspondence to: Prof. Eric Van Cutsem, Gastroenterology/Digestive Oncology, University Hospitals Gasthuisberg/Leuven & KU Leuven, Herestraat 49, 3000 Leuven, Belgium. Tel: +32-16-34-42-18; Fax: +32-16-34-44-19
| | - H. Hochster
- Rutgers Cancer Institute, New Brunswick, USA
| | - K. Shitara
- National Cancer Center Hospital East, Chiba, Japan
| | - R. Mayer
- Dana-Farber Cancer Institute, Boston, USA
| | - A. Ohtsu
- National Cancer Center Hospital East, Chiba, Japan
| | - A. Falcone
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - T. Yoshino
- National Cancer Center Hospital East, Chiba, Japan
| | - T. Doi
- National Cancer Center Hospital East, Chiba, Japan
| | - D.H. Ilson
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - H.-T. Arkenau
- Sarah Cannon Research Institute, Cancer Institute, University College London, London, UK
| | - B. George
- Medical College of Wisconsin, Milwaukee, USA
| | | | | | - J. Tabernero
- Vall d’Hebron Hospital Campus and Vall d’Hebron Institute of Oncology (VHIO), UVic-UCC, IOB-Quiron, Barcelona, Spain
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Bhat S, Arsenault T, Baydoun A, Bailey L, Amini A, George B, Nam K, Saieed G, Zeidane RA, Heo JU, Muzic R, Biswas T, Podder T. Synthetic FDG-Positron Emission Tomography Images for Patients with Non-Small Cell Lung Cancer: A Deep Learning-Based Approach Using Computed Tomography Images. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hanna D, Cassier P, Alistar A, Sharma S, Matrana M, George B, El-Khoueiry A, Okano F, Von Hoff D, Blay J. A Ph-Ib study of TRK-950 combined with anti-cancer treatment regimens in patients with advanced solid tumors. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00886-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Good J, George B, Teoh S, Gaya A, Owens R, Aznar Garcia L, Robinson M, Martin A, Chu K, Mukherjee S, Maughan T. OC-0112 Feasibility and safety of daily adapted MR-guided SABR for pancreatic cancer in the UK. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02488-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Owczarczyk K, Harford-Wright H, Shergill S, Sevitt T, Lynch J, Harris J, George B, Gaya A, Good J. PD-0502 Stereotactic MR guided online adaptive radiotherapy for abdominal and pelvic lymph node metastases. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02873-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pasangha E, George B, Bhuvana KB, Padmini D. Predictors of Pharmacotherapy and Quality of Life Among Patients With Diabetic Foot Syndrome: A Cross-Sectional Study from a Tertiary Care Hospital in India. J Pharmacol Pharmacother 2022. [DOI: 10.1177/0976500x221080291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To assess the patterns and predictors of pharmacotherapy and QOL in DFS patients in an Indian tertiary care hospital. Methods: A cross-sectional study was conducted among inpatients with DFS. Data on sociodemographic and clinical factors, pharmacotherapy, clinical outcomes, and QOL were analyzed using the chi-squared test, independent sample t-test, and binary logistic regression. Results: We screened 3284 inpatients and included consecutive 87 (2.7%) DFS patients. The mean age was 56.08 ± 11.05 years, with a male preponderance (75.8%). Mean HbA1c was 9.9 ± 2.483. About 75% of patients received insulin, and polypharmacy was noticed in 82.7%. About 67.8% of DFS patients had other vascular complications of diabetes, with diabetic retinopathy being the most common in 89%. Amputations were noticed in 32.1% of patients. Overall, poor QOL was seen in 79.3% of patients. The mean scores for different domains were as follows: physical, 41.51 ± 14.15; psychological, 42.90 ± 11.16; social relationships, 43.06 ± 19.36; and environment, 47.17 ± 13. The presence of complications from diabetes was a significant predictor of the utilization of antihypertensives (OR: 2.92, CI [1.09, 7.79], P = 0.03) and poor QOL (OR: 4.54, CI [0.965, 21.41], P = 0.05). Conclusion: DFS patients in this study were found to be younger with poor glycemic control and other vascular complications of diabetes. The presence of other complications of diabetes in DFS patients was found to be a predictor of pharmacotherapy and poor QOL.
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Affiliation(s)
- E. Pasangha
- St. John’s Medical College, Sarjapur Road, Bangalore, Karnataka, India
| | - B. George
- Department of Endocrinology, St. Johns Medical College, Sarjapur Road, Bangalore, Karnataka, India
| | - K. B. Bhuvana
- Department of Pharmacology, St. Johns Medical College, Sarjapur Road, Bangalore, Karnataka, India
| | - D. Padmini
- Department of Pharmacology, St. Johns Medical College, Sarjapur Road, Bangalore, Karnataka, India
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Robinson M, George B, Nash A, Teoh S, Gaya A, Camilleri P, Mukherjee S, Good J. PO-1895 Is the traditional dose prescription concept still relevant in modern SABR? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Speight R, Dubec M, Eccles C, George B, Henry A, Herbert T, Johnstone R, Liney G, McCallum H, Schmidt M. PO-1732 IPEM Guidelines on the use of MRI for external beam radiotherapy treatment planning. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08183-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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George L, Mahabal G, Mohanan E, Balasubramanian P, Peter D, Pulimood S, Lakshmi K, Jeyaseelan L, Abraham A, Srivastava A, Mathews V, George B. Limited utility of plasma elafin as a biomarker for skin graft-versus-host disease following allogeneic stem cell transplantation. Clin Exp Dermatol 2021; 46:1482-1487. [PMID: 34081805 DOI: 10.1111/ced.14785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Acute cutaneous graft-versus-host disease (acGVHD) following haematopoietic stem cell transplant (HSCT) is common but difficult to distinguish from other causes of rash. Plasma elafin has been proposed as a diagnostic and prognostic biomarker of skin GVHD. AIM To evaluate the role of plasma elafin as a biomarker in acGVHD in an Indian population. METHODS Plasma elafin was evaluated in a prospective study of HSCT recipients, conducted over 2 years, taking measurements at baseline and at onset of skin rash after HSCT. Patients were categorized into those with GVHD rash, those with non-GVHD rash and those with no rash and the three groups were compared. RESULTS Two hundred and sixty-one patients with a median age of 16 years (range 1-61 years) and a male predominance (175 : 86 M/F) underwent HSCT during the study period: 56 patients in the GVHD group, 49 in the non-GVHD group and 156 in the no-rash group. The median baseline elafin was similar in all three groups. At the onset of rash, median elafin level was similar between GVHD and non-GVHD rash (34 549 vs. 32 077 pg/mL; P = 0.58) and between GVHD and no rash (34 549 vs. 26 197 pg/mL; P = 0.08). A rise in elafin from baseline was significantly different between GVHD and no rash (P < 0.001) but not between GVHD and non-GVHD rash (P = 0.44). CONCLUSION The utility of plasma elafin as a biomarker of skin GVHD is very limited. Plasma elafin, although elevated in cutaneous GVHD, is not helpful in distinguishing between GVHD rash and other causes of rash following HSCT.
