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Wekking D, Porcu M, Pellegrino B, Lai E, Mura G, Denaro N, Saba L, Musolino A, Scartozzi M, Solinas C. Multidisciplinary clinical guidelines in proactive monitoring, early diagnosis, and effective management of trastuzumab deruxtecan (T-DXd)-induced interstitial lung disease (ILD) in breast cancer patients. ESMO Open 2023; 8:102043. [PMID: 37951130 PMCID: PMC10679891 DOI: 10.1016/j.esmoop.2023.102043] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 11/13/2023] Open
Abstract
Trastuzumab deruxtecan (T-DXd), a human epidermal growth factor receptor 2 (HER2)-directed antibody-drug conjugate (ADC), has altered the treatment landscape in breast cancer (BC), irrespective of the HR-receptor status. The use of the agent is increasing, despite the finding that exposure to T-DXd increases the risk of interstitial lung disease (ILD), particularly in BC patients. Although T-DXd-related ILD can be potentially severe and life-threatening, most low-grade cases can be treated safely using a multidisciplinary approach comprising early and accurate diagnosis, effective management, close monitoring, and the prompt administration of steroids. Additionally, increasing patients' education on ILD symptoms ensures close attention and enables prompt reporting, enhancing patient outcomes. It is recommended that predictive biomarkers are assessed in patients with risk factors for developing ILD. Currently, diagnostic criteria comprise newly identified pulmonary opacities, the relation of symptom onset to medication initiation, and the exclusion of other causes of ILD. The general condition of patients is weakened during the management of ILD (BC progression and corticosteroid treatment). Consequently, BC chemotherapy might be attenuated. This highlights the importance of preventing (high-grade) ILD, especially since its use is expanded. Identifying high-risk patients, diagnosing, and customizing treatment is, however, challenging and additional information on patient selection is often not fully clarified. In this paper, we provide updated multidisciplinary clinical guidance for patient selection, proactive monitoring, early diagnosis, and effectively management of T-DXd-induced ILD in HER2-positive BC patients. We describe the risk factors for developing ILD, patients' characteristics of ILD, and the histopathological and radiographic characteristics of ILD, including real-world clinical practice reports. These recommendations provide a structured step-by-step approach for managing each suspected BC-related ILD grade.
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Affiliation(s)
- D Wekking
- Amsterdam UMC, Location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - M Porcu
- Radiology Department, AOU Cagliari, Cagliari University, Policlinico di Monserrato, Monserrato (CA)
| | - B Pellegrino
- Department of Medicine and Surgery, University of Parma, Parma; Medical Oncology and Breast Unit, University Hospital of Parma, Parma; Gruppo Oncologico Italiano di Ricerca Clinica(GOIRC), Parma
| | - E Lai
- Medical Oncology, AOU Cagliari, Policlinico di Monserrato, Monserrato
| | - G Mura
- Anatomical Pathology, Valdes Laboratory, Cagliari
| | - N Denaro
- IRCCS Fondazone Ca' Granda Policlinico Milano, SC Oncologia, Milan, Italy
| | - L Saba
- Radiology Department, AOU Cagliari, Cagliari University, Policlinico di Monserrato, Monserrato (CA)
| | - A Musolino
- Department of Medicine and Surgery, University of Parma, Parma; Medical Oncology and Breast Unit, University Hospital of Parma, Parma; Gruppo Oncologico Italiano di Ricerca Clinica(GOIRC), Parma
| | - M Scartozzi
- Medical Oncology, AOU Cagliari, Policlinico di Monserrato, Monserrato
| | - C Solinas
- Medical Oncology, AOU Cagliari, Policlinico di Monserrato, Monserrato
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El Haddad L, Lai E, Murthy PKL, Biswas DD, Soufny R, Roger AL, Tata PR, ElMallah MK. GAA deficiency disrupts distal airway cells in Pompe disease. Am J Physiol Lung Cell Mol Physiol 2023; 325:L288-L298. [PMID: 37366541 PMCID: PMC10625827 DOI: 10.1152/ajplung.00032.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 06/28/2023] Open
Abstract
Pompe disease is an autosomal recessive glycogen storage disease caused by mutations in the gene that encodes acid alpha-glucosidase (GAA)-an enzyme responsible for hydrolyzing lysosomal glycogen. GAA deficiency results in systemic lysosomal glycogen accumulation and cellular disruption. Glycogen accumulation in skeletal muscles, motor neurons, and airway smooth muscle cells is known to contribute to respiratory insufficiency in Pompe disease. However, the impact of GAA deficiency on the distal alveolar type 1 and type 2 cells (AT1 and AT2) has not been evaluated. AT1 cells rely on lysosomes for cellular homeostasis so that they can maintain a thin barrier for gas exchange, whereas AT2 cells depend on lysosome-like structures (lamellar bodies) for surfactant production. Using a mouse model of Pompe disease, the Gaa-/- mouse, we investigated the consequences of GAA deficiency on AT1 and AT2 cells using histology, pulmonary function and mechanics, and transcriptional analysis. Histological analysis revealed increased accumulation of lysosomal-associated membrane protein 1 (LAMP1) in the Gaa-/- mice lungs. Furthermore, ultrastructural examination showed extensive intracytoplasmic vacuoles enlargement and lamellar body engorgement. Respiratory dysfunction was confirmed using whole body plethysmography and forced oscillometry. Finally, transcriptomic analysis demonstrated dysregulation of surfactant proteins in AT2 cells, specifically reduced levels of surfactant protein D in the Gaa-/- mice. We conclude that GAA enzyme deficiency leads to glycogen accumulation in the distal airway cells that disrupts surfactant homeostasis and contributes to respiratory impairments in Pompe disease.NEW & NOTEWORTHY This research highlights the impact of Pompe disease on distal airway cells. Prior to this work, respiratory insufficiency in Pompe disease was classically attributed to pathology in respiratory muscles and motor neurons. Using the Pompe mouse model, we note significant pathology in alveolar type 1 and 2 cells with reductions in surfactant protein D and disrupted surfactant homeostasis. These novel findings highlight the potential contributions of alveolar pathology to respiratory insufficiency in Pompe disease.
