1
|
Neal J, Pavlakis N, Kim SW, Goto Y, Lim S, Mountzios G, Fountzilas E, Mochalova A, Christoph D, Bearz A, Quantin X, Palmero R, Antic V, Chun E, Edubilli TR, Lin YC, Huseni M, Scheffold C, Vervaet P, Newsom-Davis T. 60 CONTACT-01: Efficacy and safety from a phase III study of atezolizumab (atezo) + cabozantinib (cabo) vs docetaxel (doc) monotherapy in patients (pts) with metastatic NSCLC (mNSCLC) previously treated with checkpoint inhibitors and chemotherapy. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00260-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
|
2
|
Choi E, Su C, Wu J, Aredo J, Neal J, Leung A, Backhus L, Marchand L, Liang S, Cheng I, Wakelee H, Han S. OA01.01 Second Primary Lung Cancer among Lung Cancer Survivors Who Never Smoked. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.119] [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: 01/30/2023]
|
3
|
Cho B, Wang Y, Li Y, Wu L, Besse B, Marmarelis M, Goto K, Lee JS, Lee SH, Zhang Y, Neal J, Curtin J, Bauml J, Mahoney J, Trani L, Knoblauch R, Tomasini P. 322MO Amivantamab in combination with lazertinib in patients with atypical epidermal growth factor receptor (EGFR) mutations excluding exon 20 insertion mutations: Initial results from CHRYSALIS-2. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.359] [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: 12/05/2022] Open
|
4
|
Mease PJ, Deodhar A, Van der Heijde D, Behrens F, Kivitz A, Neal J, Nys M, Lehman T, Delev N, Korish S, Nowak M, Banerjee S. POS1048 SAFETY AND EFFICACY OF DEUCRAVACITINIB, AN ORAL, SELECTIVE TYROSINE KINASE 2 INHIBITOR, IN PATIENTS WITH PSORIATIC ARTHRITIS: 52-WEEK RESULTS FROM A RANDOMISED PHASE 2 TRIAL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2456] [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
BackgroundDeucravacitinib (DEUC) is a novel, oral, selective, allosteric inhibitor of tyrosine kinase 2 (TYK2) that acts by binding to the unique TYK2 regulatory domain, thereby suppressing signalling of key cytokines (eg, IL-23) involved in skin psoriasis and psoriatic arthritis (PsA) pathogenesis. Results from the initial 16-week (wk), placebo (PBO)-controlled period (Part A) of a 52-wk, blinded Phase 2 trial in PsA showed that DEUC was significantly more efficacious than PBO.1 The Psoriatic Arthritis Disease Activity Score (PASDAS), a validated comprehensive measure assessing a variety of PsA clinical domains, was used to assess efficacy of DEUC up to 52 wks.ObjectivesEvaluate the safety and efficacy of DEUC in Part B (Wks 16-52) in the Phase 2 PsA trial.MethodsPatients (pts) with PsA were randomised 1:1:1 to PBO, DEUC 6 mg once daily (QD), or 12 mg QD. After Wk 16 (Part A), pts could enrol in an optional, double-blind period until Wk 52 (Part B). In Part B, pts receiving DEUC who had achieved minimal disease activity (MDA) at Wk 16 continued DEUC treatment and those who had not achieved MDA were switched to ustekinumab (UST) at the approved PsA dose. All pts treated with PBO in Part A switched to UST in Part B. Pts were assessed up to 52 wks for adverse events (AEs) and exploratory efficacy endpoints including change in PASDAS. Analyses were descriptive using data as observed.ResultsOf 203 pts randomised in Part A, 180 (89%) completed 16 wks of treatment and 173 (96%) of these pts chose to enrol in Part B. Of 118 pts initially randomised to DEUC, 25% (29/118; 6 mg QD, 22% [13/60]; 12 mg QD, 28% [16/58]) achieved MDA at Wk 16 and continued at the same dose. All other pts switched to UST in Part B: PBO, 100% (55/55; including 5 pts who had achieved MDA at Wk 16); DEUC 6 mg QD, 78% (47/60); DEUC 12 mg QD, 72% (42/58). The safety profile of DEUC in Part B (Table 1) was consistent with that in Part A, and all AEs were mild or moderate except 2 AEs in 1 pt with severe cataract/macular fibrosis. There were no opportunistic infections, herpes zoster, malignancy, thrombotic events, or treatment-related serious AEs reported in pts who remained on DEUC. Decreases in mean PASDAS score observed at Wk 16 were maintained at Wk 52 in pts who continued on DEUC (Figure 1). Improvements in other outcomes, including ACR components, PASI, and FACIT-Fatigue, were also sustained at Wk 52 in pts who continued DEUC treatment. Pts who had not achieved MDA on DEUC at Wk 16 showed a decrease in mean PASDAS score at Wk 52 after switching to UST.Table 1.Overall summary of safety in Part B (Weeks 16 to 52)AE, n (%)aDEUC 6 mg QD n = 13DEUC 12 mg QD n = 16DEUC 6 mg QD →UST n = 47DEUC 12 mg QD → UST n = 42PBO → UST n = 55Total AEs11 (84.6)8 (50.0)26 (55.3)26 (61.9)30 (54.5)Deaths001 (2.1)d1 (2.4)d0SAE1 (7.7)b03 (6.4)4 (9.5)0Treatment-related SAE00000Discontinued due to AE01 (6.3)c02 (4.8)c,e0Includes all treated patients in Part B. Medical Dictionary for Regulatory Activities version 23.0 was used. an is the number of patients who experienced an event. bOne patient had SAEs of psoriatic arthropathy in 1 joint and peripheral neuropathy. cPatient had an AE of COVID-19 infection leading to discontinuation. dDeaths in UST arms were due to car accident and sudden death in a 71-year-old patient with hypertension. ePatient had an AE of urinary tract infection leading to discontinuation.AE, adverse event; DEUC, deucravacitinib; PBO, placebo; QD, once daily; SAE, serious adverse event; UST, ustekinumab.ConclusionIn the 16- to 52-wk blinded Part B of a Phase 2 study in pts with PsA, no new safety signals were observed with continuous DEUC treatment vs the earlier Part A period. Efficacy in PASDAS, as well as other key efficacy measures, was maintained with continued DEUC treatment through Wk 52.References[1]Mease PJ et al. Efficacy and Safety of Selective TYK2 Inhibitor, Deucravacitinib, in a Phase 2 Trial in Psoriatic Arthritis. Ann Rheum Dis. (In Press).AcknowledgementsThis study was sponsored by Bristol Myers Squibb. Professional medical writing assistance was provided by Julianne Hatfield, PhD at Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, USA, and funded by Bristol Myers Squibb. The authors acknowledge Jonghyeon Kim, PhD, who was employed by Bristol Myers Squibb at the time the study was conducted, for his statistical assistance.Disclosure of InterestsPhilip J Mease Consultant of: Consulting and/or speaker fees: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN Pharma, and UCB., Grant/research support from: Research grants: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN Pharma, and UCB;, Atul Deodhar Consultant of: Consulting and/or