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Cruz-Lim EM, Mou B, Baker S, Arbour G, Stefanyk K, Jiang W, Liu M, Bergman A, Schellenberg D, Alexander A, Berrang T, Bang A, Chng N, Matthews Q, Carolan H, Hsu F, Miller S, Atrchian S, Chan E, Ho C, Mohamed I, Lin A, Huang V, Mestrovic A, Hyde D, Lund C, Pai H, Valev B, Lefresne S, Tyldesley S, Olson R. Prospective Longitudinal Assessment of Quality of Life After Stereotactic Ablative Radiotherapy for Oligometastases: Analysis of the Population-based SABR-5 Phase II Trial. Clin Oncol (R Coll Radiol) 2024; 36:148-156. [PMID: 38087705 DOI: 10.1016/j.clon.2023.11.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/11/2023] [Accepted: 11/28/2023] [Indexed: 02/18/2024]
Abstract
AIMS To evaluate longitudinal patient-reported quality of life (QoL) in patients treated with stereotactic ablative radiotherapy (SABR) for oligometastases. MATERIALS AND METHODS The SABR-5 trial was a population-based single-arm phase II study of SABR to up to five sites of oligometastases, conducted in six regional cancer centres in British Columbia, Canada from 2016 to 2020. Prospective QoL was measured using treatment site-specific QoL questionnaires at pre-treatment baseline and at 3, 6, 9, 12, 15, 18, 21, 24, 30 and 36 months after treatment. Patients with bone metastases were assessed with the Brief Pain Inventory (BPI). Patients with liver, adrenal and abdominopelvic lymph node metastases were assessed with the Functional Assessment of Chronic Illness Therapy-Abdominal Discomfort (FACIT-AD). Patients with lung and intrathoracic lymph node metastases were assessed with the Prospective Outcomes and Support Initiative (POSI) lung questionnaire. The two one-sided test procedure was used to assess equivalence between the worst QoL score and the baseline score of individual patients. The mean QoL at all time points was used to determine the trajectory of QoL response after SABR. The proportion of patients with 'stable', 'improved' or 'worsened' QoL was determined for all time points based on standard minimal clinically important differences (MCID; BPI worst pain = 2, BPI functional interference score [FIS] = 0.5, FACIT-AD Trial Outcome Index [TOI] = 8, POSI = 3). RESULTS All enrolled patients with baseline QoL assessment and at least one follow-up assessment were analysed (n = 133). On equivalence testing, the patients' worst QoL scores were clinically different from baseline scores and met MCID (BPI worst pain mean difference: 1.8, 90% confidence interval 1.19 to 2.42]; BPI FIS mean difference: 1.68, 90% confidence interval 1.15 to 2.21; FACIT-AD TOI mean difference: -8.76, 90% confidence interval -11.29 to -6.24; POSI mean difference: -4.61, 90% confidence interval -6.09 to -3.14). However, the mean FIS transiently worsened at 9, 18 and 21 months but eventually returned to stable levels. The mean FACIT and POSI scores also worsened at 36 months, albeit with a limited number of responses (n = 4 and 8, respectively). Most patients reported stable QoL at all time points (range: BPI worst pain 71-82%, BPI FIS 45-78%, FACIT-AD TOI 50-100%, POSI 25-73%). Clinically significant stability, worsening and improvement were seen in 70%/13%/18% of patients at 3 months, 53%/28%/19% at 18 months and 63%/25%/13% at 36 months. CONCLUSIONS Transient decreases in QoL that met MCID were seen between patients' worst QoL scores and baseline scores. However, most patients experienced stable QoL relative to pre-treatment levels on long-term follow-up. Further studies are needed to characterise patients at greatest risk for decreased QoL.
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Affiliation(s)
- E M Cruz-Lim
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - B Mou
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - S Baker
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - G Arbour
- University of British Columbia, British Columbia, Canada
| | - K Stefanyk
- University of British Columbia, British Columbia, Canada
| | - W Jiang
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - M Liu
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - A Bergman
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - D Schellenberg
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - A Alexander
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - T Berrang
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - A Bang
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - N Chng
- BC Cancer - Prince George, Prince George, British Columbia, Canada
| | - Q Matthews
- BC Cancer - Prince George, Prince George, British Columbia, Canada
| | - H Carolan
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - F Hsu
- University of British Columbia, British Columbia, Canada; BC Cancer - Abbotsford, Abbotsford, British Columbia, Canada
| | - S Miller
- University of British Columbia, British Columbia, Canada; BC Cancer - Prince George, Prince George, British Columbia, Canada
| | - S Atrchian
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - E Chan
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - C Ho
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - I Mohamed
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - A Lin
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - V Huang
- BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - A Mestrovic
- BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - D Hyde
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - C Lund
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - H Pai
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - B Valev
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - S Lefresne
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - S Tyldesley
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - R Olson
- University of British Columbia, British Columbia, Canada; BC Cancer - Prince George, Prince George, British Columbia, Canada.
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Cruz-Lim EM, Mou B, Jiang W, Liu M, Bergman A, Schellenberg D, Alexander A, Berrang T, Bang A, Chng N, Matthews Q, Carolan H, Hsu F, Miller S, Atrchian S, Chan E, Ho C, Mohamed I, Lin A, Huang V, Mestrovic A, Hyde D, Lund C, Pai H, Valev B, Lefresne S, Tyldesley S, Olson R, Baker S. Predictors of Quality of Life Decline in Patients with Oligometastases treated with Stereotactic Ablative Radiotherapy: Analysis of the Population-Based SABR-5 Phase II Trial. Clin Oncol (R Coll Radiol) 2024; 36:141-147. [PMID: 38296662 DOI: 10.1016/j.clon.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/15/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
AIMS Most patients experience stable quality of life (QoL) after stereotactic ablative radiotherapy (SABR) treatment for oligometastases. However, a subset of patients experience clinically relevant declines in QoL on post-treatment follow-up. This study aimed to identify risk factors for QoL decline. MATERIALS AND METHODS The SABR-5 trial was a population-based single-arm phase II study of SABR to up to five sites of oligometastases. Prospective QoL was measured using treatment site-specific tools at pre-treatment baseline and 3, 6, 9, 12, 15, 18, 21, 24, 30 and 36 months after treatment. The time to persistent QoL decline was calculated as the time from SABR to the first decline in QoL score meeting minimum clinically important difference with no improvement to baseline score on subsequent assessments. Univariable and multivariable logistic regression analyses were carried out to determine factors associated with QoL decline. RESULTS One hundred and thirty-three patients were included with a median follow-up of 32 months (interquartile range 25-43). Thirty-five patients (26%) experienced a persistent decline in QoL. The median time until persistent QoL decline was not reached. The cumulative incidence of QoL decline at 2 and 3 years were 22% (95% confidence interval 14.0-29.6) and 40% (95% confidence interval 28.0-51.2), respectively. In multivariable analysis, disease progression (odds ratio 5.23, 95% confidence interval 1.59-17.47, P = 0.007) and adrenal metastases (odds ratio 9.70, 95% confidence interval 1.41-66.93, P = 0.021) were associated with a higher risk of QoL decline. Grade 3 or higher (odds ratio 3.88, 95% confidence interval 0.92-16.31, P = 0.064) and grade 2 or higher SABR-associated toxicity (odds ratio 2.24, 95% confidence interval 0.85-5.91, P = 0.10) were associated with an increased risk of QoL decline but did not reach statistical significance. CONCLUSIONS Disease progression and adrenal lesion site were associated with persistent QoL decline following SABR. The development of grade 3 or higher toxicities was also associated with an increased risk, albeit not statistically significant. Further studies are needed, focusing on the QoL impact of metastasis-directed therapies.
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Affiliation(s)
- E M Cruz-Lim
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - B Mou
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - W Jiang
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - M Liu
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - A Bergman
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - D Schellenberg
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - A Alexander
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - T Berrang
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - A Bang
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - N Chng
- BC Cancer - Prince George, British Columbia, Canada
| | - Q Matthews
- BC Cancer - Prince George, British Columbia, Canada
| | - H Carolan
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - F Hsu
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Abbotsford, British Columbia, Canada
| | - S Miller
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Prince George, British Columbia, Canada
| | - S Atrchian
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - E Chan
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - C Ho
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - I Mohamed
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - A Lin
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - V Huang
- BC Cancer - Surrey, British Columbia, Canada
| | - A Mestrovic
- BC Cancer - Vancouver, British Columbia, Canada
| | - D Hyde
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - C Lund
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - H Pai
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - B Valev
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - S Lefresne
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - S Tyldesley
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - R Olson
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Prince George, British Columbia, Canada
| | - S Baker
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada.