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Affiliation(s)
- Léa El Haddad
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina, United States
| | - Elias Lai
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina, United States
| | | | - Debolina D Biswas
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina, United States
| | - Rania Soufny
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina, United States
| | - Angela L Roger
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina, United States
| | | | - Mai K ElMallah
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, School of Medicine, Duke University, Durham, North Carolina, United States
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Lai E, Unniappan S. Irisin in domestic animals. Domest Anim Endocrinol 2023; 83:106787. [PMID: 36863302 DOI: 10.1016/j.domaniend.2023.106787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
Irisin is a 112 amino acid peptide hormone cleaved from the fibronectin type III domain-containing protein. Irisin is highly conserved across vertebrates, suggesting evolutionarily conserved common functions among domestic animals. These functions include the browning of white adipose tissue and increased energy expenditure. Irisin has been detected and studied primarily in plasma, serum, and skeletal muscle, but has also been found in adipose tissue, liver, kidney, lungs, cerebrospinal fluid, breast milk, and saliva. This wider tissue presence of irisin suggests additional functions beyond its role as a myokine in regulating energy use. We are beginning to understand irisin in domestic animals. The goal of this review is to provide an up-to-date commentary on irisin structure, tissue distribution, and functions across vertebrates, especially mammals of importance in veterinary medicine. Irisin could be explored as a potential candidate for developing therapeutic agents and biomarkers in domestic animal endocrinology.
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Affiliation(s)
- E Lai
- Department of Veterinary Biomedical Sciences, Laboratory of Integrative Neuroendocrinology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada
| | - S Unniappan
- Department of Veterinary Biomedical Sciences, Laboratory of Integrative Neuroendocrinology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B4, Canada.
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Biswas DD, El Haddad L, Sethi R, Huston ML, Lai E, Abdelbarr MM, Mhandire DZ, ElMallah MK. Neuro-respiratory pathology in spinocerebellar ataxia. J Neurol Sci 2022; 443:120493. [PMID: 36410186 PMCID: PMC9808489 DOI: 10.1016/j.jns.2022.120493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/22/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
The spinocerebellar ataxias (SCA) are a heterogeneous group of neurodegenerative disorders with an autosomal dominant inheritance. Symptoms include poor coordination and balance, peripheral neuropathy, impaired vision, incontinence, respiratory insufficiency, dysphagia, and dysarthria. Although many patients with SCA have respiratory-related complications, the exact mechanism and extent of this pathology remain unclear. This review aims to provide an update on the recent clinical and preclinical scientific findings on neuropathology causing respiratory insufficiency in SCA.
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Affiliation(s)
- Debolina D Biswas
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA
| | - Léa El Haddad
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA
| | - Ronit Sethi
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA
| | - Meredith L Huston
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA
| | - Elias Lai
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA
| | - Mariam M Abdelbarr
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA
| | - Doreen Z Mhandire
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA
| | - Mai K ElMallah
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Box 2644, Durham, NC 27710, USA.
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Saponaro F, Alfi G, Cetani F, Matrone A, Mazoni L, Apicella M, Pardi E, Borsari S, Laurino M, Lai E, Gemignani A, Marcocci C. Serum calcium levels are associated with cognitive function in hypoparathyroidism: a neuropsychological and biochemical study in an Italian cohort of patients with chronic post-surgical hypoparathyroidism. J Endocrinol Invest 2022; 45:1909-1918. [PMID: 35751804 PMCID: PMC9463210 DOI: 10.1007/s40618-022-01822-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/06/2022] [Indexed: 11/14/2022]
Abstract
PURPOSE Hypoparathyroidism (HypoPT) is a rare endocrine disease and conventional therapy is based on calcium and vitamin D analogues. Conventional therapy does not restore calcium homeostasis and patients complain with neuropsychological symptoms, which have been evaluated with nonspecific self-administered questionnaires. This study aims to evaluate cognitive functions of patients with chronic post-surgical (PS)-HypoPT compared to a control population, using a standardized neuropsychological approach and evaluating the relationship with serum calcium (Alb-Ca). METHODS Observational, monocentric study on 33 patients with PS-HypoPT and 24 controls, in whom biochemical testing and a standardized neuropsychological assessment by a trained psychologist were performed. RESULTS In patients with PS-HypoPT, low Alb-Ca correlated with a worse performance on semantic memory abilities and executive function, as suggested by a significant inverse correlation between Alb-Ca and Trail Making Test A (TMT-A) scores (r = - 0.423; p = 0.014) and by a positive correlation with Semantic Fluency Test scores (SF)(r = 0.510; p = 0.002). PS-HypoPT patients with Alb-Ca ≤ 8.9 mg/dl had a significantly lower test performance compared with PS-HypoPT patients with Alb-Ca > 8.9 mg/dl, both at the TMT-A test (mean score: 34.53-18.55; p < 0.0001) and at SF test (mean score: 41.94-48.68; p = 0.01) and also a significantly lower test performance compared with control patients' group at TMT-A (mean score: 34.53-25.5; p = 0.0057). CONCLUSIONS Patients with chronic PS-HypoPT in conventional therapy do not show a severe cognitive impairment; however, cognitive functions namely visuo-spatial attention, executive function and semantic memory appear to be modulated by Alb-Ca and impaired by its low levels.
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Affiliation(s)
- F Saponaro
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
| | - G Alfi
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - F Cetani
- University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy
| | - A Matrone
- University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy
| | - L Mazoni
- University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy
| | - M Apicella
- University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy
| | - E Pardi
- University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy
| | - S Borsari
- University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy
| | - M Laurino
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - E Lai
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - A Gemignani
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - C Marcocci
- University Hospital of Pisa, Endocrine Unit 2, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Roger AL, Sethi R, Huston ML, Scarrow E, Bao-Dai J, Lai E, Biswas DD, Haddad LE, Strickland LM, Kishnani PS, ElMallah MK. What's new and what's next for gene therapy in Pompe disease? Expert Opin Biol Ther 2022; 22:1117-1135. [PMID: 35428407 PMCID: PMC10084869 DOI: 10.1080/14712598.2022.2067476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/14/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Pompe disease is an autosomal recessive disorder caused by a deficiency of acid-α-glucosidase (GAA), an enzyme responsible for hydrolyzing lysosomal glycogen. A lack of GAA leads to accumulation of glycogen in the lysosomes of cardiac, skeletal, and smooth muscle cells, as well as in the central and peripheral nervous system. Enzyme replacement therapy has been the standard of care for 15 years and slows disease progression, particularly in the heart, and improves survival. However, there are limitations of ERT success, which gene therapy can overcome. AREAS COVERED Gene therapy offers several advantages including prolonged and consistent GAA expression and correction of skeletal muscle as well as the critical CNS pathology. We provide a systematic review of the preclinical and clinical outcomes of adeno-associated viral mediated gene therapy and alternative gene therapy strategies, highlighting what has been successful. EXPERT OPINION Although the preclinical and clinical studies so far have been promising, barriers exist that need to be addressed in gene therapy for Pompe disease. New strategies including novel capsids for better targeting, optimized DNA vectors, and adjuctive therapies will allow for a lower dose, and ameliorate the immune response.