advisory boards: AbbVie, Amgen, Aurinia, Bristol Myers Squibb, Celgene, Eli Lilly, GlaxoSmithKline, Janssen, MoonLake, Novartis, Pfizer, UCB, Grant/research support from: Research grants: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer, and UCB., Désirée van der Heijde Consultant of: Consulting fees: AbbVie, Bayer, Bristol Myers Squibb, Cyxone, Eisai, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, and UCB Pharma; Director: Imaging Rheumatology BV., Frank Behrens Consultant of: Consultancies/speaker fees: AbbVie, Amgen, Boehringer, Pfizer, Roche, Chugai, UCB, BMS, Celgene, MSD, Novartis, Biotest, Janssen, Genzyme, Lilly, Boehringer, Sandoz, and Sanofi., Grant/research support from: Research Support: AbbVie, Pfizer, Roche, Chugai, Prophylix, Novartis, and Amgen, Alan Kivitz Shareholder of: Shareholder: Pfizer, Sanofi, GlaxoSmithKline, Gilead Sciences, Inc., Novartis, Consultant of: Paid Consultant: AbbVie, Boehringer Ingelheim, Flexion, Janssen, Pfizer, Sanofi, Regeneron, SUN Pharma Advanced Research, Gilead Sciences, Inc., Speakers bureau: Celgene, Merck, Lilly, Novartis, Pfizer, Sanofi, Genzyme, Flexion, AbbVie., Jeffrey Neal Grant/research support from: Research grants to foundation: AbbVie, Amgen, Eli Lilly, Genentech, Novartis, UCB, Pfizer, Gilead, and Bristol Myers Squibb., Marleen Nys Shareholder of: Bristol Myers Squibb., Employee of: Bristol Myers Squibb., Thomas Lehman Shareholder of: Bristol Myers Squibb., Employee of: Bristol Myers Squibb., Nikolay Delev Shareholder of: Bristol Myers Squibb., Employee of: Bristol Myers Squibb., Shimon Korish Shareholder of: Bristol Myers Squibb., Employee of: Bristol Myers Squibb., Miroslawa Nowak Shareholder of: Bristol Myers Squibb., Employee of: Bristol Myers Squibb., Subhashis Banerjee Shareholder of: Bristol Myers Squibb., Employee of: Bristol Myers Squibb.
Collapse
|
5
|
Wu J, Ding V, Luo S, Choi E, Hellyer J, Myall N, Henry S, Wood D, Stehr H, Ji H, Nagpal S, Hayden Gephart M, Wakelee H, Neal J, Han S. P62.02 A Predictive Model to Guide Brain MRI Surveillance in Patients With Metastatic Lung Cancer: Impact on Real World Outcomes. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Spira A, Ramalingam S, Neal J, Piotrowska Z, Mekhail T, Tsao A, Gentzler R, Riely G, Bazhenova L, Gadgeel S, Nguyen D, Johnson M, Vincent S, Jin S, Griffin C, Bunn V, Lin J, Churchill E, Mehta M, Janne P. OA15.01 Mobocertinib in EGFR Exon 20 Insertion–Positive Metastatic NSCLC Patients With Disease Control on Prior EGFR TKI Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
7
|
Mack P, Minichielle K, Redman M, Tolba K, Kozono D, Waqar S, Chowdhury A, Dowlati A, Neal J, Dragnev K, Aggarwal C, Hirsch F, Kelly K, Gandara D, Herbst R. MA08.10 LUNGMAP Master Protocol (LUNGMAP): Concordance Between Plasma ctDNA and Tissue Molecular Analysis. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Su C, Wu J, Neal J, Popat R, Backhus L, Leung A, Nagpal S, Wakelee H, Han S. MA05.08 Impact of Low-Dose CT Screening for Primary Lung Cancer on Subsequent Risk of Brain Metastasis: Secondary Analysis of NLST. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.170] [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: 10/21/2022]
|
9
|
Padda S, Whisenant J, Neal J, York S, Iams W, Neuss M, Reckamp K, Preiss J, Berry L, Shyr Y, Wakelee H, Horn L. P76.85 Afatinib and Necitumumab in EGFR mutant NSCLC with Acquired Resistance to 1st or 3rd Generation EGFR Tyrosine Kinase Inhibitors. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1142] [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: 10/21/2022]
|
10
|
Mazieres J, Drilon A, Lusque A, Mhanna L, Cortot AB, Mezquita L, Thai AA, Mascaux C, Couraud S, Veillon R, Van den Heuvel M, Neal J, Peled N, Früh M, Ng TL, Gounant V, Popat S, Diebold J, Sabari J, Zhu VW, Rothschild SI, Bironzo P, Martinez-Marti A, Curioni-Fontecedro A, Rosell R, Lattuca-Truc M, Wiesweg M, Besse B, Solomon B, Barlesi F, Schouten RD, Wakelee H, Camidge DR, Zalcman G, Novello S, Ou SI, Milia J, Gautschi O. Immune checkpoint inhibitors for patients with advanced lung cancer and oncogenic driver alterations: results from the IMMUNOTARGET registry. Ann Oncol 2020; 30:1321-1328. [PMID: 31125062 PMCID: PMC7389252 DOI: 10.1093/annonc/mdz167] [Citation(s) in RCA: 759] [Impact Index Per Article: 189.8] [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] [Indexed: 12/24/2022] Open
Abstract
Background Anti-PD1/PD-L1 directed immune checkpoint inhibitors (ICI) are widely used to treat patients with advanced non-small-cell lung cancer (NSCLC). The activity of ICI across NSCLC harboring oncogenic alterations is poorly characterized. The aim of our study was to address the efficacy of ICI in the context of oncogenic addiction. Patients and methods We conducted a retrospective study for patients receiving ICI monotherapy for advanced NSCLC with at least one oncogenic driver alteration. Anonymized data were evaluated for clinicopathologic characteristics and outcomes for ICI therapy: best response (RECIST 1.1), progression-free survival (PFS), and overall survival (OS) from ICI initiation. The primary end point was PFS under ICI. Secondary end points were best response (RECIST 1.1) and OS from ICI initiation. Results We studied 551 patients treated in 24 centers from 10 countries. The molecular alterations involved KRAS (n = 271), EGFR (n = 125), BRAF (n = 43), MET (n = 36), HER2 (n = 29), ALK (n = 23), RET (n = 16), ROS1 (n = 7), and multiple drivers (n = 1). Median age was 60 years, gender ratio was 1 : 1, never/former/current smokers were 28%/51%/21%, respectively, and the majority of tumors were adenocarcinoma. The objective response rate by driver alteration was: KRAS = 26%, BRAF = 24%, ROS1 = 17%, MET = 16%, EGFR = 12%, HER2 = 7%, RET = 6%, and ALK = 0%. In the entire cohort, median PFS was 2.8 months, OS 13.3 months, and the best response rate 19%. In a subgroup analysis, median PFS (in months) was 2.1 for EGFR, 3.2 for KRAS, 2.5 for ALK, 3.1 for BRAF, 2.5 for HER2, 2.1 for RET, and 3.4 for MET. In certain subgroups, PFS was positively associated with PD-L1 expression (KRAS, EGFR) and with smoking status (BRAF, HER2). Conclusions : ICI induced regression in some tumors with actionable driver alterations, but clinical activity was lower compared with the KRAS group and the lack of response in the ALK group was notable. Patients with actionable tumor alterations should receive targeted therapies and chemotherapy before considering immunotherapy as a single agent.
