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Ebner DK, Evans JM, Christensen B, Breinholt J, Gamez ME, Lester SC, Routman DM, Ma DJ, Price K, Dong H, Park SS, Chintakuntlawar AV, Neben-Wittich MA, McGee LA, Garces Y, Patel SH, Foote RL, Evans JD. Unique T-cell Sub-Population Shifts after SBPT and Nivolumab in Platinum Refractory HNC: Biomarker Correlates from ROR1771. Int J Radiat Oncol Biol Phys 2023; 117:e580. [PMID: 37785763 DOI: 10.1016/j.ijrobp.2023.06.1920] [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) ROR1771 was a clinical trial investigating the use of stereotactic body proton radiotherapy (SBPT) and nivolumab in recurrent platinum refractory head and neck squamous cell carcinoma (HNSCC). The planned analysis of T-cell subpopulation and biomarker response is herein presented. MATERIALS/METHODS Patients with metastatic histologically confirmed HNSCC from any primary site received 2 cycles of nivolumab followed by SBPT to 1-2 selected target lesion(s) (hilar/lung: 8 of 12 patients), followed by maintenance nivolumab. Peripheral blood mononuclear cells were isolated pre-/post-treatment. Flow cytometry identified T-cell subpopulations. Single Cell 5' Gene Expression (GEX) and V(D)J T Cell Receptor libraries were prepared using Single Cell Immune Profiling. Seurat (v4.1.1) was used to identify cell type clusters, and differential expression post-filtration was evaluated using the Wilcoxon Rank Sum test. RESULTS A total of 12 patients were eligible for analysis, with one alive at time of analysis, 52 months from start of treatment. Median overall survival here was 12.5 months vs. 7.5-months on CheckMate 141. SBPT ranged from 35-50 Gy. Sequential changes in T-cell populations from baseline were noted with initiation of nivolumab, driving decrease in tumor-reactive (TTR; CD11ahighPD1+CD8+), central memory (TCM; CCR7+CD45RA-), and effector T-cells (TEF; CCR7-CD45RA-). TTR and TCM increased following SBPT, with greatest increase (3.5x TTR and 5.2x TCM) in the surviving patient. An average of 68 genes with significant differential expression between timepoints (p<0.0001) demonstrated RNA gene expression changes across all cell subtypes, including ribosomal (RPL and RPS) genes, ACTB, FTL, MALAT1, and others. This averaged 113 genes across all timepoints in the surviving patient, with peak following nivolumab induction. On T-cell receptor (TCR) analysis of this patient, the predominant clonotype diversity changed substantially following nivolumab. Following SBPT, clonotype diversity again changed to include a milieu seen neither at baseline nor with nivolumab alone. These TCRs persisted for approximately 2 weeks following SBPT before returning to resemble the nivolumab-induced TCR diversity alone, coinciding with disease recurrence. CONCLUSION ROR1771 demonstrated overall survival favorably comparable to CheckMate 141. Biomarker analysis of peripheral blood samples demonstrated significant shifts in T-cell subpopulations and underlying gene expression to nivolumab and then to SBPT administration. SBPT to a target lesion changed TCR clonotypes within the peripheral blood beyond those seen with nivolumab administration, with fading of these TCR clonotypes coinciding with recurrence. SBPT in combination with nivolumab may drive systemic immunologic change above that induced by nivolumab alone and warrants further investigation.
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Affiliation(s)
- D K Ebner
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - J M Evans
- Intermountain Precision Genomics, St George, UT
| | | | - J Breinholt
- Intermountain Precision Genomics, St George, UT
| | - M E Gamez
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - S C Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - D M Routman
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - D J Ma
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - K Price
- Department of Medical Oncology, Mayo Clinic, Rochester, MN
| | - H Dong
- Department of Urology and Immunology, Mayo Clinic, Rochester, MN
| | - S S Park
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | | | | | - L A McGee
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - Y Garces
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - S H Patel
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ
| | - R L Foote
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - J D Evans
- Department of Radiation Oncology, Intermountain Healthcare, Murray, UT
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Ebner D, Lester S, Gamez M, Routman D, Ma D, Price K, Dong H, Park S, Chintakuntlawar A, Neben-Wittich M, McGee L, Garces Y, Patel S, Foote R, Evans J. A Prospective Observational Study of Proton Stereotactic Body Radiation Therapy and Immunotherapy for Recurrent Metastatic Head and Neck Cancer: Initial Report of MC ROR1771 Survival Analysis and Toxicity. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gao R, Routman D, Harmsen W, Ebrahimi S, Foote R, Ma D, Neben-Wittich M, McGee L, Patel S, Moore E, Choby G, Tasche K, Price K, Gamez M, Lester S. Adenoid Cystic Carcinoma of the Head and Neck: Patterns of Recurrence and Implications for Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kamdem Talom B, Weiskittle T, Abdel-Halim C, Kowalchuk R, Ebner D, Breen W, Sharifzadeh Y, Ma D, Price K, Lester S, Van Abel K, Routman D, Waddle M. Reliability of Cancer Recurrence Data: Institution Cancer Registry vs. Trained Chart Abstraction. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1475] [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]
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Ma D, Price K, Moore E, Patel S, Hinni M, Fruth B, Foster N, Van Abel K, Yin L, Neben-Wittich M, Garces Y, McGee L, Rwigema J, Routman D, Lester S, Price D, Janus J, Chintakuntlawar A, Savvides P, Foote R. Non-Inferiority Margin and Nodal Analysis of De-Escalated Adjuvant Radiation Therapy (DART) for HPV-Related Oropharyngeal Squamous Cell Carcinoma (OPSCC): A Preplanned Pooled Analysis of MC1273 & MC1675. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.015] [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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McGarrah P, Routman D, Ma D, Van Abel K, Moore E, Patel S, Hinni M, Fruth B, Foster N, Yin L, Neben-Wittich M, Garces Y, McGee L, Rwigema J, Price D, Janus J, Chintakuntlawar A, Savvides P, Foote R, Price K. Analysis of Outcomes by Smoking Status in a Phase III Trial of De-Escalated Adjuvant Chemoradiation Therapy in Human Papillomavirus (HPV(+)) Oropharyngeal Squamous Cell Carcinoma (OPSCC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.033] [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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Wood L, Chintakuntlawar A, Price K, Kaczmar J, Conn G, Bedu-Addo F, Weiss J. Preliminary Safety of PDS0101 (Versamune +HPVmix) and Pembrolizumab Combination Therapy in Subjects with Recurrent/Metastatic Human Papillomavirus-16 Positive Oropharyngeal Squamous Cell Carcinoma (OPSCC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.087] [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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Ma D, Price K, Moore E, Patel S, Hinni M, Fruth B, Foster N, Van Abel K, Yin L, Neben-Wittich M, McGee L, Rwigema J, Routman D, Lester S, Price D, Janus J, Kasperbauer J, Nagel T, Chintakuntlawar A, Savvides P, Garcia J, Foote R. MC1675, a Phase III Evaluation of De-Escalated Adjuvant Radiation Therapy (DART) vs. Standard Adjuvant Treatment for Human Papillomavirus Associated Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.09.012] [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: 10/19/2022]
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Ebrahimi S, Patel S, McGee L, Garcia J, Ma D, Foote R, Garces Y, Neben Wittich M, Price K, Schmitt A, Zhai Q, May B, Nagel T, Hinni M, Routman D, Chintakuntlawar A, Rwigema J. Clinical Outcomes of Histologically Verified Salivary Ductal Carcinomas: Retrospective Analysis of 89 Patients Treated Over 47 Years. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ma D, Price K, Eric M, Patel S, Hinni M, Ginos B, Fruth B, Foster N, Chintakuntlawar A, Neben-Wittich M, Garces Y, Van Abel K, Price D, Kasperbauer J, Janus J, Nagel T, Garcia J, Foote R. Long-Term Results for MC1273, A Phase II Evaluation of De-Escalated Adjuvant Radiation Therapy for Human Papillomavirus Associated Oropharyngeal Squamous Cell Carcinoma (HPV+ OPSCC). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Park JS, Page AT, Shen PH, Price K, Tennant M, Kruger E. Management of dental emergencies amongst Australian general medical practitioners - A case-vignette study. Aust Dent J 2021; 67:30-38. [PMID: 34591999 DOI: 10.1111/adj.12878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND In Australia, because of inequity in dental service accessibility and affordability, patients can see general medical practitioners (GPs) for acute dental conditions. METHODS This cross-sectional study consisted of surveys distributed to the board registered GPs practising in Australia. The main outcome measures included statistical analysis of GPs managing different dental emergency scenarios and their confidence and expectations in managing dental emergencies. RESULTS A total of 425 GPs participated in the study. The sample primarily consisted of GPs practising in metropolitan clinics (n = 315). Most participants reported that they would refer to the dentist for mobilized tooth (n = 402). There was a negative correlation between GPs with 5-29 years of experience and traumatized tooth management (P < 0.05). GPs aged between 40 and 49 years were more inclined to treat patients with mobilized teeth [Multivariate (MV): 0.42(0.09-0.74)]. However, GPs with 0-5 years of experience were less likely to manage patients with dental abscess [MV: -0.52(-0.80 to -0.24)]. CONCLUSION Most GPs referred dental emergencies to dentists. GP management of dental emergencies were predominantly palliative. Therefore, opportunities for collaborative practice models amongst GPs and dentists may be needed to bridge the gap in the regional and remote locations.
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Affiliation(s)
- J S Park
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, Western Australia, Australia.,UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia.,Monash Health Dental Services, Monash Health, Dandenong, Victoria, Australia
| | - A T Page
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia.,Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia.,Centre for Optimisation of Medicines, University of Western Australia, Crawley, Western Australia, Australia
| | - P-H Shen
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - K Price
- Department of General Practice, Monash University, Notting Hill, Victoria, Australia
| | - M Tennant
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, Western Australia, Australia
| | - E Kruger
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, Western Australia, Australia
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Guy GP, Hargrave J, Dunn R, Price K, Short J, Thilaganathan B. Secondary non-invasive prenatal screening for fetal trisomy: an effectiveness study in a public health setting. BJOG 2020; 128:440-446. [PMID: 32790109 DOI: 10.1111/1471-0528.16464] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of secondary screening using non-invasive prenatal testing (NIPT) in a routine NHS setting including test performance, turn-around times (TATs) and no-call (failure to obtain result) rates. To examine the influence of maternal and fetal characteristics on test performance. DESIGN Retrospective cohort. SETTING London teaching hospital. SAMPLE A total of 8651 pregnancies undergoing screening for fetal trisomy using NIPT provided by an NHS cell-free DNA screening laboratory - the SAFE laboratory. METHODS Screening test evaluation and TATs. Univariate and multivariate logistic regression analysis to identify significant predictors of no-call results and reported by low fetal fraction (<2%), very high fetal fraction (>40%) and processing failure. MAIN OUTCOME MEASURES Test performance, TATs and no-call rates, factors affecting no-call results. RESULTS Average TAT was 4.0 days (95% CI 4.0-4.2 days). Test sensitivities for trisomies 21 and 13/18 were 98.9% (95% CI 95.9-99.9%) and 90.4% (95% CI 80.0-96.8%), respectively. The overall no-call rate was 32/8651 (0.37%, 95% CI 0.26-0.52%). The overall risk of a no-call result was influenced by gestational age, dichorionic twin pregnancy, history of malignancy and pregnancies affected by trisomy 13/18, but not by maternal weight or use of low-molecular-weight heparin. CONCLUSIONS High-throughput NIPT can be effectively embedded into a public health NHS setting. TATs of 4 days and no-calls of <0.5% were well within clinically desirable tolerances. Gestational age, maternal weight, assisted reproductive techniques, use of low-molecular-weight heparin and past history of malignancy did not have major impacts on test no-call rates and should not constitute reasons for withholding the option of NIPT from women. TWEETABLE ABSTRACT Turn-around times of 4 days, no-call (test failure) rates of 0.37% and highly accurate NIPT can be successfully embedded in the NHS.