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Kelly F, Chan E, Benson A, Masoumi S, Perry E, Taubman K, Sutherland T, Ong G, Guerrieri M, Chao MWT, Wong LM, Ng M. Location of Local Recurrences Post-Prostatectomy Detected by 18F-DCPFyL and Implications for Salvage Radiotherapy Target Volumes. Int J Radiat Oncol Biol Phys 2023; 117:e399-e400. [PMID: 37785331 DOI: 10.1016/j.ijrobp.2023.06.1531] [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) The use of prostate-specific membrane antigen (PSMA) PET scans have improved detection of recurrent prostate cancer for biochemical failure post-prostatectomy. The primary aim of this study is to assess the location of local recurrences for PSMA PET positive disease post-prostatectomy relative to anatomical landmarks and to inform salvage radiotherapy contouring guidelines. MATERIALS/METHODS This is a retrospective study of patients who underwent a staging PSMA PET-CT scan with 18F-DCFPyL tracer. Eligible patients included men with biochemical recurrence (PSA >0.2ng/mL) post-prostatectomy for prostate adenocarcinoma. PSMA positive local disease (GTV) was marked on the CT scan of the PSMA PET/CT, using the PSMA PET scan fused as the secondary dataset. Reference structures were contoured to compare the positional relationship to the GTV local recurrence. Centroids of each GTV position were measured to the closest border of the reference structures and distance measured. RESULTS Forty-five patients had a local recurrence on PSMA PET, 28/45 with prostate bed recurrence and 17/45 with seminal vesicle bed recurrence. The median age was 72.7 years, median pre-treatment PSA 0.515 ng/ml (0.2-11.1), pT2 in 37.8% and pT3 in 62.2, ISUP G2-3 was 66.7%, ISUP 4-5 29.6%, 67% ECE, 15.4% SV involvement and 40% positive margin. For prostate bed recurrences, 93.6% of GTVs were within 15mm from the inferior border of pubic symphysis (median 3.3mm [-9.8-15.4]), 83.9% within 10mm from the VUA (median 3.3mm [-17.4-15.9]), and 80.6% were greater than 10mm from the most superior slice of the penile bulb (median 16.4mm [1-29.5]). Laterally, 83.9% of recurrences were within 10mm of midline and 41.9% within 5mm (median 3.3mm [-13.56-11.59]) and all were contained within levator, 35.5% within 5mm (median 7.7 [1-22.6]) of the medial muscle border. 29.0% were within 5mm from the anterior edge of the rectal wall (median -7mm [-32.3-0.5]). Seminal vesicle bed recurrences were within 17.5mm of upper border of pubic symphysis for 88.9% of patients (median -4.69mm[-30.8to18.2]), 100% were more than 7.5mm inferiorly from the vas deferens (median-22.1mm[-32.7to-7.7]). Laterally, 100% recurrences were more than 7.5mm medial from obturator internus (median 5.37mm [-23.1to37.8]), and 88.9% were more than 10mm from midline (median 23.1mm [2.0-36.6]). CONCLUSION The 18F-DCFPyL PSMA PET local recurrences can provide detailed localization of prostate bed and seminal vesicle recurrences. Our data can inform contouring guidelines for salvage radiotherapy to the prostate bed, particularly when using anatomical landmarks to define cranio-caudal extent of target volumes. For target volume laterally, the medial wall of levator ani would encompass all prostate bed recurrences, and no seminal vesicles recurrences were seen at the medial border of the obturator internus muscle.
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Affiliation(s)
- F Kelly
- Genesis Care Epping, Melbourne, VIC, Australia
| | - E Chan
- Genesis Care Australia, Melbourne, Australia
| | - A Benson
- Genesis Care, Melbourne, VIC, Australia
| | - S Masoumi
- Genesis Care Australia, Melbourne, Australia
| | - E Perry
- Pacific Radiology, Christchurch, New Zealand
| | - K Taubman
- St Vincent's Hospital Melbourne, Dept. of Nuclear Medicine, Fitzroy, VIC, Australia
| | - T Sutherland
- St Vincent's Hospital Melbourne, Dept. of Nuclear Medicine, Fitzroy, VIC, Australia
| | - G Ong
- Genesis Care, Shepparton, VIC, Australia
| | | | - M W T Chao
- Genesis Care Australia, Melbourne, Australia
| | - L M Wong
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - M Ng
- Genesis Care, Melbourne, VIC, Australia
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Teng JLL, Woo PCY, Chan E. Development of an antigen capture assay for melioidosis caused by Burkholderia pseudomallei: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 4:45-46. [PMID: 37690808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Affiliation(s)
- J L L Teng
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - P C Y Woo
- Department of Microbiology, The University of Hong Kong, Hong Kong SAR, China
| | - E Chan
- Department of Microbiology, The University of Hong Kong, Hong Kong SAR, China
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Chan E, DeVile C, Ratnamma V. Osteogenesis imperfecta. BJA Educ 2023; 23:182-188. [PMID: 37124171 PMCID: PMC10140476 DOI: 10.1016/j.bjae.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/17/2023] [Indexed: 02/26/2023] Open
Affiliation(s)
- E. Chan
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C. DeVile
- Great Ormond Street Hospital for Children, London, UK
| | - V.S. Ratnamma
- Great Ormond Street Hospital for Children, London, UK
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Deitz R, Clifford S, Ryan J, Chan E, Coster J, Furukawa M, Hage C, Sanchez P. Predicting Long-Term Functional Status after Lung Retransplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1624] [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: 04/05/2023] Open
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Chan E, Jacobs N, Lee J, Kidambi S, Zawadzki R, Kim E, Dykes J, Rosenthal D, Ma M. Racial Disparities in Pediatric Heart Transplantation: A National Registry Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.079] [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: 04/05/2023] Open
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Sethuraman A, Chan E, Jia J, Soller L, Erdle S, Avinashi V. A145 PEDIATRIC PATIENTS’ & PARENTS’ PERSPECTIVES ON TREATMENT PREFERENCE IN EOSINOPHILIC ESOPHAGITIS: A CROSS SECTIONAL, QUALITATIVE RESEARCH STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991244 DOI: 10.1093/jcag/gwac036.145] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus which impairs quality of life in children and adolescents. Given the wide variety of symptomatic presentations in pediatrics, the varying time to diagnosis, and differing severity (including stricturing phenotype) initial treatments are not standardized. An important part of this individualization, beyond the health care practitioner counseling involves the patients’ and parents’ preferences which incorporates personal beliefs and attitudes. Purpose The study aim was to qualitatively describe parental and patient preferences regarding treatment options in EoE. Method This was a cross-sectional qualitative research study conducted in the EoE clinic at BC Children’s Hospital, Vancouver. Parents and their children completed semi-structured survey questions regarding treatment preference in EoE. Patients along with their parents who completed their survey questions were included in the study. Incomplete forms were excluded from the study. Result(s) The survey was attempted by 15 children, 7-11yrs of age, and 42 children, 12-18yrs of age, along with their parents. Completed response by both parent and their children were seen in 47 patients, 40 were adolescents 12-18yrs of age and 7 were 7-11yrs of age. Parent treatment preferences were diet in 17/47(36.2%), medications in 21/47 (44.7%) and 9/47 (19%) were unsure. 75% of parents who preferred dietary management thought it was less risky than medication. Parents who chose medication thought it would be easier (8/21) and more effective (8/21). Most of the parents’ decisions were influenced by the physician (35/47; 74.5%) and more so by the gastroenterologist (28/47; 59.6%). In 12–18-yr olds, 6/40 (15%) had preference for diet, 25/40 (62.5%) preferred medication and 9/40 (22.5%) were unsure. 3/6 adolescents thought that diet was less risky and 4/6 thought it was more effective than medication. Among the teens who preferred medication, 17/25 (68%) felt it to be easier and 9/25 (36%) thought it would work better than diet. Teenagers found their parents to be helpful for deciding (50%) and doctor (50%) with the gastroenterologist again playing a prominent role. In the 7 to 11yr old age group, 4/7 (57.1%) predominantly had preference for dietary treatment. Conclusion(s) The overall preference in the adolescent age group is for medication supported by patients’ and parents’, with ease of use being a primary driver for adolescents, whereas ease of use and effectiveness were drivers for the parents. Parents were more often interested in dietary therapy than the adolescents. With regards to parents of younger children and younger children themselves, dietary management was the preference as they felt it to be less risky. The numbers, though small, represent one of the few studies done on patient preference in EoE. Future studies should include formal qualitative studies and preferences could ultimately be tied to better counseling and tracking adherence to therapy. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
- A Sethuraman
- Division of Allergy and Immunology, BC Children's Hospital, Vancouver, Canada
| | - E Chan
- Division of Allergy and Immunology, BC Children's Hospital, Vancouver, Canada
| | - J Jia
- Division of Allergy and Immunology, BC Children's Hospital, Vancouver, Canada
| | - L Soller
- Division of Allergy and Immunology, BC Children's Hospital, Vancouver, Canada
| | - S Erdle
- Division of Allergy and Immunology, BC Children's Hospital, Vancouver, Canada
| | - V Avinashi
- Division of Allergy and Immunology, BC Children's Hospital, Vancouver, Canada
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Gwilym BL, Pallmann P, Waldron CA, Thomas-Jones E, Milosevic S, Brookes-Howell L, Harris D, Massey I, Burton J, Stewart P, Samuel K, Jones S, Cox D, Clothier A, Edwards A, Twine CP, Bosanquet DC, Benson R, Birmpili P, Blair R, Bosanquet DC, Dattani N, Dovell G, Forsythe R, Gwilym BL, Hitchman L, Machin M, Nandhra S, Onida S, Preece R, Saratzis A, Shalhoub J, Singh A, Forget P, Gannon M, Celnik A, Duguid M, Campbell A, Duncan K, Renwick B, Moore J, Maresch M, Kamal D, Kabis M, Hatem M, Juszczak M, Dattani N, Travers H, Shalan A, Elsabbagh M, Rocha-Neves J, Pereira-Neves A, Teixeira J, Lyons O, Lim E, Hamdulay K, Makar R, Zaki S, Francis CT, Azer A, Ghatwary-Tantawy T, Elsayed K, Mittapalli D, Melvin R, Barakat H, Taylor J, Veal S, Hamid HKS, Baili E, Kastrisios G, Maltezos C, Maltezos K, Anastasiadou C, Pachi A, Skotsimara A, Saratzis A, Vijaynagar B, Lau S, Velineni R, Bright E, Montague-Johnstone E, Stewart K, King W, Karkos C, Mitka M, Papadimitriou C, Smith G, Chan E, Shalhoub J, Machin M, Agbeko AE, Amoako J, Vijay A, Roditis K, Papaioannou V, Antoniou A, Tsiantoula P, Bessias N, Papas T, Dovell G, Goodchild F, Nandhra S, Rammell J, Dawkins C, Lapolla P, Sapienza P, Brachini G, Mingoli A, Hussey K, Meldrum A, Dearie L, Nair M, Duncan A, Webb B, Klimach S, Hardy T, Guest F, Hopkins L, Contractor U, Clothier A, McBride O, Hallatt M, Forsythe R, Pang D, Tan LE, Altaf N, Wong J, Thurston B, Ash O, Popplewell M, Grewal A, Jones S, Wardle B, Twine C, Ambler G, Condie N, Lam K, Heigberg-Gibbons F, Saha P, Hayes T, Patel S, Black S, Musajee M, Choudhry A, Hammond E, Costanza M, Shaw P, Feghali A, Chawla A, Surowiec S, Encalada RZ, Benson R, Cadwallader C, Clayton P, Van Herzeele I, Geenens M, Vermeir L, Moreels N, Geers S, Jawien A, Arentewicz T, Kontopodis N, Lioudaki S, Tavlas E, Nyktari V, Oberhuber A, Ibrahim A, Neu J, Nierhoff T, Moulakakis K, Kakkos S, Nikolakopoulos K, Papadoulas S, D'Oria M, Lepidi S, Lowry D, Ooi S, Patterson B, Williams S, Elrefaey GH, Gaba KA, Williams GF, Rodriguez DU, Khashram M, Gormley S, Hart O, Suthers E, French S. Short-term risk prediction after major lower limb amputation: PERCEIVE study. Br J Surg 2022; 109:1300-1311. [PMID: 36065602 DOI: 10.1093/bjs/znac309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 07/31/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery. METHODS The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance. RESULTS Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679). CONCLUSION Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation.