Collapse
Affiliation(s)
- J Mazieres
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France.
| | - A Drilon
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - A Lusque
- Biostatistics Unit, Institut Claudius Regaud, IUCT-O, Toulouse
| | - L Mhanna
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - A B Cortot
- Thoracic Oncology Department, Lille University Hospital, Lille University, Lille
| | - L Mezquita
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - A A Thai
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - C Mascaux
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - S Couraud
- Respiratory Diseases and Thoracic Oncology Department, Lyon Sud Hospital, Cancer Institute of Hospices Civils de Lyon, Lyon 1 University
| | - R Veillon
- CHU Bordeaux, Respiratory Diseases Department, Bordeaux, France
| | - M Van den Heuvel
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Neal
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - N Peled
- Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel
| | - M Früh
- Department of Oncology, Haematology, Cantonal Hospital St Gallen, St Gallen, University of Bern, Switzerland
| | - T L Ng
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - V Gounant
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Popat
- Royal Marsden Hospital, London, UK
| | - J Diebold
- Cantonal Hospital, Lucerne, Switzerland
| | - J Sabari
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - V W Zhu
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - S I Rothschild
- Department Internal Medicine, University Hospital Basel, Medical Oncology, Basel, Switzerland
| | - P Bironzo
- Department of Oncology, University of Torino, Torino, Italy
| | - A Martinez-Marti
- Medical Oncology Department, Vall d'Hebron Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - R Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - M Lattuca-Truc
- Pulmonology Department, Grenoble University Hospital, Grenoble, France
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - B Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, Paris Sud University Orsay, Paris France
| | - B Solomon
- Medical Oncology Department, Peter MacCallum Cancer Institute, Melbourne, Australia
| | - F Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, CNRS, INSERM, CRCM, Marseille
| | - R D Schouten
- Faculty of Medical Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H Wakelee
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, USA
| | - D R Camidge
- Thoracic Oncology Department, University of Colorado Cancer Center, Aurora, USA
| | - G Zalcman
- Department of Thoracic Oncology, CIC1425-CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - S Novello
- Department of Oncology, University of Torino, Torino, Italy
| | - S I Ou
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine School of Medicine, Orange, USA
| | - J Milia
- Thoracic Oncology Department, Toulouse University Hospital, Université Paul Sabatier, Toulouse, France
| | - O Gautschi
- University of Bern and Cantonal Hospital, Lucerne, Switzerland
| |
Collapse
|
11
|
Karacosta L, Anchang B, Ignatiadis N, Kimmey S, Benson J, Shrager J, Sung A, Neal J, Wakelee H, Tibshirani R, Bendall S, Plevritis S. OA08.03 A Single-Cell Resolution Map of EMT and Drug Resistance States for Evaluating NSCLC Clinical Specimens. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.449] [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]
|
12
|
Lim F, Ponce S, Patel S, Van Herpen C, Kurkjian C, Lou Y, Liu Y, Ramsingh G, Pal S, Neal J. P1.01-113 Phase 1b Trial of Cabozantinib or Cabozantinib Plus Atezolizumab in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Ko R, Therkelsen K, Von Eyben R, Neal J, Loo B, Nagpal S. P1.16-02 The Real-World Risk of Brain Metastases in Stage 3 Lung Cancer Patients in the Era of PET and MRI Staging. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1228] [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: 11/24/2022]
|
14
|
Wakelee H, Reckamp K, Leal T, Chiappori A, Waqar S, Zeman K, Neal J, Liang C, Harrow K, Holzhausen A, Zhou J, Selvaggi G, Horn L. P1.14-32 Rash and Efficacy in Anaplastic Lymphoma Kinase Positive (ALK+) Non-Small Cell Lung Cancer Patients Treated with Ensartinib. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Riely G, Neal J, Camidge D, Spira A, Piotrowska Z, Horn L, Costa D, Tsao A, Patel J, Gadgeel S, Bazhenova L, Zhu V, West H, Vincent S, Zhu J, Jin S, Zhang S, Li S, Jänne P. P1.01-127 Antitumor Activity of the Oral EGFR/HER2 Inhibitor TAK-788 in NSCLC with EGFR Exon 20 Insertions. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.842] [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: 10/25/2022]
|
16
|
Neal J, Strothkamp S, Bedingar E, Cordero P, Wagner B, Vagnini V, Jiang Y. Discriminating Fake From True Brain Injury Using Latency of Left Frontal Neural Responses During Old/New Memory Recognition. Front Neurosci 2019; 13:988. [PMID: 31611760 PMCID: PMC6777439 DOI: 10.3389/fnins.2019.00988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/10/2019] [Accepted: 09/02/2019] [Indexed: 11/13/2022] Open
Abstract
Traumatic brain injury (TBI) is a major public health concern that affects 69 million individuals each year worldwide. Neuropsychologists report that up to 40% of individuals undergoing evaluations for TBI may be malingering neurocognitive deficits for a compensatory reward. The memory recognition test of malingering detection is effective but can be coached behaviorally. There is great need to develop a novel neural based method for discriminating fake from true brain injury. Here we test the hypothesis that decision making of faking memory deficits prolongs frontal neural responses. We applied an advanced method measuring decision latency in milliseconds for discriminating true TBI from malingerers who fake brain injury. To test this hypothesis, latencies of memory-related brain potentials were compared among true patients with moderate or severe TBI, and healthy age-matched individuals who were assigned either to be honest or faking memory deficit. Scalp signals of electroencephalography (EEG) were recorded with a 32-channel cap during an Old/New memory recognition task in three age- and education-matched groups: honest (n = 12), malingering (n = 15), and brain injured (n = 14) individuals. Bilateral fractional latencies of late positive ERP at frontal sites were compared among the three groups under both studied (Old) and non-studied (New) memory recognition conditions. Results show a significant difference between the fractional latencies of the late positive component during recognition of studied items in malingerers (averaged latencies = 396 ms) and the true brain injured subjects (mean = 312 ms) in the frontal sites. Only malingers showed asymmetrical frontal activity compared to the two other groups. These new findings support the hypothesis that that additional frontal processing of malingering individuals is measurably different from those of actual patients with brain injury. In contrast to our previous reported method using difference waves of amplitudes at frontal to posterior midline sites during new items recognition (Vagnini et al., 2008), there was no significant latency difference among groups during recognition of New items. The current method using delayed left frontal neural responses during studied items reached sensitivity of 80% and specificity of 79% in detecting malingers from true brain injury.