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Affiliation(s)
- L George
- Department of, Dermatology, Venereology and Leprosy, Christian Medical College, Vellore, Tamil Nadu, India
| | - G Mahabal
- Department of, Dermatology, Venereology and Leprosy, Christian Medical College, Vellore, Tamil Nadu, India
| | - E Mohanan
- Department of, Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - P Balasubramanian
- Department of, Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - D Peter
- Department of, Dermatology, Venereology and Leprosy, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Pulimood
- Department of, Dermatology, Venereology and Leprosy, Christian Medical College, Vellore, Tamil Nadu, India
| | - K Lakshmi
- Department of, Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - L Jeyaseelan
- Department of, Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Abraham
- Department of, Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Srivastava
- Department of, Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - V Mathews
- Department of, Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - B George
- Department of, Haematology, Christian Medical College, Vellore, Tamil Nadu, India
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Sterpin E, Rivas ST, Van den Heuvel F, George B, Lee JA, Souris K. Development of robustness evaluation strategies for enabling statistically consistent reporting. Phys Med Biol 2021; 66:045002. [PMID: 33296875 DOI: 10.1088/1361-6560/abd22f] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Robustness evaluation of proton therapy treatment plans is essential for ensuring safe treatment delivery. However, available evaluation procedures feature a limited exploration of the actual robustness of the plan and generally do not provide confidence levels. This study compared established and more sophisticated robustness evaluation procedures, with quantified confidence levels. We have evaluated several robustness evaluation methods for 5 bilateral head-and-neck patients optimized considering spot scanning delivery and with a conventional CTV-to-PTV margin of 4 mm. Method (1) good practice scenario selection (GPSS) (e.g. +/- 4 mm setup error 3% range uncertainty); (2) statistically sound scenario selection (SSSS) either only on or both on and inside isoprobability hypersurface encompassing 90% of the possible errors; (3) statistically sound dosimetric selection (SSDS). In the last method, the 90% best plans were selected according to either target coverage quantified by D 95 (SSDS_D 95) or to an approximation of the final objective function (OF) used during treatment optimization (SSDS_OF). For all methods, we have considered systematic setup and systematic range errors. A mix of systematic and random setup errors were also simulated for SSDS, but keeping the same conventional margin of 4 mm. All robustness evaluations have been performed using the fast Monte Carlo dose engine MCsquare. Both SSSS strategies yielded on average very similar results. SSSS and GPSS yield comparable values for target coverage (within 0.5 Gy). The most noticeable differences were found for the CTV between GPSS, on the one hand, and SSDS_D 95 and SSDS_OF, on the other hand (average worst-case D 98 were 2.8 and 2.0 Gy larger than for GPSS, respectively). Simulating explicitly random errors in SSDS improved almost all DVH metrics. We have observed that the width of DVH-bands and the confidence levels depend on the method chosen to sample the scenarios. Statistically sound estimation of the robustness of the plan in the dosimetric space may provide an improved insight on the actual robustness of the plan for a given confidence level.
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Affiliation(s)
- E Sterpin
- KU Leuven, Department of Oncology, Laboratory of Experimental Radiotherapy, Leuven, Belgium
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium
| | - Sara T Rivas
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium
| | - F Van den Heuvel
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
- Dept of Haematology/Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - B George
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - J A Lee
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium
| | - K Souris
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium
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Speight R, Tyyger M, Schmidt M, Liney G, Johnstone R, Eccles C, Dubec M, George B, Henry A, Nyholm T, Mahmood F, Korhonen J, Sims R, Tijssen R, Vanhoutte F, Busoni S, Lacornerie T, McCallum H. PH-0406: An IPEM international survey of MRI use for external beam RT treatment planning. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00428-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Teoh S, Fiorini F, George B, Vallis KA, Van den Heuvel F. Proton vs photon: A model-based approach to patient selection for reduction of cardiac toxicity in locally advanced lung cancer. Radiother Oncol 2020; 152:151-162. [PMID: 31431365 PMCID: PMC7707354 DOI: 10.1016/j.radonc.2019.06.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE/OBJECTIVE To use a model-based approach to identify a sub-group of patients with locally advanced lung cancer who would benefit from proton therapy compared to photon therapy for reduction of cardiac toxicity. MATERIAL/METHODS Volumetric modulated arc photon therapy (VMAT) and robust-optimised intensity modulated proton therapy (IMPT) plans were generated for twenty patients with locally advanced lung cancer to give a dose of 70 Gy (relative biological effectiveness (RBE)) in 35 fractions. Cases were selected to represent a range of anatomical locations of disease. Contouring, treatment planning and organs-at-risk constraints followed RTOG-1308 protocol. Whole heart and ub-structure doses were compared. Risk estimates of grade⩾3 cardiac toxicity were calculated based on normal tissue complication probability (NTCP) models which incorporated dose metrics and patients baseline risk-factors (pre-existing heart disease (HD)). RESULTS There was no statistically significant difference in target coverage between VMAT and IMPT. IMPT delivered lower doses to the heart and cardiac substructures (mean, heart V5 and V30, P < .05). In VMAT plans, there were statistically significant positive correlations between heart dose and the thoracic vertebral level that corresponded to the most inferior limit of the disease. The median level at which the superior aspect of the heart contour began was the T7 vertebrae. There was a statistically significant difference in dose (mean, V5 and V30) to the heart and all substructures (except mean dose to left coronary artery and V30 to sino-atrial node) when disease overlapped with or was inferior to the T7 vertebrae. In the presence of pre-existing HD and disease overlapping with or inferior to the T7 vertebrae, the mean estimated relative risk reduction of grade⩾3 toxicities was 24-59%. CONCLUSION IMPT is expected to reduce cardiac toxicity compared to VMAT by reducing dose to the heart and substructures. Patients with both pre-existing heart disease and tumour and nodal spread overlapping with or inferior to the T7 vertebrae are likely to benefit most from proton over photon therapy.