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Affiliation(s)
- G P Guy
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.,Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - J Hargrave
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.,St George's Antenatal Fetal Evaluation (SAFE) Laboratory, St George's Hospital, St George's University of London, London, UK
| | - R Dunn
- St George's Antenatal Fetal Evaluation (SAFE) Laboratory, St George's Hospital, St George's University of London, London, UK
| | - K Price
- St George's Antenatal Fetal Evaluation (SAFE) Laboratory, St George's Hospital, St George's University of London, London, UK
| | - J Short
- St George's Antenatal Fetal Evaluation (SAFE) Laboratory, St George's Hospital, St George's University of London, London, UK
| | - B Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.,Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.,St George's Antenatal Fetal Evaluation (SAFE) Laboratory, St George's Hospital, St George's University of London, London, UK
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Marson BA, Oakley BJ, Srinivasan S, S S, Chell J, Halliday K, Hunter J, Price K. Is it safe for extended-role radiographers to measure migration percentage in children with cerebral palsy? Radiography (Lond) 2020; 26:e246-e250. [PMID: 32335020 DOI: 10.1016/j.radi.2020.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION In the surveillance of children with cerebral palsy, the measurement of migration percentage is used to identify children at risk of hip dislocation. Early identification of children at risk facilitates early intervention with less invasive surgical procedures to prevent further deterioration. The aim of this study is to evaluate the safety of the measurements of migration percentage for surveillance in cerebral palsy by extended-role radiographers by evaluating the reliability and validity of measurements performed by these professionals. METHODS A sample of thirty pelvic x-rays were selected from the local cerebral palsy database. A range of hip displacement was selected including some challenging borderline x-rays. All ten extended-role radiographers completed measurements using TraumaCAD which were repeated at a minimum of 4 weeks. Inter-rater and intra-rater reliability was calculated using intraclass correlation coefficients. The accuracy and safety of the system was evaluated by converting measurements into referral categories (red, amber or green) and cohen's kappa was calculated when categories were compared to measurements to orthopaedic surgeon RESULTS: The inter-rater reliability between radiographers was 0.938 (95% CI 0.914-0.991). The intra-rater reliability was 0.941 (95% CI 0.931-0.949). The percentage agreement was 94.8% for green, 93.8% for amber and 98.2% for red hips. The weighted kappa value was 0.923 (95% CI 0.889-0.957). CONCLUSION The reliability and accuracy of radiographer measurement of migration percentage is excellent. It is safe for radiographers to calculate the migration percentage using semi-automated software for the surveillance of children with cerebral palsy. IMPLICATIONS FOR PRACTICE We recommend the measurement of migration percentage may be performed by extended-role radiographers to deliver accurate and reliable measurements for use in cerebral palsy surveillance.
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Affiliation(s)
- B A Marson
- Department of Trauma and Orthopaedics, Nottingham Children's Hospital, QMC, Nottingham, NG7 2UH, United Kingdom.
| | - B J Oakley
- Department of Trauma and Orthopaedics, Kings Mill Hospital, Sutton on Ashfield, NG17 4JL, United Kingdom.
| | - S Srinivasan
- Department of Trauma and Orthopaedics, Kings Mill Hospital, Sutton on Ashfield, NG17 4JL, United Kingdom.
| | - S S
- Department of Trauma and Orthopaedics, Kings Mill Hospital, Sutton on Ashfield, NG17 4JL, United Kingdom.
| | - J Chell
- Department of Trauma and Orthopaedics, Nottingham Children's Hospital, QMC, Nottingham, NG7 2UH, United Kingdom.
| | - K Halliday
- Department of Radiology, Nottingham Children's Hospital, QMC, Nottingham, NG7 2UH, United Kingdom.
| | - J Hunter
- Department of Trauma and Orthopaedics, Nottingham Children's Hospital, QMC, Nottingham, NG7 2UH, United Kingdom.
| | - K Price
- Department of Trauma and Orthopaedics, Nottingham Children's Hospital, QMC, Nottingham, NG7 2UH, United Kingdom.
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Fazer C, Chintakuntlawar A, Price K. Capecitabine for Salvage Treatment of Patients with Heavily Pre-treated Human Papillomavirus-Associated Oropharynx Cancer (HPV-OPC) with Distant Metastases. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ma D, Moore E, Van Abel K, Lohse C, Bailey K, Price K, Patel S, Hinni M, Garcia J, Neben-Wittich M, Garces Y, Chintakuntlawar A, Price D, Olsen K, Kasperbauer J, Janus J, McGee L, Lester S, Rwigema J, Foote R. Risk Factors for Disease Progression Following Aggressive Dose De-Escalation for Adjuvant Chemoradiotherapy in Human Papillomavirus–Associated Oropharynx Squamous Cell Carcinoma (HPV-OSCC). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Starrett J, Guernet A, Cuomo M, Poels K, van Alderwerelt van Rosenburgh I, Nagelberg A, Farnsworth D, Price K, Khan H, Ashtekar K, Gaefele M, Ayeni D, Stewart T, Kuhlmann A, Kaech S, Unni A, Homer R, Lockwood W, Michor F, Goldberg S, Lemmon M, Smith P, Cross D, Politi K. B32 Drug Sensitivity and Allele Specificity of First-Line Osimertinib Resistance EGFR Mutations. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Prockop S, Doubrovina E, Hasan A, Suser S, Rodriguez-Sanchez I, Price K, Slocum A, O'Reilly R. Durable responses to 3rd party viral specific T cells mediated by different patterns of engraftment. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.334] [Citation(s) in RCA: 2] [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: 10/26/2022]
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Fagogenis G, Mencattelli M, Machaidze Z, Rosa B, Price K, Wu F, Weixler V, Saeed M, Mayer JE, Dupont PE. Autonomous Robotic Intracardiac Catheter Navigation Using Haptic Vision. Sci Robot 2019; 4:eaaw1977. [PMID: 31414071 PMCID: PMC6693882 DOI: 10.1126/scirobotics.aaw1977] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
While all minimally invasive procedures involve navigating from a small incision in the skin to the site of the intervention, it has not been previously demonstrated how this can be done autonomously. To show that autonomous navigation is possible, we investigated it in the hardest place to do it - inside the beating heart. We created a robotic catheter that can navigate through the blood-filled heart using wall-following algorithms inspired by positively thigmotactic animals. The catheter employs haptic vision, a hybrid sense using imaging for both touch-based surface identification and force sensing, to accomplish wall following inside the blood-filled heart. Through in vivo animal experiments, we demonstrate that the performance of an autonomously-controlled robotic catheter rivals that of an experienced clinician. Autonomous navigation is a fundamental capability on which more sophisticated levels of autonomy can be built, e.g., to perform a procedure. Similar to the role of automation in fighter aircraft, such capabilities can free the clinician to focus on the most critical aspects of the procedure while providing precise and repeatable tool motions independent of operator experience and fatigue.