Collapse
Affiliation(s)
- Jennifer Neal
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Stephanie Strothkamp
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Esias Bedingar
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States.,Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Patrick Cordero
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Benjamin Wagner
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Victoria Vagnini
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States.,Louisville VA Medical Center, Louisville, KY, United States
| | - Yang Jiang
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| |
Collapse
|
17
|
Lam V, Hong D, Heymach J, Blumenschein G, Butler M, Johnson M, Creelan B, Gainor J, Govindan R, Mudad R, Neal J, Brophy F, Fang F, Hyland N, Holdich T, Ma Y, Trivedi T, Norry E, Amado R. Safety and anti-tumor effects of MAGE-A10c796 TCR T-cells in two clinical trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
18
|
Hirotsu K, Subramanian A, Neal J, Li S, Pugliese S, Kwong B. 1037 Antimicrobial resistance due to antibiotic use for EGFR inhibitor related papulopustular skin reaction. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1049] [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: 10/17/2022]
|
19
|
Wakelee H, Sanborn R, Nieva J, Waqar S, Brzezniak C, Bauman J, Neal J, Dukart G, Tan F, Harrow K, Liang C, Horn L. MA 07.02 Response to Ensartinib in TKI Naïve ALK+ NSCLC Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
20
|
Padda S, Reckamp K, Koczywas M, Neal J, Kawashima J, Kong S, Xin Y, Huang D, Wakelee H. P2.03-043 A Phase 1b Study of Erlotinib and Momelotinib for TKI-Naïve EGFR-Mutated Metastatic Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Chabon J, Chaudhuri A, Azad T, Kurtz D, Stehr H, Liu C, Martin JS, Merriott D, Carter J, Ayers K, Mansfield A, Jen J, Ren H, West R, Nair V, Shrager J, Neal J, Wakelee H, Loo B, Alizadeh A, Diehn M. MA 13.01 Clinical and Pathological Variables Influencing Noninvasive Detection of Early Stage Lung Cancer Using Circulating Tumor DNA. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.560] [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]
|
22
|
Piotrowska Z, Liu E, Varga A, Thakur M, Narayanan V, Liu S, Neal J, Spiegel M, Solomon B, Yu H, Ou SH, Papadimitrakopoulou V, Gadgeel S, Camidge D, Soria JC, Wakelee H, Goldman J, Kopani K, Rolfe L, Sequist L. Rociletinib-associated cataracts in EGFR-mutant NSCLC. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
23
|
Horn L, Wakelee H, Blumenschein G, Reckamp K, Waqar S, Carter C, Gitlitz B, Infante J, Sanborn R, Neal J, Gockerman J, Dukart G, Harrow K, Liang C, Gibbons J, Hernandez J, Newman-Eerkes T, Lim L, Lovly C. Phase I/II trial of X-396 in patients (pts) with ALK+ non-small cell lung cancer (NSCLC): Correlation with plasma and tissue genotyping and response to therapy (tx). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
24
|
Abstract
Solid-organ transplant recipients are at a 3- to 5-fold increased risk of a de novo malignant neoplasm developing compared with the general population. The most frequently developed virus-associated malignant neoplasms are Kaposi sarcoma (standardized incidence ratio [SIR], 208.0), nonmelanoma skin cancer (SIR, 28.6), and posttransplant lymphoproliferative disorder, primarily non-Hodgkin lymphoma (SIR, 8.1). Immunosuppressive agents such as corticosteroids, antimetabolites, calcineurin inhibitors, and mammalian target of rapamycin (mTOR) inhibitors play a key role in either causing or preventing this complication. It is hypothesized that some of these regimens can impair cancer surveillance, facilitate the action of oncogenic viruses, and promote direct oncogenic activity. Evolving research has shown promising dual antitumor and immunosuppressive properties of the mTOR inhibitor class. The effective management of posttransplant neoplasms most likely involves the use of these medications among other preventative options. These measures include monitoring certain viral loads as well as immunosuppressant drug levels. Reducing these levels to as low as possible for healthy engraftment and altering regimens when appropriate are management strategies that could lessen this complication of solid-organ transplant. More studies examining the effects of therapeutic drug monitoring are needed to determine specific plasma drug concentrations that will ensure organ engraftment without the development of de novo malignant neoplasms.
Collapse
Affiliation(s)
| | - Jennifer Neal
- Virginia Commonwealth University, Richmond, Virginia
| | - Jeanne Salyer
- Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
25
|
Soria JC, Sequist L, Goldman J, Wakelee H, Neal J, Camidge R, Gadgeel S, Papadimitrakopoulou V, Dziadziuszko R, Piotrowska Z, Varga A, Solomon B. Rociletinib: an oral, irreversible, highly selective small molecule inhibitor of mutant EGFR including T790M. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv088.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
26
|
Winthrop KL, Neal J, Hrycaj P, Soma K, Wilkinson B, Hodge J, Zwillich SH, Wang T, Rottinghaus S, Kawabata T, Riese R, Mebus C, Bradley JD, Bingham CO. OP0163 Evaluation of Influenza and Pneumococcal Vaccine Responses in Rheumatoid Arthritis Patients Using Tofacitinib. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
27
|
Alexandru D, Satyadev R, So W, Lee SH, Lee YS, Hong YK, Kang CS, Rodgers SD, Marascalchi BJ, Strom RG, Riina H, Samadani U, Frempong-Boadu A, Babu R, Sen C, Zagzag D, Anderson MD, Abel TW, Moots PL, Odia Y, Orr BA, Eberhart CG, Rodriguez F, Sweis RT, Lavingia J, Connelly J, Cochran E, van den Bent M, Hartmann C, Preusser M, Strobel T, Dubbink HJ, Kros JM, von Deimling A, Boisselier B, Sanson M, Halling KC, Diefes KL, Aldape K, Giannini C, Rodriguez FJ, Ligon AH, Horkayne-Szakaly I, Rushing EJ, Ligon KL, Vena N, Garcia DI, Douglas Cameron J, Eberhart CG, Raghunathan A, Wani K, Armstrong TS, Vera-Bolanos E, Fouladi M, Gajjar A, Goldman S, Lehman NL, Metellus P, Mikkelsen T, Necesito-Reyes MJT, Omuro A, Packer RJ, Partap S, Pollack IF, Prados MD, Ian Robbins H, Soffietti R, Wu J, Gilbert MR, Aldape KD, Prosniak M, Harshyne LA, Andrews DW, Craig Hooper D, Kagawa N, Hosen N, Kijima N, Hirayama R, Chiba Y, Yamamoto F, Kinoshita M, Hashimoto N, Fujimoto Y, Yoshimine T, Hu J, Nuno M, Patil C, Rudnick J, Phuphanich S, Bannykh S, Chu R, Yu J, Black K, Choi J, Kim D, Shim KW, Kim SH, Kanno H, Nishihara H, Tanaka S, Nishihara H, Yanagi T, Kanno H, Tanaka S, Buczkowicz P, Khuong-Quang DA, Rakopoulos P, Bouffet E, Morrison A, Bartels U, Pfister SM, Jabado N, Hawkins C, Weinberg BD, Newell KL, Kumar P, Wang F, Venneti S, Madden M, Coyne T, Phillips J, Gorovets D, Huse J, Kofler J, Lu C, Tihan T, Sullivan L, Santi M, Judkins A, Thompson C, Perry A, Iorgulescu JB, Laufer I, Hameed M, Lis E, Boland P, Komotar R, Bilsky M, Amato-Watkins AC, Neal J, Rees AD, Davies JS, Hayhurst C, Lu-Emerson C, Snuderl M, Davidson C, Kirkpatrick ND, Huang Y, Duda DG, Ancukiewicz M, Stemmer-Rachamimov A, Batchelor TT, Jain RK, Ellezam B, Theeler BJ, Sadighi ZS, Mehta V, Tran MDT, Adesina AM, Puduvalli VK, Bruner JM. CLIN-PATHOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
28
|