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Affiliation(s)
- S Teoh
- CRUK/MRC Oxford Institute for Radiation Oncology, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ, UK; Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, OX3 7LE, UK.
| | - F Fiorini
- CRUK/MRC Oxford Institute for Radiation Oncology, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ, UK; Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, OX3 7LE, UK
| | - B George
- CRUK/MRC Oxford Institute for Radiation Oncology, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ, UK; Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, OX3 7LE, UK
| | - K A Vallis
- CRUK/MRC Oxford Institute for Radiation Oncology, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ, UK; Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, OX3 7LE, UK
| | - F Van den Heuvel
- CRUK/MRC Oxford Institute for Radiation Oncology, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ, UK; Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, OX3 7LE, UK
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Drabble J, Das P, Camilleri P, Nash A, George B. Inter- and Intra-Fraction Movement of Prostate and Seminal Vesicles: Analysis from MR-Guided Hypo-Fractioned Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Nash A, Good J, Gaya A, Drabble J, George B. Creation of High-Quality Robust Pancreas Plans for Daily Adaptive Hypofractionated Stereotactic Radiotherapy on the 0.35T MRI Linac. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Juloori A, Liao C, Lemons J, Singh A, Iyer R, Robbins J, George B, Fung J, Pillai A, Arif F, Sharma M, Liauw S. Phase I Study of Stereotactic Body Radiotherapy followed by Ipilimumab with Nivolumab vs. Nivolumab alone in Unresectable Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Chung V, Alistar A, George B, Kim K, Kindler H, Oh D, Allen S, Barak H, Ci B, Lau J, Retiere A, Shemesh C, Teichgräber V, Zhang X, Lopez C. SO-4 phase Ib/II, open-label, randomised evaluation of atezolizumab plus RO6874281 vs control in MORPHEUS–pancreatic ductal adenocarcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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22
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Lee MS, Ryoo BY, Hsu CH, Numata K, Stein S, Verret W, Hack SP, Spahn J, Liu B, Abdullah H, Wang Y, He AR, Lee KH, Bang YJ, Bendell J, Chao Y, Chen JS, Chung HC, Davis SL, Dev A, Gane E, George B, He AR, Hochster H, Hsu CH, Ikeda M, Lee J, Lee M, Mahipal A, Manji G, Morimoto M, Numata K, Pishvaian M, Qin S, Ryan D, Ryoo BY, Sasahira N, Stein S, Strickler J, Tebbutt N. Atezolizumab with or without bevacizumab in unresectable hepatocellular carcinoma (GO30140): an open-label, multicentre, phase 1b study. Lancet Oncol 2020. [DOI: 10.1016/s1470-2045(20)30156-x 10.1016/s1470-2045(20)30156-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Affiliation(s)
- U Kulkarni
- Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - B George
- Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India
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Bolckmans R, Singh S, Ratnatunga K, Wickramasinghe D, Sahnan K, Adegbola S, Kalman D, Jones H, Travis S, Warusavitarne J, Myrelid P, George B. Temporary faecal diversion in ileocolic resection for Crohn's disease: is there an impact on long-term surgical recurrence? Colorectal Dis 2020; 22:430-438. [PMID: 31715062 DOI: 10.1111/codi.14895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022]
Abstract
AIM Temporary faecal diversion after ileocolic resection (ICR) for Crohn's disease reduces postoperative anastomotic complications in high-risk patients. The aim of this study was to assess if this approach also reduces long-term surgical recurrence. METHOD This was a multicentre retrospective review of prospectively maintained databases. Patient demographics, medical and surgical details were collected by three specialist centres. All patients had undergone an ICR between 2000 and 2012. The primary end-point was surgical recurrence. RESULTS Three hundred and twelve patients (80%) underwent an ICR without covering ileostomy (one stage). Seventy-seven (20%) had undergone an ICR with end ileostomy/double-barrel ileostomy/enterocolostomy followed by closure (two stage). The median follow-up was 105 months [interquartile range (IQR) 76-136 months]. The median time to ileostomy closure was 9 months (IQR 5-12 months). There was no significant difference in surgical recurrence between the one- and two-stage groups (18% vs 16%, P = 0.94). We noted that smokers (20% vs 34%, P = 0.01) and patients with penetrating disease (28% vs 52%, P < 0.01) were more likely to be defunctioned. A reduced recurrence rate was observed in the small high-risk group of patients who were smokers with penetrating disease behaviour treated with a two-stage strategy (0/10 vs 4/7, P = 0.12). CONCLUSION Despite having higher baseline risk factors, the results in terms of rate of surgical recurrence over 9 years are similar for patients having a two-stage compared with a one-stage procedure.