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Affiliation(s)
- Brenig L Gwilym
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | | | | | | | | | | | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ian Massey
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Jo Burton
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Phillippa Stewart
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Katie Samuel
- Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK
| | - Sian Jones
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - David Cox
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - Annie Clothier
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Christopher P Twine
- Bristol, Bath and Weston Vascular Network, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - David C Bosanquet
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
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Masuishi T, Kuboki Y, Fakih M, Strickler J, Furqan M, Kim E, Cardona P, Tran Q, Chan E, Hong D. 444TiP Trial in progress: A phase Ib study of sotorasib, a selective KRAS G12C inhibitor, in combination with panitumumab and FOLFIRI in treatment naïve and previously treated metastatic colorectal cancer (CodeBreaK 101). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1865] [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] Open
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11
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Deshmukh P, De Kouchkovsky I, Zhang L, Jindal T, Reyes K, Hernandez Romero E, Chan E, Desai A, Borno H, Kwon D, Wong A, Bose R, Aggarwal R, Porten S, Fong L, Small E, Chou J, Friedlander T, Koshkin V. 1751P Impact of squamous histology on clinical outcomes and molecular profiling in metastatic urothelial carcinoma (mUC) patients (pts) treated with newer therapies. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1829] [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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12
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Kuboki Y, Yaeger R, Fakih M, Strickler J, Masuishi T, Kim E, Bestvina C, Langer C, Krauss J, Puri S, Cardona P, Chan E, Tran Q, Hong D. 315O Sotorasib in combination with panitumumab in refractory KRAS G12C-mutated colorectal cancer: Safety and efficacy for phase Ib full expansion cohort. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.453] [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] Open
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13
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Greenacre L, Garcia JE, Chan E, Howard SR, Dyer AG. Vertical versus horizontal Spatial-Numerical Associations (SNA): A processing advantage for the vertical dimension. PLoS One 2022; 17:e0262559. [PMID: 36006955 PMCID: PMC9409557 DOI: 10.1371/journal.pone.0262559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/08/2022] [Indexed: 11/21/2022] Open
Abstract
Humans have associations between numbers and physical space on both horizontal and vertical dimensions, called Spatial-Numerical Associations (SNAs). Several studies have considered the hypothesis of there being a dominant orientation by examining on which dimension people are more accurate and efficient at responding during various directional SNA tasks. However, these studies have difficulty differentiating between a person’s efficiency at accessing mental representations of numbers in space, and the efficiency at which they exercise motor control functions, particularly bilateral ones, when manifesting a response during an explicit directional SNA task. In this study we use a conflict test employing combined explicit magnitude and spatial directional processing in which pairs of numbers are placed along the diagonal axes and response accuracy/efficiency are considered across the horizontal and vertical dimensions simultaneously. Participants indicated which number in each pair was largest using a joystick that only required unilateral input. The experiment was run in English using Arabic numerals. Results showed that directional SNAs have a vertical rather than horizontal dominance. A moderating factor was also found during post-hoc analysis, where response efficiency, but not accuracy, is conditional on a person’s native language being oriented the same as the language of the experiment, left to right. The dominance of the vertical orientation suggests adopting more vertical display formats for numbers may provide situational advantages, particularly for explicit magnitude comparisons, with some domains like flight controls and the stock market already using these in some cases.
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Affiliation(s)
- Luke Greenacre
- Faculty of Business and Economics, Monash University, Caulfield East, Victoria, Australia
| | - Jair E. Garcia
- Bio-Inspired Digital Sensing (BIDS) Laboratory, School of Media and Communication, RMIT University, Melbourne, Victoria, Australia
| | - Eugene Chan
- Faculty of Business and Economics, Monash University, Caulfield East, Victoria, Australia
- Ted Rogers School of Management, Toronto Metropolitan University, Toronto, Canada
| | - Scarlett R. Howard
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Burwood, Victoria, Australia
- School of Biological Sciences, Monash University, Clayton, Victoria, Australia
| | - Adrian G. Dyer
- Bio-Inspired Digital Sensing (BIDS) Laboratory, School of Media and Communication, RMIT University, Melbourne, Victoria, Australia
- Department of Physiology, Monash University, Clayton, Victoria, Australia
- * E-mail:
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14
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Kharytaniuk N, Lim EA, Chan E, Pavlou M, Werring DJ, Bamiou DE. Olfactory dysfunction is common in classical infratentorial superficial siderosis of the central nervous system. J Neurol 2022; 269:6582-6588. [PMID: 35997818 PMCID: PMC9396566 DOI: 10.1007/s00415-022-11329-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/12/2022]
Abstract
Background Established features of classical infratentorial superficial siderosis (iSS) include hearing loss, impaired balance, myelopathy and, less commonly, cognitive compromise. Olfactory function may be affected but dedicated studies are lacking. This study aimed to assess the prevalence of olfactory dysfunction in iSS and correlate it with auditory and cognitive functions. Methods Ten participants with iSS completed the University of Pennsylvania Smell Identification Test (UPSIT). The scores were compared with population norms; regression analysis was performed to evaluate associations between the scores and hearing thresholds (3-frequency average, 3FA) or the number of cognitive domains impaired. Imaging was reviewed for haemosiderin distribution and to exclude other causes of olfactory and hearing dysfunction. Results Eight of ten participants were male; the mean (standard deviation, SD) age was 52.5 (14.5) years. Olfactory hypofunction was identified in all participants and in six (60%) was moderate or completely absent. The mean UPSIT score of 25.5 (7.8) was significantly worse than population norms (difference in means − 10.0; 95% CI − 15.6 to − 4.4). Linear regression identified an association between UPSIT and hearing thresholds (R = 0.75; p = 0.013). The score decreases by 0.157 units (95% CI − 0.31 to − 0.002; p = 0.048) per unit increase in 3FA, after adjusting for hearing loss risk factors. There was no statistically significant association between UPSIT and cognitive function (R = 0.383; p = 0.397). Conclusion We report a high prevalence of olfactory dysfunction in iSS, the severity of which correlated with hearing loss. Olfaction appears to be a core feature of the iSS clinical syndrome that should be assessed routinely.
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Affiliation(s)
- Natallia Kharytaniuk
- Ear Institute, University College London, London, UK. .,National Institute for Health and Care Research, University College London Hospitals Biomedical Research Centre (Deafness and Hearing Problems Theme), London, UK. .,Department of Neuro-Otology, Royal ENT and Eastman Dental Hospitals, London, UK. .,Centre for Auditory Research, UCL Ear Institute, 332-336 Gray's Inn Road, London, WC1X 8EE, UK.
| | - E A Lim
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - E Chan
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Stroke Research Centre, Department of Brain Repair and Rehabilitation, Queen Square Institute of Neurology, University College London, London, UK
| | - M Pavlou
- Department of Statistical Science, University College London, London, UK
| | - D J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, Queen Square Institute of Neurology, University College London, London, UK.,Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - D E Bamiou
- Ear Institute, University College London, London, UK.,National Institute for Health and Care Research, University College London Hospitals Biomedical Research Centre (Deafness and Hearing Problems Theme), London, UK.,Department of Neuro-Otology, Royal ENT and Eastman Dental Hospitals, London, UK
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15
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Furukawa M, Chan E, Jhonson B, Sanchez P. Bridge Using the Hemolung System for Re-Do Double Lung Transplant In Situs Inversus Patient. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1250] [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] Open
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16
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Chan E, Yu E, Angeletti A, Arslan Z, Basu B, Boyer O, Chan CY, Colucci M, Dorval G, Dossier C, Drovandi S, Ghiggeri GM, Gipson D, Hamada R, Hogan J, Ishikura K, Kamei K, Kemper M, Ma ALT, Parekh R, Radhakrishnan S, Saini P, Shen Q, Sinha R, Subun C, Teo S, Vivarelli M, Webb H, Xu H, Yap HK, Tullus K. Long-term Efficacy and Safety of Repeated Rituximab to Maintain Remission in Idiopathic Childhood Nephrotic Syndrome: An International Study. J Am Soc Nephrol 2022; 33:1193-1207. [PMID: 35354600 PMCID: PMC9161790 DOI: 10.1681/asn.2021111472] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/14/2022] [Indexed: 11/03/2022] Open
Abstract
Background: Long-term outcomes following multiple rituximab courses among children with frequently-relapsing, steroid-dependent nephrotic syndrome (FRSDNS) are unknown. Methods: A retrospective cohort study at 16 pediatric nephrology centers from 10 countries in Asia, Europe, and North America included children with FRSDNS who received ≥2 rituximab courses. Primary outcomes were relapse-free survival and adverse events. Results: 346 children (age 9.8 years, IQR 6.6-13.5; 73% boys) received 1149 rituximab courses. 145, 83, 50, 28, 22, and 18 children received 2, 3, 4, 5, 6 and ≥7 courses, respectively. Median follow-up was 5.9 years (IQR, 4.3-7.7). Relapse-free survival differed by treatment courses (clustered log-rank test p<0.001). Compared to the first course (10.0 months, 95% CI, 9.0-10.7), relapse-free period and relapse risk progressively improved following subsequent courses (12.0-16.0 months; HRadj, 0.03-0.13; 95% CI, 0.01-0.18; ps<0.001). B-cell depletion duration remained similar with repeated treatments (6.1 months, 95% CI, 6.0-6.3). Adverse events were mostly mild, most commonly hypogammaglobulinemia (50.9%), infection (4.5%), and neutropenia (3.7%). Side effects did not increase with more treatment courses nor higher cumulative dose. Only 78 of the 353 episodes of hypogammaglobulinemia were clinically significant. Younger age at presentation (2.8 vs 3.3 years; p=0.05) and at first rituximab (8.0 y vs 10.0 years; p=0.01) and history of steroid resistance (28% vs 18%; p=0.01) were associated with significant hypogammaglobulinemia. All 53 infective episodes resolved, except one patient with hepatitis B infection and another with EBV infection. There were 42 episodes of neutropenia, associated with history of steroid resistance (30% vs 20%, p=0.04). Upon last follow-up, 332 children (96%) had normal kidney function. Conclusion: Children receiving repeated rituximab for FRSDNS experience an improving clinical response. Side effects appear acceptable but significant complications can occur. These findings support repeated rituximab use in FRSDNS.
