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Aprikian S, Kasvis P, Vigano M, Hachem Y, Canac-Marquis M, Vigano A. Medical cannabis is effective for cancer-related pain: Quebec Cannabis Registry results. BMJ Support Palliat Care 2024; 13:e1285-e1291. [PMID: 37130724 DOI: 10.1136/spcare-2022-004003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/23/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES To evaluate the safety and effectiveness of medical cannabis (MC) in reducing pain and concurrent medications in patients with cancer. METHODS This study analysed data collected from patients with cancer who were part of the Quebec Cannabis Registry. Brief Pain Inventory (BPI), revised Edmonton Symptom Assessment System (ESAS-r) questionnaires, total medication burden (TMB) and morphine equivalent daily dose (MEDD) recorded at 3-month, 6-month, 9-month and 12-month follow-ups were compared with baseline values. Adverse events were also documented at each follow-up visit. RESULTS This study included 358 patients with cancer. Thirteen out of 15 adverse events reported in 11 patients were not serious; 2 serious events (pneumonia and cardiovascular event) were considered unlikely related to MC. Statistically significant decreases were observed at 3-month, 6-month and 9-month follow-up for BPI worst pain (5.5±0.7 baseline, 3.6±0.7, 3.6±0.7, 3.6±0.8; p<0.01), average pain (4.1±0.6 baseline, 2.4±0.6, 2.3±0.6, 2.7±0.7; p<0.01), overall pain severity (3.7±0.5 baseline, 2.3±0.6, 2.3±0.6, 2.4±0.6; p<0.01) and pain interference (4.3±0.6 baseline, 2.4±0.6, 2.2±0.6, 2.4±0.7, p<0.01). ESAS-r pain scores decreased significantly at 3-month, 6-month and 9-month follow-up (3.7±0.6 baseline, 2.5±0.6, 2.2±0.6, 2.0±0.7, p<0.01). THC:CBD balanced strains were associated with better pain relief as compared with THC-dominant and CBD-dominant strains. Decreases in TMB were observed at all follow-ups. Decreases in MEDD were observed at the first three follow-ups. CONCLUSIONS Real-world data from this large, prospective, multicentre registry indicate that MC is a safe and effective complementary treatment for pain relief in patients with cancer. Our findings should be confirmed through randomised placebo-controlled trials.
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Affiliation(s)
- Saro Aprikian
- School of Medicine, Royal College of Surgeons, Dublin, Ireland
- Medical Cannabis Program in Oncology, Cedars Cancer Centre, McGill University Health Centre, Montreal, Quebec, Canada
| | - Popi Kasvis
- McGill Nutrition and Performance Laboratory, Montreal, Quebec, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - MariaLuisa Vigano
- McGill Nutrition and Performance Laboratory, Montreal, Quebec, Canada
- Department of Science, McGill University, Montreal, Quebec, Canada
| | - Yasmina Hachem
- Medical Cannabis Program in Oncology, Cedars Cancer Centre, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Internal Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Antonio Vigano
- Medical Cannabis Program in Oncology, Cedars Cancer Centre, McGill University Health Centre, Montreal, Quebec, Canada
- McGill Nutrition and Performance Laboratory, Montreal, Quebec, Canada
- Division of Supportive and Palliative Care, McGill University Health Centre, Montreal, Quebec, Canada
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2
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Selber-Hnatiw S, Sultana T, Tse W, Abdollahi N, Abdullah S, Al Rahbani J, Alazar D, Alrumhein NJ, Aprikian S, Arshad R, Azuelos JD, Bernadotte D, Beswick N, Chazbey H, Church K, Ciubotaru E, D'Amato L, Del Corpo T, Deng J, Di Giulio BL, Diveeva D, Elahie E, Frank JGM, Furze E, Garner R, Gibbs V, Goldberg-Hall R, Goldman CJ, Goltsios FF, Gorjipour K, Grant T, Greco B, Guliyev N, Habrich A, Hyland H, Ibrahim N, Iozzo T, Jawaheer-Fenaoui A, Jaworski JJ, Jhajj MK, Jones J, Joyette R, Kaudeer S, Kelley S, Kiani S, Koayes M, Kpata AJAAL, Maingot S, Martin S, Mathers K, McCullogh S, McNamara K, Mendonca J, Mohammad K, Momtaz SA, Navaratnarajah T, Nguyen-Duong K, Omran M, Ortiz A, Patel A, Paul-Cole K, Plaisir PA, Porras Marroquin JA, Prevost A, Quach A, Rafal AJ, Ramsarun R, Rhnima S, Rili L, Safir N, Samson E, Sandiford RR, Secondi S, Shahid S, Shahroozi M, Sidibé F, Smith M, Sreng Flores AM, Suarez Ybarra A, Sénéchal R, Taifour T, Tang L, Trapid A, Tremblay Potvin M, Wainberg J, Wang DN, Weissenberg M, White A, Wilkinson G, Williams B, Wilson JR, Zoppi J, Zouboulakis K, Gamberi C. Metabolic networks of the human gut microbiota. Microbiology (Reading) 2020; 166:96-119. [PMID: 31799915 DOI: 10.1099/mic.0.000853] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The human gut microbiota controls factors that relate to human metabolism with a reach far greater than originally expected. Microbial communities and human (or animal) hosts entertain reciprocal exchanges between various inputs that are largely controlled by the host via its genetic make-up, nutrition and lifestyle. The composition of these microbial communities is fundamental to supply metabolic capabilities beyond those encoded in the host genome, and contributes to hormone and cellular signalling that support the dynamic adaptation to changes in food availability, environment and organismal development. Poor functional exchange between the microbial communities and their human host is associated with dysbiosis, metabolic dysfunction and disease. This review examines the biology of the dynamic relationship between the reciprocal metabolic state of the microbiota-host entity in balance with its environment (i.e. in healthy states), the enzymatic and metabolic changes associated with its imbalance in three well-studied diseases states such as obesity, diabetes and atherosclerosis, and the effects of bariatric surgery and exercise.
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Affiliation(s)
- Susannah Selber-Hnatiw