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Affiliation(s)
- R Bolckmans
- Department of Colorectal Surgery, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Singh
- Department of Colorectal Surgery, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K Ratnatunga
- Department of Colorectal Surgery, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - D Wickramasinghe
- Department of Colorectal Surgery, St Mark's Hospital, London, UK
| | - K Sahnan
- Department of Colorectal Surgery, St Mark's Hospital, London, UK
| | - S Adegbola
- Department of Colorectal Surgery, St Mark's Hospital, London, UK
| | - D Kalman
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Surgery, County Council of Östergötland, Linköping, Sweden
| | - H Jones
- Department of Colorectal Surgery, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Travis
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - J Warusavitarne
- Department of Colorectal Surgery, St Mark's Hospital, London, UK
| | - P Myrelid
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Surgery, County Council of Östergötland, Linköping, Sweden
| | - B George
- Department of Colorectal Surgery, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Menon S, Ellis C, Poudel S, Johnson J, Szabo A, George B, Kevin Kelly W, Grant S, McPherson J, Cristofanilli M, Hoimes C, Gutierrez M, Doudement J, Chan L, Singal G, Alexander B, Miller V, Sohal D. B08 Impact of Concurrent STK11 Loss and c-MYC Amplification in Metastatic Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Das A, George B, Ranebennur V, Parthasarathy MR, Shreenivas GS, Todankar P, Shrivastav A, Reddy AK, Akolo C, Cassell M, Mane S, Tripathi D, Baishya J. Getting to the First 90: Incentivized Peer Mobilizers Promote HIV Testing Services to Men Who Have Sex With Men Using Social Media in Mumbai, India. Glob Health Sci Pract 2019; 7:469-477. [PMID: 31558601 PMCID: PMC6816816 DOI: 10.9745/ghsp-d-19-00094] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 06/11/2019] [Indexed: 11/15/2022]
Abstract
Recent studies of Indian men who have sex with men (MSM) have shown widespread use of social media for seeking sex partners. We piloted a peer mobilization approach to explore the feasibility of engaging previously unreached MSM online to link them to HIV testing services (HTS). MSM were encouraged to seek HTS through messages posted on a popular dating website. Those who visited the designated HTS site and tested for HIV were recruited as peer mobilizers and given coupons with unique identifying codes to distribute to other men in their virtual networks. If a network member presented at the site with a coupon and tested for HIV, the peer mobilizer was given a small monetary incentive. Network members presenting at the testing site were also recruited as peer mobilizers and given coupons. In a 6-month period, 247 MSM were recruited and tested for HIV and syphilis, of whom 244 (99%) were first-time testers. Two-thirds were less than 25 years old and about half reported inconsistent or no condom use during the last 10 anal sex acts. Eight individuals (3.2%) tested positive for HIV, and 22 (8.9%) had a high titer for syphilis; all were referred to tertiary hospitals for treatment. Our approach was modestly successful in reaching and providing HTS to previously unreached MSM, but challenges included lower-than-expected recruitment, individuals not returning for posttest counseling, and loss to follow-up of individuals with HIV. The next phase of peer mobilization will aim to scale up these services through government-supported targeted interventions for this subpopulation of primarily young, unreached MSM at high risk. The challenges will be addressed by targeting more dating sites, increasing access to testing using rapid HIV tests at several community-based facilities, and offering peer navigation support for people living with HIV.
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Affiliation(s)
- Anjana Das
- FHI 360, New Delhi, India. Now an independent consultant.
| | | | | | | | | | | | | | | | | | | | | | | | - Jiban Baishya
- United States Agency for International Development, New Delhi, India
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Sudhir PK, Varghese KG, George B. Evaluation of academic performance of undergraduate dental students in a government medical university in Kerala, India. Indian J Dent Res 2019; 30:175-179. [PMID: 31169145 DOI: 10.4103/ijdr.ijdr_692_17] [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: 11/04/2022] Open
Abstract
Introduction Dentistry is considered to be a high-stress profession. The educational period in dental schools is viewed as a highly demanding and stressful learning environment. The aim of the study was to evaluate the academic performance of undergraduate dental students of 2010, 2011, and 2012 batches admitted at Kerala University of Health Sciences. Materials and Methods The present retrospective study evaluated the performance of dental students of 2010, 2011, and 2012 batches from their first Bachelor of Dental Surgery (BDS) to the completion of final BDS Part 2 examination. The study was carried out from August 2010 to March 2017. The data were analyzed using SPSS version 19 software. Chi-square test was used for analyzing the significance of difference between proportions. The level of significance was set at P < 0.05. Results The results of first BDS students of 2010, 2011, and 2012 batches were 35.8%, 49.9%, and 55.5%, respectively. Whereas, the results of the final BDS Part 2 students of 2010, 2011, and 2012 batches were 92.6%, 88.4%, and 92.5%, respectively. Conclusion The present study shows a decline in performance of dental students at the time of inception of the university, and as time progressed, the results of the students showed significant improvement.
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Affiliation(s)
- P K Sudhir
- Controller of Examinations, Kerala University of Health Sciences, Thrissur, Kerala, India
| | - K G Varghese
- Department of Oral and Maxillofacial Surgery, Pushpagiri College of Dental Sciences, Kerala, India
| | - B George
- Department of Public Health Dentistry, Pushpagiri College of Dental Sciences, Kerala, India
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Babatunde O, O’Cathail S, Cooke R, George B, Robinson M, Van den Heuvel F, Hawkins M. PO-1121 Characterizing Dosimetric Uncertainties to Tumour Volume and Organs at Risk in Rectal Cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31541-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kelm S, Longo J, Bedi M, Siker M, Thomas J, George B, Ludwig K, Peterson C, Ridolfi T, Erickson B. The Impact of Hemoglobin on Outcomes in Anal Canal Cancer Treated with Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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30
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Witztum A, Holyoake D, George B, Van Den Heuvel F, Hawkins M. Interfraction Duodenal Dose-Surface Map Changes with and without Abdominal Compression. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Johnson M, Patel M, Ulahannan S, Hansen A, George B, Chu QC, Elgadi M, Ge M, Duffy C, Graeser R, Khedkar S, Jones S, Burris H. Phase I study of BI 754111 (anti-LAG-3) plus BI 754091(anti-PD-1) in patients (pts) with advanced solid cancers, followed by expansion in pts with microsatellite stable metastatic colorectal cancer (mCRC), anti-PD-(L)1-pretreated non-small cell lung cancer (NSCLC) and other solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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George B, Song W. Risk for Eating Disorders Among US Army Reserve Officer Training Corps (ROTC) Cadets in Midwest. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.08.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mohanan E, Panetta JC, Lakshmi KM, Edison ES, Korula A, Fouzia NA, Abraham A, Viswabandya A, Mathews V, George B, Srivastava A, Balasubramanian P. Correction: Population pharmacokinetics of fludarabine in patients with aplastic anemia and Fanconi anemia undergoing allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2018; 53:1490. [PMID: 30135463 PMCID: PMC6327191 DOI: 10.1038/s41409-018-0276-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article was originally published under a CC BY-NC-ND 4.0 license, but has now been made available under a CC BY 4.0 license. The PDF and HTML versions of the article have been modified accordingly.
