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Pun M, Ng T, Vermeylen K, Tran J. Innervation of the hip joint: implications for regional anaesthesia and image-guided interventional pain procedures. BJA Educ 2024; 24:191-202. [PMID: 38764441 PMCID: PMC11096440 DOI: 10.1016/j.bjae.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 05/21/2024] Open
Affiliation(s)
- M. Pun
- Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - T. Ng
- Tuen Mun Hospital, Tuen Mun, Hong Kong
- University of Hong Kong, Pok Fu Lam, Hong Kong
- Frankston Pain Management, Melbourne, VIC, Australia
- Center for Regional Anesthesia and Pain medicine, Wan Fang Hospital, Taipei Medical Univeristy, Taipei, Taiwan
| | | | - J. Tran
- University of Toronto, Toronto, ON, Canada
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Abstract
Poor oral health affects the health and well-being of older adults in many ways. Despite years of international research investigating poor oral health among older adults, it has remained a largely unresolved problem. The aim of this article is to explore the combination of 2 key frameworks, ecosocial theory and intersectionality, to guide our exploration and understanding of oral health and aging and help inform research, education, policy, and services. Proposed by Krieger, ecosocial theory is concerned with the symbiotic relationship among embodied biological processes and social, historical, and political contexts. Building on the work of Crenshaw, intersectionality explores how social identities such as race, gender, socioeconomic status, and age interconnect in ways that can enhance privilege or compound discrimination and social disadvantage. Intersectionality offers a layered understanding of how power relations reflected in systems of privilege or oppression influence an individual's multiple intersecting social identities. Understanding this complexity and the symbiotic relationships offers an opportunity to reconsider how inequities in oral health for older adults can be addressed in research, education, and practice and increase the focus on equity, prevention, interdisciplinary care, and use of innovative technology.
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Affiliation(s)
- L Slack-Smith
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - T Ng
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - M E Macdonald
- Department of Medicine, Dalhousie University, Halifax, Canada
| | - A Durey
- School of Population and Global Health, University of Western Australia, Perth, Australia
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Beltran-Bless AA, Larocque G, Brackstone M, Arnaout A, Caudrelier JM, Boone D, Fallah P, Ng T, Cross P, Alqahtani N, Hilton J, Vandermeer L, Pond G, Clemons M. P279 A patient survey evaluating COVID-19-induced changes in follow-up of patients with EBC: opportunities for enhanced evidence-based practice? Breast 2023. [PMCID: PMC10013697 DOI: 10.1016/s0960-9776(23)00397-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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4
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Titmuss E, Milne K, Jones MR, Ng T, Topham JT, Brown SD, Schaeffer DF, Kalloger S, Wilson D, Corbett RD, Williamson LM, Mungall K, Mungall AJ, Holt RA, Nelson BH, Jones SJM, Laskin J, Lim HJ, Marra MA. Immune Activation following Irbesartan Treatment in a Colorectal Cancer Patient: A Case Study. Int J Mol Sci 2023; 24:ijms24065869. [PMID: 36982943 PMCID: PMC10051648 DOI: 10.3390/ijms24065869] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Colorectal cancers are one of the most prevalent tumour types worldwide and, despite the emergence of targeted and biologic therapies, have among the highest mortality rates. The Personalized OncoGenomics (POG) program at BC Cancer performs whole genome and transcriptome analysis (WGTA) to identify specific alterations in an individual's cancer that may be most effectively targeted. Informed using WGTA, a patient with advanced mismatch repair-deficient colorectal cancer was treated with the antihypertensive drug irbesartan and experienced a profound and durable response. We describe the subsequent relapse of this patient and potential mechanisms of response using WGTA and multiplex immunohistochemistry (m-IHC) profiling of biopsies before and after treatment from the same metastatic site of the L3 spine. We did not observe marked differences in the genomic landscape before and after treatment. Analyses revealed an increase in immune signalling and infiltrating immune cells, particularly CD8+ T cells, in the relapsed tumour. These results indicate that the observed anti-tumour response to irbesartan may have been due to an activated immune response. Determining whether there may be other cancer contexts in which irbesartan may be similarly valuable will require additional studies.
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Affiliation(s)
- E Titmuss
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | - K Milne
- Deeley Research Centre, BC Cancer, Victoria, BC V8R 6V5, Canada
| | - M R Jones
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | - T Ng
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
| | - J T Topham
- Pancreas Centre BC, Vancouver, BC V5Z 1G1, Canada
| | - S D Brown
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | | | - S Kalloger
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
| | - D Wilson
- Department of Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - R D Corbett
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | - L M Williamson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | - K Mungall
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | - A J Mungall
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | - R A Holt
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
| | - B H Nelson
- Deeley Research Centre, BC Cancer, Victoria, BC V8R 6V5, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
| | - S J M Jones
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
| | - J Laskin
- Department of Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - H J Lim
- Department of Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - M A Marra
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC V5Z 4S6, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
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5
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Ray M, Smeltzer M, Faris N, Fehnel C, Akinbobola W, Saulsberry A, Dortch K, Pacheco A, Levi P, Ng T, Robbins E, Osarogiagbon R. MA03.08 Survival Impact of Benchmarking Lung Cancer Surgeons’ Performance by Quality Metrics. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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6
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Akinbobola O, Faris N, Smeltzer M, Ray M, Fehnel C, Pacheco A, Saulsberry A, Dortch K, Wiggins H, Talton D, Eubanks R, Stevenson D, Valaulikar G, Patel H, Wolf B, Koury A, Levy P, Ng T, Robbins T, Osarogiagbon R. EP02.03-022 Evolution of Lung Cancer Resection Quality: A Prospective Staggered Implementation Quality Improvement Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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7
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Vicencio JM, Evans R, Green R, An Z, Deng J, Treacy C, Mustapha R, Monypenny J, Costoya C, Lawler K, Ng K, De-Souza K, Coban O, Gomez V, Clancy J, Chen SH, Chalk A, Wong F, Gordon P, Savage C, Gomes C, Pan T, Alfano G, Dolcetti L, Chan JNE, Flores-Borja F, Barber PR, Weitsman G, Sosnowska D, Capone E, Iacobelli S, Hochhauser D, Hartley JA, Parsons M, Arnold JN, Ameer-Beg S, Quezada SA, Yarden Y, Sala G, Ng T. Osimertinib and anti-HER3 combination therapy engages immune dependent tumor toxicity via STING activation in trans. Cell Death Dis 2022; 13:274. [PMID: 35347108 PMCID: PMC8960767 DOI: 10.1038/s41419-022-04701-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/07/2022] [Accepted: 03/01/2022] [Indexed: 11/28/2022]
Abstract
Over the past decade, immunotherapy delivered novel treatments for many cancer types. However, lung cancer still leads cancer mortality, and non-small-cell lung carcinoma patients with mutant EGFR cannot benefit from checkpoint inhibitors due to toxicity, relying only on palliative chemotherapy and the third-generation tyrosine kinase inhibitor (TKI) osimertinib. This new drug extends lifespan by 9-months vs. second-generation TKIs, but unfortunately, cancers relapse due to resistance mechanisms and the lack of antitumor immune responses. Here we explored the combination of osimertinib with anti-HER3 monoclonal antibodies and observed that the immune system contributed to eliminate tumor cells in mice and co-culture experiments using bone marrow-derived macrophages and human PBMCs. Osimertinib led to apoptosis of tumors but simultaneously, it triggered inositol-requiring-enzyme (IRE1α)-dependent HER3 upregulation, increased macrophage infiltration, and activated cGAS in cancer cells to produce cGAMP (detected by a lentivirally transduced STING activity biosensor), transactivating STING in macrophages. We sought to target osimertinib-induced HER3 upregulation with monoclonal antibodies, which engaged Fc receptor-dependent tumor elimination by macrophages, and STING agonists enhanced macrophage-mediated tumor elimination further. Thus, by engaging a tumor non-autonomous mechanism involving cGAS-STING and innate immunity, the combination of osimertinib and anti-HER3 antibodies could improve the limited therapeutic and stratification options for advanced stage lung cancer patients with mutant EGFR.