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Tarin Sultana
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - W Tse
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Niki Abdollahi
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Sheyar Abdullah
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Jalal Al Rahbani
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Diala Alazar
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Nekoula Jean Alrumhein
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Saro Aprikian
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Rimsha Arshad
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Jean-Daniel Azuelos
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Daphney Bernadotte
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Natalie Beswick
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Hana Chazbey
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Kelsey Church
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Emaly Ciubotaru
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Lora D'Amato
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Tavia Del Corpo
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Jasmine Deng
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Briana Laura Di Giulio
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Diana Diveeva
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Elias Elahie
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - James Gordon Marcel Frank
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Emma Furze
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Rebecca Garner
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Vanessa Gibbs
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Rachel Goldberg-Hall
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Chaim Jacob Goldman
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Fani-Fay Goltsios
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Kevin Gorjipour
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Taylor Grant
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Brittany Greco
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Nadir Guliyev
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Andrew Habrich
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Hillary Hyland
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Nabila Ibrahim
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Tania Iozzo
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Anastasia Jawaheer-Fenaoui
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Julia Jane Jaworski
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Maneet Kaur Jhajj
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Jermaine Jones
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Rodney Joyette
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Samad Kaudeer
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Shawn Kelley
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Shayesteh Kiani
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Marylin Koayes
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | | | - Shannon Maingot
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Sara Martin
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Kelly Mathers
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Sean McCullogh
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Kelly McNamara
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - James Mendonca
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Karamat Mohammad
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Sharara Arezo Momtaz
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Thiban Navaratnarajah
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Kathy Nguyen-Duong
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Mustafa Omran
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Angela Ortiz
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Anjali Patel
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Kahlila Paul-Cole
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Paul-Arthur Plaisir
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | | | - Ashlee Prevost
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Angela Quach
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Aries John Rafal
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Rewaparsad Ramsarun
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Sami Rhnima
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Lydia Rili
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Naomi Safir
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Eugenie Samson
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Rebecca Rose Sandiford
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Stefano Secondi
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Stephanie Shahid
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Mojdeh Shahroozi
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Fily Sidibé
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Megan Smith
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Alina Maria Sreng Flores
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Anabel Suarez Ybarra
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Rebecca Sénéchal
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Tarek Taifour
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Lawrence Tang
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Adam Trapid
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Maxim Tremblay Potvin
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Justin Wainberg
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Dani Ni Wang
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Mischa Weissenberg
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Allison White
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Gabrielle Wilkinson
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Brittany Williams