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Affiliation(s)
- E Mohanan
- Department of Hematology, Christian Medical College, Vellore, India
| | - J C Panetta
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - K M Lakshmi
- Department of Hematology, Christian Medical College, Vellore, India
| | - E S Edison
- Department of Hematology, Christian Medical College, Vellore, India
| | - A Korula
- Department of Hematology, Christian Medical College, Vellore, India
| | - N A Fouzia
- Department of Hematology, Christian Medical College, Vellore, India
| | - A Abraham
- Department of Hematology, Christian Medical College, Vellore, India
| | - A Viswabandya
- Department of Hematology, Christian Medical College, Vellore, India
| | - V Mathews
- Department of Hematology, Christian Medical College, Vellore, India
| | - B George
- Department of Hematology, Christian Medical College, Vellore, India
| | - A Srivastava
- Department of Hematology, Christian Medical College, Vellore, India
| | - P Balasubramanian
- Department of Hematology, Christian Medical College, Vellore, India.
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Elayaperumal S, Fouzia NA, Biswas A, Nair SC, Viswabandya A, George B, Abraham A, Oldenburg J, Edison ES, Srivastava A. Type-3 von Willebrand disease in India-Clinical spectrum and molecular profile. Haemophilia 2018; 24:930-940. [PMID: 29984440 DOI: 10.1111/hae.13542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Type 3 von Willebrand disease (VWD) is the rare and most severe form of VWD which results from a near-complete deficiency of the von Willebrand factor (VWF). This study evaluates in detail the molecular pathology of type-3 VWD in India. One hundred and two patients from 90 families were evaluated. PATIENTS AND METHODS Phenotypic data, including bleeding scores (BS), were documented using structured questionnaires. Diagnosis of type 3 VWD was based on undetectable VWF antigen levels in the plasma. Genomic DNA from these patients was screened for mutations in VWF gene. Structural modeling and expression studies were carried out for missense mutations. RESULTS Out of 102 patients, mutations could be identified in 91% (n = 93). Fifty-five different gene variants were identified. Thirty-four (61.8%) were novel. Mutations could be identified in both the alleles in 90 patients, while no causative mutation could be identified in 9 patients; twenty-four (23.5%) patients had mutations clustered in the propeptide region of VWF. Interestingly, five mutations accounted for the defects in 37/93 (39.8%) patients. Structural analysis and in vitro studies on missense mutations imply impaired processes associated with secretion of VWF. CONCLUSION This study is one of the largest series to define the molecular basis of type-3 VWD.
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Affiliation(s)
- S Elayaperumal
- Department of Hematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - N A Fouzia
- Department of Hematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Biswas
- Institute of Experimental Hematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany
| | - S C Nair
- Department of Immunohaematology & Transfusion Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Viswabandya
- Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - B George
- Department of Hematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Abraham
- Department of Hematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Oldenburg
- Institute of Experimental Hematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany
| | - E S Edison
- Department of Hematology, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Srivastava
- Department of Hematology, Christian Medical College, Vellore, Tamil Nadu, India
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Mahabal GD, George L, Peter D, Bindra M, Thomas M, Srivastava A, Mathews V, George B, Pulimood SA. Utility of tissue elafin as an immunohistochemical marker for diagnosis of acute skin graft-versus-host disease: a pilot study. Clin Exp Dermatol 2018; 44:161-168. [DOI: 10.1111/ced.13678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 12/25/2022]
Affiliation(s)
- G. D. Mahabal
- Department of Dermatology; Christian Medical College; Vellore Tamil Nadu India
| | - L. George
- Department of Dermatology; Christian Medical College; Vellore Tamil Nadu India
| | - D. Peter
- Department of Dermatology; Christian Medical College; Vellore Tamil Nadu India
| | - M. Bindra
- Department of Pathology; Christian Medical College; Vellore Tamil Nadu India
| | - M. Thomas
- Department of Pathology; Christian Medical College; Vellore Tamil Nadu India
| | - A. Srivastava
- Department of Haematology; Christian Medical College; Vellore Tamil Nadu India
| | - V. Mathews
- Department of Haematology; Christian Medical College; Vellore Tamil Nadu India
| | - B. George
- Department of Haematology; Christian Medical College; Vellore Tamil Nadu India
| | - S. A. Pulimood
- Department of Dermatology; Christian Medical College; Vellore Tamil Nadu India
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Mazzio E, Badisa R, Eyunni S, Ablordeppey S, George B, Soliman KFA. Bioactivity-Guided Isolation of Neuritogenic Factor from the Seeds of the Gac Plant ( Momordica cochinchinensis). Evid Based Complement Alternat Med 2018; 2018:8953958. [PMID: 29955238 PMCID: PMC6000838 DOI: 10.1155/2018/8953958] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/02/2018] [Accepted: 05/10/2018] [Indexed: 12/11/2022]
Abstract
Nerve growth factor (NGF) is an endogenously produced protein with the capacity to induce central nervous system (CNS) neuronal differentiation and repair. NGF signaling involves its binding to tropomyosin-related kinase (Trk) receptors, internalization, and initiation of phosphorylation cascades which cause microtubule reorganization and neuronal outgrowth. Because NGF cannot cross the blood-brain barrier, its therapeutic use is limited. Synthetic peptides that can act as NGF receptor agonists (NGF mimetics) are known to attenuate neurodegenerative pathologies in experimental models of Alzheimer's disease and Parkinson's disease; however, the existence of plant-based NGF mimetics is uncertain. For this reason, we recently completed a high throughput screening of over 1100 nutraceuticals (vitamins, herbal plant parts, polyphenolics, teas, fruits, and vegetables) to identify neuritogenic factor using a PC-12 cell model. Remarkably we found only one, commonly known as the seed of Gac plant (Momordica cochinchinensis) (MCS). In the current study, we further investigated this seed for its neuritogenic effect using bioactivity-guided chemical separations. The data show no biological neuritogenic activity in any chemical solvent fraction, where activity was exclusive to the crude protein. MSC crude proteins were then separated by 1D electrophoresis, where the active neuritogenic activity was confirmed to have a molecular mass of approximately 17 kDa. Subsequently, the 17kDa band was excised, digested, and run on a UPLC-MS/MS with a Q Exactive Hybrid Quadrupole-Orbitrap Mass Spectrometer with data evaluated diverse tools such as X! Tandem, OMS, and K-score algorithms. Proteomic evaluation of the 17kDa band confirmed evidence for 11S globulin subunit beta, napin, oleosin, Momordica trypsin inhibitors (TI) MCoTI-I /II, and many isoforms of Two Inhibitor Peptide Topologies (TIPTOPs). While all peptides identified correspond to the genus/species, Momordica cochinchinensis and Cucumis Sativus, a significant limitation of the analysis is the nonexistence of full annotation for the Momordica cochinchinensis proteome. In conclusion, these findings demonstrate that there is a stable protein within MCS having a mass of 17kDa with the capacity to induce neurite outgrowth. Future work will be required to establish the therapeutic value of the MCS for the treatment of neurodegenerative diseases.