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Affiliation(s)
- Eugene Chan
- E Chan, Paediatric Nephrology Centre, Hong Kong Children's Hospital, Kowloon, Hong Kong
| | - Ellen Yu
- E Yu, Clinical Research Center, Princess Margaret Hospital, Toronto, Canada
| | - Andrea Angeletti
- A Angeletti, Division of Nephrology, Dialysis, and Transplantation, Instituto di ricovero e cura a carattere scientifico (IRRCS), Giannina Gaslini Children's Hospital, Genova, Italy
| | - Zainab Arslan
- Z Arslan, Department of Paediatric Nephrology, Great Ormond Street Hospital For Children NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Biswanath Basu
- B Basu, Division of Pediatric Nephrology, Nilratan Sircar Medical College and Hospital, Kolkata, India
| | - Olivia Boyer
- O Boyer, Néphrologie pédiatrique, centre de référence du syndrome néphrotique de l'enfant et de l'adulte, Hôpital universitaire Necker-Enfants malades, Paris, France
| | - Chang-Yien Chan
- C Chan, Department of Paediatrics, NUS Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Manuela Colucci
- M Colucci, Renal Diseases Research Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, Rome, Italy
| | - Guillaume Dorval
- G Dorval, Néphrologie pédiatrique, centre de référence du syndrome néphrotique de l'enfant et de l'adulte, Hôpital universitaire Necker-Enfants malades, Paris, France
| | - Claire Dossier
- C Dossier, Department of Pediatric Nephrology, Centre de Référence Syndrome Néphrotique de l'Enfant et de l'Adulte (CMR SNI), Hopital Universitaire Robert-Debre, Paris, France
| | - Stefania Drovandi
- S Drovandi, Division of Nephrology, Dialysis, and Transplantation, Instituto di ricovero e cura a carattere scientifico (IRRCS), Giannina Gaslini Children's Hospital, Genova, Italy
| | - Gian Marco Ghiggeri
- G Ghiggeri, Division of Nephrology, Dialysis, and Transplantation, Instituto di ricovero e cura a carattere scientifico (IRRCS), Giannina Gaslini Children's Hospital, Genova, Italy
| | - Debbie Gipson
- D Gipson, Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, United States
| | - Riku Hamada
- R Hamada, Department of Nephrology and Rheumatology, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
| | - Julien Hogan
- J Hogan, Department of Pediatric Nephrology, Centre de Référence Syndrome Néphrotique de l'Enfant et de l'Adulte (CMR SNI), Hospital Robert Debré, Amboise, France
| | - Kenji Ishikura
- K Ishikura, Department of Pediatrics, Kitasato University School of Medicine, Japan, Japan
| | - Koichi Kamei
- K Kamei, Division of Nephrology and Rheumatology, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Markus Kemper
- M Kemper, Department of Pediatrics, Asklepios Medical School GmbH, Hamburg, Germany
| | - Alison Lap-Tak Ma
- A Ma, Paediatric Nephrology Centre, Princess Margaret Hospital, Hong Kong, Hong Kong
| | - Rulan Parekh
- R Parekh, Division of Pediatric Nephrology, Hospital for Sick Children, Toronto, Canada
| | - Seetha Radhakrishnan
- S Radhakrishnan, Division of Pediatric Nephrology, Hospital For Sick Children, London, United Kingdom of Great Britain and Northern Ireland
| | - Priya Saini
- P Saini, Division of Pediatric Nephrology, Hospital for Sick Children, Toronto, Canada
| | - Qian Shen
- Q Shen, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Rajiv Sinha
- R Sinha, Pediatric Nephrology Unit, Institute of Child Health, Kolkata, India
| | - Chantida Subun
- C Subun, Department of Paediatric Nephrology, Great Ormond Street Hospital For Children NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Sharon Teo
- S Teo, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Marina Vivarelli
- M Vivarelli, Division of Nephrology, Department of Pediatric Subspecialties, Bambino Gesù Children's Hospital, Roma, Italy
| | - Hazel Webb
- H Webb, Department of Paediatric Nephrology, Great Ormond Street Hospital For Children NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Hong Xu
- H Xu, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Hui Kim Yap
- H Yap, Department of Paediatrics, NUS Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Kjell Tullus
- K Tullus, Department of Paediatric Nephrology, Great Ormond Street Hospital For Children NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
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Ribas A, Chesney J, Long G, Kirkwood J, Dummer R, Puzanov I, Hoeller C, Gajewski T, Gutzmer R, Rutkowski P, Demidov L, Arenberger P, Shin S, Ferrucci P, Diede S, Anderson J, Treichel S, Chan E, Hodi F, Gogas H. 1037O MASTERKEY-265: A phase III, randomized, placebo (Pbo)-controlled study of talimogene laherparepvec (T) plus pembrolizumab (P) for unresectable stage IIIB–IVM1c melanoma (MEL). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1422] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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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18
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De Mel S, Goh J, Rashid MBMA, Zhang XY, Jaynes P, Liu X, Poon L, Chan E, Lee J, Chee YL, Koh LP, Tan LK, Soh TG, Yuen YC, Loi H, Ng S, Goh X, Tan D, Cheah DMZ, Pang WL, Huang D, Chan JY, Somasundaram N, Tang T, Lim ST, Ong CK, Chng W, Chow EK, Jeyasekharan AD. CLINICAL APPLICATION OF AN EX‐VIVO PLATFORM TO GUIDE THE CHOICE OF DRUG COMBINATIONS IN RELAPSED/REFRACTORY LYMPHOMA; A PROSPECTIVE STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.147_2880] [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: 11/06/2022]
Affiliation(s)
- S De Mel
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - J Goh
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | | | - X. Y Zhang
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - P Jaynes
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - X Liu
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - L Poon
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - E Chan
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - J Lee
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - Y. L Chee
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - L. P Koh
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - L. K Tan
- National University Hospital Department of Laboratory Medicine Singapore Singapore
| | - T. G Soh
- National University Hospital Department of Laboratory Medicine Singapore Singapore
| | - Y. C Yuen
- National University Health System Department of Pharmacy Singapore Singapore
| | - Hoi‐Y Loi
- National University Hospital Singapore Department of Diagnostic Imaging Singapore Singapore
| | - Siok‐B Ng
- National University of Singapore Department of Pathology Yong Loo Lin School of Medicine Singapore Singapore
| | - X Goh
- National University Hospital, Department of Otorhinolaryngology Singapore Singapore
| | - D Tan
- Mt Elizabeth Hospital, Dr Daryl Tan Clinic for Lymphoma, Myeloma and Blood Disorders Singapore Singapore
| | - D. M. Z Cheah
- National Cancer Centre Singapore Lymphoma Genomic Translational Research Laboratory Division of Cellular and Molecular Research Singapore Singapore
| | - W. L Pang
- National Cancer Centre Singapore Lymphoma Genomic Translational Research Laboratory Division of Cellular and Molecular Research Singapore Singapore
| | - D Huang
- National Cancer Centre Singapore Lymphoma Genomic Translational Research Laboratory Division of Cellular and Molecular Research Singapore Singapore
| | - J. Y Chan
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - N Somasundaram
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - T Tang
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - S. T Lim
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - C. K Ong
- National Cancer Centre Singapore Division of Cellular and Molecular Research Singapore Singapore
| | - W.‐J Chng
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
| | - E. K Chow
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - A. D Jeyasekharan
- National University Health System Department of Haematology‐Oncology National University Cancer Institute, Singapore Singapore Singapore
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Hoppe MM, Fan S, Jaynes P, Peng Y, Liu X, De Mel S, Poon L, Chan E, Lee J, Chee YL, Ong CK, Tang T, Lim ST, Chng WJ, Grigoropoulos NF, VanSchoiack A, Bertolazzi G, Ng S, Tripodo C, Jeyasekharan AD. DIGITAL SPATIAL PROFILING OF DIFFUSE LARGE B‐CELL LYMPHOMAS REVEALS STING AS AN IMMUNE‐RELATED DETERMINANT OF SURVIVAL AFTER R‐CHOP THERAPY. Hematol Oncol 2021. [DOI: 10.1002/hon.8_2880] [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: 11/05/2022]
Affiliation(s)
- M. M Hoppe
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - S Fan
- National University of Singapore Department of Pathology Yong Loo Lin School of Medicine Singapore Singapore
| | - P Jaynes
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - Y Peng
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - X Liu
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - S De Mel
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - L Poon
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - E Chan
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - J Lee
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - Y. L Chee
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - C. K Ong
- National Cancer Centre Singapore Division of Cellular and Molecular Research Singapore Singapore
| | - T Tang
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - S. T Lim
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - W. J Chng