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Joshua Roth Wilson
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Johanna Zoppi
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Katerina Zouboulakis
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
| | - Chiara Gamberi
- Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada
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Chennakrishnaiah S, Tsering T, Gregory C, Tawil N, Spinelli C, Montermini L, Karatzas N, Aprikian S, Choi D, Klewes L, Mai S, Rak J. Extracellular vesicles from genetically unstable, oncogene-driven cancer cells trigger micronuclei formation in endothelial cells. Sci Rep 2020; 10:8532. [PMID: 32444772 PMCID: PMC7244541 DOI: 10.1038/s41598-020-65640-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 02/19/2020] [Accepted: 05/07/2020] [Indexed: 01/08/2023] Open
Abstract
Oncogenic transformation impacts cancer cell interactions with their stroma, including through formation of abnormal blood vessels. This influence is often attributed to angiogenic growth factors, either soluble, or associated with tumor cell-derived extracellular vesicles (EVs). Here we examine some of the cancer-specific components of EV-mediated tumor-vascular interactions, including the impact of genetic driver mutations and genetic instability. Cancer cells expressing mutant HRAS oncogene exhibit aberrations of chromatin architecture, aneuploidy, cytoplasmic chromatin deposition and formation of micronuclei with a non-random chromosome content. EVs released from such HRAS-driven cells carry genomic DNA, including oncogenic sequences, and transfer this material to endothelial cells while inducing abnormal formation of micronuclei, along with cell migration and proliferation. Micronuclei were also triggered following treatment with EVs derived from glioma cells (and stem cells) expressing EGFRvIII oncogene, and in both endothelial cells and astrocytes. EVs from HRAS and EGFRvIII-driven cancer cells carry 19 common proteins while EVs from indolent control cells exhibit more divergent proteomes. Immortalized endothelial cell lines with disrupted TP53 pathway were refractory to EV-mediated micronuclei induction. We suggest that oncogenic transformation and intercellular trafficking of cancer-derived EVs may contribute to pathological vascular responses in cancer due to intercellular transmission of genomic instability.
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Affiliation(s)
- Shilpa Chennakrishnaiah
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Thupten Tsering
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Caroline Gregory
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Nadim Tawil
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Cristiana Spinelli
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Laura Montermini
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Nicolaos Karatzas
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Saro Aprikian
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Dongsic Choi
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Ludger Klewes
- Department of Cell Biology, Research Institute of Oncology and Hematology, Cancer Care Manitoba, University of Manitoba, Winnipeg, Canada
| | - Sabine Mai
- Department of Cell Biology, Research Institute of Oncology and Hematology, Cancer Care Manitoba, University of Manitoba, Winnipeg, Canada
| | - Janusz Rak
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, H4A 3J1, Canada.
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Vigano A, Aprikian S, Kasvis P, Bacis V, Al Harrasi A, Aubin NM, Vigano M, Borod M. Safety and effectiveness of medical cannabis as a complementary option for supportive cancer care: Results from the Cannabis Pilot Project. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.12106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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
12106 Background: Access to medical cannabis (MC) is a common request by patients and caregivers in supportive cancer care (SCC). However, healthcare professionals require more evidence on MC safety and effectiveness. Methods: The Cannabis Pilot Project (CPP) was implemented at the Cedars Cancer Centre of the McGill University Health Centre to evaluate MC as a complementary option for symptom control in SCC. Referral to the CPP was reserved for patients who were receiving SCC but had not obtained adequate symptom relief. An interdisciplinary team (physician, nurse and research coordinator) was established to systematically assess patients, prescribe and monitor MC treatments and record data on their safety and effectiveness. Patients were enrolled in the CPP between February 2018 and December 2019 and reassessed at intervals of one to six months. Results: Ninety-six cancer patients (mean age 60.0y (±13.9); 41 (42.7%) males) had at least one follow-up (FUP) and were included in the study. The main cancer types were breast (19.8%), lung (9.4%) and colorectal (9.4%). Adverse events (top three: drowsiness, low energy and nausea) were reported in 28% of patients, with 9% having to stop MC. Mean Brief Pain Inventory scores significantly improved between baseline, FUP-2 and FUP-3 for worst pain (5.4± SEM 0.3 vs 4.3±0.3 and 3.7±0.4) and average pain severity (4.2±0.2 vs 3.2±0.3 and 3.2±0.4). Anorexia improved (3.4±0.3 vs 2.2±0.4 and 1.7±0.4), as measured via the revised Edmonton Symptom Assessment System (ESAS-r). ESAS-r wellbeing improved significantly between baseline and FUP-1 (4.4±0.2 vs 3.7±0.2). Between baseline and each FUP, approximately a third of patients dropped their use of concurrent medications (including analgesics, antidepressants and anxiolytics), as measured by the Medication Quantification Scale. Conclusions: The CPP data support the safety and effectiveness of MC as a complementary option for improving pain control, appetite and quality of life in SCC.