Muluneh B, Alexander M, Deal AM, Deal M, Markey J, Neal J, Bernard SA, Valgus J, Dressler LG. Prospective evaluation of perceived barriers to medication adherence by patients on oral antineoplastics. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.6042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6042 Background: Appropriate use of oral antineoplastics (OA), especially those with a food-effect, is a challenge for patients and clinicians. Patient adherence is essential to optimize outcomes, minimize toxicity, minimize bias in clinical trials, and reduce health care costs. As the use of OA grows, due to the narrow therapeutic margin, it is critical to understand the barriers to patient adherence. The purpose of this study was to analyze cancer patients’ use of OAs and identify opportunities to improve patient adherence. Methods: We developed and tested a 30-question survey to address frequency and reasons for reducing/skipping doses; sources of information for OA use; perceived importance of food-drug effects, and ease of understanding directions on vial label. Surveys, consisting of Likert scale and multiple choice questions, were distributed to adult cancer patients on OAs at the UNC Cancer Hospital clinics. Results: Seventy-seven patients taking OAs with CML, RCC, breast cancer, and GI tumors completed the survey with a response rate of 97%. This was a well-educated population with 71% having completed some college; 54% female and 58% older than 50 years. Forty-three percent of patients taking drugs with a significant food-drug effect (sorafenib, pazopanib, lapatinib, imatinib, nilotinib, and capecitabine) did not think about the last time they ate before taking their OA and 23% did not know that their OA had a food-drug effect. In addition, 21% of patients indicated they intentionally skipped/cut back on their OAs and 38% of those did not inform their physician. Although 97% reported no difficulty reading instructions on drug vial, nearly 20% had some difficulty understanding the directions. Conclusions: There are three main barriers associated with appropriate use of OAs: confusion or misunderstanding about the timing of drug with food; reducing/stopping drug without informing MD; and difficulty understanding directions on the drug vial label. A multipronged integrated approach involving the pharmacist, physician and nurse is needed to optimize communication of directions for optimal OA use.
Collapse
Affiliation(s)
- Benyam Muluneh
- University of North Carolina Hospitals and Clinics Department of Pharmacy, Chapel Hill, NC
| | - Maurice Alexander
- University of North Carolina Hospitals and Clinics Department of Pharmacy, Chapel Hill, NC
| | | | - Meredith Deal
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC
| | - Janell Markey
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC
| | - Jennifer Neal
- University of Virginia Health System Department of Pharmacy, Charlottesville, VA
| | | | - John Valgus
- University of North Carolina Hospitals and Clinics Department of Pharmacy, Chapel Hill, NC
| | - Lynn G. Dressler
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC
| |
Collapse
|
29
|
Kalhan A, Gharibi B, Vazquez M, Jasani B, Neal J, Kidd M, Modlin IM, Pfragner R, Rees DA, Ham J. Adenosine A2A and A2B receptor expression in neuroendocrine tumours: potential targets for therapy. Purinergic Signal 2011; 8:265-74. [PMID: 22119961 DOI: 10.1007/s11302-011-9280-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [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: 10/14/2011] [Accepted: 11/04/2011] [Indexed: 12/26/2022] Open
Abstract
The clinical management of neuroendocrine tumours is complex. Such tumours are highly vascular suggesting tumour-related angiogenesis. Adenosine, released during cellular stress, damage and hypoxia, is a major regulator of angiogenesis. Herein, we describe the expression and function of adenosine receptors (A(1), A(2A), A(2B) and A(3)) in neuroendocrine tumours. Expression of adenosine receptors was investigated in archival human neuroendocrine tumour sections and in two human tumour cell lines, BON-1 (pancreatic) and KRJ-I (intestinal). Their function, with respect to growth and chromogranin A secretion was carried out in vitro. Immunocytochemical data showed that A(2A) and A(2B) receptors were strongly expressed in 15/15 and 13/18 archival tumour sections. Staining for A(1) (4/18) and A(3) (6/18) receptors was either very weak or absent. In vitro data showed that adenosine stimulated a three- to fourfold increase in cAMP levels in BON-1 and KRJ-1 cells. The non-selective adenosine receptor agonist (adenosine-5'N-ethylcarboxamide, NECA) and the A(2A)R agonist (CGS21680) stimulated cell proliferation by up to 20-40% which was attenuated by A(2B) (PSB603 and MRS1754) and A(2A) (SCH442416) receptor selective antagonists but not by the A(1) receptor antagonist (PSB36). Adenosine and NECA stimulated a twofold increase in chromogranin A secretion in BON-1 cells. Our data suggest that neuroendocrine tumours predominantly express A(2A) and A(2B) adenosine receptors; their activation leads to increased proliferation and secretion of chromogranin A. Targeting adenosine signal pathways, specifically inhibition of A(2) receptors, may thus be a useful addition to the therapeutic management of neuroendocrine tumours.
Collapse
Affiliation(s)
- A Kalhan
- Centre for Endocrine and Diabetes Sciences, School of Medicine, Cardiff University, Heath Park, Cardiff, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
MESH Headings
- Aged, 80 and over
- Antineoplastic Agents/adverse effects
- Humans
- Immunocompromised Host
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Male
- Opportunistic Infections/complications
- Opportunistic Infections/diagnosis
- Opportunistic Infections/immunology
- Toxoplasmosis, Cerebral/complications
- Toxoplasmosis, Cerebral/diagnosis
- Toxoplasmosis, Cerebral/immunology
- Vidarabine/adverse effects
- Vidarabine/analogs & derivatives
Collapse
Affiliation(s)
- S Bacchu
- Department of Haematology, University Hospitals of Wales, Cardiff, UK.
| | | | | |
Collapse
|
31
|
Neal J, Provenzano E, Brodie C, Wishart G, Pinder S. O-77 Incidental malignant breast disease in routine breast reduction specimens. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71767-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
32
|
Abstract
Although several forage species such as perennial ryegrass are predominant, there is a wide range of forage species that could be grown in subtropical and temperate regions in Australia as dairy pastures. These species have differing seasonal patterns of growth, nutrient quality, and water-use efficiency, as demonstrated in a large experiment evaluating over 30 species at the University of Sydney (Camden, New South Wales, Australia). Some species can be grazed, whereas others require mechanical harvesting, which incurs a further cost. Previous comparisons of species that relied on yield of dry matter per unit of some input (typically land or water) did not simultaneously take into account the season in which forage is produced, or other factors related to the costs of production and delivery to the cows. To effectively compare the profitability of individual species, or combinations of species, requires the use of a whole-farm, multiperiod model. Linear programming was used to find the most profitable mix of forage species for an irrigated dairy farm in a warm temperate irrigation region of New South Wales, Australia. It was concluded that for a typical farmer facing the prevailing milk and purchased feed prices with average milk production per cow, the most profitable mix of species would include a large proportion of perennial ryegrass (Lolium perenne) and prairie grass (Bromus willdenowii). The result was robust to changes in seasonal milk pricing and a move from year-round to a more seasonal calving pattern.