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - N. F Grigoropoulos
- Singapore General Hospital Department of Haematology Singapore Singapore
| | | | - G Bertolazzi
- University of Palermo Tumor Immunology Unit Palermo Italy
| | - Siok‐B Ng
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - C Tripodo
- University of Palermo Tumor Immunology Unit Palermo Italy
| | - A. D Jeyasekharan
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
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Hoppe MM, Jaynes P, Fan S, Peng Y, Hoang PM, Liu X, De Mel S, Poon L, Chan E, Lee J, Chee YL, Ong CK, Tang T, Lim ST, Grigoropoulos NF, Tan S, Hue SS, Chang S, Chuang S, Li S, Khoury JD, Choi H, Farinha P, Mottok A, Scott DW, Chng W, Ng S, Tripodo C, Jeyasekharan AD. MYC, BCL2 AND BCL6 COEXPRESSION PATTERNS AT SINGLE‐CELL RESOLUTION RE‐DEFINE DOUBLE EXPRESSOR LYMPHOMAS. Hematol Oncol 2021. [DOI: 10.1002/hon.9_2880] [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: 11/08/2022]
Affiliation(s)
- M. M Hoppe
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - P Jaynes
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - S Fan
- National University of Singapore Department of Pathology Yong Loo Lin School of Medicine Singapore Singapore
| | - Y Peng
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - P. M Hoang
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - X Liu
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - S De Mel
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - L Poon
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - E Chan
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - J Lee
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - Y. L Chee
- National University Health System Department of Haematology‐Oncology Singapore Singapore
| | - C. K Ong
- National Cancer Centre Singapore Division of Cellular and Molecular Research Singapore Singapore
| | - T Tang
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - S. T Lim
- National Cancer Centre Singapore Division of Medical Oncology Singapore Singapore
| | - N. F Grigoropoulos
- Singapore General Hospital Department of Haematology Singapore Singapore
| | - S.‐Y Tan
- National University of Singapore Department of Pathology Yong Loo Lin School of Medicine Singapore Singapore
| | - S. S.‐S Hue
- National University of Singapore Department of Pathology Yong Loo Lin School of Medicine Singapore Singapore
| | - S.‐T Chang
- Chi‐Mei Medical Center Department of Pathology Tainan Taiwan
| | - S.‐S Chuang
- Chi‐Mei Medical Center Department of Pathology Tainan Taiwan
| | - S Li
- The University of Texas MD Anderson Cancer Center Department of Hematopathology, Division of Pathology and Laboratory Medicine Houston USA
| | - J. D Khoury
- The University of Texas MD Anderson Cancer Center Department of Hematopathology, Division of Pathology and Laboratory Medicine Houston USA
| | - H Choi
- National University of Singapore Department of Medicine, Yong Loo Lin School of Medicine Singapore Singapore
| | - P Farinha
- BC Cancer Research Centre Department of Lymphoid Cancer Research Vancouver Canada
| | - A Mottok
- University Medical Center and University of Ulm, Institute of Human Genetics Ulm Germany
| | - D. W Scott
- BC Cancer Research Centre Department of Lymphoid Cancer Research Vancouver Canada
| | - Wee‐J Chng
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - S.‐B Ng
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
| | - C Tripodo
- University of Palermo Tumor Immunology Unit Palermo Italy
| | - A. D Jeyasekharan
- National University of Singapore Cancer Science Institute of Singapore Singapore Singapore
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Chaabo K, Chan E, Garrood T, Rutter-Locher Z, Vincent A, Galloway J, Norton S, Kirkham B. POS0494 AN INVESTIGATION OF JOINT INFLAMMATION DEFINED BY COMPREHENSIVE ULTRASOUND ASSESSMENT AND PAIN SENSITISATION IN PATIENTS WITH ACTIVE RA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Treat-to-target strategies have improved outcomes in patients with RA. Targets based on clinical assessments of tender (TJC) and swollen joints (SJC) were developed when most patients had active inflammatory disease. It is now recognised some patients have pain sensitisation often termed fibromyalgia (FM), making clinical assessment of inflammatory disease more complex. An indicator of pain sensitisation is the difference between TJC and SJC, an observation we described in a pilot study (1).Objectives:To study patients with RA to describe the relationships between enhanced clinical and patient-reported outcome measures (PROMS) and active inflammatory joint disease detected by comprehensive PDUS.Methods:158 sequential patients with RA with a DAS28ESR score >¬3.2 were enrolled from GSTT Rheumatology after informed consent. They were assessed by a rheumatologist for 66SJC, 68TJC, fibromyalgia tender points & physician global. Recorded PROMS were: patient global, widespread pain index (WPI), symptom severity score (somatic & fatigue), FACIT fatigue, HAQ, EQ5D QoL, GAD7, PHQ9 and PHQ15. All patients had a 44 joint US scored for PD and grey scale by the EULAR scale blind to all patient data. Data were recorded on MedSciNet and statistical analysis used STATA.Results:Patients meeting the ACR 2010 criteria for FM2(n=72) vs those that did not(n=86) had similar demographics. SJC and US doppler scores were higher in the non-FM group, whereas rheumatoid factor, DAS28 and PROMs were higher in the FM group. Analysis of group differences using multinomial logistic regression and subsequent regularised (lasso) logistic regression, showed the FM group related to higher 28TJC, FACIT-F and PHQ15, with the non-FM group related to higher 28SJC, logESR, and lower Differences in 28S/TJC, Physician Global and FACIT-F. Patients were divided into four groups based on presence or absence of at least one PDUS+ joint and FM criteria; -FM-PD, -FM+PD, +FM-PD and +FM+PD, data summarised Table 1. The -FM-PD and -FM+PD groups related to Physician Global and negatively related to FACIT-F, Difference in 28S/TJC, and PHQ15 (-FM-PD). The +FM-PD group related positively to FACIT-F, Difference 28S/TJC, PHQ15, and negatively to Physician Global with +FM+PD related to PHQ9, FACIT-F and DAS28ESR.TABLE 1.-FM -PD -FM +PD +FM -PD +FM +PD p-valueFemale34 (79%)33 (77%)35 (83%)22 (73%)0.77Total power doppler score0.0 (0.0-1.0)16.0 (10.0-25.0)0.0 (0.0-0.0)9.0 (8.0-20.0)<0.001Total gray scale score40.0(34.0-48.0)57.5(45.0-82.0)34.5(20.0-43.0)60.0(46.0-84.0)<0.001Total Swollen JC3.0 (1.0-5.0)6.0 (3.0-9.0)2.0 (0.0-5.0)5.5 (2.0-10.5)<0.001Total Tender5.5 (3.0-12.0)8.0 (4.0-11.0)13.0 (8.0-20.0)15.0 (8.0-20.0)<0.001Tender-Swollen JC Difference4.0 (0.0-8.0)2.0 (0.0-4.0)8.0 (4.0-18.0)5.5 (2.5-13.5)<0.001ESR mm/hour10.0 (8.0-16.0)14.0 (10.0-30.0)12.0 (7.0-23.0)19.5 (11.5-42.5)0.021Pain VAS50.0 (40.0-65.0)50.0 (30.0-60.0)60.0 (47.5-77.5)67.5 (55.0-80.0)<0.001Patient VAS50.0 (30.0-70.0)40.0 (30.0-70.0)60.0 (40.0-80.0)65.0 (50.0-80.0)0.006Physician VAS30.0 (20.0-50.0)50.0 (40.0-60.0)30.0 (20.0-40.0)50.0 (32.5-70.0)<0.001DAS28 (ESR)4.2 (3.7-4.9)4.7 (4.1-5.2)4.7 (3.9-5.8)5.6 (4.9-6.6)<0.001Conclusion:These data using comprehensive US assessment to detect inflammatory joint disease, demonstrate that active inflammation defined as at least 1PDUS+ joint, may account for disease activity in slightly less than half of unselected patients with RA with a DAS28ESR score >3.2. This study shows how frequently pain sensitisation accounts for symptoms and signs in RA. We suggest in addition to central sensitisation, often called FM, another group identified here as -FM-PD, may have pain from joint damage or peripheral pain sensitisation of joints, likely due to different mechanisms than central pain sensitisation.References:[1]Mian A et al, BMC Musculoskelet Disord. 2016;17: 404[2]Wolfe F et al, Arth Care & Res 2010; 62:600Disclosure of Interests:Khaldoun Chaabo: None declared, Estee Chan: None declared, Toby Garrood: None declared, Zoe Rutter-Locher: None declared, Alexandra Vincent: None declared, James Galloway Speakers bureau: Dr Galloway has received speaker fees / honoraria from Abbvie, BMS, Celgene, Chugai, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi, Sobi and UCB, Sam Norton: None declared, Bruce Kirkham Speakers bureau: Professor Bruce Kirkham has received speaker fees / honoraria from Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer,and UCB., Grant/research support from: Professor Bruce Kirkham has received research support from Lilly, Novartis and UCB.Professor Bruce Kirkham has received speaker fees / honoraria from Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer and UCB.
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Chan E, Chirico D, Arena R, Feng Y, Liang Z, Ahmed SB, Colbert J, Aggarwal S. Sex-based differences in program completion and clinical outcomes in patients following outpatient cardiac rehabilitation. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.390] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Females have greater reduction in mortality compared to males, following completion of a cardiac rehabilitation (CR) program, yet they continue to have lower referral rates and program completion. Since 1996, a local rehabilitation program has been the main provider of CR in our health zone. A standardized rapid referral program was implemented in 2008 to improve referral rates of hospitalized patients. Since then, the relationship between sex and CR completion is unknown.