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Affiliation(s)
- J M Vicencio
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK.
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK.
| | - R Evans
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - R Green
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Z An
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - J Deng
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - C Treacy
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - R Mustapha
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - J Monypenny
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - C Costoya
- Cancer Immunology Unit, Cancer Institute, University College London, London, UK
| | - K Lawler
- Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - K Ng
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - K De-Souza
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - O Coban
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - V Gomez
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
| | - J Clancy
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
| | - S H Chen
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
| | - A Chalk
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
| | - F Wong
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - P Gordon
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - C Savage
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - C Gomes
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
| | - T Pan
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - G Alfano
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - L Dolcetti
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - J N E Chan
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - F Flores-Borja
- Centre for Immunobiology and Regenerative Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - P R Barber
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - G Weitsman
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - D Sosnowska
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - E Capone
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Center for Advanced Studies and Technology (CAST), Chieti, Italy
| | | | - D Hochhauser
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
| | - J A Hartley
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK
| | - M Parsons
- Randall Centre for Cell and Molecular Biophysics, King's College London, London, UK
| | - J N Arnold
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - S Ameer-Beg
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - S A Quezada
- Cancer Immunology Unit, Cancer Institute, University College London, London, UK
| | - Y Yarden
- Department of Biological Regulation, The Weizmann Institute of Science, Rehovot, Israel
| | - G Sala
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Center for Advanced Studies and Technology (CAST), Chieti, Italy
| | - T Ng
- Molecular Oncology Group, Cancer Institute, Paul O'Gorman Building, University College London, London, UK.
- Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King's College London, London, UK.
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8
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Amoruso E, Dowdall L, Kollamkulam MT, Ukaegbu O, Kieliba P, Ng T, Dempsey-Jones H, Clode D, Makin TR. Intrinsic somatosensory feedback supports motor control and learning to operate artificial body parts. J Neural Eng 2022; 19:016006. [PMID: 34983040 PMCID: PMC10431236 DOI: 10.1088/1741-2552/ac47d9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/05/2021] [Revised: 12/09/2021] [Accepted: 01/04/2022] [Indexed: 11/11/2022]
Abstract
Objective.Considerable resources are being invested to enhance the control and usability of artificial limbs through the delivery of unnatural forms of somatosensory feedback. Here, we investigated whether intrinsic somatosensory information from the body part(s) remotely controlling an artificial limb can be leveraged by the motor system to support control and skill learning.Approach.We used local anaesthetic to attenuate somatosensory inputs to the big toes while participants learned to operate through pressure sensors a toe-controlled and hand-worn robotic extra finger. Motor learning outcomes were compared against a control group who received sham anaesthetic and quantified in three different task scenarios: while operating in isolation from, in synchronous coordination, and collaboration with, the biological fingers.Main results.Both groups were able to learn to operate the robotic extra finger, presumably due to abundance of visual feedback and other relevant sensory cues. Importantly, the availability of displaced somatosensory cues from the distal bodily controllers facilitated the acquisition of isolated robotic finger movements, the retention and transfer of synchronous hand-robot coordination skills, and performance under cognitive load. Motor performance was not impaired by toes anaesthesia when tasks involved close collaboration with the biological fingers, indicating that the motor system can close the sensory feedback gap by dynamically integrating task-intrinsic somatosensory signals from multiple, and even distal, body-parts.Significance.Together, our findings demonstrate that there are multiple natural avenues to provide intrinsic surrogate somatosensory information to support motor control of an artificial body part, beyond artificial stimulation.
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Affiliation(s)
- E Amoruso
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - L Dowdall
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - M T Kollamkulam
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - O Ukaegbu
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
- East London NHS Foundation Trust, London, United Kingdom
| | - P Kieliba
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - T Ng
- Royal Free London NHS Foundation Trust, London, United Kingdom
| | - H Dempsey-Jones
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - D Clode
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - T R Makin
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
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McAteer MA, O'Connor JPB, Koh DM, Leung HY, Doran SJ, Jauregui-Osoro M, Muirhead N, Brew-Graves C, Plummer ER, Sala E, Ng T, Aboagye EO, Higgins GS, Punwani S. Introduction to the National Cancer Imaging Translational Accelerator (NCITA): a UK-wide infrastructure for multicentre clinical translation of cancer imaging biomarkers. Br J Cancer 2021; 125:1462-1465. [PMID: 34316019 PMCID: PMC8313668 DOI: 10.1038/s41416-021-01497-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 03/11/2021] [Accepted: 07/09/2021] [Indexed: 12/14/2022] Open
Abstract
The National Cancer Imaging Translational Accelerator (NCITA) is creating a UK national coordinated infrastructure for accelerated translation of imaging biomarkers for clinical use. Through the development of standardised protocols, data integration tools and ongoing training programmes, NCITA provides a unique scalable infrastructure for imaging biomarker qualification using multicentre clinical studies.
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Affiliation(s)
- M A McAteer
- Department of Oncology, University of Oxford, Oxford, UK.
| | - J P B O'Connor
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - D M Koh
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - H Y Leung
- Beatson Institute for Cancer Research, University of Glasgow, Glasgow, UK
| | - S J Doran
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, London, UK
| | - M Jauregui-Osoro
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - N Muirhead
- Centre for Medical Imaging, University College London, London, UK
| | - C Brew-Graves
- Centre for Medical Imaging, University College London, London, UK
| | - E R Plummer
- Northern Institute for Cancer Care, Freeman Hospital and Newcastle University, Newcastle upon Tyne, UK
| | - E Sala
- Department of Radiology, University of Cambridge and CRUK Cambridge Centre, Cambridge, UK
| | - T Ng
- UCL Cancer Institute, University College London, London, UK
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - E O Aboagye
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - G S Higgins
- Department of Oncology, University of Oxford, Oxford, UK
| | - S Punwani
- Centre for Medical Imaging, University College London, London, UK
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Brown LL, Ng T, Anksorus H, Savage A, Mak V. International Collaboration as an interdisciplinary approach for the development of a Cultural Competency online module. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab016.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Culture is a concept most people instinctively understand, but may struggle to fully articulate. Culture is not limited to ethnicity and religion, but encompasses age, gender, sexual orientation, occupation, socioeconomic status, ethnic origin or migrant experience, religious or spiritual belief, and dis/ability. Given the breadth and complexity of culture, healthcare professionals in particular are challenged to interact with an increasingly multicultural world and various cultural groups. There is a growing need for appropriate training models to enhance cultural awareness, and cultural competence, including in pharmacy schools.
“Interdisciplinary” can be defined as “relating to more than one branch of knowledge” [1], and international collaboration allows the connection of knowledge of different cultures. Developing a teaching intervention internationally, across three continents allows wider exposure to different cultures and can help students appreciate what culture may mean in different countries and how different ways of living are accepted and/or perceived in different societies.
Aim
To design and disseminate an online cultural communication module for use by pharmacy students across three countries and continents
Methods
A team from the Schools of Pharmacy at University College London (UCL), UK; Monash University, Australia and University of North Carolina (UNC), USA worked collaboratively to build an online module to help pharmacy students understand the importance of cultural awareness when communicating with patients. The Schools identified a range of cultural groups and scenarios in which pharmacist led communications could occur. Each School designed and filmed three scenarios, with two versions: one relatively good demonstration of communication and one poor. A range of actors, patients and pharmacists from different cultural groups (e.g. ethnic background, disability, LGBTQi, gender etc.) were involved in the design and filming. The module required students to reflect on the roleplays and provided feedback in the form of summary key points for each topic area. This module was embedded into the existing curricula for all Year 1 (Monash and UCL) and Year 2 (UNC) students in 2019. Students were informed as part of their regular course communication. A Likert style evaluation survey, including free text responses about the module was included, Questions were adapted from previous teaching evaluations. This data was recorded via each School’s Learning Management System. Descriptive statistics and a basic thematic analysis were conducted.