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Affiliation(s)
- G Fagogenis
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - M Mencattelli
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Z Machaidze
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - B Rosa
- ICube, Université de Strasbourg, CNRS, Strasbourg, France
| | - K Price
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - F Wu
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - V Weixler
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - M Saeed
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - J E Mayer
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - P E Dupont
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Harrington L, Price K, Rampota C, Edmonds P. 61ELECTRONIC DO NOT ATTEMPT CARDIO-PULMONARY RESUSCITATION (DNACPR): TOO FAR? AN EVALUATION OF PRACTICE WITHIN GERONTOLOGY AT KING’S COLLEGE HOSPITAL (KCH), LONDON, UK. Age Ageing 2019. [DOI: 10.1093/ageing/afy211.61] [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)
- L Harrington
- Core Trainees in Departments of Gerontology and
- Equal Co-authorship between L Harrington and K Price
| | - K Price
- Renal Medicine, King’s College Hospital, NHS Foundation Trust Consultant in Palliative Care
- Equal Co-authorship between L Harrington and K Price
| | - C Rampota
- Core Trainees in Departments of Gerontology and
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, 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Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 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Manzar G, Lester S, Kobic A, Hosfield E, Neben-Wittich M, Garces Y, Price K, Chintakuntlawar A, Price D, Foote R, Graner D, Ma D. Longitudinal Objective Speech and Swallow Function after Treatment with Definitive Radiation Therapy (RT) for Larynx Cancer in the Intensity Modulated Radiation Therapy (IMRT) Era. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.947] [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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Deshmukh S, Marson B, Price K. Characterising the incidence and management of paediatric forearm fractures in a UK trauma centre over a one-year period. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.381] [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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Alsidawi S, Price K, Foote R, Garcia J, Westin G, Moore E, Chintakuntlawar A. Adjuvant Chemotherapy Utilization According to Treatment Facility Type in Resected Head and Neck Cancer With Negative Surgical Margins and No Extracapsular Nodal Extension. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Price K, Moore E, Foote R, Patel S, Hinni M, Chintakuntlawar A, Garcia J, Graner D, Neben-Wittich M, Garces Y, Hallemeier C, Kasperbauer J, Janus J, Van Abel K, Price D, Ma D. Toxicity, Swallow Function, and Quality of life on MC1273, a Phase 2 Study of Dose De-escalation for Adjuvant Chemoradiation in HPV+ Oropharynx Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ma D, Price K, Moore E, Patel S, Hinni M, Chintakuntlawar A, Garcia J, Graner D, Neben-Wittich M, Garces Y, Hallemeier C, Price D, Kasperbauer J, Janus J, Foster N, Foote R. Two-Year Results for MC1273, a Phase 2 Evaluation of Aggressive Dose De- Escalation for Adjuvant Chemoradiation in HPV+ Oropharynx Squamous Cell Carcinoma (OPSCC). Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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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Routman D, Funk R, Tangsriwong K, Lin A, Michael K, Garcia J, Stoddard D, Eric M, Day C, Zhai Q, Price K, Lukens J, Samuel S, Weinstein G, O'Malley B, Foote R, Ma D. Relapse Rates with Surgery Alone in HPV-Related Intermediate- and High-Risk-Group Oropharynx Squamous Cell Cancer: A Multi-Institutional Review. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1482] [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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Thürlimann B, Giobbie-Hurder A, Colleoni M, Jensen MB, Ejlertsen B, de Azambuja E, Neven P, Láng I, Gladieff L, Bonnefoi H, Harvey VJ, Spazzapan S, Tondini C, Price K, Piccart-Gebhart M, Regan MM, Gelber RD, Coates AS, Goldhirsch A. Abstract P2-09-05: 12 years' median follow up (MFU) of BIG 1-98: Adjuvant letrozole, tamoxifen and their sequence for postmenopausal women with endocrine responsive early breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-09-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The Breast International Group (BIG) 1-98 study is a randomized, phase 3, double-blind trial that compared five yrs of adjuvant treatment with letrozole, tamoxifen, or their sequence in postmenopausal women with hormone-receptor–positive early breast cancer. The study is conducted by the International Breast Cancer Study Group (IBCSG) on behalf of BIG. 8010 patients (pts) were enrolled between March 1998 and May 2003, and first results demonstrating a significant DFS benefit favoring letrozole compared with tamoxifen were reported in 2005 at 25.8 months' MFU. Subsequent updates showed continuing DFS benefit and updated results published in 2011 at 8.1 yrs' MFU showed OS benefit. Industry-sponsorship of the original BIG 1-98 ended in 2010; IBCSG launched an observational, non-interventional long-term follow-up study (BIG 1-98 LTFU) to collect survival, disease status and adverse events for an additional 5 yrs. We report results from BIG 1-98 LTFU at 12 yrs' MFU.
Methods
The original trial includes the 8010 patients enrolled. The potential BIG 1-98 LTFU cohort consisted of 148 academic medical centers with a maximum of 6843 pts who were alive and continuing follow-up when the original study ended. Response bias was addressed using weighting class adjustments estimated using multivariable logistic regression. Unadjusted incidence rates are reported here per 1000 pt-yrs with 95% Poisson confidence intervals. An updated abstract will include adjusted incidence rates, as well as estimates of OS and DFS based on a weighted Kaplan-Meier approach. The database will close in July 2016.