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Affiliation(s)
- Angela L. Roger
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Ronit Sethi
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Meredith L. Huston
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Evelyn Scarrow
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Joy Bao-Dai
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Elias Lai
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Debolina D. Biswas
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Léa El Haddad
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Laura M. Strickland
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
| | - Priya S. Kishnani
- Division of Medical Genetics, Department of Pediatrics, Duke University, Durham, North Carolina USA
| | - Mai K. ElMallah
- Division of Pulmonary Medicine, Department of Pediatrics, Duke University Medical Center Box 2644, Durham, North Carolina, 27710, USA
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El Haddad L, Lai E, Murthy P, Tata PR, ElMallah MK. GAA Deficiency Disrupts Distal Airway Cells in Pompe Disease. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.l7829] [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: 11/11/2022]
Affiliation(s)
- Léa El Haddad
- Department of Pediatrics ‐ Division of Pulmonary and Sleep MedicineDuke UniversityDurhamNC
| | - Elias Lai
- Department of Pulmonary and Sleep MedicineDuke UniversityDurhamNC
| | | | | | - Mai K. ElMallah
- Department of Pediatrics ‐ Division of Pulmonary and Sleep MedicineDuke UniversityDurhamNC
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Coghe F, Fanni D, Gerosa C, Ravarino A, Mureddu M, Cerrone G, Coni P, Pichiri G, Congiu T, Piras M, Cau F, Aimola V, Balestrieri A, Lai E, Manchia M, Scano A, Orrù G, La Nasa G, Van Eyken P, Saba L, Scartozzi M, Castagnola M, Faa G. The role of fetal programming in human carcinogenesis - May the Barker hypothesis explain interindividual variability in susceptibility to cancer insurgence and progression? Eur Rev Med Pharmacol Sci 2022; 26:3585-3592. [PMID: 35647840 DOI: 10.26355/eurrev_202205_28854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The growing incidence of cancers is pushing oncologists to find out new explanations other than the somatic mutation theory, based on the accumulation of DNA mutations. In particular, the embryo-fetal exposure to an increasing number of environmental factors during gestation might represent a trigger able to influence the susceptibility of the newborn to develop cancer later in life. This idea agrees with the fetal programming theory, also known as the Barker hypothesis. Here the role of insulin-like growth factors, thymosin beta-4, and epigenome are discussed as mediators of cancer in prenatal human development. The role of epigenetic factors that during gestation increase the predisposition to develop cancer and the similarities in the gene expression (like MMP9, OPN, TP53 and CDKN2A) between embryonic development and cancer are key factors. Likewise, maternal obesity might be able to re-program embryo-fetal development with long-term changes, including an increased risk to develop neuroblastoma and acute leukemia. Birth weight alone and birth weight corrected for gestational age are proposed as important variables capable of predicting the vulnerability to develop cancers. According to the findings here reported, we hypothesize that cancer prevention should start during gestation by improving the quality of maternal diet. In conclusion, the Barker hypothesis should be applied to cancer as well. Therefore, the identification of the epigenetic factors of cancer appears mandatory, so that the cancer prevention might start in the womb before birth.
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Affiliation(s)
- F Coghe
- Department of Clinical Laboratory, Azienda Ospedaliero Universitaria (AOU) di Cagliari - Polo di Monserrato, Cagliari, Italy.
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Wallace S, Kim Y, Lai E, Mehta S, Gaigbe-Togbe B, Zhang C, Von Bargen E, Sokol E. Postoperative complications and pelvic organ prolapse recurrence following combined rectal prolapse and pelvic organ prolapse surgery compared to pelvic organ prolapse surgery only. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.166] [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: 11/01/2022]
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Ziranu P, Aimola V, Pretta A, Cerrone G, Persano M, Liscia N, Dubois M, Migliari M, Sarais F, Cimbro E, Parrino A, Spanu D, Mariani S, Donisi C, Pinna G, Pusceddu V, Puzzoni M, Lai E, Faa G, Scartozzi M. 490P New horizons in metastatic colorectal cancer: Role of CD44 expression. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1009] [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] Open
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Lai E, Murgioni S, Ziranu P, Basile D, Cherri S, Madeddu C, Bergamo F, Piacentini G, Smiroldo V, Squadroni M, De Grandis M, Mascia L, Rosati G, Zampino M, Spallanzani A, Conca V, Palladino M, Flaminio V, Di Bella S, Scartozzi M. 467P Monocyte to red blood cells ratio (MRR): an innovative haematologic prognostic parameter in FOLFIRI-aflibercept treated patients: A subgroup analysis from the DISTINCTIVE trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.988] [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: 11/16/2022] Open
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Rapposelli IG, Shimose S, Kumada T, Okamura S, Hiraoka A, Di Costanzo GG, Marra F, Tamburini E, Forgione A, Foschi FG, Silletta M, Lonardi S, Masi G, Scartozzi M, Nakano M, Shibata H, Kawata K, Pellino A, Vivaldi C, Lai E, Takata A, Tajiri K, Toyoda H, Tortora R, Campani C, Viola MG, Piscaglia F, Conti F, Fulgenzi CAM, Frassineti GL, Rizzato MD, Salani F, Astara G, Torimura T, Atsukawa M, Tada T, Burgio V, Rimini M, Cascinu S, Casadei-Gardini A. Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma. ESMO Open 2021; 6:100190. [PMID: 34144271 PMCID: PMC8219999 DOI: 10.1016/j.esmoop.2021.100190] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND After the advent of new treatment options for advanced hepatocellular carcinoma (HCC), the identification of prognostic factors is crucial for the selection of the most appropriate therapy for each patient. PATIENTS AND METHODS With the aim to fill this gap, we applied recursive partitioning analysis (RPA) to a cohort of 404 patients treated with lenvatinib. RESULTS The application of RPA resulted in a classification based on five variables that originated a new prognostic score, the lenvatinib prognostic index (LEP) index, identifying three groups: low risk [patients with prognostic nutritional index (PNI) >43.3 and previous trans-arterial chemoembolization (TACE)]; medium risk [patients with PNI >43.3 but without previous TACE and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage B (BCLC-B)]; high risk [patients with PNI <43.3 and ALBI grade 2 and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage C (BCLC-C)]. Median overall survival was 29.8 months [95% confidence interval (CI) 22.8-29.8 months] in low risk patients (n = 128), 17.0 months (95% CI 15.0-24.0 months) in medium risk (n = 162) and 8.9 months (95% CI 8.0-10.7 months) in high risk (n = 114); low risk hazard ratio (HR) 1 (reference group), medium risk HR 1.95 (95% CI 1.38-2.74), high risk HR 4.84 (95% CI 3.16-7.43); P < 0.0001. The LEP index was validated in a cohort of 127 Italian patients treated with lenvatinib. While the same classification did not show a prognostic value in a cohort of 311 patients treated with sorafenib, we also show a possible predictive role in favor of lenvatinib in the low risk group. CONCLUSIONS LEP index is a promising, easy-to-use tool that may be used to stratify patients undergoing systemic treatment of advanced HCC.