Results
Across the three Schools, a total of 525 students were offered the online module and 208 completed it. At UNC, 72.2% of students who completed would recommend the module to others, at UCL 83% and Monash 88%. Students’ feedback fell under three themes as seen in Table 1.
Conclusion
The innovation and strength of this learning intervention comes from the international collaboration. The online module allows students to identify and be culturally aware of a diverse group of people across three continents, allowing a unique and rich experience for all students through this collaboration and developing them not only as culturally competent healthcare professionals but also global citizens.
References
1. Oxford Dictionaries, Oxford University Press, Definition of Interdisciplinary in English, Oxford, 2020. [Accessed 11th October 2020]. Available from: https://premium-oxforddictionaries-com.libproxy.ucl.ac.uk/definition/english/interdisciplinary
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Affiliation(s)
- L L Brown
- School of Pharmacy, University College London
| | - T Ng
- School of Pharmacy, University College London
| | - H Anksorus
- UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
| | - A Savage
- UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
| | - V Mak
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Australia
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11
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Clemons M, Dranitsaris G, Sienkiewicz M, Sehdev S, Ng T, Robinson A, Mates M, Hsu T, McGee S, Freedman O, Kumar V, Fergusson D, Hutton B, Vandermeer L, Hilton J. A randomized trial of individualized versus standard of care antiemetic therapy for breast cancer patients at high risk for chemotherapy-induced nausea and vomiting. Breast 2020; 54:278-285. [PMID: 33242754 PMCID: PMC7695916 DOI: 10.1016/j.breast.2020.11.002] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 02/08/2023] Open
Abstract
Purpose Despite triple antiemetic therapy use for breast cancer patients receiving emetogenic chemotherapy, nausea remains a clinical challenge. We evaluated adding olanzapine (5 mg) to triple therapy on nausea control in patients at high personal risk of chemotherapy-induced nausea and vomiting (CINV). Methods This multi-centre, placebo-controlled, double-blind trial randomized breast cancer patients scheduled to receive neo/adjuvant chemotherapy with anthracycline-cyclophosphamide or platinum-based chemotherapy to olanzapine (5 mg, days 1–4) or placebo. Primary endpoint was frequency of self-reported significant nausea, repeated for all cycles of chemotherapy. Secondary endpoints included: duration of nausea, overall total control of CINV, Health Related Quality of Life (HRQoL) using FLIE questionnaire, use of rescue mediation and treatment-related adverse events. Results 218 eligible patients were randomised to placebo (105) or olanzapine (113). From days 0–5 following each cycle of chemotherapy, 41.3% (95%CI: 36.1–46.7%) of patients in the placebo group reported significant nausea compared to 27.7% (95%CI: 23.2–32.4%) in the olanzapine group (p = 0.001). Across all cycles of chemotherapy, patients receiving olanzapine experienced a statistically significant improvement in HRQoL (p < 0.001). Grade 1/2 sedation was the most commonly side effect reported at 40.8% in the placebo group vs. 54.1% with olanzapine (p < 0.001). Conclusion In patients at high personal risk of CINV, the addition of olanzapine 5 mg daily to standard antiemetic therapy significantly improves the control of nausea, HRQoL, with no unexpected toxicities. Double-blind trial evaluated the addition of olanzapine to triple therapy in patients at high personal risk of CINV. Adding 5 mg olanzapine was associated with significantly improved nausea control with no unexpected toxicities. Olanzapine plus triple therapy should be considered standard of care for breast cancer patients at high risk of CINV.
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Affiliation(s)
- M Clemons
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Clinical Epidemiology Program, The Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada.
| | - G Dranitsaris
- Consultant Biostatistician, 283 Danforth Ave, Toronto, Canada
| | - M Sienkiewicz
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - S Sehdev
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada
| | - T Ng
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada
| | - A Robinson
- Cancer Centre of Southeastern Ontario, Kingston General Hospital, Kingston, ON, Canada
| | - M Mates
- Cancer Centre of Southeastern Ontario, Kingston General Hospital, Kingston, ON, Canada
| | - T Hsu
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada
| | - S McGee
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada
| | - O Freedman
- Division of Medical Oncology, Durham Regional Cancer Centre, Oshawa, Ontario, Canada
| | - V Kumar
- Markham Stouffville Hospital, Shakir Rehmatullah Cancer Clinic, Markham, Ontario, Canada
| | - D Fergusson
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | - B Hutton
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Canada
| | - L Vandermeer
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - J Hilton
- Department of Medicine and Division of Medical Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada; Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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12
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Mazieres J, Tomasini P, Lusque A, Boucekine M, Gautschi O, Cortot A, Couraud S, Thai A, Ng T, Greillier L, Veillon R, Neal J, Popat S, Gounant V, Mhanna L, Drilon A, Baron JM, Barlesi F. 1279P Impact of KRAS mutations and subtypes on efficacy of immune-checkpoint inhibitors (ICI) in non-small cell lung cancer (NSCLC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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13
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Jang A, Nakashima L, Ng T, Fung M, Jiwani S, Schaff K, Suess J, Goncalves R, Jang D, Kuik K, Labelle S, Pow A. A real-world data approach to determine the optimal dosing strategy for pembrolizumab. J Oncol Pharm Pract 2020; 27:635-643. [PMID: 32539663 DOI: 10.1177/1078155220929756] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 11/17/2022]
Abstract
INTRODUCTION Cancer drug therapy costs continue to rise and threaten the sustainability of Canada's public healthcare system. Previous studies have calculated potential savings utilizing different dosing regimens of cancer treatments. Our objectives were to determine the financial impact of drug wastage and to explore cost-effective dosing regimens for pembrolizumab. METHODS This was a retrospective study reviewing data for non-small cell lung cancer and melanoma patients at all six BC Cancer Regional Centres during fiscal years 2017 and 2018. Pembrolizumab waste amounts recorded in pharmacy wastage logs were totalled. Estimates of the number of vials used were compared between vial sharing and non-vial sharing practices to determine the cost differences. Costs for dosing regimens used during fiscal years 2017 and 2018 were compared to 2 mg/kg weight-based dosing (to a maximum of 200 mg), 2 mg/kg dosing rounding down within 5% and 10%, and flat dosing of 200 mg. RESULTS There were a total of 202 non-small cell lung cancer and 182 melanoma patients with 2948 doses dispensed. Documented wastage was valued at $1,829,047.44 (8.65%) and across all six centres, vial sharing could reduce costs by $3,207,600.00 using the 100 mg vials. Compared to fiscal years 2017 and 2018, 2 mg/kg dosing (to a maximum of 200 mg) was the most cost-effective, decreasing costs by $222,719.20; flat dosing of 200 mg was the most expensive, increasing costs by $6,625,260.40. CONCLUSIONS Having smaller vial sizes, practicing vial sharing, and using weight-based dosing all improve cost savings. Further investigations on the allocation of resources to optimize drug use and minimize wastage are needed.
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Affiliation(s)
- Ashley Jang
- Provincial Pharmacy, BC Cancer, Vancouver, Canada.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | | | - Tonya Ng
- Provincial Pharmacy, BC Cancer, Vancouver, Canada
| | - Mayo Fung
- Provincial Pharmacy, BC Cancer, Vancouver, Canada
| | | | | | | | | | - Dennis Jang
- Provincial Pharmacy, BC Cancer, Vancouver, Canada
| | | | | | - Alison Pow
- Provincial Pharmacy, BC Cancer, Vancouver, Canada
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14
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Reddy P, O'meara K, Patel S, Chau E, Banayan A, Ng T, Elkayam U. P4138Clinical differences between methamphetamine and non-methamphetamine associated non-ischemic dilated cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Methamphetamine associated cardiomyopathy (MACM) is an increasingly recognized form of dilated cardiomyopathy around the globe which remains poorly characterized.
Purpose
To compare the clinical characteristics of MACM to those of non-MA associated dilated CM (NMACM).
