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Liquid biopsies and patient-reported outcome measures for integrative monitoring of patients with early-stage breast cancer: a study protocol for the longitudinal observational Prospective Breast Cancer Biobanking (PBCB) study. BMJ Open 2022; 12:e054404. [PMID: 35487718 PMCID: PMC9058781 DOI: 10.1136/bmjopen-2021-054404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Breast cancer is still the most common malignancy among women worldwide. The Prospective Breast Cancer Biobank (PBCB) collects blood and urine from patients with breast cancer every 6 or 12 months for 11 years from 2011 to 2030 at two university hospitals in Western Norway. The project aims to identify new biomarkers that enable detection of systemic recurrences at the molecular level. As blood represents the biological interface between the primary tumour, the microenvironment and distant metastases, liquid biopsies represent the ideal medium to monitor the patient's cancer biology for identification of patients at high risk of relapse and for early detection systemic relapse.Including patient-reported outcome measures (PROMs) allows for a vast number of possibilities to compare PROM data with biological information, enabling the study of fatigue and Quality of Life in patients with breast cancer. METHODS AND ANALYSIS A total of 1455 patients with early-stage breast cancer are enrolled in the PBCB study, which has a one-armed prospective observational design. Participants consent to contribute liquid biopsies (i.e., peripheral blood and urine samples) every 6 or 12 months for 11 years. The liquid biopsies are the basis for detection of circulating tumour cells, circulating tumour DNA (ctDNA), exosomal micro-RNA (miRNA), miRNA in Tumour Educated Platelet and metabolomic profiles. In addition, participants respond to 10 PROM questionnaires collected annually. Moreover, a control group comprising 200 women without cancer aged 25-70 years will provide the same data. ETHICS AND DISSEMINATION The general research biobank PBCB was approved by the Ministry of Health and Care Services in 2007, by the Regional Ethics Committee (REK) in 2010 (#2010/1957). The PROM (#2011/2161) and the biomarker study PerMoBreCan (#2015/2010) were approved by REK in 2011 and 2015 respectively. Results will be published in international peer reviewed journals. Deidentified data will be accessible on request. TRIAL REGISTRATION NUMBER NCT04488614.
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Simultaneous Quantification of Aromatase Inhibitors and Estrogens in Postmenopausal Breast Cancer Patients. J Clin Endocrinol Metab 2022; 107:1368-1374. [PMID: 34958096 PMCID: PMC9016448 DOI: 10.1210/clinem/dgab923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Indexed: 11/25/2022]
Abstract
CONTEXT Currently there are no assays that can simultaneously quantify serum levels of the third-generation aromatase inhibitors (AIs): letrozole, anastrozole, and exemestane, and the ultra-low levels of estrogens in postmenopausal breast cancer patients on AI treatment. Such measurements may be pivotal for the determination of optimal and individualized treatment regimens. We aimed at developing a liquid chromatography-tandem mass spectrometry (MS/MS) method for simultaneous assessment of letrozole, anastrozole, exemestane, and 17-hydroxyexemestane as well as subpicomolar levels of estradiol and estrone. METHODS Internal standards, calibrators, serum samples, and quality controls were in fully automated steps transferred to a deep-well plate for a 2-step liquid-liquid extraction. The extracts were reconstituted and analytes were separated chromatographically using 2 serially coupled columns, then subject to MS/MS in electrospray ionization mode. The method was thoroughly validated and is traceable to 2 accredited estrogen methods. RESULTS The measurement range for estrone and estradiol was 0.2 to 12 000 pmol/L and 0.8 to 13 000 pmol/L, and covered the expected therapeutic range for the AIs. All analytes had a precision of less than or equal to 13%, and accuracies within 100 ± 8%. As proof of concept, AI and estrogen levels were determined in serum samples from postmenopausal breast cancer patients under treatment. CONCLUSION We present here an assay suitable for the simultaneous measurement of serum levels of all third-generation AIs and ultra-low levels of estrogens, providing a powerful new tool to study drug efficacy and compliance. The method is highly valuable for postmenopausal patients whose pretreatment estradiol levels are below the threshold of detection for most routine assays, but still require suppression.