Purpose
To evaluate the relationship between sex and CR completion and to evaluate the association between CR completion and clinical outcomes, stratified by sex.
Methods: We included consecutive patients who were referred to CR and who
1) were hospitalized for an acute coronary syndrome (ACS) or stable angina between 2008 and 2016; 2) had angiographic evidence of at least one-vessel coronary disease; and 3) had revascularization with percutaneous intervention, coronary artery bypass or medical management. The outcomes of interest were CR completion, anxiety and depression categories, exercise capacity, death, and need for revascularization. Logistics regression models were used to determine the association between sex and CR completion. The association between sex, CR completion, and the outcomes of interest were assessed using multivariable cox proportional hazards models.
Results
A total of 726 females and 2645 males were included in this study. The rate of CR completion was lower in females compared to males (64.6% vs 69.98%, p = 0.006). Following adjustment for baseline characteristics, female sex independently predicted lower rates of CR completion, OR 0.81 (95%CI 0.67-0.97).
Both sexes displayed improvements in peak metabolic equivalents (METs) achieved during exercise testing (W: initial 5.99 ± 1.93; 12-week 7.22 ± 1.92; M: initial 7.62 ± 2.04; 12-week 8.81 ± 1.93, p = 0.001). Amongst CR completers, one-year mortality was similar between sex (W: 1.84% vs M: 3.27%, p = 0.118), as was revascularization (W: 14.29% vs M: 11.97%, p = 0.193), however both sexes had higher one-year mortality in CR non-completers.
Conclusion
Despite a standardized CR referral protocol, a sex-difference in CR completion remains. In CR completers, one-year mortality and revascularization was similar in both sexes, however mortality was higher in CR non-completers. Our study suggests that addressing the causes of female CR non-completion following ACS or stable angina may improve outcomes.
Outcomes by CR Completion and Sex All NC (n = 1051) W-NC (n = 257) M-NC (n = 794) p-value All C (n = 2320) W-C (n = 469) M-C (n = 1851) p-value Revascularization-1 year (%) 146 (14.94) 28 (11.72) 118 (15.59) 0.107 267 (12.44) 62 (14.29) 205 (11.97) 0.193 Death-1 year (%) 67 (6.86) 19 (7.95) 48 (6.50) 0.442 64 (2.98) 8 (1.84) 56 (3.27) 0.118 W = Women;M = Men;NC = Non-Completers;C = Completers
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Affiliation(s)
- E Chan
- Libin Cardiovascular Institute, Calgary, Canada
| | - D Chirico
- TotalCardiologyTM Rehabilitation, Calgary, Canada
| | - R Arena
- University of Illinois at Chicago, Department of Physical Therapy, Chicago, United States of America
| | - Y Feng
- University of Calgary, Department of Medicine, Cumming School of Medicine, Calgary, Canada
| | - Z Liang
- University of Calgary, Department of Medicine, Cumming School of Medicine, Calgary, Canada
| | - SB Ahmed
- Libin Cardiovascular Institute, Calgary, Canada
| | - J Colbert
- Libin Cardiovascular Institute, Calgary, Canada
| | - S Aggarwal
- Libin Cardiovascular Institute, Calgary, Canada
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Edel L, Grime C, Robinson V, Manzur A, Abel F, Munot P, Ridout D, Scoto M, Muntoni F, Chan E. A new respiratory scoring system for evaluation of respiratory outcomes in children with spinal muscular atrophy type1 (SMA1) on SMN enhancing drugs. Neuromuscul Disord 2021; 31:300-309. [PMID: 33752934 DOI: 10.1016/j.nmd.2021.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 01/05/2021] [Accepted: 01/18/2021] [Indexed: 11/28/2022]
Abstract
Nusinersen (NUS), the first treatment approved for Spinal Muscular Atrophy type 1 (SMA1), was made available in the UK for SMA1 through the Expanded Access Program (EAP) in 2017. The Great Ormond Street Respiratory (GSR) score was developed as an objective respiratory assessment for children with SMA1 during their treatment. Aims: Track respiratory status of SMA1 children over the course of Nusinersen treatment and compare GSR scores amongst SMA1 sub-types. Single centre study on SMA1 patients using the GSR score at set time points: prior to first NUS dose; 2 weeks post end of loading doses; 2 weeks post-subsequent doses. GSR score ranges 1-28, being 1-9 = Stable minimal support, thorough to 23-28 = Poor reserve with maximum support. 20 SMA1 children underwent NUS treatment between January 2017 - November 2018. Median age of diagnosis was 5.0 months. NUS started at median of 9.57 months. From 5th dose onwards, GSR scores were significantly lower for Type 1C patients compared to Type 1B By month 18, irrespective of subtypes, the whole cohort appears to stabilise GSR Scores. As treatment duration increases, an overall stabilisation of respiratory status across the cohort was observed. Further longitudinal studies are needed to validate the GSR.
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Affiliation(s)
- L Edel
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK.
| | - C Grime
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK
| | - V Robinson
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK
| | - A Manzur
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK
| | - F Abel
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK
| | - P Munot
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK
| | - D Ridout
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK
| | - M Scoto
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK; The Dubowitz Neuromuscular Centre, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - F Muntoni
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK; The Dubowitz Neuromuscular Centre, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - E Chan
- Respiratory Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St, London WC1N 3JH, UK
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Rooprai J, Chan E, Rodger J, Visintini S, Rodger N, Mielniczuk L, Sun L. Sex-Based Differences in Outpatient Specialist Referral Patterns of Heart Failure Patients: A Scoping Review. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2020.02.047] [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] Open
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Edel L, Abbott L, Chan E, Main M, Robinson V, Munot P, Manzur A, Ridout D, Baranello G, Scoto M, Muntoni F. SMA - CLINICAL. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.098] [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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Teoh J, Chan E, Cheuk A, Chan R, Qin J, Ng C. A newly developed computer-aided endoscopic diagnostic system for bladder cancer detection. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33498-4] [Citation(s) in RCA: 3] [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: 11/26/2022] Open
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27
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Zhuang K, Patel A, Tay K, Irani F, Matchar D, Sivapragasam N, Pua U, Sum L, Tze Tec C, Tan G, Chan E, Win H, Burgmans M, Gogna A, Damodharan K, Chan S, Too C, Karaddi Venkatanarasimha N, Quek L, Gummalla K, Siew Ping C, Tan B. 4:12 PM Abstract No. 50 Quality of life outcomes from a randomized controlled trial comparing drug-eluting balloon to conventional balloon angioplasty for below-the-knee arteries in patients with critical limb ischemia. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.073] [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] Open
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Al Yaarubi Z, Foster A, Avinashi V, Lam G, Soller L, Chan E. A198 EOSINOPHILIC ESOPHAGITIS WITH STRICTURE PRESENTING SHORTING AFTER INITIATION OF ORAL PEANUT IMMUNOTHERAPY. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.197] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Oral immunotherapy (OIT) is increasingly practiced outside of research settings with reasonable success (Soller 2019).
With OIT, a patient eats their food allergen daily, gradually increasing the dose, with the goal to prevent or reduce the severity of an anaphylactic reaction.
One of the described adverse events of OIT is a risk of developing Eosinophilic Esophagitis (EoE), with cited frequency of 2.7% (Lucendo 2014). In addition, OIT is typically contraindicated in patients with known EoE but patients are not routinely screened for EoE prior to initiation of OIT.
Aims
To present a case of a 12 year old boy with peanut anaphylaxis who developed eosinophilic esophagitis and an esophageal stricture shortly after starting peanut immunotherapy
Methods
Patient chart review was conducted. A literature review was done using the words “eosinophilic esophagitis” and “immunotherapy”.
Results
A12 year old boy with asthma, allergic rhinitis and multiple anaphylactic food allergies, started peanut OIT with an allergist. Prior to OIT, the patient had no symptoms suggestive of EoE such as dysphagia, heartburn, chest pain or washing of food. Approximately 3.5 weeks into treatment, the patient developed daily vomiting. The patient was advised to stop the peanut OIT three days after symptom onset, but the vomiting continued for another 8 days. By the time of endoscopy (16 days after onset of vomiting), the vomiting had completely subsided for the previous five days.
The upper GI endoscopy demonstrated signs of EoE throughout the length of the esophagus. In the mid esophagus there was resistance where the 9.8 mm gastroscope was unable to pass. A smaller gastroscope with a 5.9 mm width was easily able to pass through the stricture. Histology showed marked eosinophilia throughout the esophagus with basal cell hyperplasia, spongiosis, superficial microabscesses and stromal fibrosis consistent with EoE. The patient continued to be ‘asymptomatic’ at the time of endoscopy and after despite the presence of a stricture. After discussion, the patient was started on oral viscous budesonide (OVB) 1mg PO BID.
The patient was re-scoped 4 weeks into OVB therapy with complete resolution of the stricture with neither macroscopic nor histologic findings of EoE. Patient is now off OVB for over a month, remains asymptomatic, and will undergo repeat endoscopy in the upcoming month to ensure normal histology
Conclusions
This is the first case describing EoE with an esophageal stricture shortly after initiation of OIT. Pediatric Gastroenterologists need to be increasingly aware that patients undergoing OIT are at an increasing risk of ‘developing’ or at least ‘unmasking’ EoE. More research is required to evaluate whether EoE screening, by symptom questionnaire or endoscopy is warranted prior to beginning OIT, and whether OIT is truly needed.