Methods
Consecutive patients with MACM presenting to our institution between Jun 2018 and Jan 2019 were prospectively studied and compared to an age and gender-matched cohort of dilated non-ischemic CM cases.
Results
Seventy patients were studied (35 MACM and 35 NMACM). Mean age was similar between groups (49±9 vs. 48±10 years, p=0.465) and 97% of patients were male. Median duration of MA use prior to cardiomyopathy diagnosis was 5 years (range 0–30). Patients were predominantly Hispanic in both groups (48% vs. 62%, p=0.229), but with a greater proportion of Caucasians in the MACM group compared to NMACM (26% vs 6%, p=0.045).MACM was characterized by lower left ventricular ejection fraction (LVEF) and greater left ventricular end diastolic volume (LVEDV) compared to NMACM. RV dilation was present more often in MACM cases (Table). Years of MA use was associated with greater LA volumes (R2= 0.13, p=0.048). Association with larger LVEDV and incidence of RV dilation were borderline significant (R2= 0.11, p=0.054 and p=0.058 respectively). The amount of MA used per week correlated with higher RVSP (R2=0.317, p=0.004). Polysubstance abuse was associated with greater LVEF (p=0.028), lower LVEDV (p=0.037) and lower LV mass (p=0.004).
Echocardiographic parameters MACM Non-MACM p-value LVEDV (ml) 215 (62) 181 (40) 0.009* LVESV (ml) 166 (63) 133 (41) 0.017* LVEF (%) 20 (8) 26 (10) 0.006* LV Mass (g) 311 (109) 285 (81) 0.286 LA Volume (ml) 88 (26) 85 (29) 0.670 RV Dilation (no.) 23 (65.7%) 14 (40.0%) 0.027* Reduced RV Function (no.) 21 (60.0%) 21 (60.0%) 0.596 RVSP (mmHg) 40 (14) 44 (12) 0.671 RAP (mmHg) 9 (5) 10 (5) 0.682 Intracardiac Thrombus (no.) 3 (8.6%) 2 (5.7%) 0.500 Mean values are reported with standard deviation. *p<0.05.
Conclusion
MACM is associated with higher degree of LV and RV dilatation as well as LV systolic dysfunction when compared to matched NMACM cases. Years of MA use and amount of MA consumed appear to influence severity of disease.
Acknowledgement/Funding
None
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Affiliation(s)
- P Reddy
- University of Southern California, Los Angeles, United States of America
| | - K O'meara
- University of Southern California, Los Angeles, United States of America
| | - S Patel
- University of Southern California, Los Angeles, United States of America
| | - E Chau
- University of Southern California, Los Angeles, United States of America
| | - A Banayan
- University of Southern California, Los Angeles, United States of America
| | - T Ng
- University of Southern California, Los Angeles, United States of America
| | - U Elkayam
- University of Southern California, Los Angeles, United States of America
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15
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Lo KL, Chui KL, Leung CH, Ma SF, Lim K, Ng T, Wong J, Li JKM, Mak SK, Ng CF. Outcomes of transperineal and transrectal ultrasound-guided prostate biopsy. Hong Kong Med J 2019; 25:209-215. [PMID: 31178436 DOI: 10.12809/hkmj187599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/05/2022] Open
Abstract
OBJECTIVE To compare the clinical outcomes and pathological findings of transperineal ultrasound-guided prostate biopsy (TPUSPB) and transrectal ultrasound-guided prostate biopsy (TRUSPB) in a secondary referral hospital. METHODS This was a retrospective study of 100 TPUSPBs and 100 TRUSPBs performed in our centre. Pre-biopsy patient parameters (eg, patient age, clinical staging, serum prostate-specific antigen [PSA] level, prostate size, and PSA density), as well as pathological results and 30-day complication and readmission rates, were retrieved from the patients' medical records and compared between the two groups. RESULTS One hundred TPUSPBs performed from January 2018 to May 2018 and 100 TRUSPBs performed from January 2016 to April 2016 were included for analysis. Mean age did not significantly differ between the groups. The TPUSPB group had a higher mean PSA level, smaller prostate size, and higher PSA density, compared with the TRUSPB group. The overall prostate cancer detection rate was similar between the TPUSPB and TRUSPB groups (35% vs 25%, P=0.123). There were no significant differences between the groups in prostate cancer detection rates after stratification according to PSA density and clinical staging. With respect to complications, no patients developed fever in the TPUSPB group, while 4% of patients in the TRUSPB group had fever and required at least 1-week admission for intravenous antibiotic administration. CONCLUSION For prostate biopsy, TPUSPB is safer, with no infection complications, and has similar prostate cancer detection rate compared with TRUSPB.
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Affiliation(s)
- K L Lo
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - K L Chui
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - C H Leung
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S F Ma
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - K Lim
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - T Ng
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - J Wong
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - J K M Li
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - S K Mak
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong
| | - C F Ng
- Division of Urology, North District Hospital, New Territories East Cluster Urology Unit, Prince of Wales Hospital, Shatin, Hong Kong.,SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
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16
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Abstract
INTRODUCTION This serial cross-sectional survey study aimed to review the trend in various infection control practices in residential care homes for the elderly (RCHEs) in Hong Kong from 2005 to 2014. METHODS Annual cross-sectional surveys were conducted at all RCHEs in Hong Kong, including self-administered questionnaires, on-site interviews, inspections, and assessments conducted by trained nurses, from 2005 to 2014. In all, 98.5% to 100% of all RCHEs were surveyed each year based on the list of licensed RCHEs in Hong Kong. RESULTS There was a substantial increase in the proportion of RCHE residents aged ≥85 years, from 40.0% in 2005 to 50.2% in 2014 (P=0.002). The percentage of RCHE residents with special care needs also increased, from 22.3% in 2005 to 32.6% in 2014 for residents with dementia (P<0.001) and from 3.4% in 2005 to 5.0% in 2014 for residents with a long-term indwelling urinary catheter (P<0.001). The proportion of RCHEs with separate rooms for isolation areas ranged from 73.6% to 80% but did not show any significant trend over the study period. The proportion of RCHEs with alcohol hand rub available showed an increasing trend from 25.4% in 2006 to 99.2% in 2014 (P=0.008). The proportion of health or care workers (who were not the designated infection control officers) passing skills tests on hand washing techniques increased from 79.2% in 2006 to 91.5% in 2014 (P=0.02). An increasing trend was also observed for the proportion of infection control officers who were able to prepare properly diluted bleach solution, from 71.5% in 2005 to 92.2% in 2014 (P=0.002). CONCLUSIONS For infection control practice to continue improving, more effort should be made to enhance and maintain proper practice, and to mitigate the challenge posed by the high turnover rates of healthcare workers in RCHEs. Introduction of self-audits on infection control practices should be considered.