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Affiliation(s)
- I G Rapposelli
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori'-IRST, Meldola, Italy
| | - S Shimose
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Kumada
- Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - S Okamura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - A Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G G Di Costanzo
- Liver Unit, Department of Transplantation, Cardarelli Hospital, Naples, Italy
| | - F Marra
- Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Florence, Italy
| | - E Tamburini
- Department of Medical Oncology, Card. G. Panico Hospital of Tricase, Tricase, Italy
| | - A Forgione
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - F G Foschi
- Department of Internal Medicine, Faenza Hospital, AUSL Romagna, Faenza, Italy
| | - M Silletta
- Medical Oncology Unit, University Campus Bio-Medico, Rome, Italy
| | - S Lonardi
- Early Phase Clinical Trial Unit, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy; Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - G Masi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - M Scartozzi
- Medical Oncology, University and University Hospital of Cagliari, Italy
| | - M Nakano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - H Shibata
- Department of Gastroenterology, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - K Kawata
- Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - A Pellino
- Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - C Vivaldi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - E Lai
- Medical Oncology, University and University Hospital of Cagliari, Italy
| | - A Takata
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - K Tajiri
- Department of Gastroenterology, Toyama University Hospital, Toyama, Japan
| | - H Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - R Tortora
- Liver Unit, Department of Transplantation, Cardarelli Hospital, Naples, Italy
| | - C Campani
- Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Florence, Italy
| | - M G Viola
- Department of Surgery, Card. G. Panico Hospital of Tricase, Tricase, Italy
| | - F Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - F Conti
- Department of Internal Medicine, Faenza Hospital, AUSL Romagna, Faenza, Italy
| | - C A M Fulgenzi
- Medical Oncology Unit, University Campus Bio-Medico, Rome, Italy
| | - G L Frassineti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori'-IRST, Meldola, Italy
| | - M D Rizzato
- Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - F Salani
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - G Astara
- Medical Oncology, University and University Hospital of Cagliari, Italy
| | - T Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - M Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Tada
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - V Burgio
- Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Rimini
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, Modena, Italy
| | - S Cascinu
- Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - A Casadei-Gardini
- Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
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Pretta A, Donisi C, Persano M, Pinna G, Cimbro E, Parrino A, Migliari M, Dubois M, Liscia N, Mariani S, Lai E, Puzzoni M, Pusceddu V, Ziranu P, Scartozzi M. P-127 Lymphocyte to monocyte ratio as a prognostic factor in stage IV pancreatic ductal adenocarcinoma naive patients before gemcitabine-nab-paclitaxel chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.182] [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] Open
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Pretta A, Pinna G, Donisi C, Persano M, Cimbro E, Parrino A, Migliari M, Dubois M, Liscia N, Mariani S, Lai E, Pusceddu V, Puzzoni M, Ziranu P, Scartozzi M. P-128 Influence of anti-diabetic medications on the outcomes of patients with pancreatic ductal adenocarcinoma and type 2 diabetes mellitus. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.183] [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] Open
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15
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Pretta A, Persano M, Pinna G, Donisi C, Cimbro E, Parrino A, Migliari M, Dubois M, Mariani S, Liscia N, Lai E, Pusceddu V, Puzzoni M, Ziranu P, Scartozzi M. P-129 Concomitant RAS and BRAF mutations: Impact on overall survival and progression free survival in metastatic colorectal cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.184] [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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Goodwin A, Holubyeva A, Lai E, Zamora A, Schwartz B, Finamore P. 31 Pessary incarceration complicated by vesicovaginal fistula requiring ureteroneocystostomy: A video case presentation. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.175] [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: 11/16/2022]
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17
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Lai E, Cremolini C, Puzzoni M, Bergamo F, Zucchelli G, Libertini M, Dettori M, Banzi M, Boccaccino A, Cinieri S, Cavo A, Piacentini G, Andreozzi F, Banna G, Nappo F, Iachetta F, Rota S, Conca V, Zaniboni A, Scartozzi M. 447P Long term survival with regorafenib: REALITY (real life in Italy) trial - A GISCAD Study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.558] [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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18
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Ferreira D, Ng R, Lai E, Collins N, Thompson-Bowe K, Kehr J, Singh D. 668 Kawasaki Disease in the Australian Population: The John Hunter Hospital Experience. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.675] [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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19
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Lai E, Schirripa M, Puzzoni M, Loupakis F, Ziranu P, Pretta A, Giampieri R, Mariani S, Liscia N, Soro P, Pusceddu V, Astara G, Impera V, Camera S, Musio F, Zaniboni A, Fassan M, Lonardi S, Zagonel V, Scartozzi M. Correlation between p53 expression and clinical outcome in RAS/BRAF wild type metastatic colorectal cancer patients receiving later-line irinotecan-cetuximab. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.078] [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: 11/14/2022] Open
