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Challapalli A, Barwick TD, Dubash SR, Inglese M, Grech-Sollars M, Kozlowski K, Tam H, Patel NH, Winkler M, Flohr P, Saleem A, Bahl A, Falconer A, De Bono JS, Aboagye EO, Mangar S. Bench to Bedside Development of [ 18F]Fluoromethyl-(1,2- 2H 4)choline ([ 18F]D4-FCH). Molecules 2023; 28:8018. [PMID: 38138508 PMCID: PMC10745874 DOI: 10.3390/molecules28248018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Malignant transformation is characterised by aberrant phospholipid metabolism of cancers, associated with the upregulation of choline kinase alpha (CHKα). Due to the metabolic instability of choline radiotracers and the increasing use of late-imaging protocols, we developed a more stable choline radiotracer, [18F]fluoromethyl-[1,2-2H4]choline ([18F]D4-FCH). [18F]D4-FCH has improved protection against choline oxidase, the key choline catabolic enzyme, via a 1H/2D isotope effect, together with fluorine substitution. Due to the promising mechanistic and safety profiles of [18F]D4-FCH in vitro and preclinically, the radiotracer has transitioned to clinical development. [18F]D4-FCH is a safe positron emission tomography (PET) tracer, with a favourable radiation dosimetry profile for clinical imaging. [18F]D4-FCH PET/CT in lung and prostate cancers has shown highly heterogeneous intratumoral distribution and large lesion variability. Treatment with abiraterone or enzalutamide in metastatic castrate-resistant prostate cancer patients elicited mixed responses on PET at 12-16 weeks despite predominantly stable radiological appearances. The sum of the weighted tumour-to-background ratios (TBRs-wsum) was associated with the duration of survival.
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Affiliation(s)
- Amarnath Challapalli
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
- Department of Clinical Oncology, Bristol Haematology and Oncology Center, Horfield Road, Bristol BS2 8ED, UK;
| | - Tara D. Barwick
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
- Department of Radiology & Nuclear Medicine, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; (H.T.); (N.H.P.)
| | - Suraiya R. Dubash
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Marianna Inglese
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Matthew Grech-Sollars
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Kasia Kozlowski
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Henry Tam
- Department of Radiology & Nuclear Medicine, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; (H.T.); (N.H.P.)
| | - Neva H. Patel
- Department of Radiology & Nuclear Medicine, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; (H.T.); (N.H.P.)
| | - Mathias Winkler
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK; (M.W.); (A.F.)
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research and Royal Marsden Hospital, Cotswold Road, Sutton SM2 5NG, UK; (P.F.); (J.S.D.B.)
| | - Azeem Saleem
- Invicro, A Konica Minolta Company, Burlington Danes Building, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK;
- Hull York Medical School, University of Hull, Cottingham Road, Hull HU6 7RX, UK
| | - Amit Bahl
- Department of Clinical Oncology, Bristol Haematology and Oncology Center, Horfield Road, Bristol BS2 8ED, UK;
| | - Alison Falconer
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK; (M.W.); (A.F.)
| | - Johann S. De Bono
- Division of Clinical Studies, The Institute of Cancer Research and Royal Marsden Hospital, Cotswold Road, Sutton SM2 5NG, UK; (P.F.); (J.S.D.B.)
| | - Eric O. Aboagye
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0NN, UK; (A.C.); (T.D.B.); (S.R.D.); (M.I.); (M.G.-S.); (K.K.)
| | - Stephen Mangar
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK; (M.W.); (A.F.)
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Dubash SR, Keat N, Kozlowski K, Barnes C, Allott L, Brickute D, Hill S, Huiban M, Barwick TD, Kenny L, Aboagye EO. Clinical translation of 18F-fluoropivalate - a PET tracer for imaging short-chain fatty acid metabolism: safety, biodistribution, and dosimetry in fed and fasted healthy volunteers. Eur J Nucl Med Mol Imaging 2020; 47:2549-2561. [PMID: 32123971 PMCID: PMC7515955 DOI: 10.1007/s00259-020-04724-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/12/2019] [Accepted: 02/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Fatty acids derived de novo or taken up from the extracellular space are an essential source of nutrient for cell growth and proliferation. Radiopharmaceuticals including 11C-acetate, and 18F-FAC (2-18F-fluoroacetate), have previously been used to study short-chain fatty acid (SCFA) metabolism. We developed 18F-fluoropivalate (18F-FPIA; 3-18F-fluoro-2,2-dimethylpropionic acid) bearing a gem-dimethyl substituent to assert metabolic stability for studying SCFA metabolism. We report the safety, biodistribution, and internal radiation dosimetry profile of 18F-FPIA in 24 healthy volunteers and the effect of dietary conditions. MATERIALS AND METHODS Healthy volunteer male and female subjects were enrolled (n = 24), and grouped into 12 fed and 12 fasted. Non-esterified fatty acids (NEFA) and carnitine blood measurements were assessed. Subjects received 159.48 MBq (range, 47.31-164.66 MBq) of 18F-FPIA. Radiochemical purity was > 99%. Safety data were obtained during and 24 h after radiotracer administration. Subjects underwent detailed multiple whole-body PET/CT scanning with sampling of venous bloods for radioactivity and radioactive metabolite quantification. Regions of interest were defined to derive individual and mean organ residence times; effective dose was calculated using OLINDA 1.1. RESULTS All subjects tolerated 18F-FPIA with no adverse events. Over 90% of radiotracer was present in plasma at 60 min post-injection. The organs receiving highest absorbed dose (in mGy/MBq) were the liver (0.070 ± 0.023), kidneys (0.043 ± 0.013), gallbladder wall (0.026 ± 0.003), and urinary bladder (0.021 ± 0.004); otherwise there was low tissue uptake. The calculated effective dose using mean organ residence times over all 24 subjects was 0.0154 mSv/MBq (SD ± 0.0010). No differences in biodistribution or dosimetry were seen in fed and fasted subjects, though systemic NEFA and carnitine levels reflected fasted and fed states. CONCLUSION The favourable safety, imaging, and dosimetric profile makes 18F-FPIA a promising candidate radiotracer for tracing SCFA metabolism.