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Affiliation(s)
- G C Y Wong
- Elderly Health Service, Department of Health, Hong Kong SAR Government, Hong Kong
| | - T Ng
- Elderly Health Service, Department of Health, Hong Kong SAR Government, Hong Kong
| | - T Li
- Elderly Health Service, Department of Health, Hong Kong SAR Government, Hong Kong
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17
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Lacambra M, Loong H, To K, Feng X, Taylor G, Pleasance E, Laskin J, Marra M, Griffith J, Yeung H, Wong KC, Chow C, Kumta S, Ng W, Tse T, Tong C, Ng T. FUS-NFATc2 sarcoma of bone, a novel molecular entity with aggressive behavior: Clinical and molecular pathology findings of two cases. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy443.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Ng T, Smith D, Mushtaq R, Patil T, Dimou A, Yang S, Liu Q, Li X, Zhou C, Yan F, Bowman I, Liu S, Doebele R, Aisner D, Ren S, Camidge R. MA02.01 ROS1 Gene Rearrangements Are Associated with an Exaggerated Risk of Peri-Diagnosis Thromboembolic Events. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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19
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Ren S, Yu H, Rivard C, Suda K, Caldwell C, Rozeboom L, Ng T, Rivalland G, Mitchell P, Zhou C, Hirsch F. P2.04-13 The Immune Checkpoint, HVEM Contribute to Immune Escape in Non Small Cell Lung Cancer of Lacking PDL1 Expression. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Li B, Offin M, Hembrough T, Cecchi F, Shen R, Olah Z, Panora E, Myers M, Brzostowski E, Buonocore D, Ginsberg M, Rudin C, Kris M, Weitsman G, Barber P, Ng T, Ulaner G, Arcila M, Scaltriti M. P1.13-43 Molecular and Imaging Predictors of Response to Ado-Trastuzumab Emtansine in Patients with HER2 Mutant Lung Cancers: An Exploratory Phase 2 Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Jones MR, Lim H, Shen Y, Pleasance E, Ch'ng C, Reisle C, Leelakumari S, Zhao C, Yip S, Ho J, Zhong E, Ng T, Ionescu D, Schaeffer DF, Mungall AJ, Mungall KL, Zhao Y, Moore RA, Ma Y, Chia S, Ho C, Renouf DJ, Gelmon K, Jones SJM, Marra MA, Laskin J. Successful targeting of the NRG1 pathway indicates novel treatment strategy for metastatic cancer. Ann Oncol 2018; 28:3092-3097. [PMID: 28950338 DOI: 10.1093/annonc/mdx523] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background NRG1 fusion-positive lung cancers have emerged as potentially actionable events in lung cancer, but clinical support is currently limited and no evidence of efficacy of this approach in cancers beyond lung has been shown. Patients and methods Here, we describe two patients with advanced cancers refractory to standard therapies. Patient 1 had lung adenocarcinoma and patient 2 cholangiocarcinoma. Whole-genome and transcriptome sequencing were carried out for these cases with select findings validated by fluorescence in situ hybridization. Results Both tumors were found to be positive for NRG1 gene fusions. In patient 1, an SDC4-NRG1 gene fusion was detected, similar gene fusions having been described in lung cancers previously. In patient 2, a novel ATP1B1-NRG1 gene fusion was detected. Cholangiocarcinoma is not a disease type in which NRG1 fusions had been described previously. Integrative genome analysis was used to assess the potential functional significance of the detected genomic events including the gene fusions, prioritizing therapeutic strategies targeting the HER-family of growth factor receptors. Both patients were treated with the pan HER-family kinase inhibitor afatinib and both displayed significant and durable response to treatment. Upon progression sites of disease were sequenced. The lack of obvious genomic events to describe the disease progression indicated that broad transcriptomic or epigenetic mechanisms could be attributed to the lack of prolonged response to afatinib. Conclusion These observations lend further support to the use of pan HER-tyrosine kinase inhibitors for the treatment of NRG1 fusion-positive in both cancers of lung and hepatocellular origin and indicate more broadly that cancers found to be NRG1 fusion-positive may benefit from such a clinical approach regardless of their site of origin. Clinical trial information Personalized Oncogenomics (POG) Program of British Columbia: Utilization of Genomic Analysis to Better Understand Tumour Heterogeneity and Evolution (NCT02155621).
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Affiliation(s)
- M R Jones
- Canada's Michael Smith Genome Sciences Centre
| | - H Lim
- Division of Medical Oncology, BC Cancer Agency, Vancouver
| | - Y Shen
- Canada's Michael Smith Genome Sciences Centre
| | - E Pleasance
- Canada's Michael Smith Genome Sciences Centre
| | - C Ch'ng
- Canada's Michael Smith Genome Sciences Centre
| | - C Reisle
- Canada's Michael Smith Genome Sciences Centre
| | | | - C Zhao
- Canada's Michael Smith Genome Sciences Centre
| | - S Yip
- Department of Pathology & Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - J Ho
- Department of Pathology & Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - E Zhong
- Department of Pathology & Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - T Ng
- Department of Pathology & Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - D Ionescu
- Department of Pathology & Laboratory Medicine, BC Cancer Agency, Vancouver
| | - D F Schaeffer
- Department of Pathology & Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - A J Mungall
- Canada's Michael Smith Genome Sciences Centre
| | - K L Mungall
- Canada's Michael Smith Genome Sciences Centre
| | - Y Zhao
- Canada's Michael Smith Genome Sciences Centre
| | - R A Moore
- Canada's Michael Smith Genome Sciences Centre
| | - Y Ma
- Canada's Michael Smith Genome Sciences Centre
| | - S Chia
- Division of Medical Oncology, BC Cancer Agency, Vancouver
| | - C Ho
- Division of Medical Oncology, BC Cancer Agency, Vancouver
| | - D J Renouf
- Division of Medical Oncology, BC Cancer Agency, Vancouver
| | - K Gelmon
- Division of Medical Oncology, BC Cancer Agency, Vancouver
| | - S J M Jones
- Canada's Michael Smith Genome Sciences Centre.,Department of Medical Genetics, University of British Columbia, Vancouver.,Department of Molecular Biology and Biochemistry, Simon Fraser University, Vancouver, Canada
| | - M A Marra
- Canada's Michael Smith Genome Sciences Centre.,Department of Medical Genetics, University of British Columbia, Vancouver
| | - J Laskin
- Division of Medical Oncology, BC Cancer Agency, Vancouver
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22
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Ng T, Vandenberg J, Perry M. Pharmacological Activation of hERG Potassium Channels in Congenital Long QT Syndrome 2: Activator Compound ICA-105574 and its Effects on Mutant hERG Potassium Channels in Long QT Syndrome 2. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Ng T, Yu H, York E, Leedy S, Gao D, Heasley L, Hirsch F, Camidge D. P2.02-011 Clinical and Molecular Features of Lung Cancers with Increased FGFR1 mRNA and/or Gene Copy Number. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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24
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Chooback N, Shen Y, Jones M, Kasaian K, Martin M, Ng T, Thomson T, Marra M, Laskin J, Ho C. Carcinoma ex pleomorphic adenoma: case report and options for systemic therapy. ACTA ACUST UNITED AC 2017; 24:e251-e254. [PMID: 28680294 DOI: 10.3747/co.24.3588] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The most common benign salivary tumour is a pleomorphic adenoma. Transformation to malignancy, carcinoma ex pleomorphic adenoma (cxpa), occurs in 6% of cases. Management focuses on surgical resection and radiotherapy; however, rare cases require systemic management. We present the case of a 60-year-old woman with a cxpa of the left parotid gland who required systemic therapy for locally recurrent disease. Treatment options were guided by the literature concerning malignant salivary gland tumour and by whole-genome and transcriptome sequencing of the tumour. The patient received multiple systemic agents during the course of her disease, with cyclophosphamide-doxorubicin-cisplatin providing the best control (partial response). Genomeand transcriptome-directed therapy, including sorafenib and vismodegib, were utilized with limited clinical benefit. Malignant transformation in cxpa is a complex process, and therapy directed at a single tumour pathway might not be sufficient to control disease.