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Pretta A, Lai E, Liscia N, Impera V, Camera S, Musio F, Mariani S, Soro P, Persano M, Donisi C, Tolu S, Balconi F, Atzori F, Dessì M, Massa E, Madeddu C, Pusceddu V, Astara G, Demurtas L, Puzzoni M, Ziranu P, Scartozzi M. Overall survival and progression-free survival in metastatic colorectal cancer patients with concomitant RAS and BRAF mutations: a single center experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.295] [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: 11/14/2022] Open
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21
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Mariani S, Soro P, Liscia N, Balconi F, Camera S, Donisi C, Impera V, Musio F, Persano M, Pireddu A, Pretta A, Tolu S, Pusceddu V, Lai E, Faloppi L, Demurtas L, Ziranu P, Puzzoni M, Scartozzi M. Effectiveness of CA 19.9 in predicting prognosis in metastatic pancreatic cancer patients treated with nab-paclitaxel plus gemcitabine. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Ziranu P, Lai E, Casadei Gardini A, Pretta A, Faloppi L, Andrikou K, Astara G, Orsi G, Impera V, Mariani S, Liscia N, Soro P, Musio F, Camera S, Tolu S, Madeddu C, Massa E, Pusceddu V, Demurtas L, Puzzoni M, Cascinu S, Scartozzi M. A new prognostic score for biliary tract cancer: a multicenter experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.331] [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: 11/14/2022] Open
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Mccann C, Chow E, Vesprini D, Eric L, Paruag C, Lai E, Wronski M. EP-1324 A Dosimetric Study of Heart and Lung Dose in Breast Radiotherapy-Our Institutional Experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31744-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: 10/26/2022]
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Chua GT, Li PH, Ho MH, Lai E, Ngai V, Yau FY, Kwan MY, Leung TF, Lee TH. Hong Kong Institute of Allergy and Hong Kong Society for Paediatric Immunology Allergy & Infectious Diseases joint consensus statement 2018 on vaccination in egg-allergic patients. Hong Kong Med J 2019; 24:527-531. [PMID: 30318478 DOI: 10.12809/hkmj177137] [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: 11/05/2022] Open
Abstract
Vaccination of egg-allergic individuals has been a historical concern, particularly for influenza and measles-mumps-rubella-varicella vaccines that are developed in chicken egg embryos or chicken cell fibroblasts. The egg proteins in these vaccines were believed to trigger an immediate allergic reaction in egg-allergic individuals. However, recently published international guidelines have updated their recommendations and now state that these vaccines can be safely administered to egg-allergic individuals. This joint consensus statement by the Hong Kong Institute of Allergy and the Hong Kong Society for Paediatric Immunology Allergy & Infectious Diseases summarises the updates and provides recommendations for local general practitioners and paediatricians. Hong Kong Institute of Allergy and Hong Kong Society for Paediatric Immunology Allergy & Infectious Diseases joint consensus statement 2018 on vaccination in egg-allergic patients Background.
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Affiliation(s)
- G T Chua
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - P H Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - M Hk Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - E Lai
- Department of Pharmacy, Queen Mary Hospital, Pokfulam, Hong Kong
| | - V Ngai
- Department of Pharmacy, Queen Mary Hospital, Pokfulam, Hong Kong
| | - F Ys Yau
- Department of Paediatrics and Adolescent Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - M Yw Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong
| | - T F Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - T H Lee
- Allergy Centre, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
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25
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Puzzoni M, Demurtas L, Ziranu P, Lai E, Giampieri R, Faloppi L, Mandolesi A, Cremolini C, Masi G, Gelsomino F, Mariani S, Cubeddu A, Casula L, Liscia N, Pusceddu V, Antoniotti C, Loretelli C, Meriggi F, Zaniboni A, Falcone A, Cascinu S, Scartozzi M. P 53 abnormal expression might influence global outcome through EGFR modulation in RAS/BRAF wild type metastatic colorectal cancer patients receiving later-line irinotecan cetuximab. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
A uremic toxin fraction (fraction 2-3-1) in the middle molecular mass range (300-2000 Da) containing a sodium potassium inhibitor pump was studied. As fraction 2-3-1 was known to be present in minute quantities in urine and plasma, erythrocyte lysates were used as an alternative source. Results show that fraction 2-3-1 is more abundant in erythrocytes than in normal urine. In addition, the fraction is present in a greater quantity in uremic erythrocytes than in normal blood cells. It is concluded that fraction 2-3-1 is concentrated at the erythrocyte level in uremic patients
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Affiliation(s)
- P. Gallice
- Biophysics Laboratory, Faculty of Pharmacy, Marseille
| | - E. Lai
- Biophysics Laboratory, Faculty of Pharmacy, Marseille
| | - P. Brunet
- Nephrology Department, Sainte-Marguerite Hospital, Marseille
| | - Y. Berland
- Nephrology Department, Sainte-Marguerite Hospital, Marseille
| | - R. Elsen
- Althin Group Research, Miami - USA and Marseille - France
| | - A. Crevat
- Biophysics Laboratory, Faculty of Pharmacy, Marseille
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Fackler MJ, Downs BM, Mercado-Rodriguez C, Cimino-Mathews A, Chen C, Yuan J, Cope LM, Kohlway A, Kocmond K, Lai E, Weidler J, Visvanathan K, Umbricht CB, Harvey S, Wolff AC, Bates M, Sukumar S. Abstract P6-03-07: An automated DNA methylation assay (QM-MSP) for rapid breast cancer diagnosis in underdeveloped countries. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-03-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Underdeveloped countries reported 882,900 new cases of breast cancer and 324,000 deaths in 2012, likely to be a gross underestimation according to recent reports. Often, mammography screening is not available, primary care services are limited, and pathology and treatment services are available only in the regional hospitals. Because of the lack of access to diagnostic and treatment services, it is estimated that more than 90% of patients with breast cancer never present for medical treatment. To address this situation, an accurate, easy-to-perform diagnostic test appropriate for use in remote clinics is desperately needed. Johns Hopkins (JH) and Cepheid partnered to translate a robust Quantitative Multiplex Methylation-Specific PCR (QM-MSP) assay to an automated, cartridge-based system that provides quantitative measures of DNA methylation within hours of fine needle aspiration or core biopsy of image-detected suspicious lesions.