Results
As of May 2016, 81 centers participated in the BIG 1-98 LTFU study, contributing data from approximately 3900 pts (57%) and extending MFU to 12 yrs. Compared with the potential cohort of 6843 pts, the ~3900 in the LTFU analytic cohort were more likely to be under age 65 yrs at enrollment, have node-positive disease, and have tumors that were < 2 cm, PgR positive (≥1%), and with no evidence of peritumoral vascular invasion. Extended adjuvant endocrine therapy for primary BC was continued in 2% of pts. Unadjusted incidence estimates of myocardial infarction increased during LTFU, while incidence of thromboembolic events and osteoporosis decreased (Table). Variations in incidence rates were noted depending on recording mechanism (e.g. registry, clinic visit, telephone, information from family).
Unadjusted Incidence Rate/1000 pt-yrs (95% CI)Adverse EventDuring original studyDuring LTFUMyocardial Infarction1.7 (1.4-2.0)3.5 (2.7-4.5)Thromboembolic event6.0 (5.4-6.6)2.5 (1.8-3.3)Osteoporosis23.6 (22.5-24.9)18.2 (16.3-20.3)Bone fractures17.2 (16.2-18.3)15.0 (13.2-16.9)
Overall 1845 deaths were reported; the unadjusted incidence of death was lower in the original study compared with during LTFU (21.9 vs. 26.6/1000 pt-yrs); incidence remained relatively stable for pts assigned to tamoxifen (24.9 vs. 25.2/1000 pt-yrs), and increased for pts assigned to letrozole (22.0 vs. 27.1/1000 pt-yrs).
Conclusions
The BIG 1-98 LTFU study has been successfully conducted. The additional data from the BIG 1-98 LTFU study provides important long-term clinical information about OS, DFS and adverse events.
Citation Format: Thürlimann B, Giobbie-Hurder A, Colleoni M, Jensen M-B, Ejlertsen B, de Azambuja E, Neven P, Láng I, Gladieff L, Bonnefoi H, Harvey VJ, Spazzapan S, Tondini C, Price K, Piccart-Gebhart M, Regan MM, Gelber RD, Coates AS, Goldhirsch A. 12 years' median follow up (MFU) of BIG 1-98: Adjuvant letrozole, tamoxifen and their sequence for postmenopausal women with endocrine responsive early breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-09-05.
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Affiliation(s)
- B Thürlimann
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - A Giobbie-Hurder
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - M Colleoni
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - M-B Jensen
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - B Ejlertsen
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - E de Azambuja
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - P Neven
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - I Láng
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - L Gladieff
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - H Bonnefoi
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - VJ Harvey
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - S Spazzapan
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - C Tondini
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - K Price
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - M Piccart-Gebhart
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - MM Regan
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - RD Gelber
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - AS Coates
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
| | - A Goldhirsch
- International Breast Cancer Study Group and BIG 1-98 Collaborative Group
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Bobridge A, Price K, Taylor A. A ‘one stop cancer screening shop’, a way of improving screening participation rates? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw385.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gill TK, Price K, Dal Grande E, Daly A, Taylor AW. Feeling angry about current health status: using a population survey to determine the association with demographic, health and social factors. BMC Public Health 2016; 16:588. [PMID: 27423465 PMCID: PMC4947290 DOI: 10.1186/s12889-016-3232-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/15/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related anger within the community and variables associated with reporting health-related anger. METHODS A population-based Computer Assisted Telephone Interview (CATI) survey of 3003 randomly selected adults Australia-wide was conducted to examine the prevalence of health-related anger. A wide range of other covariates were included in the survey. Multivariable logistic regression and path analysis were undertaken to identify the relationships between different variables associated with feeling angry about the health status of people, to explore the direction of these associations and as a consequence of the results, consider implications for health service use and delivery. RESULTS Overall, 18.5 % of the population reported feeling angry about their health "some of the time", "most of the time" or "all of the time". People who felt angry about their health were more likely to have a severe health condition, at least one chronic condition, high psychological distress, fair to poor health status, and needed to adjust their daily lives because of a health condition. Having a tertiary level education was protective. Receiving some form of social support, usually from a support group, and not always doing as advised by a doctor, were also associated with a higher likelihood of being angry about their health. CONCLUSIONS People living with significant health problems are more likely to feel angry about their health. The path between illness and anger is, however, complex. Further research is needed to understand the extent that feeling angry influences the progression of health problems and, if necessary, how to minimise this progression. What also needs examining is whether identifying people who feel angry in the general population could be a predictor of persons most likely to develop significant health problems.
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Affiliation(s)
- Tiffany K. Gill
- />School of Medicine, Faculty of Health Sciences, The University of Adelaide, SAHMRI, Level 7, North Tce, Adelaide, SA 5000 Australia
| | - K. Price
- />School of Nursing and Midwifery, University of South Australia, City East Campus, North Tce, Adelaide, SA 5000 Australia
| | - E. Dal Grande
- />Population Research and Outcome Studies, School of Medicine, The University of Adelaide, SAHMRI, Level 7, North Tce, Adelaide, SA 5000 Australia
| | - A. Daly
- />Consultant statistician, Perth, WA Australia
| | - A. W. Taylor
- />Population Research and Outcome Studies, School of Medicine, The University of Adelaide, SAHMRI, Level 7, North Tce, Adelaide, SA 5000 Australia