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Affiliation(s)
- N Chooback
- Department of Medical Oncology, BC Cancer Agency
| | - Y Shen
- BC Cancer Research Centre
| | | | | | - M Martin
- Department of Diagnostic Imaging, BC Cancer Agency
| | - T Ng
- Department of Pathology and Laboratory Medicine, Vancouver Coastal Health Research Institute; and
| | - T Thomson
- Department of Pathology and Laboratory Medicine, BC Cancer Agency, Vancouver, BC
| | | | - J Laskin
- Department of Medical Oncology, BC Cancer Agency
| | - C Ho
- Department of Medical Oncology, BC Cancer Agency
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25
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Weitsman G, Mitchell NJ, Evans R, Cheung A, Kalber TL, Bofinger R, Fruhwirth GO, Keppler M, Wright ZVF, Barber PR, Gordon P, de Koning T, Wulaningsih W, Sander K, Vojnovic B, Ameer-Beg S, Lythgoe M, Arnold JN, Årstad E, Festy F, Hailes HC, Tabor AB, Ng T. Detecting intratumoral heterogeneity of EGFR activity by liposome-based in vivo transfection of a fluorescent biosensor. Oncogene 2017; 36:3618-3628. [PMID: 28166195 PMCID: PMC5421598 DOI: 10.1038/onc.2016.522] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/12/2016] [Accepted: 12/21/2016] [Indexed: 12/20/2022]
Abstract
Despite decades of research in the epidermal growth factor receptor (EGFR) signalling field, and many targeted anti-cancer drugs that have been tested clinically, the success rate for these agents in the clinic is low, particularly in terms of the improvement of overall survival. Intratumoral heterogeneity is proposed as a major mechanism underlying treatment failure of these molecule-targeted agents. Here we highlight the application of fluorescence lifetime microscopy (FLIM)-based biosensing to demonstrate intratumoral heterogeneity of EGFR activity. For sensing EGFR activity in cells, we used a genetically encoded CrkII-based biosensor which undergoes conformational changes upon tyrosine-221 phosphorylation by EGFR. We transfected this biosensor into EGFR-positive tumour cells using targeted lipopolyplexes bearing EGFR-binding peptides at their surfaces. In a murine model of basal-like breast cancer, we demonstrated a significant degree of intratumoral heterogeneity in EGFR activity, as well as the pharmacodynamic effect of a radionuclide-labeled EGFR inhibitor in situ. Furthermore, a significant correlation between high EGFR activity in tumour cells and macrophage-tumour cell proximity was found to in part account for the intratumoral heterogeneity in EGFR activity observed. The same effect of macrophage infiltrate on EGFR activation was also seen in a colorectal cancer xenograft. In contrast, a non-small cell lung cancer xenograft expressing a constitutively active EGFR conformational mutant exhibited macrophage proximity-independent EGFR activity. Our study validates the use of this methodology to monitor therapeutic response in terms of EGFR activity. In addition, we found iNOS gene induction in macrophages that are cultured in tumour cell-conditioned media as well as an iNOS activity-dependent increase in EGFR activity in tumour cells. These findings point towards an immune microenvironment-mediated regulation that gives rise to the observed intratumoral heterogeneity of EGFR signalling activity in tumour cells in vivo.
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Affiliation(s)
- G Weitsman
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
| | - N J Mitchell
- Department of Chemistry, University College London, London, UK
| | - R Evans
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
| | - A Cheung
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
- Breast Cancer Now Research Unit, King’s College London, London, UK
| | - T L Kalber
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - R Bofinger
- Department of Chemistry, University College London, London, UK
| | - G O Fruhwirth
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
| | - M Keppler
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
| | - Z V F Wright
- Department of Chemistry, University College London, London, UK
| | - P R Barber
- Gray Laboratories, Department of Oncology, Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Oxford, UK
| | - P Gordon
- Breast Cancer Now Research Unit, King’s College London, London, UK
| | - T de Koning
- Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
| | - W Wulaningsih
- Cancer Epidemiology Group, Division of Cancer Studies, King’s College London, London, UK
| | - K Sander
- Institute of Nuclear Medicine, University College London, London, UK
| | - B Vojnovic
- Gray Laboratories, Department of Oncology, Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Oxford, UK
| | - S Ameer-Beg
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
| | - M Lythgoe
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - J N Arnold
- Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
| | - E Årstad
- Institute of Nuclear Medicine, University College London, London, UK
| | - F Festy
- King’s College London Dental Institute, Tissue Engineering and Biophotonics, Guy’s Hospital Campus, London, UK
| | - H C Hailes
- Department of Chemistry, University College London, London, UK
| | - A B Tabor
- Department of Chemistry, University College London, London, UK
| | - T Ng
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, Kings College London, Guy’s Medical School Campus, London, UK
- Breast Cancer Now Research Unit, King’s College London, London, UK
- UCL Cancer Institute, Paul O’Gorman Building, University College London, London, UK
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Lee S, Ng T, Wong F, Tung S. THE VALUE OF PROGNOSTIC NUTRITIONAL INDEX AT DIAGNOSIS IN PATIENTS WITH FOLLICULAR LYMPHOMA: A RETROSPECTIVE COHORT STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Lee
- Department of Clinical Oncology; Tuen Mun Hospital, Hong Kong; Hong Kong
| | - T. Ng
- Department of Clinical Oncology; Tuen Mun Hospital, Hong Kong; Hong Kong
| | - F. Wong
- Department of Clinical Oncology; Tuen Mun Hospital, Hong Kong; Hong Kong
| | - S. Tung
- Department of Clinical Oncology; Tuen Mun Hospital, Hong Kong; Hong Kong
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Diocou S, Volpe A, Jauregui-Osoro M, Boudjemeline M, Chuamsaamarkkee K, Man F, Blower PJ, Ng T, Mullen GED, Fruhwirth GO. [ 18F]tetrafluoroborate-PET/CT enables sensitive tumor and metastasis in vivo imaging in a sodium iodide symporter-expressing tumor model. Sci Rep 2017; 7:946. [PMID: 28424464 PMCID: PMC5430436 DOI: 10.1038/s41598-017-01044-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 03/22/2017] [Indexed: 12/22/2022] Open
Abstract
Cancer cell metastasis is responsible for most cancer deaths. Non-invasive in vivo cancer cell tracking in spontaneously metastasizing tumor models still poses a challenge requiring highest sensitivity and excellent contrast. The goal of this study was to evaluate if the recently introduced PET radiotracer [18F]tetrafluoroborate ([18F]BF4-) is useful for sensitive and specific metastasis detection in an orthotopic xenograft breast cancer model expressing the human sodium iodide symporter (NIS) as a reporter. In vivo imaging was complemented by ex vivo fluorescence microscopy and γ-counting of harvested tissues. Radionuclide imaging with [18F]BF4- (PET/CT) was compared to the conventional tracer [123I]iodide (sequential SPECT/CT). We found that [18F]BF4- was superior due to better pharmacokinetics, i.e. faster tumor uptake and faster and more complete clearance from circulation. [18F]BF4--PET was also highly specific as in all detected tissues cancer cell presence was confirmed microscopically. Undetected comparable tissues were similarly found to be free of metastasis. Metastasis detection by routine metabolic imaging with [18F]FDG-PET failed due to low standard uptake values and low contrast caused by adjacent metabolically active organs in this model. [18F]BF4--PET combined with NIS expressing disease models is particularly useful whenever preclinical in vivo cell tracking is of interest.
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Affiliation(s)
- S Diocou
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK
| | - A Volpe
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK
| | - M Jauregui-Osoro
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK
| | - M Boudjemeline
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK
| | - K Chuamsaamarkkee
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK
| | - F Man
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK
| | - P J Blower
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK
| | - T Ng
- King's College London, The Richard Dimbleby Department of Cancer Research, Randall Division of Molecular Biophysics and Cancer Division, Guy's Campus, London, SE1 1UL, UK
- UCL, Cancer Institute, Paul O'Gorman Building, London, WC1E 6BT, UK
| | - G E D Mullen
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK.
| | - G O Fruhwirth
- King's College London, Imaging Chemistry and Biology, Division of Imaging Sciences and Biomedical Engineering, 4th Floor Lambeth Wing, St. Thomas' Hospital, London, SE1 7EH, UK.
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Bossé D, Ng T, Ahmad C, Alfakeeh A, Alruzug I, Biagi J, Brierley J, Chaudhury P, Cleary S, Colwell B, Cripps C, Dawson LA, Dorreen M, Ferland E, Galiatsatos P, Girard S, Gray S, Halwani F, Kopek N, Mahmud A, Martel G, Robillard L, Samson B, Seal M, Siddiqui J, Sideris L, Snow S, Thirwell M, Vickers M, Goodwin R, Goel R, Hsu T, Tsvetkova E, Ward B, Asmis T. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016. ACTA ACUST UNITED AC 2016; 23:e605-e614. [PMID: 28050151 DOI: 10.3747/co.23.3394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 12/14/2022]
Abstract
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents.