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Affiliation(s)
- Suraiya R Dubash
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | | | - Kasia Kozlowski
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK
| | - Chris Barnes
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK
| | - Louis Allott
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK
| | - Diana Brickute
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK
| | | | | | - Tara D Barwick
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK
- Department of Radiology/Nuclear Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Laura Kenny
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Eric O Aboagye
- Department of Surgery and Cancer, Imperial College London, GN1 Commonwealth Building, Hammersmith Hospital, DuCane Rd, London, W12 0NN, UK.
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Dubash SR, Merchant S, Heinzmann K, Mauri F, Lavdas I, Inglese M, Kozlowski K, Rama N, Masrour N, Steel JF, Thornton A, Lim AK, Lewanski C, Cleator S, Coombes RC, Kenny L, Aboagye EO. Clinical translation of [ 18F]ICMT-11 for measuring chemotherapy-induced caspase 3/7 activation in breast and lung cancer. Eur J Nucl Med Mol Imaging 2018; 45:2285-2299. [PMID: 30259091 PMCID: PMC6208806 DOI: 10.1007/s00259-018-4098-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 01/16/2018] [Accepted: 07/17/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Effective anticancer therapy is thought to involve induction of tumour cell death through apoptosis and/or necrosis. [18F]ICMT-11, an isatin sulfonamide caspase-3/7-specific radiotracer, has been developed for PET imaging and shown to have favourable dosimetry, safety, and biodistribution. We report the translation of [18F]ICMT-11 PET to measure chemotherapy-induced caspase-3/7 activation in breast and lung cancer patients receiving first-line therapy. RESULTS Breast tumour SUVmax of [18F]ICMT-11 was low at baseline and unchanged following therapy. Measurement of M30/M60 cytokeratin-18 cleavage products showed that therapy was predominantly not apoptosis in nature. While increases in caspase-3 staining on breast histology were seen, post-treatment caspase-3 positivity values were only approximately 1%; this low level of caspase-3 could have limited sensitive detection by [18F]ICMT-11-PET. Fourteen out of 15 breast cancer patients responded to first-line chemotherapy (complete or partial response); one patient had stable disease. Four patients showed increases in regions of high tumour [18F]ICMT-11 intensity on voxel-wise analysis of tumour data (classed as PADS); response was not exclusive to patients with this phenotype. In patients with lung cancer, multi-parametric [18F]ICMT-11 PET and MRI (diffusion-weighted- and dynamic contrast enhanced-MRI) showed that PET changes were concordant with cell death in the absence of significant perfusion changes. CONCLUSION This study highlights the potential use of [18F]ICMT-11 PET as a promising candidate for non-invasive imaging of caspase3/7 activation, and the difficulties encountered in assessing early-treatment responses. We summarize that tumour response could occur in the absence of predominant chemotherapy-induced caspase-3/7 activation measured non-invasively across entire tumour lesions in patients with breast and lung cancer.
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Affiliation(s)
- S R Dubash
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - S Merchant
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - K Heinzmann
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - F Mauri
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - I Lavdas
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - M Inglese
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
- Department of Computer, Control and Management Engineering Antonio Ruberti, University of Rome, La Sapienza, Italy
| | - K Kozlowski
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - N Rama
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - N Masrour
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - J F Steel
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - A Thornton
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK
| | - A K Lim
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - C Lewanski
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - S Cleator
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - R C Coombes
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK
| | - Laura Kenny
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK.
- Department of Oncology, Imperial College Healthcare NHS Trust, London, UK.
| | - Eric O Aboagye
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Rd, London, W120NN, UK.