Upper GI endoscopy showing signs of EoE and an esophageal stricture
Funding Agencies
CAG
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Affiliation(s)
- Z Al Yaarubi
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - A Foster
- BC Children’s Hospital, Vancouver, BC, Canada
| | - V Avinashi
- BC Children’s Hospital, Vancouver, BC, Canada
| | - G Lam
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - L Soller
- BC Children’s Hospital, Vancouver, BC, Canada
| | - E Chan
- BC Children’s Hospital, Vancouver, BC, Canada
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Bonifacio G, Chan E, Squitieri M, Islam S, Werring D. Cognitive and imaging correlates in cerebral amyloid angiopathy subtypes. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.746] [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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Chan E, Ibarra S, Reul R, Ravi V, Shapira O, Kim M, Reardon M. P2.15-08 Multicenter Experience with Complete Surgical Resection of Primary Pulmonary Artery Sarcoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1862] [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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31
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Ibarra S, Chan E, Reul R, Kim M, Macgillivray T, Ravi V, Reardon M. P1.15-06 Resection of Thoracic Paragangliomas: A Multicenter Experience. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1219] [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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32
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Lau AYL, Chan E, Lau KK, Mok V, Siu DYW, Lee R. Neutralising antibodies to interferon-beta therapy in relapsing multiple sclerosis: a pilot study. Hong Kong Med J 2019; 25 Suppl 5:22-25. [PMID: 31416982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- A Y L Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - E Chan
- Department of Pathology, Queen Mary Hospital
| | - K K Lau
- Department of Medicine, Princess Margaret Hospital
| | - V Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - D Y W Siu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital
| | - R Lee
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital
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Witzig T, Maddocks K, de Vos S, Lyons R, Edenfield W, Sharman J, Vose J, Yimer H, Wei H, Chan E, Patel P, Di Simone C, Gandhi M, Vaughn J, Kolibaba K, Cheson B, Samaniego F. ACALABRUTINIB PLUS PEMBROLIZUMAB IN RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA: A PHASE 1/2 STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.139_2630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- T.E. Witzig
- Division of Hematology; Mayo Clinic; Rochester MN United States
| | - K. Maddocks
- Internal Medicine; Ohio State University; Columbus United States
| | - S. de Vos
- Assistant Professor; Medicine, David Geffen School of Medicine at University of California Los Angeles; Los Angeles United States
| | - R. Lyons
- Hematology; Texas Oncology-San Antonio Medical Center, US Oncology Research; San Antonio United States
| | - W. Edenfield
- Hematology and Oncology; Greenville Health System Cancer Institute; Greenville United States
| | - J. Sharman
- Hematology; Willamette Valley Cancer Institute and Research Center, US Oncology Research; Eugene United States
| | - J. Vose
- Internal Medicine; Nebraska Medical Center; Omaha United States
| | - H. Yimer
- Hematology; Texas Oncology-Tyler, US Oncology Research; Tyler United States
| | - H. Wei
- Bio statistics; Acerta Pharma; South San Francisco United States
| | - E. Chan
- Clinical Director; Acerta Pharma; South San Francisco United States
| | - P. Patel
- Clinical Director; Acerta Pharma; South San Francisco United States
| | - C. Di Simone
- Medical Oncology & Hematology; Arizona Oncology, US Oncology Research; Tucson United States
| | - M. Gandhi
- Medical Oncologist; Virginia Cancer Specialists, US Oncology Research; Woodbridge United States
| | - J. Vaughn
- Hematology; Fred Hutchinson Cancer Research Center; Seattle United States
| | - K. Kolibaba
- Medical Oncology & Hematology; Northwest Cancer Specialists, US Oncology Research; Vancouver United States
| | - B. Cheson
- Division of Hematology and Oncology; Georgetown University Hospital; Washington DC United States
| | - F. Samaniego
- Department of Lymphoma/Myeloma; The University of Texas MD Anderson Cancer Center, Houston; United States
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Jeyasekharan A, Hoppe M, Fan S, VanSchoiack A, Xin L, De Mel S, Poon M, Chan E, Lee J, Chee Y, Chng W, Ng S. DIGITAL SPATIAL PROFILING OF IMMUNE MARKERS IN R-CHOP TREATED DIFFUSE LARGE B-CELL LYMPHOMA REVEALS A DOMINANT PROGNOSTIC SIGNIFICANCE OF M2 MACROPHAGE INFILTRATION. Hematol Oncol 2019. [DOI: 10.1002/hon.18_2631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A.D. Jeyasekharan
- Cancer Science Institute; National University of Singapore; Singapore Singapore
| | - M.M. Hoppe
- Cancer Science Institute; National University of Singapore; Singapore Singapore
| | - S. Fan
- Pathology; National University of Singapore; Singapore Singapore
| | - A. VanSchoiack
- Digital Pathology; Nanostring Technologies Inc; Seattle WA United States
| | - L. Xin
- Haematology-Oncology; National University Hospital Singapore; Singapore Singapore
| | - S. De Mel
- Haematology-Oncology; National University Hospital Singapore; Singapore Singapore
| | - M. Poon
- Haematology-Oncology; National University Hospital Singapore; Singapore Singapore
| | - E. Chan
- Haematology-Oncology; National University Hospital Singapore; Singapore Singapore
| | - J. Lee
- Haematology-Oncology; National University Hospital Singapore; Singapore Singapore
| | - Y.L. Chee
- Haematology-Oncology; National University Hospital Singapore; Singapore Singapore
| | - W.J. Chng
- Haematology-Oncology; National University Hospital Singapore; Singapore Singapore
| | - S.B. Ng
- Pathology; National University of Singapore; Singapore Singapore
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Poon L, Hoppe M, Fan S, Choo S, Choi H, Xin L, De Mel S, Chan E, Lee J, Chee Y, Chng W, Ng S, Jeyasekharan A. SINGLE CELL LEVEL ANALYSIS OF MYC/ BCL2/ BCL6 CO-EXPRESSION IN DIFFUSE LARGE B-CELL LYMPHOMA THROUGH MULTIPLEXED QUANTITATIVE IMMUNOFLUORESCENCE. Hematol Oncol 2019. [DOI: 10.1002/hon.13_2630] [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)
- L.M. Poon
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - M.M. Hoppe
- Cancer Science Institute of Singapore; National University of Singapore; Singapore Singapore
| | - S. Fan
- Department of Pathology; National University of Singapore; Singapore Singapore
| | - S.N. Choo
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - H.W. Choi
- Saw Swee Hock School of public health; National University of Singapore; Singapore Singapore
| | - L. Xin
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - S. De Mel
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - E. Chan
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - J. Lee
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - Y.L. Chee
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - W.J. Chng
- Department of Haematology-Oncology; National University Hospital of Singapore; Singapore Singapore
| | - S.B. Ng
- Cancer Science Institute of Singapore; National University of Singapore; Singapore Singapore
| | - A.D. Jeyasekharan
- Cancer Science Institute of Singapore; National University of Singapore; Singapore Singapore
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Punjani N, Chan G, Chan E, Abed H, Campbell J, Brock G. 250 Single Perineal Incision for Artificial Urinary Sphincter: An Analysis of Technique, Outcomes, and Experience. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.256] [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: 10/27/2022]
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Edel L, Muntoni F, Robinson V, Grime C, Abel F, Manzur A, Munot P, Scoto M, Chan E. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.195] [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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Chan E, Quinn C, Hirji I, Hillengass J, Anderson K, Oukessou A, Davis C. Alternative metrics for assessing clinical benefit with immunotherapy in oncology. Oncoimmunology 2018; 8:e1343774. [PMID: 31646068 DOI: 10.1080/2162402x.2017.1343774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/08/2017] [Accepted: 06/12/2017] [Indexed: 01/09/2023] Open
Abstract
Therapies for cancer have traditionally been assessed with metrics such as the response rate, hazard ratio, or median survival. Such metrics have value in measuring the outcomes of conventional therapies, but may not be the most appropriate for new therapies. Immuno-oncology therapies offer a new approach to treating cancer by stimulating patients' immune systems to fight cancer. The value of these novel therapies has so far been assessed with traditional metrics, but the different ways in which immuno-oncology therapies work can mean the full value is not captured. Immuno-oncology therapies can produce longer survival times but this effect can be delayed or even preceded by an apparent phase of progression, which median survival or response rates may not reflect. This paper discusses a range of traditional and alternative metrics and their benefits or disadvantages in measuring the effects of immuno-oncology therapies, using examples of several novel drugs as case studies.
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Affiliation(s)
- E Chan
- PRMA Consulting, Linea House, Ancells Business Park, Harvest Crescent, Fleet, GU51 2UZ, UK
| | - C Quinn
- PRMA Consulting, Linea House, Ancells Business Park, Harvest Crescent, Fleet, GU51 2UZ, UK
| | - I Hirji
- Bristol-Myers Squibb, Princeton, NJ, USA
| | - J Hillengass
- Heidelberg University, Grabengasse 1, 69117 Heidelberg, Germany
| | - K Anderson
- Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, USA
| | - A Oukessou
- Bristol-Myers Squibb, Princeton, NJ, USA
| | - C Davis
- Bristol-Myers Squibb, Princeton, NJ, USA
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Raman S, Pless M, Cubillo A, Calvo A, Hecht R, Liu C, Chan E, Chesney J, Prat A. 3:36 PM Abstract No. 375 Early safety from a phase 1, multicenter, open-label clinical trial of talimogene laherparepvec (T-VEC) injected into liver tumors. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.416] [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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40
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Koutsifeli P, Varma U, Chan E, Delbridge L, Mellor K. Glycogen Autophagy Plays an Important Role in Glycogen Overload in Diabetic Cardiomyocytes in Vitro. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.037] [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: 10/28/2022]
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41
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Pence K, Correa AM, Chan E, Khaitan P, Hofstetter W, Kim MP. Management of esophageal gastrointestinal stromal tumor: review of one hundred seven patients. Dis Esophagus 2017; 30:1-5. [PMID: 28881878 DOI: 10.1093/dote/dox064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/23/2016] [Accepted: 05/17/2017] [Indexed: 12/11/2022]
Abstract
Gastrointestinal stromal tumors (GIST) are the most common type of gastrointestinal mesenchymal tumor, but are rarely found in the thoracic esophagus. There is no clear consensus about the optimal treatment of this rare disease. A systematic search of the literature was performed for localized esophageal GIST that was resected between 2000 and 2015, and individual patients were included from two major academic institutions. We obtained information on demographics, tumor size and location, mitotic rate, treatment method, and time to recurrence or death. We performed univariate and multivariate Cox regression analyses to evaluate the factors associated with recurrence or death. A total of 28 studies met our inclusion and exclusion criteria, and with two patients from two academic institutions, we had a total of 107 patients in the study. Due to lack of uniformity among studies, there were several missing data for different variables. The average patient age was 56 (n = 98) with mostly males (60%, n = 91). The average tumor size on the CT scan was 7.9 ± 5.4 cm (n = 91), located mostly in the distal esophagus (81%, n = 74). A similar number of patients underwent enucleation (n = 47) compared to esophagectomy (n = 42). Approximately half of the patients had a mitotic rate of 0-4 mitosis per 50 high-powered field (48%, n = 80). The median survival time was 73 months with a 5-year disease free survival of 57% (n = 97). Univariate Cox regression analyses showed that a large tumor, undergoing esophagectomy, and a high mitotic rate were associated with poor survival or recurrence control. We found that patients with a lesion smaller than or equal to 5 cm on the CT scan had a better disease-free survival rate than those with a size greater than 5 cm (HR = 12.41, p = 0.014) and had a 5-year survival rate of 92% with 90% of those patients undergoing enucleation (n = 29). Esophageal GIST is a very rare malignancy. The tumor size and mitotic rate of the tumor are associated with poor survival. However, patients with esophageal GIST measuring 5 cm or smaller may be safely treated with esophageal enucleation.