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Affiliation(s)
- D Bossé
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - T Ng
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - C Ahmad
- Newfoundland and Labrador: Dr. H. Bliss Murphy Cancer Centre, St. John's (Ahmad, Seal, Siddiqui)
| | - A Alfakeeh
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - I Alruzug
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - J Biagi
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - J Brierley
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - P Chaudhury
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Cleary
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - B Colwell
- Nova Scotia: QEII Health Sciences Centre, Halifax (Colwell, Dorreen, Snow)
| | - C Cripps
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - L A Dawson
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - M Dorreen
- Nova Scotia: QEII Health Sciences Centre, Halifax (Colwell, Dorreen, Snow)
| | - E Ferland
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - P Galiatsatos
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Girard
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Gray
- New Brunswick: Saint John Regional Hospital, Saint John (Gray)
| | - F Halwani
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - N Kopek
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - A Mahmud
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - G Martel
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - L Robillard
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - B Samson
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - M Seal
- Newfoundland and Labrador: Dr. H. Bliss Murphy Cancer Centre, St. John's (Ahmad, Seal, Siddiqui)
| | - J Siddiqui
- Newfoundland and Labrador: Dr. H. Bliss Murphy Cancer Centre, St. John's (Ahmad, Seal, Siddiqui)
| | - L Sideris
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Snow
- Nova Scotia: QEII Health Sciences Centre, Halifax (Colwell, Dorreen, Snow)
| | - M Thirwell
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - M Vickers
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - R Goodwin
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - R Goel
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - T Hsu
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - E Tsvetkova
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - B Ward
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - T Asmis
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
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Ng R, Phey X, Ng T, Yeo H, Shwe M, Gan Y, Ho H, Chan A. Impact of adjuvant anthracycline-based and taxane-based chemotherapy on plasma VEGF levels and cognitive function in early-stage breast cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
A number of analogues of benzoic acid were evaluated in a T cell costimulation assay. One compound, the sodium salt of 2-chloro-5-nitrobenzoic acid (CNBA-Na) was chosen for further study and was found to be a potent costimulator of anti-CD3-induced proliferation of both H9 lymphoblastoid cells ( P<0.001) and human peripheral blood mononuclear cells ( P=0.001) in a dose-dependent manner. The costimulatory effect of CNBA-Na on CD3-triggered DNA synthesis did not enhance human immunodeficiency virus replication in infected cells. Studies with blocking monoclonal antibodies against B7-1 or B7-2 indicated that the immunopotentiatory effect of CNBA-Na required a macromolecular interaction between CD28 (a costimulatory receptor on T cells) and its counter receptor B7 expressed on antigen-presenting cells. The discovery that this low molecular weight compound causes T cell proliferation highlights a potentially novel therapeutic approach to immunodeficiency diseases.
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Affiliation(s)
- D Kinchington
- Department of Virology, St Bartholomew's and the Royal London School of Medicine and Dentistry, 51-53 Bartholomew Place, West Smithfield, London EC1A 7BE, UK
| | - T Ng
- Department of Immunology, St Bartholomew's and the Royal London School of Medicine and Dentistry, 38 Little Britain, West Smithfield, London EC1A 7BE, UK
| | - N Mathews
- Department of Virology, St Bartholomew's and the Royal London School of Medicine and Dentistry, 51-53 Bartholomew Place, West Smithfield, London EC1A 7BE, UK
| | - M Tisdale
- Pharmaceutical Sciences Institute, Aston University, Aston Triangle, Birmingham B4 7ET, UK
| | - D Devine
- Department of Virology, St Bartholomew's and the Royal London School of Medicine and Dentistry, 51-53 Bartholomew Place, West Smithfield, London EC1A 7BE, UK
| | - WO Ayuko
- Pharmaceutical Sciences Institute, Aston University, Aston Triangle, Birmingham B4 7ET, UK
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Abstract
Objective The objective of this study is to develop a systematic approach to standardize the use of auxiliary labels for oral oncology drugs. Design The project was multi-phased: environmental scan of auxiliary labels used at six BC Cancer Agency centre pharmacies, develop guidelines to support auxiliary labels standardization, develop inclusion criteria for common warnings and standardize warnings based on guiding principles and evidence (Canadian Compendium of Pharmaceutical Specialties, BC Cancer Agency Cancer Drug Manual, British National Formulary, literature). Results Consistent auxiliary labels use was rare (7% of drugs). No explicit methodology for determining previous auxiliary labels use was identified. Guiding principles developed include auxiliary labels supplement counselling and drug-specific patient handouts; a maximum of four auxiliary labels (limited container size and alert fatigue); identify hazardous drugs with auxiliary labels; auxiliary labels not intended for universal warnings (e.g., keep out of reach of children); warnings prioritized by impact on storage, efficacy (e.g., administration instructions), toxicity (including interactions) and other clinical issues. Inclusion criteria were developed for warnings on pregnancy, crushing/chewing, taking with plenty of water, drowsiness/dizziness, alcohol, grapefruit juice, hazardous and sunlight exposure. First list of standardized auxiliary labels was completed in June 2014. Conclusion A systematic approach was developed to determine and prioritize auxiliary labels for oral oncology drugs. This has led to a standardized and more accurate labelling throughout the six BC Cancer Agency centres' pharmacies.
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Affiliation(s)
- Tonya Ng
- Provincial Pharmacy, British Columbia, Canada
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Jones MR, Schrader KA, Shen Y, Pleasance E, Ch'ng C, Dar N, Yip S, Renouf DJ, Schein JE, Mungall AJ, Zhao Y, Moore R, Ma Y, Sheffield BS, Ng T, Jones SJM, Marra MA, Laskin J, Lim HJ. Response to angiotensin blockade with irbesartan in a patient with metastatic colorectal cancer. Ann Oncol 2016; 27:801-6. [PMID: 27022066 PMCID: PMC4843189 DOI: 10.1093/annonc/mdw060] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 11/30/2015] [Accepted: 02/08/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND A patient suffering from metastatic colorectal cancer, treatment-related toxicity and resistance to standard chemotherapy and radiation was assessed as part of a personalized oncogenomics initiative to derive potential alternative therapeutic strategies. PATIENTS AND METHODS Whole-genome and transcriptome sequencing was used to interrogate a metastatic tumor refractory to standard treatments of a patient with mismatch repair-deficient metastatic colorectal cancer. RESULTS Integrative genomic analysis indicated overexpression of the AP-1 transcriptional complex suggesting experimental therapeutic rationales, including blockade of the renin-angiotensin system. This led to the repurposing of the angiotensin II receptor antagonist, irbesartan, as an anticancer therapy, resulting in the patient experiencing a dramatic and durable response. CONCLUSIONS This case highlights the utility of comprehensive integrative genomic profiling and bioinformatics analysis to provide hypothetical rationales for personalized treatment options.