Collapse
Affiliation(s)
- M Neal
- Risk and Sustainable Management Group, University of Queensland, St. Lucia, Queensland 4072, Australia.
| | | | | |
Collapse
|
33
|
Jordan N, Boody G, Broussard W, Glover JD, Keeney D, McCown BH, McIsaac G, Muller M, Murray H, Neal J, Pansing C, Turner RE, Warner K, Wyse D. Environment. Sustainable development of the agricultural bio-economy. Science 2007; 316:1570-1. [PMID: 17569847 DOI: 10.1126/science.1141700] [Citation(s) in RCA: 213] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A U.S. farm policy shift to joint production of commodities and ecological services will advance sustainable agriculture.
Collapse
Affiliation(s)
- N Jordan
- Agronomy and Plant Genetics Department, University of Minnesota, St. Paul, MN 55018, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Abstract
Pulse-shape discrimination (PSD) has been utilised for about 40 years as a method to obtain estimates for dose in mixed neutron and photon fields. Digitizers that operate close to GHz are currently available at a reasonable cost, and they can be used to directly sample signals from photomultiplier tubes. This permits one to perform digital PSD rather than the traditional, and well-established, analogoue techniques. One issue that complicates PSD for neutrons in mixed fields is that the light output characteristics of typical scintillators available for PSD, such as BC501A, vary as a function of energy deposited in the detector. This behaviour is more easily accommodated with digital processing of signals than with analogoue signal processing. Results illustrate the effectiveness of digital PSD.
Collapse
Affiliation(s)
- L F Miller
- Department of Nuclear Engineering, The University of Tennessee, Knoxville, Tennessee 37996-2300, USA.
| | | | | | | | | |
Collapse
|
35
|
Neal J, Raju GP, Bodell A, Apse K, Walsh CA, Sheen VL. Periventricular heterotopia with complete agenesis of the corpus callosum. J Neurol 2006; 253:1358-9. [PMID: 16906346 DOI: 10.1007/s00415-006-0182-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Revised: 12/20/2005] [Accepted: 02/01/2006] [Indexed: 10/24/2022]
|
36
|
Masruha M, Caboclo L, Carrete H, Cendes I, Rodrigues M, Garzon E, Yacubian E, Sakamoto A, Sheen V, Harney M, Neal J, Hill R, Bodell A, Walsh C, Vilanova L. Response: Filamin A, Periventricular Nodular Heterotopia, and West Syndrome. Epilepsia 2006. [DOI: 10.1111/j.1528-1167.2006.00579_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
37
|
|
38
|
|
39
|
De P, Rees DA, Davies N, John R, Neal J, Mills RG, Vafidis J, Davies JS, Scanlon MF. Transsphenoidal surgery for acromegaly in wales: results based on stringent criteria of remission. J Clin Endocrinol Metab 2003; 88:3567-72. [PMID: 12915637 DOI: 10.1210/jc.2002-021822] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
We retrospectively analyzed 90 patients who underwent transsphenoidal surgery (performed by three surgeons) in our center as initial therapy for acromegaly. We used a combination of modern, evidence-based remission criteria including mean day curve GH less than 2.5 micro g/liter (5 mU/liter), a nadir GH less than 1.0 micro g/liter (2 mU/liter) after an oral glucose tolerance test, and normal age-related IGF-I levels (where available). Fifty-seven of 90 (63%) patients remained in remission after surgery. Seventy-nine percent of patients with microadenomas but only 56% of patients with macroadenomas achieved remission (P < 0.001). Eighty-six percent of patients with preoperative GH levels below 10 micro g/liter (day profile or after oral glucose tolerance test) went into remission, compared with 51% of patients with GH levels above 25 micro g/liter at diagnosis (P < 0.002). The remission rate was also related to the period of surgery that was significantly higher in 1998-2001 (76%; P < 0.05) compared with 1990-1997 (54%) and 1980-1989 (63%). There were no recurrences or perioperative deaths. Meningitis occurred in 3% of patients, cerebrospinal fluid rhinorrhea in 7%, and permanent diabetes insipidus in 15%. The proportion of patients who developed new anterior pituitary hormone deficiencies and panhypopituitarism was significantly less in the period 1998-2001 (P < 0.001) when compared with the periods from 1990-1997 and 1980-1989. Transsphenoidal surgery is a safe and effective treatment for acromegaly, and our results compare favorably with those from published series. The presence of an intrasellar lesion and low preoperative GH levels is a good predictor of remission in the long term, but historically in our center this can only be achieved in a significant proportion of patients at the expense of some degree of hypopituitarism. However, surgical outcome in our center, including a reduced frequency of hypopituitarism, has improved significantly over time, coincident with the arrival of a dedicated pituitary neurosurgeon and the use of selective adenomectomy as the preferred surgical approach wherever possible.
Collapse
Affiliation(s)
- P De
- Department of Endocrinology, Metabolism, and Diabetes, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Stolnik S, Heald CR, Neal J, Garnett MC, Davis SS, Illum L, Purkis SC, Barlow RJ, Gellert PR. Polylactide-poly(ethylene glycol) micellar-like particles as potential drug carriers: production, colloidal properties and biological performance. J Drug Target 2002; 9:361-78. [PMID: 11770706 DOI: 10.3109/10611860108998772] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The micellar-like particle systems produced from poly-D,L-lactide-poly(ethylene glycol) (PLA-PEG) copolymers have been assessed using a range of physicochemical characterisation methods, followed by in vivo studies of their biodistribution after intravenous administration to the rat. The size of the PEG chain was kept constant at 5 or 2 kDa, while the PLA size increased within a series from 2 to 25 kDa. The results obtained reveal, that in an aqueous medium the copolymers assembled into micellar-like structures, with the PLA segments forming the core and the PEG segments the surrounding corona. The size of the PLA segments dominated the process of assembly of the molecules and the characteristics of the resultant micellar-like particles. The PLA-PEG micellar particles were found to be less dynamic than those obtained from conventional surfactants. Particles formed from the lower molecular weight PLA polymers allowed a level of chain mobility while the cores of the micellar particles formed from higher molecular weight PLA appeared to be solid-like in nature. The size of the micellar particles was dependent on the copolymer molecular weight and the z-average diameter increased from 25 to 76 nm as the molecular weight of the PLA moiety increased. This provides an ability to control the particle size by adjusting the molecular weight of the PLA moiety. Following intravenous administration to the rat model, micellar-like particles smaller than approximately 70 nm accumulated in the liver, despite the fact that the PEG corona provided an effective steric stabilization effect. Micellar-like particles with a diameter of more than approximately 70 nm exhibited prolonged systemic circulation and reduced liver uptake, although the steric stabilisation of these particles was shown to be less effective. These findings agree with recent observations from other research groups; that indicate a possibility that very small particulates can pass through the sinusoidal fenestrations in the liver and gain access to the parenchymal cells of the liver.