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Affiliation(s)
| | - Saro Aprikian
- McGill University Health Centre, Montréal, QC, Canada
| | - Popi Kasvis
- McGill University Health Centre, Montréal, QC, Canada
| | | | | | | | | | - Manuel Borod
- McGill University Health Centre, Montréal, QC, Canada
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5
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Chennakrishnaiah S, Tsering T, Aprikian S, Rak J. Leukobiopsy - A Possible New Liquid Biopsy Platform for Detecting Oncogenic Mutations. Front Pharmacol 2020; 10:1608. [PMID: 32038264 PMCID: PMC6993065 DOI: 10.3389/fphar.2019.01608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022] Open
Abstract
Detection of unique oncogenic alterations encoded by the sequence or biochemical modification in cancer-associated transforming macromolecules has revolutionized diagnosis, classification and management of human cancers. While these signatures were traditionally regarded as largely intracellular and confined to the tumor mass, oncogenic mutations and actionable cancer-related molecular alterations can also be accessed remotely through their recovery from biofluids of either rare circulating tumor cells (CTCs), or of more abundant non-cellular carriers, such as extracellular vesicles (EVs), protein complexes, or cell-free tumor DNA (ctDNA). Tumor-related macromolecules may also accumulate in circulating platelets. Collectively, these approaches are known as liquid biopsy and hold promise as non-invasive, real-time opportunities to access to the evolving molecular landscape of human malignancies. More recently, a possibility of recovering cancer-specific DNA sequences from circulating leukocytes has also been postulated using experimental models. While it is often assumed that these and other liquid biopsy approaches rely on material passively shed from the tumor mass or its debris, recent evidence suggests that several regulated processes contribute to the abundance, nature, half-life, and turnover of different circulating cancer-related molecular signals. Moreover, many of these signals possess biological activity and may elicit local and systemic regulatory responses. Thus, a better understanding of the biology of liquid biopsy platforms and analytes may enable achieving improved performance of this promising and emerging diagnostic strategy in cancer.
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Affiliation(s)
| | - Thupten Tsering
- Montreal Children's Hospital, RI MUHC, McGill University, Montreal, QC, Canada
| | - Saro Aprikian
- Montreal Children's Hospital, RI MUHC, McGill University, Montreal, QC, Canada
| | - Janusz Rak
- Montreal Children's Hospital, RI MUHC, McGill University, Montreal, QC, Canada
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Aprikian S, Luz M, Brimo F, Scarlata E, Hamel L, Cury FL, Tanguay S, Aprikian AG, Kassouf W, Chevalier S. Improving ultrasound-based prostate volume estimation. BMC Urol 2019; 19:68. [PMID: 31340802 PMCID: PMC6657110 DOI: 10.1186/s12894-019-0492-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 06/30/2019] [Indexed: 12/02/2022] Open
Abstract
Background To define a new coefficient to be used in the formula (Volume = L x H x W x Coefficient) that better estimates prostate volume using dimensions of fresh prostates from patients who had transrectal ultrasound (TRUS) imaging prior to prostatectomy. Methods The prostate was obtained from 153 patients, weighed and measured to obtain length (L), height (H), and width (W). The density was determined by water displacement to calculate volume. TRUS data were retrieved from patient charts. Linear regression analyses were performed to compare various prostate volume formulas, including the commonly used ellipsoid formula and newly introduced bullet-shaped formula. Results By relating measured prostate volumes from fresh prostates to TRUS-estimated prostate volumes, 0.66 was the best fitting coefficient in the (L x H x W x Coefficient) equation. This newfound coefficient combined with outlier removal yielded a linear equation with an R2 of 0.64, compared to 0.55 and 0.60, for the ellipsoid and bullet, respectively. By comparing each of the measured vs. estimated dimensions, we observed that the mean prostate height and length were overestimated by 11.1 and 10.8% using ultrasound (p < 0.05), respectively, while the mean width was similar (p > 0.05). Overall, the ellipsoid formula underestimates prostate volumes by 18%, compared to an overestimation of 4.6 and 5.7% for the bullet formula and the formula using our coefficient, respectively. Conclusions This study defines, for the first time, a coefficient based on freshly resected prostates as a reference to estimate volumes by imaging. Our findings support a bullet rather than an ellipsoid prostate shape. Moreover, substituting the coefficient commonly used in the ellipsoid formula by our calculated coefficient in the equation estimating prostate volume by TRUS, provides a more accurate value of the true prostate volume.