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Price K, Price D, Dierks L, Rhodes D, Ferguson J, Peterson S, Hein J, Murad A, Clark M, Olsen K. Holistic Wellness Intervention for Head and Neck Cancer (HNC) Patients and Caregivers: Mayo Clinic Rochester (MCR) Pilot. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chintakuntlawar A, Shon W, Erickson-Johnson M, Bilodeau E, Jenkins S, Davidson J, Keeney M, Rivera M, Price D, Moore E, Olsen K, Kasperbauer J, Foote R, Price K, Garcia J. High-Grade Transformation of Acinic Cell Carcinoma: Potentially Underrecognized and Inadequately Treated. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Price K, Wilson N, Holmes S, Bridle C, Heke S, Markides C, Dain V. Implementing a dedicated, embedded psychology service within a Maxillofacial Trauma Outpatient Clinic: preliminary evaluation and findings from the first 4 months. Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.08.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pasalic D, Funk R, Moore E, Garcia J, Price K, Price D, Foote R, Ma D. Comparing the Survival, Recurrence, and Toxicities Between Surgery With Adjuvant Therapy Versus Surgery Alone for Human Papillomavirus–Positive Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mullikin T, Pasalic D, Garcia J, Price K, Price D, Moore E, Foote R, Ma D. Primary Chemoradiation Therapy Versus Surgery With Adjuvant Radiation Therapy: Survival, Failure Rates, and Toxicities for HPV-Positive Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1358] [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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Price K, Dyer A, Rondo T, Hickman P. Healthy healing and wound prevention. Aust Nurs Midwifery J 2015; 23:33. [PMID: 26665846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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English A, Harsh B, Price K, MAfi G, VanOverbeke D, Joseph P, Ramanathan R. Effects of water- and oil-based rosemary on ground beef metmyoglobin reducing activity. Meat Sci 2015. [DOI: 10.1016/j.meatsci.2014.09.028] [Citation(s) in RCA: 2] [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: 10/24/2022]
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Seiwert T, Adkins D, Worden F, Wade J, Hu S, Price K, Zavala J, Lussier Y, Vokes E, Cohen E. Activity of Temsirolimus Added to Cetuximab in Patients With Cetuximab-Resistant, Recurrent/Metastatic Head-and-Neck Cancer: Results of the Randomized Phase 2 Maestro-HN Study. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2013.11.148] [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: 10/25/2022]
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Larpent A, Davidson-Park B, McCallum S, Price K, Evans D, Ullrich S, Williamson P. LIVING WELL DYING WELL: PUTTING THESE WORDS INTO ACTION. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.73] [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: 11/04/2022]
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Boone JH, Goodykoontz M, Rhodes SJ, Price K, Smith J, Gearhart KN, Carman RJ, Kerkering TM, Wilkins TD, Lyerly DM. Clostridium difficile prevalence rates in a large healthcare system stratified according to patient population, age, gender, and specimen consistency. Eur J Clin Microbiol Infect Dis 2011; 31:1551-9. [PMID: 22167256 DOI: 10.1007/s10096-011-1477-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 10/22/2011] [Indexed: 02/07/2023]
Abstract
We evaluated Clostridium difficile prevalence rates in 2,807 clinically indicated stool specimens stratified by inpatient (IP), nursing home patient (NH), outpatient (OP), age, gender, and specimen consistency using bacterial culture, toxin detection, and polymerase chain reaction (PCR) ribotyping. Rates were determined based on the detection of toxigenic C. difficile isolates. We identified significant differences in the rates between patient populations and with age. Specimens from NH had a higher rate (46%) for toxigenic C. difficile than specimens from IP (18%) and OP (17%). There were no gender-related differences in the rates. Liquid specimens had a lower rate (15%) than partially formed and soft specimens (25%) and formed specimens (18%) for the isolation of toxigenic C. difficile. The nontoxigenic rate was lowest for NH (4%) and highest for patients<20 years of age (23%). We identified 31 different toxigenic ribotypes from a sampling of 190 isolates that showed the lowest diversity in NH. Fluoroquinolone resistance was observed in 93% of the 027 isolates, all of the 053 isolates, and in four other ribotypes. We observed different rates for toxigenic C. difficile in stratified patient populations, with the highest rate for NH, a low overall nontoxigenic rate, and fluoroquinolone resistance.
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Affiliation(s)
- J H Boone
- Research and Development, TechLab, Inc., 2001 Kraft Drive, Blacksburg, VA 24060, USA
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Price K, Suzuki S, Grabowecky M. Costs of Switching Scene Category in Real-World Visual Search. J Vis 2011. [DOI: 10.1167/11.11.1330] [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
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Gill T, Taylor A, Price K, Pilkington R. SP1-66 Chronic disease in specific populations: an epidemiological analysis. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976n.43] [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: 11/03/2022]
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Price K, Krishnan K. An integrated QSAR-PBPK modelling approach for predicting the inhalation toxicokinetics of mixtures of volatile organic chemicals in the rat. SAR QSAR Environ Res 2011; 22:107-128. [PMID: 21391144 DOI: 10.1080/1062936x.2010.548350] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The objective of this study was to predict the inhalation toxicokinetics of chemicals in mixtures using an integrated QSAR-PBPK modelling approach. The approach involved: (1) the determination of partition coefficients as well as V(max) and K(m) based solely on chemical structure for 53 volatile organic compounds, according to the group contribution approach; and (2) using the QSAR-driven coefficients as input in interaction-based PBPK models in the rat to predict the pharmacokinetics of chemicals in mixtures of up to 10 components (benzene, toluene, m-xylene, o-xylene, p-xylene, ethylbenzene, dichloromethane, trichloroethylene, tetrachloroethylene, and styrene). QSAR-estimated values of V(max) varied compared with experimental results by a factor of three for 43 out of 53 studied volatile organic compounds (VOCs). K(m) values were within a factor of three compared with experimental values for 43 out of 53 VOCs. Cross-validation performed as a ratio of predicted residual sum of squares and sum of squares of the response value indicates a value of 0.108 for V(max) and 0.208 for K(m). The integration of QSARs for partition coefficients, V(max) and K(m), as well as setting the K(m) equal to K(i) (metabolic inhibition constant) within the mixture PBPK model allowed to generate simulations of the inhalation pharmacokinetics of benzene, toluene, m-xylene, o-xylene, p-xylene, ethylbenzene, dichloromethane, trichloroethylene, tetrachloroethylene and styrene in various mixtures. Overall, the present study indicates the potential usefulness of the QSAR-PBPK modelling approach to provide first-cut evaluations of the kinetics of chemicals in mixtures of increasing complexity, on the basis of chemical structure.