Collapse
Affiliation(s)
- S Stolnik
- Department of Pharmaceutical Sciences, University of Nottingham, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
He M, Rettie AE, Neal J, Trager WF. Metabolism of sulfinpyrazone sulfide and sulfinpyrazone by human liver microsomes and cDNA-expressed cytochrome P450s. Drug Metab Dispos 2001; 29:701-11. [PMID: 11302937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Human liver microsomes catalyze the oxidation of sulfinpyrazone sulfide (SPZS) to a variable mixture of sulfinpyrazone (SPZ) enantiomers and two minor phenolic metabolites. In one, the thiophenyl ring is hydroxylated, whereas in the second an N-phenyl ring is hydroxylated. SPZ is further oxidized to sulfinpyrazone sulfone (SPZO) and a minor polar metabolite that also has an N-phenyl ring hydroxylated. Determination of the metabolism of SPZ and SPZS under modified incubation conditions of prior heat treatment, higher pH, and the presence of detergent indicated that the formation of SPZ was cytochrome P450 (P450)- but not flavin monooxygenase-dependent. Specific P450 inhibitors (sulfaphenazole, quinidine sulfate, coumarin, diethyldithiocarbamic acid, troleandomycin, and furafylline) and specific cDNA-expressed P450s were used to identify the major isoforms responsible for the oxidation of SPZS to SPZ and SPZ to SPZO. Both P450 2C9 and P450 3A4 were responsible for the oxidation of SPZS to SPZ, whereas P450 3A4 alone catalyzed the further oxidation of SPZ to SPZO. SPZS was found to be metabolized by P450 2C9 to SPZ with a high degree of enantiomeric selectivity (9:1) and a K(m) comparable with its previously determined K(i) for inhibition of the P450 2C9-dependent 7-hydroxylation of (S)-warfarin (WARF). In contrast, the P450 3A4-catalyzed oxidation of SPZS to SPZ proceeded with the same enantioselectivity but to a much lesser degree (58:42). These results provide evidence that the metabolism of both (S)-WARF and SPZS is mediated by a common enzyme, P450 2C9, which is central to understanding the WARF-SPZ interaction and SPZS-mediated drug interactions in general.
Collapse
Affiliation(s)
- M He
- Department of Medicinal Chemistry, School of Pharmacy, University of Washington, Seattle, WA 98195, USA
| | | | | | | |
Collapse
|
42
|
Williams PG, Dalrymple N, Neal J. Eating habits of children with autism. Pediatr Nurs 2000; 26:259-64. [PMID: 12026389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Autism is a developmental disorder characterized by severe deficits in social interaction and communication, as well as by stereotyped and repetitive behaviors. Children with autism frequently have significant eating difficulties with highly restricted range of food choices. Eating habits and patterns are often unusual and have an impact on family life. The purpose of this article was to review pertinent information regarding this complex developmental disorder and describe a recent study based on a parent survey of feeding patterns in children with autism to give a new perspective for both parents and professionals.
Collapse
Affiliation(s)
- P G Williams
- University of Louisville, Child Evaluation Center, Louisville, KY, USA
| | | | | |
Collapse
|
43
|
Abstract
This study was a focused ethnography of a 21-bed, inpatient psychiatric unit. Patient care was provided by a multidisciplinary team, and a case coordinator role was developed to coordinate the team's efforts. The purpose of the study was to describe perceptions of the implementation of the case coordinator role. Data collection methods included document review, participant and nonparticipant observation, and personal interviews of key informants. Field notes and transcriptions were analyzed throughout data collection. Three themes were identified: role development, role confusion, and role expectation. Role development was defined as the process of recognizing the need for and instituting the position of case coordinator. Role confusion was defined as the lack of a clear distinction between the role of the case coordinator and the role of the staff nurse. Role expectation was defined as the process of directing the development of the role based on individuals' perceptions of the role. Although the role as implemented had not met initial expectations, team members were confident the role would evolve to fulfill the unit's needs.
Collapse
Affiliation(s)
- J Neal
- School of Nursing, University of Kansas, Kansas City 66160-7502, USA
| | | | | |
Collapse
|
44
|
Abstract
A 42-year-old house wife presented with worsening headaches over 6 months in the absence of visual symptoms or symptoms suggestive of focal neurology. She was a life-long smoker. Systems review was unremarkable apart from secondary amenorrhoea and galactorrhoea of 6 months duration. Her serum prolactin was found to be 620 mU/l (60-400), FT4 12.6 nmol/l (9.8-23.1), TSH 1.38 mU/l (0.35-5.5), oestradiol < 73 pmol/l, LH and FSH of 4.4 and 12.6 mIU/l, respectively. She was on bromocriptine. A presumptive diagnosis of pneumonia, based on pyrexia and CXR findings, was made and she was started on IV antibiotics. Two days later she developed meningism and deterioration of conscious level. (Lumbar puncture results: no organisms, 312 neutrophils and 164 lymphocytes). CT scan revealed a 2.5-cm pituitary adenoma, with suprasellar extension. A repeat hormonal profile revealed FSH 1.4, LH < 0.3 mU/l, oestradiol < 73 pmol/l, prolactin 488 mU/l (60-400), and low random cortisol at 29 nmol/l. T1-weighted MRI revealed a large pituitary mass with evidence of haemorrhage. The patient subsequently underwent a transsphenoidal exploration with resection of the pituitary lesion. Whilst awaiting the histopathology results, CT of chest revealed a 1. 5-cm diameter rounded well defined density in the right lower lobe associated with hilar, pre- and right para-tracheal lymphadenopathy. The histopathology of the pituitary lesion, obtained piecemeal, revealed fragments of fibrous tissue infiltrated by sheets of acidophilic prolactin-positive cells, in keeping with a prolactinoma. In addition, other fragments with blood clot included highly atypical epithelial cells with mitotic figures. These were negative for prolactin but showed HMFG-and CEA-positivity, excluding them from a pituitary lineage. Transbronchial biopsy revealed moderately differentiated adenocarcinoma, with evidence of lymphatic spread. The overall conclusion was of bronchogenic adenocarcinoma, metastasizing to a prolactinoma and complicated by apoplexy.