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Finding the e in healthcare. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2001; 18:21-4, 26. [PMID: 11727657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Getting more personal. JOURNAL OF AHIMA 2001; 72:32-6. [PMID: 15712479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Healthcare computing salutes a pioneer. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2001; 18:23-5. [PMID: 11791520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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The elusive CPO (chief privacy officer). HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2001; 18:26-9. [PMID: 11766436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Hire ups. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2001; 18:34-8, 40. [PMID: 11263103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Erectile dysfunction. BUSINESS AND HEALTH 2001; 18:11-3. [PMID: 11146849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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The journey of 1,000 miles: are providers really ready for HIPAA's privacy requirements? JOURNAL OF AHIMA 2001; 72:28-32. [PMID: 11216043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Major HIPAA compliance efforts underway, despite uncertainty. HEALTHPLAN 2001; 42:46-9. [PMID: 11218801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Perspectives. TennCare on the edge: can reformers fix it--before it's too late? MEDICINE & HEALTH (1997) 2000; 54:suppl 1-4. [PMID: 11141732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Austria automates hospital discharge process. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2000; 17:36-8. [PMID: 11188198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Creating a worldwide code of ethics. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2000; 17:33-6. [PMID: 11188197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Smart cards knock at healthcare's door. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2000; 17:77-8, 80, 82. [PMID: 11141749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Moving gradually toward a paperless world. JOURNAL OF AHIMA 2000; 71:26-31; quiz 33-4. [PMID: 11186619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Perspectives. High-tech, primary care-oriented, Finland tackles care quality, choice. MEDICINE & HEALTH (1997) 2000; 54:suppl 1-4. [PMID: 11009926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Risk adjustment: Medicare's latest move to tinker with your income. MEDICAL ECONOMICS 2000; 77:45-6, 51-2. [PMID: 11010475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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The many hats of a CIO. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2000; 17:69-72, 74, 76. [PMID: 11142898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Measuring progress in e-health. HEALTHPLAN 2000; 41:23, 26, 29-30. [PMID: 11066247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Blueprint for a 21st century hospital: a casebook in strategic and operational planning. STRATEGIES FOR HEALTHCARE EXCELLENCE : ORGANIZATIONAL PRODUCTIVITY, QUALITY AND EFFECTIVENESS 2000; 13:1-6. [PMID: 11009694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Online consumer health records: revolution or confusion? JOURNAL OF AHIMA 2000; 71:28-32. [PMID: 11009664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Getting it together: integrating disease management. HEALTHPLAN 2000; 41:42-6. [PMID: 11067360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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What we've learned about carving out health care. BUSINESS AND HEALTH 2000; 18:28-31. [PMID: 10788137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Payment challenges. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 1999; 16:38, 40, 42 passim. [PMID: 10977292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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You've got data. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 1999; 16:81-4, 86, 88 passim. [PMID: 11143131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Making the connection. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 1999; 16:48-52, 54, 56. [PMID: 11143129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Perspectives. Outcomes measurement: are collaboration, standardization still distant goals? MEDICINE & HEALTH (1997) 1999; 53:suppl 1-4. [PMID: 10558144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Perspectives. Justice ruling on Aetna-Pru raises bar for future deals. MEDICINE & HEALTH (1997) 1999; 53:suppl 1-4. [PMID: 10558142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Maybe doctors can't beat HMOs at their own game. MEDICAL ECONOMICS 1999; 76:122-4, 126. [PMID: 10558225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Dateline--Western Europe. Four countries with national health plans have rolled out technologies Americans still dream about. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 1999; 16:47-54, 56-62, 64-6. [PMID: 10622810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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American managed care organization creates a global product. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 1999; 16:35-6, 38, 40. [PMID: 10557373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Perspectives. Salaried doctors turn to unions to stem losses of income, autonomy. MEDICINE & HEALTH (1997) 1999; 53:suppl 1-4. [PMID: 10538106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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At Kelsey-Seybold Clinic, unity in diversity. MEDICAL NETWORK STRATEGY REPORT 1999; 8:1-6. [PMID: 10538220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Kelsey-Seybold Clinic (KSC), the Houston metro market's dominant physician organization, finds itself at a crossroads these days. As a tightly knit multispecialty group with strong physician leadership and significant opportunities for expansion in a rapidly-expanding healthcare market, KSC faces multiple challenges related to health plan consolidation and the ins and outs of capitation. Theirs is a situation epigrammatic of the challenges facing highly evolved medical organizations nationwide.