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Affiliation(s)
- K Price
- Departement de sante environnementale et sante au travail, Faculte de medecine, Universite de Montreal, PQ, Canada
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Clarke MT, Newton C, Griffiths T, Price K, Lysley A, Petrides KV. Factors associated with the participation of children with complex communication needs. Res Dev Disabil 2011; 32:774-780. [PMID: 21129915 DOI: 10.1016/j.ridd.2010.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 11/05/2010] [Accepted: 11/05/2010] [Indexed: 05/30/2023]
Abstract
The aim of this study was to conduct a preliminary analysis of relations between child and environmental variables, including factors related to communication aid provision, and participation in informal everyday activities in a sample of children with complex communication needs. Ninety-seven caregivers of children provided with communication aids responded to a questionnaire survey. Child variables assessed were level of ability, trait emotional self-efficacy, and competence in communication aid use. Environmental variables assessed were the impact of childhood disability on the family, family socio-economic category, perceived reliability of electronic communication aids provided to children, and ease of use of the aid. The outcome measure was the intensity of child participation in informal activities. Significant correlations were observed between participation scores and the following variables: child age, level of ability, trait emotional self-efficacy, and family impact of childhood disability. Regression analyses highlighted trait emotional self-efficacy and, to a lesser degree, family impact of childhood disability as the strongest potential predictors of participation. While aspects of child personality may be difficult to disentangle from behaviours related to disability type or developmental age, this research highlights a clinical requirement to assess systematically child behaviours relating to their general emotional functioning.
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Affiliation(s)
- M T Clarke
- Psychology and Language Sciences, University College London, Chandler House, 2 Wakefield Street, and Wolfson Neurodisability Service, Great Ormond Street Hospital for Children, NHS Trust, London WC1N 1PF, United Kingdom.
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Suvkhanov A, Hunn J, Wu W, Thomson D, Price K, Parikh N, Irene E, Davis RF, Krasnobaev L. Doping of GaN by Ion Implantation: Does it Work? ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-512-475] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTEpitaxially grown GaN by metal organic chemical vapor deposition (MOCVD) on SiC were implanted with 100 keV Si+ (for n-type) and 80 keV Mg+ (for p-type) with various fluences from 1×1012 to 7×1015 ions/cm2 at liquid nitrogen temperature (LT), room temperature (RT), and 700 °C (HT). High temperature (1200 °C and 1500 °C) annealing was carried out after capping the GaN with epitaxial AIN by MOCVD to study damage recovery. Samples were capped by a layer of AIN in order to protect the GaN surface during annealing. Effects of implant temperature, damage and dopant activation are critically studied to evaluate a role of ion implantation in doping of GaN. The damage was studied by Rutherford Backscattering/Channeling, spectroscopic ellipsometry and photoluminescence. Results show dependence of radiation damage level on temperature of the substrate during implantation: implantations at elevated temperatures up to 550 °C decrease the lattice disorder; “hot implants” above 550 °C can not be useful in doping of GaN due to nitrogen loss from the surface. SE measurements have indicated very high sensitivity to the implantation damage. PL measurements at LT of 80 keV Mg+ (5×1014 cm-2) implanted and annealed GaN showed two peaks : one ∼100 meV and another ∼140 meV away from the band edge.
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Thomas J, Dunn M, Burns L, Swift W, Price K, Mattick R. Reasons for and against illicit drug use among elite Australian athletes. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2009.10.457] [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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Paridaens RJ, Gelber S, Cole BF, Gelber RD, Thürlimann B, Price K, Holmberg S, Crivellari D, Coates AS, Goldhirsch A. Evaluation of Adjuvant! Online to predict the effect of optimal endocrine therapy (ovarian function suppression plus tamoxifen) for premenopausal breast cancer patients with estrogen-receptor-positive breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
585 Background: Adjuvant! Online (AOL) is a user-friendly, web-based tool that provides estimates of adjuvant therapy outcomes for individual patients. While reliable evidence underpins estimates for most patient cohorts, there is a paucity of data on the effect of adding chemotherapy to complete estrogen blockade for premenopausal women with estrogen-receptor positive breast cancer. Methods: International Breast Cancer Study Group (IBCSG) Trial 11–93 enrolled 174 premenopausal women with estrogen-receptor positive, node-positive breast cancer from 1993 to 1998. Fifty percent of patients had 1 positive axillary lymph node and 97% had between 1 and 3 positive nodes. Patients were randomized to receive ovarian function suppression plus five years of tamoxifen with or without chemotherapy. The estimated hazard rates and corresponding 10-year relapse-free survival percents obtained from Trial 11–93 data (Breast Cancer Res Treat. 2009;113:137–144) were compared with those predicted using AOL. Results: The 10-year relapse-free survival percents predicted from AOL were 64.4% (95% CI, 61.9% to 67.2%) for endocrine therapy alone and 74.9% (95% CI, 73.1% to 76.8%) for chemoendocrine therapy. By contrast, these estimates in Trial 11–93 were 76.4% (95% CI, 65.8% to 84.0%) for endocrine therapy alone and 74.9% (95% CI, 64.5% to 82.7%) for chemoendocrine therapy. The AOL estimate for the endocrine alone control group is lower than that observed in Trial 11–93 (p = 0.03), while the estimates for the two chemoendocrine therapy groups are similar. Conclusions: AOL appears to underestimate the effectiveness of adjuvant endocrine therapy alone for premenopausal women with endocrine responsive breast cancer, thus overestimating the added benefit - if any - from chemotherapy for this patient population. Prospective clinical trials addressing the question are warranted. No significant financial relationships to disclose.