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Affiliation(s)
- E. Mazzio
- College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - R. Badisa
- College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - S. Eyunni
- College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - S. Ablordeppey
- College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - B. George
- College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - K. F. A. Soliman
- College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
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Ris F, Liot E, Buchs NC, Kraus R, Ismael G, Belfontali V, Douissard J, Cunningham C, Lindsey I, Guy R, Jones O, George B, Morel P, Mortensen NJ, Hompes R, Cahill RA. Multicentre phase II trial of near-infrared imaging in elective colorectal surgery. Br J Surg 2018; 105:1359-1367. [PMID: 29663330 PMCID: PMC6099466 DOI: 10.1002/bjs.10844] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 12/28/2017] [Accepted: 01/28/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Decreasing anastomotic leak rates remain a major goal in colorectal surgery. Assessing intraoperative perfusion by indocyanine green (ICG) with near-infrared (NIR) visualization may assist in selection of intestinal transection level and subsequent anastomotic vascular sufficiency. This study examined the use of NIR-ICG imaging in colorectal surgery. METHODS This was a prospective phase II study (NCT02459405) of non-selected patients undergoing any elective colorectal operation with anastomosis over a 3-year interval in three tertiary hospitals. A standard protocol was followed to assess NIR-ICG perfusion before and after anastomosis construction in comparison with standard operator visual assessment alone. RESULTS Five hundred and four patients (median age 64 years, 279 men) having surgery for neoplastic (330) and benign (174) pathology were studied. Some 425 operations (85·3 per cent) were started laparoscopically, with a conversion rate of 5·9 per cent. In all, 220 patients (43·7 per cent) underwent high anterior resection or reversal of Hartmann's operation, and 90 (17·9 per cent) low anterior resection. ICG angiography was achieved in every patient, with a median interval of 29 s to visualization of the signal after injection. NIR-ICG assessment resulted in a change in the site of bowel division in 29 patients (5·8 per cent) with no subsequent leaks in these patients. Leak rates were 2·4 per cent overall (12 of 504), 2·6 per cent for colorectal anastomoses and 3 per cent for low anterior resection. When NIR-ICG imaging was used, the anastomotic leak rates were lower than those in the participating centres from over 1000 similar operations performed with identical technique but without NIR-ICG technology. CONCLUSION Routine NIR-ICG assessment in patients undergoing elective colorectal surgery is feasible. NIR-ICG use may change intraoperative decisions, which may lead to a reduction in anastomotic leak rates.
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Affiliation(s)
- F Ris
- Department of Surgery, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - E Liot
- Department of Surgery, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - N C Buchs
- Department of Surgery, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.,Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - R Kraus
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - G Ismael
- Department of Surgery, Mater Misericordiae University Hospital, and Section of Surgery and Surgical Sciences, University College Dublin, Dublin, Ireland
| | - V Belfontali
- Department of Surgery, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - J Douissard
- Department of Surgery, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - C Cunningham
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - I Lindsey
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - R Guy
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - O Jones
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - B George
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - P Morel
- Department of Surgery, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - N J Mortensen
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - R Hompes
- Departments of Colorectal Surgery, Oxford University Hospitals, Oxford, UK
| | - R A Cahill
- Department of Surgery, Mater Misericordiae University Hospital, and Section of Surgery and Surgical Sciences, University College Dublin, Dublin, Ireland
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Teoh S, Fiorini F, George B, Vallis K, Van den Heuvel F. EP-2062: Probabilistic scenarios for assessing setup uncertainty in VMAT and IMPT plans for lung cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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George B, Teoh S, Shukla V, Petillion S, Verhoeven K, Weltens C, Van den Heuvel F. EP-1917: Comparison of Robustness Metrics in Intensity Modulated Proton Therapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32226-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Goldman J, Waterhouse D, George B, O'Dwyer P, Chen T, Trunova N, Kelly K. P1.03-026 Interim Results of a Phase I Study of Nivolumab plus Nab-Paclitaxel/Carboplatin in Patients with NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Ntentas G, Dedeckova K, Andrilik M, Aznar M, George B, Darby S, Cutter D. Predicted Cardiac and Second Cancer Risks in Hodgkin Lymphoma Patients Treated With Advanced Proton Beam Therapy Compared to Photon Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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42
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Saeed H, Cheng H, Aldakkak M, Tsai S, Evans D, Christians K, Thomas J, George B, Ritch P, Hall W, Erickson B, Wittmann D. Neoadjuvant Chemoradiation With IMRT for Pancreatic Cancer is Associated With Minimal Toxicity without Compromising Local Control. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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43
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Marzook H, Deivendran S, George B, Reshmi G, Santhoshkumar TR, Kumar R, Pillai MR. Cytoplasmic translocation of MTA1 coregulator promotes de-repression of SGK1 transcription in hypoxic cancer cells. Oncogene 2017; 36:5263-5273. [PMID: 28504714 DOI: 10.1038/onc.2017.19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/16/2016] [Accepted: 01/05/2017] [Indexed: 12/17/2022]
Abstract
Chromatin remodeling factor metastatic tumor protein 1 (MTA1), one of the most upregulated oncogene in human cancer, has an important role in gene expression, cell survival and promoting hypoxic response. Successful cancer progression is dependent on the ability of cells to utilize its survival pathways for adapting to hypoxic microenvironment. Although MTA1 is a stress-responsive gene, but whether hypoxia modulates its function and its role in engaging other core stress-responsive survival pathway(s) remains unknown. Here we have discovered that MTA1 is a novel corepressor of serum and glucocorticoid-inducible kinase 1 (SGK1). Surprisingly, this regulatory corepressive function of MTA1 is lost under hypoxia, allowing upregulation of SGK1 expression and engaging the MTA1-SGK1 axis for the benefit of the cell survival. The underlying mechanism of the noticed stimulation of SGK1 expression by hypoxia includes de-repression of SGK1 transcription because of hypoxia-triggered nucleus-to-cytoplasmic translocation of MTA1. In addition, the newly recognized cytoplasmic translocation of MTA1 was dependent on the chaperoning function of heat shock protein 90 (HSP90) and co-accompanied by the formation of MTA1, HSP90 and HIF1α complex under hypoxic condition but not under normoxic condition. Hypoxia-triggered redistribution of MTA1, SGK1 upregulation and cell survival functions were compromised by a pharmacological SGK1 inhibitor. In summary, for the first time, we report MTA1 regulation of SGK1 expression, hypoxia-dependent MTA1 translocation to the cytoplasm and de-repression of SGK1 transcription. These findings illustrate how cancer cells utilize a chromatin remodeling factor to engage a core survival pathway to support its cancerous phenotypes, and reveal new facets of MTA1-SGK1 axis by a physiologic signal in cancer progression.