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Affiliation(s)
- K Pence
- Department of Surgery, Houston Methodist Hospital
| | - A M Correa
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center
| | - E Chan
- Department of Surgery, Houston Methodist Hospital
| | - P Khaitan
- Department of Surgery, Houston Methodist Hospital.,Weill Cornell Medical College, Houston Methodist Hospital, Houston, Texas, USA
| | - W Hofstetter
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center
| | - M P Kim
- Department of Surgery, Houston Methodist Hospital.,Weill Cornell Medical College, Houston Methodist Hospital, Houston, Texas, USA
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Cipolotti L, Spano B, Healy C, Tudor-Sfetea C, Chan E, White M, Biondo F, Duncan J, Shallice T, Bozzali M. Inhibition processes are dissociable and lateralized in human prefrontal cortex. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.813] [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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43
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Chan E, Johnson C, Gauthier N, Turek M, Liddy C, Keely E, Shoki A, Archibald D. SHOULD I WORRY ABOUT THIS ABNORMAL CARDIAC TEST RESULT? INSIGHTS INTO CARDIAC TEST REPORTING FROM QUALITATIVE ANALYSIS OF A CARDIOLOGY ECONSULT SERVICE. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.162] [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] Open
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44
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Chan E, Altendorff S, Khan S, Oliver R, Gill S, Healy C, Werring D, Cipolotti L. The test accuracy of the montreal cognitive assessment (MoCA) in stroke. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3356] [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: 12/01/2022]
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45
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Collins S, Chan E. Clergy counseling and medical helpseeking among infertile U.S. women. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.236] [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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46
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Bjorkman S, Chan E, Collins S. Ethical views of third-party reproduction and attitudes/utilization of adoption among reproductive-aged U.S. women. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.884] [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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47
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Cheung B, Tam F, Cheung C, Lee S, Tsui S, Chan E. Serum Beta-2 Microglobulin Level is Elevated in Patients with Acute Coronary Syndrome. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.162] [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: 10/19/2022]
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48
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Chan E, Glass G, Qi Q, Chua K, Ali N, Lim W. PROTECTIVE EFFECT OF MASTERY AGAINST PSYCHOLOGICAL DISTRESS IN FAMILY CAREGIVERS OF OLDER PERSONS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4546] [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: 11/14/2022] Open
Affiliation(s)
- E. Chan
- Tan Tock Seng Hospital, Singapore, Singapore,
- National University of Singapore, Singapore, Singapore,
| | - G.F. Glass
- Tan Tock Seng Hospital, Singapore, Singapore,
| | - Q. Qi
- Tan Tock Seng Hospital, Singapore, Singapore,
| | - K. Chua
- King’s College London, London, United Kingdom
| | - N. Ali
- Tan Tock Seng Hospital, Singapore, Singapore,
| | - W. Lim
- Tan Tock Seng Hospital, Singapore, Singapore,
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Ott PA, Piha-Paul SA, Munster P, Pishvaian MJ, van Brummelen EMJ, Cohen RB, Gomez-Roca C, Ejadi S, Stein M, Chan E, Simonelli M, Morosky A, Saraf S, Emancipator K, Koshiji M, Bennouna J. Safety and antitumor activity of the anti-PD-1 antibody pembrolizumab in patients with recurrent carcinoma of the anal canal. Ann Oncol 2017; 28:1036-1041. [PMID: 28453692 PMCID: PMC5406758 DOI: 10.1093/annonc/mdx029] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [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] [Indexed: 12/20/2022] Open
Abstract
Background Safety and efficacy of pembrolizumab, a humanized programmed death 1 monoclonal antibody, was assessed in KEYNOTE-028, a multicohort, phase Ib trial for patients with programmed death ligand 1 (PD-L1)-positive advanced solid tumors. We report results for the cohort of patients with advanced anal carcinoma. Patients and methods Patients with PD-L1-positive tumors (≥1%) received intravenous pembrolizumab 10 mg/kg once every 2 weeks for up to 2 years or until confirmed progression or unacceptable toxicity. Response was assessed every 8 weeks for the first 6 months and every 12 weeks thereafter per Response Evaluation Criteria In Solid Tumors, version 1.1. Primary endpoints were safety and overall response rate per investigator review. Secondary endpoints included progression-free survival, overall survival, and response duration. Data cutoff date was 1 July 2015. Results Of the 43 patients with advanced anal carcinoma evaluable for PD-L1 expression, 32 (74%) had PD-L1-positive tumors as assessed with the 22C3 prototype assay, of whom 25 were enrolled between April and September 2014. Sixteen patients (64%) experienced treatment-related adverse events; the most common ones were diarrhea and fatigue in four patients (16%) each and nausea in three patients (12%). There were no treatment-related deaths or discontinuations as of the data cutoff date. Among the 24 patients with squamous cell carcinoma histology, four had confirmed partial response, for an overall response rate of 17% [95% confidence interval (CI), 5%-37%) and 10 (42%) had confirmed stable disease, for a disease control rate of 58%. One additional patient with non-squamous histology had confirmed stable disease. Conclusion In this population of patients with PD-L1-positive advanced squamous cell anal carcinoma, pembrolizumab demonstrated a manageable safety profile and encouraging antitumor activity. These data support further study of pembrolizumab for this patient population. ClinicalTrials.gov NCT02054806.
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MESH Headings
- Aged
- Aged, 80 and over
- Anal Canal/pathology
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Agents, Immunological/adverse effects
- Antineoplastic Agents, Immunological/therapeutic use
- Anus Neoplasms/drug therapy
- Anus Neoplasms/mortality
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/mortality
- Disease-Free Survival
- Female
- Humans
- Male
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Treatment Outcome
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Affiliation(s)
- P. A. Ott
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston
| | - S. A. Piha-Paul
- Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - P. Munster
- Department of Medicine (Hematology/Oncology), Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
| | - M. J. Pishvaian
- Department of Hematology/Oncology, Georgetown University, Washington DC, USA
| | - E. M. J. van Brummelen
- Department of Molecular Pathology & Clinical Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R. B. Cohen
- Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - C. Gomez-Roca
- Clinical Research Unit, Institut Claudius Regaud and Institut Universitaire du Cancer—Oncopole, Toulouse, France
| | - S. Ejadi
- Department of Medical Oncology, Virginia G. Piper Cancer Center, Scottsdale
| | - M. Stein
- Department of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - E. Chan
- Department of Medicine (Hematology/Oncology), Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - M. Simonelli
- Department of Medical Oncology and Hematology, Humanitas Cancer Center, Rozzano, Italy
| | - A. Morosky
- Department of Clinical Oncology, Merck & Co, Inc., Kenilworth, USA
| | - S. Saraf
- Department of Clinical Oncology, Merck & Co, Inc., Kenilworth, USA
| | - K. Emancipator
- Department of Clinical Oncology, Merck & Co, Inc., Kenilworth, USA
| | - M. Koshiji
- Department of Clinical Oncology, Merck & Co, Inc., Kenilworth, USA
| | - J. Bennouna
- Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Nantes, France
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Allen A, Ansari R, Thurley J, Murphy L, Chan E, McKinnon C, Fitzgerald R, Deeley A, Wachter R, Rajewski J. Adult ADHD and the use of mindfulness-based practice: A pilot study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Educational objectivesThe goal of this poster is to discuss a brief pilot study in which mindfulness – and yoga-based practices were utilized with a group of adult ADHD patients.MethodsA sample of 10 adults participated in a pilot group which utilized the use mindfulness-based and yoga practices to address ADHD. This group was a single 2 hour session which was a pilot for a future 6-week psycho-educational group. The participants completed the following questionnaires: the Cognitive and Affective Mindfulness Scale (CAMS-R), the Freiburg mindfulness inventory and the Mindful Attention Awareness Scale (MAAS) in addition to a survey regarding levels of knowledge of yoga and mindfulness prior to the beginning of the session. The participants completed a survey at the end of the session.ResultsIn our small sample group, all respondents reported that they found the session helpful (43% strongly agreed; 57% agreed). When asked if the participants were likely to explore and learn more about ADHD and meditation on their own based on what they learned in the session, most indicated that they were likely to (43% strongly agreed; 43% agreed and 14% were neutral).ConclusionsThe use of treatment modalities involving the use of meditation and mindfulness-based techniques in a group setting are thought to be helpful in addressing some of the target symptoms of ADHD. Based on the preliminary data collected in our small pilot study, our group intends to further explore the efficacy of meditation-based groups in the form of a 6-week training program in 2017.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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