Collapse
Affiliation(s)
- F W Hanna
- Department of Medicine, University Hospital of Wales, Cardiff, UK
| | | | | | | | | | | |
Collapse
|
45
|
Sills RC, Hailey JR, Neal J, Boorman GA, Haseman JK, Melnick RL. Examination of low-incidence brain tumor responses in F344 rats following chemical exposures in National Toxicology Program carcinogenicity studies. Toxicol Pathol 1999; 27:589-99. [PMID: 10528639 DOI: 10.1177/019262339902700513] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neoplasms in the brain are uncommon in control Fischer 344 (F344) rats; they occur at a rate of less than 1% in 2-yr toxicity/carcinogenicity studies. Furthermore, only 10 of nearly 500 studies conducted by the National Toxicology Program (NTP) showed any evidence of chemically related neoplastic effects in the brain. Generally, the brain tumor responses were considered equivocal, because the characteristics of potential neurocarcinogenic agents (such as statistically significant increased incidences, decreased latency and/or survival, and demonstration of dose-response relationships) were not observed. A thorough examination, including comparisons with a well-established historical database, is often critical in evaluating rare brain tumors. Chemicals that gave equivocal evidence of brain tumor responses were generally associated with carcinogenicity at other sites, and many chemicals were mutagenic when incubated with metabolic activating enzymes. Other factors that were supportive of the theory that marginal increases in brain tumor incidence were related to chemical exposure were that (a) some of the tumors were malignant, (b) no brain neoplasms were observed in concurrent controls from some studies, and/or (c) brain tumors were also seen following exposure to structurally related chemicals. In 2-yr studies in F344 rats (studies conducted by the NTP), equivocal evidence of carcinogenicity was observed for the following 9 chemicals: isoprene, bromoethane, chloroethane, 3,3'-dimethylbenzidine dihydrochloride, 3,3'-dimethoxybenzidine dihydrochloride, furosemide, C.I. direct blue 15, diphenhydramine hydrochloride, and 1-H-benzotriazole. Glycidol was the only chemical evaluated by the NTP with which there was clear evidence of brain tumor induction in F344 rats. Clarification of the potential neurocarcinogenic risks of chemicals that produce equivocal evidence of a brain tumor response in conventional 2-yr rodent studies may be aided by the use of transgenic mouse models that exhibit genetic alterations that reflect those present in human brain tumors as well as by the use of in utero exposures.
Collapse
Affiliation(s)
- R C Sills
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709, USA.
| | | | | | | | | | | |
Collapse
|
46
|
Benjamin RJ, Rojas P, Christmas S, Neal J, Broughton S, Burgio C, Barrett B, Churchill WH. Plateletpheresis efficiency: a comparison of the spectra LRS and AMICUS separators. Transfusion 1999; 39:895-9. [PMID: 10504127 DOI: 10.1046/j.1537-2995.1999.39080895.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Optimizing the yields of plateletpheresis by increasing collection efficiencies may provide several benefits: to patients, by increasing the dose in single-donor platelet (SDP) units; to the collection center, by increasing the percentage of components that may be split into double units; and/or to the donor, by reducing the duration of donation. STUDY DESIGN AND METHODS A prospective, randomized study was undertaken to compare the efficiency of platelet collection in paired donations by 21 donors on two cell separators (Spectra LRS, version [v] 5.1; and AMICUS, v2.37). The order of donation was randomly assigned; donations were performed at least 2 weeks apart. A fixed blood volume (4000 mL) was processed by utilizing standard protocols. Findings were confirmed in a retrospective, matched study that compared the two separators by using fixed collection times (90 min). RESULTS The AMICUS and Spectra LRS separators consistently produced white cell-reduced (<1 x 10(6) white cells) components. The AMICUS harvested 32 percent more platelets on average (median, 4.9 x 10(11); range, 1.5-8.7 x 10(11)) than the Spectra LRS (median, 3.7 x 10(11); range, 2.1-7.7 x 10(11)) (p = 0.03), with mean times of 71.5 and 66.0 minutes (p = 0.03), respectively, to process 4000 mL. Mild donor reactions tended to be more common on the AMICUS separator, which used significantly more ACD (median 482 mL vs. 389 mL; p<0.0001) than on the Spectra LRS. CONCLUSIONS The AMICUS separator harvested more platelets per unit of blood volume processed than the Spectra LRS. Possible benefits include increased dose in each single-donor unit, increased double-unit harvests, and/or shorter donation time.
Collapse
Affiliation(s)
- R J Benjamin
- Dana Farber/Partners CancerCare and the Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Elmadbouh H, Halpin SF, Neal J, Hatfield RH, Hourihan MD. Posterior fossa epithelial cyst: case report and review of the literature. AJNR Am J Neuroradiol 1999; 20:681-5. [PMID: 10319981 PMCID: PMC7056040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/1998] [Indexed: 02/12/2023]
Abstract
A 49-year old woman with progressive cranial nerve signs and hemiparesis was found at MR imaging and at surgery to have a cyst at the foramen magnum. Immunohistochemistry and electron microscopy showed an epithelial cyst of endodermal origin. MR findings were of an extraaxial mass, with short T1 and T2 times. Unless immunohistochemistry and electron microscopy are used in the final diagnosis of such cysts, all posterior fossa cysts lined by a single layer of epithelium should be described simply as epithelial cysts.
Collapse
Affiliation(s)
- H Elmadbouh
- Department of Neuroradiology, University Hospital of Wales, Health Park, Cardiff
| | | | | | | | | |
Collapse
|
48
|
Kehoe PG, Russ C, McIlory S, Williams H, Holmans P, Holmes C, Liolitsa D, Vahidassr D, Powell J, McGleenon B, Liddell M, Plomin R, Dynan K, Williams N, Neal J, Cairns NJ, Wilcock G, Passmore P, Lovestone S, Williams J, Owen MJ. Variation in DCP1, encoding ACE, is associated with susceptibility to Alzheimer disease. Nat Genet 1999; 21:71-2. [PMID: 9916793 DOI: 10.1038/5009] [Citation(s) in RCA: 181] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
49
|
Kehoe PG, Williams H, Holmans P, Wilcock G, Cairns NJ, Neal J, Owen MJ. The butyrylcholinesterase K variant and susceptibility to Alzheimer's disease. J Med Genet 1998; 35:1034-5. [PMID: 9863603 PMCID: PMC1051518 DOI: 10.1136/jmg.35.12.1034] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previous work has shown an association between the K variant of the butyrylcholinesterase (BCHE) gene and Alzheimer's disease (AD) in patients carrying the epsilon4 allele of ApoE. We attempted to replicate this finding in 181 UK white AD cases and 71 controls. No difference was found in BCHE-K genotypes (p=0.75) or alleles (p=0.70) between patients and controls. Moreover, despite a significant excess of ApoE epsilon4 in patients versus controls (p<0.0001), we found no evidence to support previous reports of an interaction between ApoE and BCHE-K (chi2=1.49, df=4, p=0.83).
Collapse
Affiliation(s)
- P G Kehoe
- Neuropsychiatric Genetics Unit, Division of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff, UK
| | | | | | | | | | | | | |
Collapse
|
50
|
Madden K, Hiner B, Neal J. Surgical therapy of Parkinson's disease. WMJ 1998; 97:39-41. [PMID: 9810256] [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] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
|