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Affiliation(s)
- Saro Aprikian
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada
| | - Murilo Luz
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada.,Department of Surgery (Urology Division), MUHC and McGill University, Montreal, Canada
| | - Fadi Brimo
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada.,Department of Pathology, MUHC and McGill University, Montreal, Canada
| | - Eleonora Scarlata
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada
| | - Lucie Hamel
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada
| | - Fabio L Cury
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada.,Department of Radiation Oncology, MUHC and McGill University, Montreal, Canada
| | - Simon Tanguay
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada.,Department of Surgery (Urology Division), MUHC and McGill University, Montreal, Canada.,Department of Oncology, MUHC and McGill University, Montreal, Canada
| | - Armen G Aprikian
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada.,Department of Surgery (Urology Division), MUHC and McGill University, Montreal, Canada.,Department of Oncology, MUHC and McGill University, Montreal, Canada
| | - Wassim Kassouf
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada.,Department of Surgery (Urology Division), MUHC and McGill University, Montreal, Canada.,Department of Oncology, MUHC and McGill University, Montreal, Canada
| | - Simone Chevalier
- Urologic Oncology Research Group, Cancer Research Program, Research Institute (RI) of McGill University Health Center (MUHC), Glen Campus, E M2.2210, 1001 Blvd Décarie, Montréal, Qc, H4A 3J1, Canada. .,Department of Surgery (Urology Division), MUHC and McGill University, Montreal, Canada. .,Department of Oncology, MUHC and McGill University, Montreal, Canada. .,Department of Medicine, MUHC and McGill University, Montreal, Canada.
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Wissing MD, Chevalier S, O'Flaherty A, McKercher G, Aprikian S, Saad F, Carmel M, Lacombe L, Hamel M, Aprikian A. Psychosocial adjustment to a prostate cancer diagnosis in a cohort of radical prostatectomy patients in Quebec, Canada. Psychooncology 2019; 28:839-846. [PMID: 30762265 DOI: 10.1002/pon.5031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The psychosocial impact of a prostate cancer diagnosis significantly affects a patient's quality of life. We studied patient communication at the time of diagnosis and its impact on psychosocial adjustment of patients. METHODS This is a cross-sectional data analysis from self-administered questionnaires in the PROCURE biobank study, consisting of a cohort of patients with localized prostate cancer undergoing radical prostatectomy in Québec (Canada), 2006 to 2013. Odds ratios (OR) and their respective 95% confidence intervals (95% CI) were calculated using binary or ordered logistic regression models. RESULTS Data from 1841 patients were analyzed. The median age of patients was 62 years (range 41-80 years), the majority was French-Canadian (68.3%) and married (79.6%). Most patients (90.1%) considered conversations with their treating physician a useful information source. Patients were dissatisfied on the communication when receiving their diagnosis by telephone (OR = 0.19, 95% CI, 0.11-0.33). Younger patients were also more dissatisfied. Most patients preferred to receive information on prostate cancer (89.5%) and radical prostatectomy (88.0%) at the time of diagnosis, while only 58.8% and 52.4% of patients received this information at this stage. Patients who were dissatisfied with the communication of the diagnosis had more negative responses, such as increased worries and fear (P < 0.05). The five most useful coping mechanisms were physical activity (62.3%), breathing exercises (44.5%), music (32.8%), faith (30.3%), and muscle relaxation (30.1%), but varied by demographics. CONCLUSIONS This study highlights the importance of physicians communicating a prostate cancer diagnosis well to their patients. Patients may benefit from individually tailored interventions to facilitate their overall coping.