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Affiliation(s)
- H Marzook
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - S Deivendran
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - B George
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - G Reshmi
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - T R Santhoshkumar
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - R Kumar
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
- Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - M R Pillai
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
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Singavi A, Menon S, Kilari D, Alqwasmi A, Ritch P, Thomas J, Martin A, Oxencis C, Ali S, George B. Predictive biomarkers for hyper-progression (HP) in response to immune checkpoint inhibitors (ICI) – analysis of somatic alterations (SAs). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ntentas G, Dedeckova K, Andrilik M, Aznar M, George B, Darby S, Cutter D. PREDICTED CARDIAC AND SECOND CANCER RISKS IN HODGKIN LYMPHOMA PATIENTS TREATED WITH ADVANCED PROTON BEAM THERAPY COMPARED TO PHOTON RADIOTHERAPY. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- G. Ntentas
- Nuffield Department of Population Health; University of Oxford; Oxford UK
| | - K. Dedeckova
- Oncology; Proton Therapy Center Praha; Prague Czech Republic
| | - M. Andrilik
- Oncology; Proton Therapy Center Praha; Prague Czech Republic
| | - M.C. Aznar
- Nuffield Department of Population Health; University of Oxford; Oxford UK
| | - B. George
- Department of Oncology; University of Oxford; Oxford UK
| | - S. Darby
- Nuffield Department of Population Health; University of Oxford; Oxford UK
| | - D. Cutter
- Nuffield Department of Population Health; University of Oxford; Oxford UK
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Van den Heuvel F, Fiorini F, George B. PO-0830: Quantification of density and tissue changes in pencil beam scanning proton treatment. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31267-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Falls C, Lolay G, Kido K, George B, Omar H, Guglin M. A Longitudinal Analysis of NT-proBNP After LVAD Implantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Martí-Gallostra M, Myrelid P, Mortensen N, Keshav S, Travis SPL, George B. The role of a defunctioning stoma for colonic and perianal Crohn's disease in the biological era. Scand J Gastroenterol 2017; 52:251-256. [PMID: 27855530 DOI: 10.1080/00365521.2016.1205127] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE A defunctioning stoma is a therapeutic option for colonic or perianal Crohn's disease. In the pre-biologic era the response rate to defunctioning in our unit was high (86%), but intestinal continuity was only restored in 11-20%. Few data exist on the outcome of defunctioning since the widespread introduction of biologicals. MATERIAL AND METHODS All patients undergoing a defunctioning stoma for colonic/perianal Crohn's disease since 2003-2011 were identified from a prospective database. Indications for surgery, medical therapy, response to defunctioning and long-term clinical outcome were recorded. Successful restoration of continuity was defined as no stoma at last follow up. RESULTS Seventy-six patients were defunctioned (57 with biologicals) and at last follow up, 20 (27%) had continuity restored. Early clinical response rate (<3 months) was 15/76 (20%) and overall response 31/76 (41%). Complex anal fistulae/stenosis were associated with a very low chance of restoring continuity (10% and 0%, respectively), while colitis was associated with a higher chance of restoring continuity (48%). Endoscopic or histological improvement in colitis after defunctioning was associated with a higher rate of restoring continuity (10/16, 63%) compared to no such improvement (4/15, 27%, p = 0.05). Those failing biologics had similar chance of restoration as those not receiving biologics, 15/57 (26%) and 5/19 (26%), respectively. CONCLUSION Overall response to colonic defunctioning was 41%. Successful restoration of continuity occurred in 27%, but 48% in the absence of perianal disease. Response is appreciably less in the pre-biologic era, so patient and physician expectations need to be managed appropriately.