METHODS: With a goal of discriminating malignant from benign breast disease with high sensitivity and specificity, we evaluated 24 breast cancer-specific DNA methylation markers (selected through comprehensive methylome analysis) in 119 invasive ductal carcinomas and 186 benign breast tissues. QM-MSP was performed on sections of formalin-fixed paraffin-embedded (FFPE) tissues to quantify DNA methylation. The dynamic range and performance of quantitative methylation detection was tested using a subset of 9 genes in the cartridge-based system.
RESULTS: QM-MSP was performed in a Training set consisting of 93 tissues [n=43 IDC, n=50 benign lesions (25 usual ductal hyperplasia, UDH, and 25 papilloma)] from the US. We selected 9 DNA markers significantly (p<0.05) more methylated in malignant compared to benign lesions, which had low or no methylation. An independent Test set consisted of benign (n=26) and malignant (n=10) tissues (mostly Caucasian; JH Test Set). As a panel, the 9 markers were significantly more methylated in malignant than benign tissue (p<0.001), revealing a sensitivity of 90% and specificity of 92%, using a laboratory cutoff of 9.5 CMI units (900 unit scale) based on receiver operator characteristic statistics (ROC; p<0.0001, AUC=0.977). To determine if the markers characterized in the JH Test Set could perform as well in samples from a different geography, the panel was tested on 176 tissues from Wuhan, China (China Test Set). In this cohort (66 IDC and 110 benign tissues - 49 fibroadenoma, 19 benign cyst, 12 UDH, 30 papilloma), sensitivity was 89% and specificity was 89% for detection of breast cancer with ROC AUC=0.945. An advanced version of the cartridge with up to 12 methylated DNA markers is under development, thus far showing robust signals in cancer and low background in benign tissues. Current work at JH is focused on optimizing the technical performance of the cartridge.
CONCLUSIONS: We identified a panel of methylated DNA markers that discriminate malignant from benign breast lesions and built a prototype automated cartridge-based assay with promising sensitivity and specificity for breast cancer. Such an assay has the potential to aid in specimen triage in the pathology lab and provide fast, low cost and accurate diagnosis of breast cancer in LMIC settings.
Citation Format: Fackler MJ, Downs BM, Mercado-Rodriguez C, Cimino-Mathews A, Chen C, Yuan J, Cope LM, Kohlway A, Kocmond K, Lai E, Weidler J, Visvanathan K, Umbricht CB, Harvey S, Wolff AC, Bates M, Sukumar S. An automated DNA methylation assay (QM-MSP) for rapid breast cancer diagnosis in underdeveloped countries [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-03-07.
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Affiliation(s)
- MJ Fackler
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - BM Downs
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - C Mercado-Rodriguez
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - A Cimino-Mathews
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - C Chen
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - J Yuan
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - LM Cope
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - A Kohlway
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - K Kocmond
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - E Lai
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - J Weidler
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - K Visvanathan
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - CB Umbricht
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - S Harvey
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - AC Wolff
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - M Bates
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
| | - S Sukumar
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Wuhan University, Wuhan, Hubei, China; Cephied, Sunnyvale, CA
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Orgiano L, Cubeddu A, Mascia R, Lai E, Dessì M, Pedditzi E, Piredda P, Saba E, Palmas V, Camboni T, Massa E, Astara G, Manzin A, Madeddu C, Scartozzi M. CREAM study: Clinical correlation between immunotherapy-RElated colitis And intestinal Microbiote in metastatic patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Astara G, Lai E, Tolu S, Mascia R, Impera V, Dessì M, Camera S, Pusole G, Cubeddu A, Pireddu A, Liscia N, Pretta A, Demurtas L, Ziranu P, Puzzoni M, Atzori F, Pusceddu V, Massa E, Madeddu C, Scartozzi M. Medical management of malignant bowel obstruction: our center experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Tolu S, Lai E, Impera V, Pusole G, Pretta A, Liscia N, Camera S, Cubeddu A, Mascia R, Pireddu A, Dessì M, Puzzoni M, Demurtas L, Ziranu P, Pusceddu V, Massa E, Madeddu C, Atzori F, Astara G, Scartozzi M. Management of breakthrough cancer pain in patients with oral mucositis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx437.009] [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: 11/14/2022] Open
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Lai E, Tolu S, Mascia R, Impera V, Pretta A, Liscia N, Pireddu A, Pusole G, Camera S, Cubeddu A, Dessì M, Puzzoni M, Demurtas L, Ziranu P, Atzori F, Pusceddu V, Massa E, Madeddu C, Astara G, Scartozzi M. Fentanyl pectin nasal spray for breakthrough cancer pain treatment: a single center experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx437.002] [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: 11/14/2022] Open
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Orgiano L, Dessi A, Cubeddu A, Lai E, Mascia R, Tolu S, Palmas V, Camboni T, Madeddu C, Massa E, Astara G, Manzin A, Scartozzi M. 403TiP CREAM study: Clinical correlation between ipilimumab-Related colitis And intestinal Microbiote in metastatic melanoma patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw588.009] [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: 11/14/2022] Open
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Caldwell A, Lai E, Gmitter A, Allanore A. Influence of mass transfer and electrolyte composition on anodic oxygen evolution in molten oxides. Electrochim Acta 2016. [DOI: 10.1016/j.electacta.2016.09.132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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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Puzzoni M, Pusole G, Mascia R, Demurtas L, Dessì A, Cubeddu A, Lai E, Tolu S, Ziranu P, Orgiano L, Pusceddu V, Astara G, Madeddu C, Massa E, Casula L, Palmieri G, Scartozzi M. Selection with a molecUlar PanEl foR Panitumumab EfficAcy in K-ras and n-ras wild type metastatic colorectal cancer (SUPER- PEAK). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Demurtas L, Lai E, Cubeddu A, Puzzoni M, Pusole G, Tolu S, Dessì A, Mascia R, Pusceddu V, Astara G, Madeddu C, Massa E, Ziranu P, Orgiano L, Casula L, Scartozzi M. REINVENT (REgorafenIb traNslational eValuation angiogENesis proTocol). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lai E, Zhao Y, Pan Y, Mitloehner FM. 1183 The effects of vermifiltration on gaseous emissions from dairy lagoon water. J Anim Sci 2016. [DOI: 10.2527/jam2016-1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pusole G, Puzzoni M, Mascia R, Demurtas L, Dessì A, Cubeddu A, Lai E, Tolu S, Ziranu P, Orgiano L, Pusceddu V, Astara G, Madeddu C, Massa E, Casula L, Palmieri G, Scartozzi M. Selection with a molecUlar PanEl foR Panitumumab EfficAcy in K-ras and n-ras wild type metastatic colorectal cancer (SUPER- PEAK). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.46] [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: 11/14/2022] Open
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Dessì A, Demurtas L, Tolu S, Puzzoni M, Cubeddu A, Lai E, Pusole G, Mascia R, Ziranu P, Orgiano L, Pusceddu V, Astara G, Madeddu C, Massa E, Casula L, Scartozzi M. REINVENT (REgorafenIb traNslational eValuation angiogENesis proTocol). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vicini P, Fields O, Lai E, Litwack ED, Martin AM, Morgan TM, Pacanowski MA, Papaluca M, Perez OD, Ringel MS, Robson M, Sakul H, Vockley J, Zaks T, Dolsten M, Søgaard M. Precision medicine in the age of big data: The present and future role of large-scale unbiased sequencing in drug discovery and development. Clin Pharmacol Ther 2015; 99:198-207. [PMID: 26536838 DOI: 10.1002/cpt.293] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 10/30/2015] [Indexed: 12/15/2022]
Abstract
High throughput molecular and functional profiling of patients is a key driver of precision medicine. DNA and RNA characterization has been enabled at unprecedented cost and scale through rapid, disruptive progress in sequencing technology, but challenges persist in data management and interpretation. We analyze the state-of-the-art of large-scale unbiased sequencing in drug discovery and development, including technology, application, ethical, regulatory, policy and commercial considerations, and discuss issues of LUS implementation in clinical and regulatory practice.