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Affiliation(s)
| | - S. Gelber
- International Breast Cancer Study Group, Bern, Switzerland
| | - B. F. Cole
- International Breast Cancer Study Group, Bern, Switzerland
| | - R. D. Gelber
- International Breast Cancer Study Group, Bern, Switzerland
| | - B. Thürlimann
- International Breast Cancer Study Group, Bern, Switzerland
| | - K. Price
- International Breast Cancer Study Group, Bern, Switzerland
| | - S. Holmberg
- International Breast Cancer Study Group, Bern, Switzerland
| | - D. Crivellari
- International Breast Cancer Study Group, Bern, Switzerland
| | - A. S. Coates
- International Breast Cancer Study Group, Bern, Switzerland
| | - A. Goldhirsch
- International Breast Cancer Study Group, Bern, Switzerland
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Price K, Kris MG, Rusch V, Finley DJ, Azzoli CG, Downey RJ, Bains MS, Miller VA, Rizk N, Rizvi NA. Phase II study of induction and adjuvant bevacizumab in patients with stage IB-IIIA non-small cell lung cancer (NSCLC) receiving induction docetaxel and cisplatin. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.7531] [Citation(s) in RCA: 5] [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
7531 Background: VEGF supports growth of NSCLC and is blocked by bevacizumab. Bevacizumab with chemotherapy is an established treatment for advanced NSCLC. We conducted this study to assess the efficacy and toxicity of induction bevacizumab (Bev) with cisplatin (C) and docetaxel (D) in patients with resectable NSCLC. Methods: All patients (pts) had resectable Stage IB-IIIA NSCLC and received up to 4 cycles of D 75 mg/m2 and C 75 mg/m2 followed by surgery. Pts with non-squamous NSCLC also received 3 cycles of Bev 15 mg/kg along with induction DC (Bev-DC). Bev was not given in pre-operative cycle 4. Pts with squamous or central tumors or hemoptysis received 4 cycles of DC only (DC). All resected pts were eligible for adjuvant Bev 15 mg/kg q3 weeks for 1 year. The primary endpoint was rate of downstaging from pre-operative clinical stage to pathologic stage. Results: From Aug 2005 - Nov 2008, 47 pts were enrolled: 27 women; median age 62; Stage 1B -15%, Stage II-17%, Stage IIIA-68%. Of 36 pts given Bev-DC, 15/30 (50%) who have completed surgery were downstaged. Of 11 pts given DC, 3/11 (27%) were downstaged. In Bev-DC group, 22/33 (67%) completed all 4 cycles of DC without a dose reduction and 28/33 pts (85%) completed all 3 planned cycles of Bev. Pts received <3 cycles due to: hemoptysis (n=3), consent withdrawal (n=1), hypertension (n=1), and sepsis (n=1). For DC, 6/11 pts (55%) completed all 4 cycles of DC without a dose reduction. 42/43 patients were resected. R0 resection rate: 29/31 for Bev-DC and 9/11 for DC. Grade 3/4 surgical complications were seen in 5/31 pts (16%) in Bev-DC and 1/11 (9%) in DC. Only 17/41 (41%) who completed surgery received adjuvant bev (median 6 cycles), and 7/41 (17%) completed all adjuvant Bev. Pts did not receive adjuvant Bev due to: POD prior to adjuvant Bev (n=9), POD during adjuvant Bev (n=6), toxicity (n=4), consent withdrawal (n=1), RT for unresectable disease (n=1), surgical complications (n=4), chemotherapy complications (n=4). No treatment related deaths. Conclusions: Induction chemotherapy with Bev-DC in NSCLC is feasible and is associated with an improved rate of downstaging compared with historical controls (33%). In patients treated with DC-Bev, grade 3/4 surgical complications were increased by 7%. [Table: see text]
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Affiliation(s)
- K. Price
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. G. Kris
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - V. Rusch
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - D. J. Finley
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - C. G. Azzoli
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - R. J. Downey
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. S. Bains
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - V. A. Miller
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - N. Rizk
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - N. A. Rizvi
- Memorial Sloan-Kettering Cancer Center, New York, NY
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Crawford MJ, Price K, Gordon F, Josson M, Taylor B, Bateman A, Fonagy P, Tyrer P, Moran P. Engagement and retention in specialist services for people with personality disorder. Acta Psychiatr Scand 2009; 119:304-11. [PMID: 19120048 DOI: 10.1111/j.1600-0447.2008.01306.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [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: 11/29/2022]
Abstract
OBJECTIVE To quantify levels of engagement and retention in specialist services for people with personality disorder (PD). METHOD Demographic and clinical data were collected on referrals to 10 specialist services for people with PD. Follow-up data on retention and drop-out from services were collected over the following 30 months. RESULTS Seven hundred and thirteen (60.1%) of 1186 people referred to services were taken by them, of whom 164 (23.0%) subsequently dropped out prior to the completion of an episode of care. Men, younger people and those with higher levels of personality disturbance were less likely to complete a package of care. CONCLUSION Specialist community-based services for adults with PD are able to engage most of those that are referred to them, but further efforts need to be made to find ways to engage younger people and men with PD.
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Affiliation(s)
- M J Crawford
- Department of Psychological Medicine, Faculty of Medicine, Imperial College London, UK.
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Waller H, Eiser C, Knowles J, Rogers N, Wharmby S, Heller S, Hall C, Greenhalgh S, Tinklin T, Metcalfe C, Millard E, Parkin V, Denial M, Price K. Pilot study of a novel educational programme for 11-16 year olds with type 1 diabetes mellitus: the KICk-OFF course. Arch Dis Child 2008; 93:927-31. [PMID: 18676435 DOI: 10.1136/adc.2007.132126] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS To pilot an educational programme (KICk-OFF) for children and adolescents with type 1 diabetes mellitus (DM). Evaluation included (i) independent assessment of curriculum quality, (ii) acceptability to families and (iii) possible impact on standardised outcome measures (HbA1c, body mass index (BMI), diary reports of hypoglycaemia, quality of life (QoL)). METHODS 48 children aged 11-16 years (mean age 13.60 (SD 1.36) years) were recruited from three UK centres. Six 5-day outpatient courses on carbohydrate counting and insulin dose adjustment were held. Semi-structured interviews were conducted with children and parents before and after the course. Glycaemic control (HbA1c), BMI and frequency of hypoglycaemia were assessed before the course and at 3 and 6 months after intervention. QoL was assessed before the course and at 2 weeks, 3 and 6 months. RESULTS Educational evaluation indicated the course format was appropriate and consistent. Parent and child interviews suggested that pre-course expectations were largely met. There were no changes in HbA1c, BMI or episodes of hypoglycaemia, but children and parents reported improved QoL (p<0.05). CONCLUSIONS KICk-OFF was well-received by children and parents and was associated with improved QoL. In this small pilot study, glycaemic control did not change but findings justify conducting a future randomised controlled trial involving a revised curriculum, a larger study population including a control group and longer follow-up.
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Affiliation(s)
- H Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
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Stein T, Cosimo E, Smith P, Simon R, Price K, Baird L, Bell AK, Sauter G, Crook T, Gusterson BA. Reelin expression in breast tumours is associated with increased survival and is controlled by promoter methylation. Breast Cancer Res 2008. [PMCID: PMC3300728 DOI: 10.1186/bcr1909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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