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Affiliation(s)
- M Martí-Gallostra
- a Unit of Colorectal Surgery, Department of General Surgery , Hospital Universitari Vall Hebrón , Barcelona , Spain.,b Unit of Colorectal Surgery, Department of Surgery , Oxford University Hospitals , Oxford , UK
| | - P Myrelid
- b Unit of Colorectal Surgery, Department of Surgery , Oxford University Hospitals , Oxford , UK.,c Division of Surgery, Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden.,d Department of Surgery , County Council of Östergötland , Linköping , Sweden
| | - N Mortensen
- b Unit of Colorectal Surgery, Department of Surgery , Oxford University Hospitals , Oxford , UK
| | - S Keshav
- e Translational Gastroenterology Unit , Oxford University Hospitals , Oxford , UK
| | - S P L Travis
- e Translational Gastroenterology Unit , Oxford University Hospitals , Oxford , UK
| | - B George
- b Unit of Colorectal Surgery, Department of Surgery , Oxford University Hospitals , Oxford , UK
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Rajamanickam ESP, Christians KK, Aldakkak M, Krepline AN, Ritch PS, George B, Erickson BA, Foley WD, Aburajab M, Evans DB, Tsai S. Poor Glycemic Control Is Associated with Failure to Complete Neoadjuvant Therapy and Surgery in Patients with Localized Pancreatic Cancer. J Gastrointest Surg 2017; 21:496-505. [PMID: 27896658 DOI: 10.1007/s11605-016-3319-4] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 10/31/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND The impact of glycemic control in patients with pancreatic cancer treated with neoadjuvant therapy is unclear. METHODS Glycated hemoglobin (HbA1c) values were measured in patients with localized pancreatic cancer prior to any therapy (pretreatment) and after neoadjuvant therapy prior to surgery (preoperative). HbA1c levels greater than 6.5% were classified as abnormal. Patients were categorized based on the change in HbA1c levels from pretreatment to preoperative: GrpA, always normal; Gr B, worsened; GrpC, improved; and GrpD, always abnormal. RESULTS Pretreatment HbA1c levels were evaluable in 123 patients; there were 67 (55%) patients in GrpA, 8 (6%) in GrpB, 22 (18%) in GrpC, and 26 (21%) in GrpD. Of the 123 patients, 92 (75%) completed all intended therapy to include surgery; 57 (85%) patients in GrpA, 4 (50%) patients in GrpB, 16 (72%) patients in GrpC, and 15 (58%) patients in GrpD (p = 0.01). Elevated preoperative carbohydrate antigen 19-9 (CA19-9) (OR 0.22;[0.07-0.66]), borderline resectable (BLR) disease stage (OR 0.20;[0.01-0.45]) and abnormal preoperative HbA1c (OR 0.30;[0.11-0.90]) were negatively associated with completion of all intended therapy. Abnormal preoperative HbA1c was associated with a 2.74-fold increased odds of metastatic progression during neoadjuvant therapy (p = 0.08). CONCLUSIONS Elevated preoperative HbA1c is associated with failure to complete neoadjuvant therapy and surgery and a trend for increased risk of metastatic progression.
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Affiliation(s)
- E S Paul Rajamanickam
- Department of Surgery (Division of Surgical Oncology), Pancreatic Cancer Program, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, 53226, USA
| | - K K Christians
- Department of Surgery (Division of Surgical Oncology), Pancreatic Cancer Program, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, 53226, USA
| | - M Aldakkak
- Department of Surgery (Division of Surgical Oncology), Pancreatic Cancer Program, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, 53226, USA
| | - A N Krepline
- Department of Surgery (Division of Surgical Oncology), Pancreatic Cancer Program, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, 53226, USA
| | - P S Ritch
- Department of Medicine, Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - B George
- Department of Medicine, Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - B A Erickson
- Department of Radiation Oncology, Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - W D Foley
- Department of Radiology, Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Aburajab
- Department of Gastroenterology, Pancreatic Cancer Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - D B Evans
- Department of Surgery (Division of Surgical Oncology), Pancreatic Cancer Program, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, 53226, USA
| | - S Tsai
- Department of Surgery (Division of Surgical Oncology), Pancreatic Cancer Program, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, 53226, USA.
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Arun AK, Senthamizhselvi A, Mani S, Vinodhini K, Janet NB, Lakshmi KM, Abraham A, George B, Srivastava A, Srivastava VM, Mathews V, Balasubramanian P. Frequency of rare BCR-ABL1 fusion transcripts in chronic myeloid leukemia patients. Int J Lab Hematol 2016; 39:235-242. [PMID: 28035733 DOI: 10.1111/ijlh.12616] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 09/13/2016] [Accepted: 11/24/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The hallmark of chronic myeloid leukemia (CML) is the presence of Philadelphia chromosome, its resultant fusion transcript (BCR-ABL1), and fusion protein (p210). Alternate breakpoints in BCR (m-bcr, μ-bcr, and others) or ABL1 result in the expression of few rare fusion transcripts (e19a2, e1a2, e13a3, e14a3) and fusion proteins (p190, p200, p225) whose exact clinical significance remains to be determined. METHODS Our study was designed to determine the type and frequency of BCR-ABL1 fusion transcripts in 1260 CML patients and to analyze the prognosis and treatment response in patients harboring rare BCR-ABL1 fusion transcripts. RESULTS The frequency of various BCR-ABL1 fusion transcripts was as follows: e14a2 (60%), e13a2 (34.3%), e1a2 (1.2%), e1a2 + e13a2 (2.0%), e1a2 + e14a2 (1.8%), e19a2 (0.3%), and e14a3 (0.3%). CML patients with e1a2 transcripts had higher rates of disease progression, resistance, or suboptimal response to imatinib and failed to achieve major molecular response. CONCLUSION Characterization of the specific fusion transcript in CML patients is important owing to the difference in prognosis and response to therapy in addition to the conventional need for monitoring treatment response. CML patients with e1a2 transcripts have to be closely monitored due to the high incidence of disease progression and treatment resistance/failure.
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Affiliation(s)
- A K Arun
- Department of Haematology, Christian Medical College, Vellore, India
| | - A Senthamizhselvi
- Department of Haematology, Christian Medical College, Vellore, India
| | - S Mani
- Department of Haematology, Christian Medical College, Vellore, India
| | - K Vinodhini
- Department of Haematology, Christian Medical College, Vellore, India
| | - N B Janet
- Department of Haematology, Christian Medical College, Vellore, India
| | - K M Lakshmi
- Department of Haematology, Christian Medical College, Vellore, India
| | - A Abraham
- Department of Haematology, Christian Medical College, Vellore, India
| | - B George
- Department of Haematology, Christian Medical College, Vellore, India
| | - A Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | - V M Srivastava
- Cytogenetics Unit, Christian Medical College, Vellore, India
| | - V Mathews
- Department of Haematology, Christian Medical College, Vellore, India
| | - P Balasubramanian
- Department of Haematology, Christian Medical College, Vellore, India
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