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Dubash SR, Bryer D, Fitton J, Barr A, Wenham C, Marzo-Ortega H, Freeston JE. 065 Personalising care: the use of anti-drug antibodies and drug trough levels is a safe and cost-effective treatment strategy in spondyloarthritis. Rheumatology (Oxford) 2018. [DOI: 10.1093/rheumatology/key075.289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S R Dubash
- Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UNITED KINGDOM
- Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UNITED KINGDOM
| | - D Bryer
- Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UNITED KINGDOM
- Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UNITED KINGDOM
| | - J Fitton
- Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UNITED KINGDOM
- Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UNITED KINGDOM
| | - A Barr
- Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UNITED KINGDOM
- Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UNITED KINGDOM
| | - C Wenham
- Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UNITED KINGDOM
- Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UNITED KINGDOM
| | - H Marzo-Ortega
- Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UNITED KINGDOM
- Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UNITED KINGDOM
| | - JE Freeston
- Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UNITED KINGDOM
- Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UNITED KINGDOM
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Dubash SR, Keat N, Mapelli P, Twyman F, Carroll L, Kozlowski K, Al-Nahhas A, Saleem A, Huiban M, Janisch R, Frilling A, Sharma R, Aboagye EO. Clinical Translation of a Click-Labeled 18F-Octreotate Radioligand for Imaging Neuroendocrine Tumors. J Nucl Med 2016; 57:1207-13. [PMID: 27173162 DOI: 10.2967/jnumed.115.169532] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 11/12/2015] [Accepted: 01/29/2016] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED We conducted the first-in-human study of (18)F-fluoroethyl triazole [Tyr(3)] octreotate ((18)F-FET-βAG-TOCA) in patients with neuroendocrine tumors (NETs) to evaluate biodistribution, dosimetry, and safety. Despite advances in clinical imaging, detection and quantification of NET activity remains a challenge, with no universally accepted imaging standard. METHODS Nine patients were enrolled. Eight patients had sporadic NETs, and 1 had multiple endocrine neoplasia type 1 syndrome. Patients received 137-163 MBq (mean ± SD, 155.7 ± 8 MBq) of (18)F-FET-βAG-TOCA. Safety data were obtained during and 24 h after radioligand administration. Patients underwent detailed whole-body PET/CT multibed scanning over 4 h with sampling of venous bloods for radioactivity and radioactive metabolite quantification. Regions of interest were defined to derive individual and mean organ residence times; effective dose was calculated with OLINDA 1.1. RESULTS All patients tolerated (18)F-FET-βAG-TOCA with no adverse events. Over 60% parent radioligand was present in plasma at 60 min. High tumor (primary and metastases)-to-background contrast images were observed. Physiologic distribution was seen in the pituitary, salivary glands, thyroid, and spleen, with low background distribution in the liver, an organ in which metastases commonly occur. The organs receiving highest absorbed dose were the gallbladder, spleen, stomach, liver, kidneys, and bladder. The calculated effective dose over all subjects (mean ± SD) was 0.029 ± 0.004 mSv/MBq. CONCLUSION The favorable safety, imaging, and dosimetric profile makes (18)F-FET-βAG-TOCA a promising candidate radioligand for staging and management of NETs. Clinical studies in an expanded cohort are ongoing to clinically qualify this agent.
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Affiliation(s)
- Suraiya R Dubash
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Nicholas Keat
- Imanova Centre for Imaging Sciences, London, United Kingdom
| | - Paola Mapelli
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Frazer Twyman
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Laurence Carroll
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Kasia Kozlowski
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Adil Al-Nahhas
- Department of Radiology/Nuclear Medicine, Imperial College Healthcare NHS Trust, London, United Kingdom; and
| | - Azeem Saleem
- Imanova Centre for Imaging Sciences, London, United Kingdom
| | - Mickael Huiban
- Imanova Centre for Imaging Sciences, London, United Kingdom
| | - Ryan Janisch
- Imanova Centre for Imaging Sciences, London, United Kingdom
| | - Andrea Frilling
- Department of Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Rohini Sharma
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Eric O Aboagye
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality worldwide. HCC a heterogeneous disease occurring on the background of cirrhosis. The presence of cirrhosis limits the sensitivity of conventional imaging modalities in differentiating HCC from surrounding cirrhotic parenchyma. Positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) is widely used for assessing a variety of malignancies, however, has poor sensitivity in the evaluation of HCC. This has led to the investigation of other radiotracers such as 11C-acetate and 11C-choline, with improved sensitivity in terms of detection and therapeutic response. In this review, we discuss the emerging field of PET imaging for the detection, staging and assessment of treatment response in HCC. In particular we discuss the role of 18F-FDG-PET in imaging hepatocellular cancer, the limitations of this PET tracer and emerging novel PET tracers being investigated that exploit key metabolic processes including fatty acid and lipid synthesis, choline kinase activity and gene expression.
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Affiliation(s)
- Suraiya R Dubash
- Department of Surgery & Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.,Department of Surgery & Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - Oluwagbemiga A Idowu
- Department of Medical Oncology, Hammersmith Hospital, London, UK.,Department of Medical Oncology, Hammersmith Hospital, London, UK
| | - Rohini Sharma
- Division of Translational & Experimental Medicine, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.,Medical Oncology & Clinical Pharmacology, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0HS, UK.,Division of Translational & Experimental Medicine, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.,Medical Oncology & Clinical Pharmacology, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0HS, UK
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