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Affiliation(s)
- P Vicini
- Pfizer Worldwide Research & Development, La Jolla, California, Collegeville, Pennsylvania, and New York, New York, USA
| | - O Fields
- Pfizer Worldwide Research & Development, La Jolla, California, Collegeville, Pennsylvania, and New York, New York, USA
| | - E Lai
- Takeda Pharmaceuticals International, Deerfield, Illinois, USA
| | - E D Litwack
- Food and Drug Administration, Silver Spring, Maryland, USA
| | - A-M Martin
- GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - T M Morgan
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, and East Hanover, New Jersey, USA
| | - M A Pacanowski
- Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - O D Perez
- Pfizer Worldwide Research & Development, La Jolla, California, Collegeville, Pennsylvania, and New York, New York, USA
| | - M S Ringel
- Boston Consulting Group, Boston, Massachusetts, USA
| | - M Robson
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, and East Hanover, New Jersey, USA
| | - H Sakul
- Pfizer Worldwide Research & Development, La Jolla, California, Collegeville, Pennsylvania, and New York, New York, USA
| | - J Vockley
- Inova Translational Medicine Institute, Falls Church, Virginia, USA
| | - T Zaks
- Sanofi, Cambridge, Massachusetts, USA
| | - M Dolsten
- Pfizer Worldwide Research & Development, La Jolla, California, Collegeville, Pennsylvania, and New York, New York, USA
| | - M Søgaard
- Pfizer Worldwide Research & Development, La Jolla, California, Collegeville, Pennsylvania, and New York, New York, USA
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Shang E, Nathan D, Lai E, Gorman R, Gorman J, Woo E, Wang G, Fairman R, Barker C, Jackson B. Finite Element Models Provide Superior Prediction of Abdominal Aortic Aneurysm Growth Compared to Aneurysm Geometric Indices. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.727] [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: 10/25/2022]
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Madeddu C, Maccio' A, Antoni G, Serpe R, Orgiano L, Lai E, Omoto I, Mantovani G. PP101-MON AN EFFECTIVE AND SAFE TWO-DRUG COMBINATION REGIMEN FOR CANCER-RELATED CACHEXIA. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60412-4] [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: 11/28/2022]
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Ho PL, Lai E, Chan PY, Lo WU, Chow KH. Rare occurrence of vancomycin-resistant Enterococcus faecium among livestock animals in China. J Antimicrob Chemother 2013; 68:2948-9. [DOI: 10.1093/jac/dkt293] [Citation(s) in RCA: 5] [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: 11/13/2022] Open
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Lauring B, Taggart AKP, Tata JR, Dunbar R, Caro L, Cheng K, Chin J, Colletti SL, Cote J, Khalilieh S, Liu J, Luo WL, MacLean AA, Peterson LB, Polis AB, Sirah W, Wu TJ, Liu X, Jin L, Wu K, Boatman PD, Semple G, Behan DP, Connolly DT, Lai E, Wagner JA, Wright SD, Cuffie C, Mitchel YB, Rader DJ, Paolini JF, Waters MG, Plump A. Niacin Lipid Efficacy Is Independent of Both the Niacin Receptor GPR109A and Free Fatty Acid Suppression. Sci Transl Med 2012; 4:148ra115. [DOI: 10.1126/scitranslmed.3003877] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Mehanna R, Moore S, Hou JG, Lai E, Sarwar A. Comparing Clinical Features of Young-Onset, Middle-Onset and Late-Onset Parkinson's Disease (P06.089). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lai E, Schulz P, Patel N, Fisher R. Autoimmune Limbic Encephalitis: PET Imaging Findings of Two Distinct Metabolic Patterns (P03.152). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Feig PU, Shah S, Hermanowski-Vosatka A, Plotkin D, Springer MS, Donahue S, Thach C, Klein EJ, Lai E, Kaufman KD. Effects of an 11β-hydroxysteroid dehydrogenase type 1 inhibitor, MK-0916, in patients with type 2 diabetes mellitus and metabolic syndrome. Diabetes Obes Metab 2011; 13:498-504. [PMID: 21272190 DOI: 10.1111/j.1463-1326.2011.01375.x] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM We examined the effects of the 11β-hydroxysteroid dehydrogenase type 1 (HSD1) inhibitor, MK-0916, on the multiple components of the metabolic syndrome (MetS) in patients with type 2 diabetes (T2DM) and MetS. METHODS This was a 12-week, multicentre, randomized, double-blind, placebo-controlled study. Patients with T2DM (mean baseline A1C: 7.3%) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)-defined MetS were randomized 1 : 1 : 1 : 1 to 0.5, 2 or 6 mg/day MK-0916 or placebo. The primary efficacy endpoint was a change from baseline at week 12 in fasting plasma glucose (FPG). Secondary endpoints included glycosylated haemoglobin A(1c) (A1C), 2-h postprandial glucose (2-h PPG), body weight, waist circumference, blood pressure and lipid profile. RESULTS Treatment with MK-0916 had no significant effect relative to placebo on FPG at week 12. Compared to placebo, 6 mg MK-0916 produced a modest, significant (p = 0.049) reduction in A1C of 0.3% at week 12, but no significant difference was observed in 2-h PPG. Six milligram MK-0916 increased LDL-C relative to placebo by 10.4% (p = 0.041). Treatment with MK-0916 led to modest dose-dependent decreases in blood pressure and body weight. Overall, MK-0916 was generally well tolerated. MK-0916 produced mechanism-based activation of the hypothalamic-pituitary-adrenal axis, resulting in mean increases in adrenal androgen levels that remained within the normal range at all doses tested. CONCLUSIONS Inhibition of HSD1 with MK-0916 was generally well tolerated in patients with T2DM and MetS. Although no significant improvement in FPG was observed with MK-0916 compared to placebo, modest improvements in A1C, body weight and blood pressure were observed.