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Affiliation(s)
- Michel D Wissing
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.,Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Simone Chevalier
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.,Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Ana O'Flaherty
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Ginette McKercher
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Fred Saad
- Department of Surgery, Université de Montréal, Montreal, Quebec, Canada
| | - Michel Carmel
- Department of Surgery, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Louis Lacombe
- Department of Surgery, Laval University, Quebec City, Quebec, Canada
| | - Marc Hamel
- Psychosocial Oncology Program, McGill University Health Centre, Montreal, Quebec, Canada
| | - Armen Aprikian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.,Department of Oncology, McGill University, Montreal, Quebec, Canada
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Wissing M, Brimo F, Chevalier S, Scarlata E, McKercher G, O'Flaherty A, Aprikian S, Thibodeau V, Saad F, Carmel M, Lacombe L, Têtu B, Ekindi-Ndongo N, Latour M, Trudel D, Aprikian A. Optimization of the 2014 Gleason grade grouping in a Canadian cohort of patients with localized prostate cancer. BJU Int 2018; 123:624-631. [PMID: 30113732 DOI: 10.1111/bju.14512] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To evaluate the five-tier Gleason grade group (GG) scoring of prostate cancers adopted by the International Society of Urology Pathology (ISUP) in 2014, and to propose modifications to optimize its performance. PATIENTS AND METHODS Data were obtained from PROCURE, a prospective cohort of patients with localized prostate cancer undergoing radical prostatectomy in Québec, 2006-2013. Surgical specimens were evaluated by genitourinary pathologists using 2014 ISUP criteria. Treatment failure was defined as biochemical recurrence and/or initiation of secondary, non-adjuvant therapy. Analyses were conducted using Kaplan-Meier methods, log-rank tests, Cox proportional hazards models and Harrell's concordance indices. RESULTS A total of 1 917 patients were included, with a median follow-up of 69 months. The 5-year treatment failure rates were 9.6%, 23.5%, 43.1%, 52.6% and 84.3% in GG1-5, respectively (P < 0.001 when comparing GG2 with GG3). Treatment failure rates for patients in GG2 and GG3 with tertiary Gleason 5 pattern were higher than patients in the same group without a tertiary pattern (P < 0.001), but were similar to rates for patients in GGs 3 or 4 without a tertiary pattern (P > 0.3). Primary Gleason pattern (4/5) predicted treatment failure in GG5 (5-year failure rates 82.3% vs 97.1%, respectively; P = 0.001). The five-tier GG system had greater accuracy as a prognostic indicator compared with the four-tier system (Harrell's concordance index 0.716 vs 0.676). When upgrading patients in GG2/3 with tertiary Gleason 5 pattern to patients in GG3/4, and separating patients in GG5 by primary Gleason pattern, the Harrell's concordance index increased to 0.730. CONCLUSION The five-tier GG system increased accuracy for predicting treatment failure compared with the previous grading systems, but can be further improved.