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Washington, we have a problem. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 1999; 16:49-50, 52, 54 passim. [PMID: 10539414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Specialty carveouts: how big a threat to primary care? MEDICAL ECONOMICS 1999; 76:143-4, 146, 151-2. [PMID: 10387828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Perspectives. Time to rethink? Providers ponder plan sponsorship anew. MEDICINE & HEALTH (1997) 1999; 53:suppl 1-4. [PMID: 10345550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Strategic issues for diverse focused factories. THE HEALTHCARE STRATEGIST 1999; 3:8-9. [PMID: 10346015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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Intensive care: the next level for IT. HEALTH MANAGEMENT TECHNOLOGY 1998; 19:18-21, 23, 27. [PMID: 10187479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Intensive patient care areas like the emergency room, surgical suites and intensive care units have their own challenges, radically different from other inpatient units. Automating these areas requires a different level of IT product, design and development.
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Provider profiling. HEALTHPLAN 1998; 39:32-7. [PMID: 10351345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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IT and point-of-care decision support. HEALTH MANAGEMENT TECHNOLOGY 1998; 19:10-2, 14, 69-70. [PMID: 10185156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Practice made perfect. HEALTH MANAGEMENT TECHNOLOGY 1998; 19:12-6, 18-9, 62. [PMID: 10185146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The perfect practice management system? Users say it is one that integrates financial operational and clinical information within a practice, and at the same time connects the practice to other parts of the organization.
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Americans abroad. Why United HealthCare went to Germany--and what it learned there. HEALTHPLAN 1998; 39:67-72. [PMID: 10351338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Perspectives. Allegheny's collapse triggers a debate over pluses of health care conglomerates. MEDICINE & HEALTH (1997) 1998; 52:suppl 1-4. [PMID: 10182922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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IT for capitation: getting the whole picture. HEALTH MANAGEMENT TECHNOLOGY 1998; 19:22-6, 45. [PMID: 10182547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Perspectives. Viagra or bust: is pharmacy cost crisis unraveling HMO utilization strategy? MEDICINE & HEALTH (1997) 1998; 52:suppl 1-4. [PMID: 10181087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Data warehousing: not quite on target. HEALTH MANAGEMENT TECHNOLOGY 1998; 19:20-4, 26-7. [PMID: 10181219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Managing diseases by managing IT. HEALTH MANAGEMENT TECHNOLOGY 1998; 19:18-20, 22, 24-5. [PMID: 10181210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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The gap: HIPAA and secure IT. HEALTH MANAGEMENT TECHNOLOGY 1998; 19:24-6, 28, 30. [PMID: 10179288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The Health Insurance Portability and Accountability Act (HIPAA) had many objectives and IT implications. But the greatest area of concern for most providers is security and privacy of electronic patient information.
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Taking pages from other notebooks. Managed care executives turn to other industries for ideas on how to improve member service and satisfaction. HEALTHPLAN 1998; 39:78-82, 85-6. [PMID: 10181755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Perspectives. Sub-acute payment changes hint at brave new world of outcomes. MEDICINE & HEALTH (1997) 1998; 52:suppl 1-4. [PMID: 10178029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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