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Affiliation(s)
- P U Feig
- Merck Sharp & Dohme Corp., Rahway, NJ, USA.
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Lia C, Gallo V, Frassanito A, Cavaggioni G, Lai E. [Prevalence of Mood Disorders in a university students population]. Clin Ter 2011; 162:e67-e72. [PMID: 21717036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIMS To evaluate (i) the incidence of psychiatric disorders and (ii) the frequency of Mood Disorders diagnoses in a sample of 115 university students afferent to Sportello Counseling-Accoglienza Studenti "Fatti vivo!" of "Sapienza" University of Rome, between November 2008 and December 2010; to point out correlations with socio-demographic variables. MATERIALS AND METHODS The prevalence of Mood Disorders was evaluated with the Structured Clinical Interview for DSM IV Axis I Disorders Clinical Version (SCID-I cv), drawn up by the counselor at first meeting. Each student completed a data collection from which investigates socio-demographic characteristics. A descriptive analysis was conducted and the associations between variables and Axis I diagnoses were investigated. RESULTS The overall mean age is 24.7 years. A DSM IV-TR Axis I Disorder was diagnosed in 26.9%, of which 45.2% is constituted by Mood Disorders (mean age of 25.7 years). Male students, the highest family members' mean age and the lowest regular studies (64% pursue a course of regular studies) seem to be characteristics of the subgroup of students with Mood Disorders diagnoses compared to the subgroups with other Axis I Disorders diagnoses. Moreover, the same subgroup most frequently recognizes as pathological its condition (78.6%) compared to the subgroup with other Axis I Disorders diagnoses (53.3%). Those differences, however, aren't statistically significant. CONCLUSIONS The discovered percentage of Axis I diagnoses in general and Mood Disorders in particular could be considered representative of perceived unease degree in a population of university students. At the same time, the difficulty in identifying the early signs of uneasiness and in recognizing as pathological own condition interferes with and delays the awareness of the need of a psychological/psychiatric support and the expression of the help-seek.
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Affiliation(s)
- C Lia
- Dipartimento di Neurologia e Psichiatria "Sapienza" Università di Roma, UOD Psicoterapia, Sportello Counseling-Accoglienza Studenti "Fatti vivo!"
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Abstract
Abstract
Background: Breast cancer is a heterogeneous disease with different molecular subtypes. It is known that triple negative breast cancer and the HER-2 positive breast cancer subtypes are associated with more brain metastases. We further explored different subtypes of breast cancer patients with brain metastasis and analyzed their clinical behaviour with particular reference to the Hong Kong Chinese population. Methodology: We reviewed all breast cancer patients with brain metastasis presented to the Department of Clinical Oncology in the Queen Mary Hospital, the University of Hong Kong which is a teaching hospital during January 2004 to June 2008. Sociodemographic factors, date of primary breast cancer diagnosis and the tumour features, clinical behaviour at presentation, treatment received such as surgery, chemotherapy, hormonal therapy and targeted therapy, time of local recurrence, metastasis including brain metastasis, the recursive partitioning analysis (RPA) classes and treatment for the brain metastasis were all recorded. We classified the patients into 3 main subtypes, hormone positive, triple-negative (TNC) and HER-2 positive subtypes and further studied the clinical features and brain metastasis behaviour. Statistical analysis using SPSS 16.0 version was applied. Results: Altogether, there were 60 breast cancer patients with brain metastasis occurred during January 2004 to June 2008 requiring further management in our Department. Hormone positive patients constituted 46.6% while TNC accounted for 15.5% and HER-2 positive patients accounted for 37.9% of the cohort. The majority presented with symptoms at the time of the brain metastasis (93.1%) with headache being the most common symptom (43.1%), and 54 patients received whole brain radiotherapy (WBRT) and 8 patients received surgical resection of the brain metastasis. There were no significant statistical significance between the breast cancer subtypes and the metastatic behaviour except that the TNC patients were associated with concurrent lung metastasis when they first presented with brain metastasis (p = 0.03) when compared to the hormone positive and HER-2 positive patients. The ANOVA analysis showed there was a statistically significant difference between the RPA Classes of the patients and their time of survival after the brain metastasis (p = 0.002). Further ANOVA Post Hoc showed the RPA Class 3 patients were associated with shorter time of survival after brain metastasis when compared to the Class 1 patients (2.4 months vs 11.8 months, p = 0.001). However, patients with brain metastasis and different breast cancer subtypes did not have statistically significant different time of survival after their brain metastases. Conclusion: Hong Kong Chinese triple negative breast cancer patients with brain metastasis were associated with more concurrent lung metastasis. The RPA Classification still serves as a prognostic indicator with reference to the survival after brain metastasis in the breast cancer patients when compared to the breast cancer subtypes. Further large-scale multi-centre epidemiology study is warranted to confirm the above findings.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3072.
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Affiliation(s)
- J. Tsang
- 1Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of China
| | - V. Li
- 1Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of China
| | - E. Lai
- 1Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of China
| | - G. Au
- 1Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of China
| | - D. Chua
- 1Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of China
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