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Affiliation(s)
- Michel Wissing
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada.,Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada
| | - Fadi Brimo
- Department of Pathology, McGill University Health Centre, Montreal, QC, Canada
| | - Simone Chevalier
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Eleonora Scarlata
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Ginette McKercher
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada.,PROCURE, Mount Royal, QC, Canada
| | - Ana O'Flaherty
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | | | | | - Fred Saad
- Department of Surgery, Université de Montréal, Montreal, QC, Canada
| | - Michel Carmel
- Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Louis Lacombe
- Department of Surgery, Laval University, Quebec City, QC, Canada
| | - Bernard Têtu
- Department of Pathology, Laval University, Quebec City, QC, Canada
| | | | - Mathieu Latour
- Department of Pathology and Cell Biology, Université de Montreal, Montreal, QC, Canada
| | - Dominique Trudel
- Department of Pathology and Cell Biology, Université de Montreal, Montreal, QC, Canada
| | - Armen Aprikian
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
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Wissing M, Chevalier S, McKercher G, Laprise C, Aprikian S, O'Flaherty A, Scarlata E, Saad F, Carmel M, Lacombe L, Brimo F, Latour M, Ekindi-Ndongo N, Têtu B, Aprikian A. The relationship between body-mass index, physical activity, and pathologic and clinical outcomes after radical prostatectomy for prostate cancer. World J Urol 2018; 37:789-798. [PMID: 30136199 DOI: 10.1007/s00345-018-2457-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/16/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE We evaluated whether an increased body-mass index (BMI) and decreased physical activity increase the risk of locally advanced or high-risk prostate cancer (PCa) at radical prostatectomy (RP), and treatment failure after surgery. METHODS Data were collected from the PROCURE Biobank, a prospective cohort of patients with localized PCa undergoing RP in four academic centers in Québec between 2006 and 2013. Treatment failure was defined as biochemical recurrence and/or initiation of secondary, non-adjuvant therapy, and analyzed using the Kaplan-Meier method, log-rank tests, and Cox proportional-hazards models. Uni- and multivariate (ordered) logistic regression was used for time-independent variables. RESULTS 1813 patients were included. Median follow-up time was 69 months. Patients who reported a lower BMI were generally older, of Asian descent, and physically more active (p < 0.05). Younger, black, and overweight/obese patients reported less physical activity (p < 0.05). In multivariate analyses, a higher BMI increased the risk for locally advanced, high-risk PCa (defined as a pT3, N1 and/or Gleason 8-10 tumor; odds ratio 1.33, p < 0.001), but increased physical activity did not predict high-risk disease (odds ratio 0.84, p = 0.39). Patients with a higher BMI also had a larger prostate at surgery (odds ratio 1.13, p = 0.03). BMI and physical activity were not associated with positive surgical margins or time to treatment failure (p > 0.05). CONCLUSIONS BMI was an independent predictor for locally advanced, high-risk disease in this cohort of PCa patients undergoing RP, but was unrelated to treatment failure. Physical activity was not related to locally advanced, high-risk PCa or treatment failure.
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Affiliation(s)
- Michel Wissing
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada.
- Department of Oncology, McGill University, 5100 Boulevard de Maisonneuve West, Room 720F, Montreal, QC, H4A 3T2, Canada.
| | - Simone Chevalier
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
- Cancer Research Program, McGill University Health Centre - Research Institute, Montreal, QC, Canada
| | - Ginette McKercher
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
- Cancer Research Program, McGill University Health Centre - Research Institute, Montreal, QC, Canada
- PROCURE, Mont-Royal, Montreal, QC, Canada
| | - Claudie Laprise
- Department of Oncology, McGill University, 5100 Boulevard de Maisonneuve West, Room 720F, Montreal, QC, H4A 3T2, Canada
| | - Saro Aprikian
- Cancer Research Program, McGill University Health Centre - Research Institute, Montreal, QC, Canada
- PROCURE, Mont-Royal, Montreal, QC, Canada
| | - Ana O'Flaherty
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Eleonora Scarlata
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
- Cancer Research Program, McGill University Health Centre - Research Institute, Montreal, QC, Canada
| | - Fred Saad
- Department of Surgery, Université de Montréal, Montreal, QC, Canada
| | - Michel Carmel
- Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Louis Lacombe
- Department of Surgery, Laval University, Laval, QC, Canada
| | - Fadi Brimo
- Department of Pathology, McGill University, Montreal, QC, Canada
| | - Mathieu Latour
- Department of Pathology and Cell Biology, Université de Montreal, Montreal, QC, Canada
| | | | - Bernard Têtu
- Department of Pathology, Laval University, Laval, QC, Canada
| | - Armen Aprikian
- Department of Urology, McGill University Health Centre, Montreal, QC, Canada
- Department of Oncology, McGill University, 5100 Boulevard de Maisonneuve West, Room 720F, Montreal, QC, H4A 3T2, Canada
- Cancer Research Program, McGill University Health Centre - Research Institute, Montreal, QC, Canada
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