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Affiliation(s)
- M R Jones
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - K A Schrader
- Department of Medical Genetics, University of British Columbia, Vancouver
| | - Y Shen
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - E Pleasance
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - C Ch'ng
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - N Dar
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - S Yip
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - D J Renouf
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver
| | - J E Schein
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - A J Mungall
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - Y Zhao
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - R Moore
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - Y Ma
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver
| | - B S Sheffield
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - T Ng
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver
| | - S J M Jones
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver Department of Medical Genetics, University of British Columbia, Vancouver Department of Molecular Biology and Biochemistry, Simon Fraser University, Vancouver, Canada
| | - M A Marra
- British Columbia Cancer Agency, Canada's Michael Smith Genome Sciences Centre, Vancouver Department of Medical Genetics, University of British Columbia, Vancouver
| | - J Laskin
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver
| | - H J Lim
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver
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Lee RW, Ortiz-Zapater E, Weitsman G, Fruhwirth G, Owen W, Ng T, Santis G. T6 MET targeted therapy in Lung adenocarcinoma: Does ‘Resistant’ EGFR make a MET-responsive dimer? Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hepel J, Leonard K, Howard S, Ng T, Taber A, Khurshid H, Birnbaum A, (BrUOG) B, Wazer D, DiPetrillo T. SBRT Boost Following Concurrent Chemoradiation for Locally Advanced NSCLCa: A Phase 1 Dose-Escalation Study. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lam Y, Ng T, Shwe M, Gan Y, Cheung Y, Fan G, Tan Y, Yong W, Madhukumar P, Loh W, Jain A, Lee G, Koo S, Wong M, Dent R, Yap Y, Ng C, Chan A. 1543 Trajectory of self-perceived cognitive impairment: A 15-month prospective, longitudinal study in Asian early-stage breast cancer (ESBC) patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30633-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lawler K, Papouli E, Tutt A, Ng T, Pinder S, Parker P, Holmberg L, Gillett C, Grigoriadis A, Purushotham A. Clinical patterns of metastatic spread from formalin-fixed, paraffin-embedded (FFPE) expression profiles: A case-control study of 1,357 breast cancer patients. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv116.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cheung YT, Ng T, Shwe M, Ho HK, Foo KM, Cham MT, Lee JA, Fan G, Tan YP, Yong WS, Madhukumar P, Loo SK, Ang SF, Wong M, Chay WY, Ooi WS, Dent RA, Yap YS, Ng R, Chan A. Association of proinflammatory cytokines and chemotherapy-associated cognitive impairment in breast cancer patients: a multi-centered, prospective, cohort study. Ann Oncol 2015; 26:1446-51. [PMID: 25922060 PMCID: PMC4478978 DOI: 10.1093/annonc/mdv206] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [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: 11/13/2014] [Accepted: 04/20/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Existing evidence suggests that proinflammatory cytokines play an intermediary role in postchemotherapy cognitive impairment. This is one of the largest multicentered, cohort studies conducted in Singapore to evaluate the prevalence and proinflammatory biomarkers associated with cognitive impairment in breast cancer patients. PATIENTS AND METHODS Chemotherapy-receiving breast cancer patients (stages I-III) were recruited. Proinflammatory plasma cytokines concentrations [interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor, interferon-γ and tumor necrosis factor-α] were evaluated at 3 time points (before chemotherapy, 6 and 12 weeks after chemotherapy initiation). The FACT-Cog (version 3) was utilized to evaluate patients' self-perceived cognitive disturbances and a computerized neuropsychological assessment (Headminder) was administered to evaluate patients' memory, attention, response speed and processing speed. Changes of cognition throughout chemotherapy treatment were compared against the baseline. Linear mixed-effects models were applied to test the relationships of clinical variables and cytokine concentrations on self-perceived cognitive disturbances and each objective cognitive domain. RESULTS Ninety-nine patients were included (age 50.5 ± 8.4 years; 81.8% Chinese; mean duration of education = 10.8 ± 3.3 years). Higher plasma IL-1β was associated with poorer response speed performance (estimate: -0.78; 95% confidence interval (CI) -1.34 to -0.03; P = 0.023), and a higher concentration of IL-4 was associated with better response speed performance (P = 0.022). Higher concentrations of IL-1β and IL-6 were associated with more severe self-perceived cognitive disturbances (P = 0.018 and 0.001, respectively). Patients with higher concentrations of IL-4 also reported less severe cognitive disturbances (P = 0.022). CONCLUSIONS While elevated concentrations of IL-6 and IL-1β were observed in patients with poorer response speed performance and perceived cognitive disturbances, IL-4 may be protective against chemotherapy-associated cognitive impairment. This study is important because cytokines would potentially be mechanistic mediators of chemotherapy-associated cognitive changes.
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Affiliation(s)
- Y T Cheung
- Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - T Ng
- Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - M Shwe
- Department of Pharmacy, National University of Singapore, Singapore
| | - H K Ho
- Department of Pharmacy, National University of Singapore, Singapore
| | | | - M T Cham
- Breast Centre, KK Women's and Children's Hospital, Singapore
| | - J A Lee
- Breast Centre, KK Women's and Children's Hospital, Singapore
| | - G Fan
- Departments of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
| | - Y P Tan
- Departments of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
| | - W S Yong
- Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - P Madhukumar
- Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - S K Loo
- Medical Oncology, National Cancer Centre Singapore, Singapore
| | - S F Ang
- Medical Oncology, National Cancer Centre Singapore, Singapore
| | - M Wong
- Medical Oncology, National Cancer Centre Singapore, Singapore
| | - W Y Chay
- Medical Oncology, National Cancer Centre Singapore, Singapore
| | - W S Ooi
- Medical Oncology, National Cancer Centre Singapore, Singapore
| | - R A Dent
- Medical Oncology, National Cancer Centre Singapore, Singapore Clinical Sciences, DUKE-NUS Graduate Medical School, Singapore, Singapore
| | - Y S Yap
- Medical Oncology, National Cancer Centre Singapore, Singapore
| | - R Ng
- Medical Oncology, National Cancer Centre Singapore, Singapore Clinical Sciences, DUKE-NUS Graduate Medical School, Singapore, Singapore
| | - A Chan
- Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore Clinical Sciences, DUKE-NUS Graduate Medical School, Singapore, Singapore
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Hahn-Goldberg S, Chow E, Appel E, Ko FTF, Tan P, Gavin MB, Ng T, Abrams HB, Casaubon LK, Carter MW. Discrete event simulation of patient admissions to a neurovascular unit. J Healthc Eng 2014; 5:347-59. [PMID: 25193372 DOI: 10.1260/2040-2295.5.3.347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Evidence exists that clinical outcomes improve for stroke patients admitted to specialized Stroke Units. The Toronto Western Hospital created a Neurovascular Unit (NVU) using beds from general internal medicine, Neurology and Neurosurgery to care for patients with stroke and acute neurovascular conditions. Using patient-level data for NVU-eligible patients, a discrete event simulation was created to study changes in patient flow and length of stay pre- and post-NVU implementation. Varying patient volumes and resources were tested to determine the ideal number of beds under various conditions. In the first year of operation, the NVU admitted 507 patients, over 66% of NVU-eligible patient volumes. With the introduction of the NVU, length of stay decreased by around 8%. Scenario testing showed that the current level of 20 beds is sufficient for accommodating the current demand and would continue to be sufficient with an increase in demand of up to 20%.
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Affiliation(s)
- S Hahn-Goldberg
- Centre for Innovation in Complex Care, University Health Network, Toronto, Ontario, Canada
| | - E Chow
- Centre for Innovation in Complex Care, University Health Network, Toronto, Ontario, Canada
| | - E Appel
- Centre for Innovation in Complex Care, University Health Network, Toronto, Ontario, Canada
| | - F T F Ko
- Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
| | - P Tan
- Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
| | - M B Gavin
- Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
| | - T Ng
- Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
| | - H B Abrams
- Centre for Innovation in Complex Care, University Health Network, Toronto, Ontario, Canada University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
| | - L K Casaubon
- University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
| | - M W Carter
- Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada
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Laskin J, Moore R, Shen Y, Lim H, Gelmon K, Renouf D, Yip S, Huntsman D, Ng T, Mungall A, Fok A, Ho C, Chia S, Leelakumari S, Kasaian K, Eirew P, Ma Y, Aparicio S, Jones S, Marra M. Demonstration of Temporal Heterogeneity Identified By Genome Sequencing and the Potential Effect on Treatment Decisions for Advanced Cancer Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu358.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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40
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Chowdhury R, Ganeshan B, Irshad S, Lawler K, Eisenblätter M, Milewicz H, Rodriguez-Justo M, Miles K, Ellis P, Groves A, Punwani S, Ng T. The use of molecular imaging combined with genomic techniques to understand the heterogeneity in cancer metastasis. BJR Case Rep 2014. [DOI: 10.1259/bjrcr.20140065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ortiz-Zapater E, Lee R, Fruhwirth G, Weitsman G, Owen W, Ng T, Santis G. 357: Targeted therapy makes EGFR promiscuous: EGFR and c-Met interaction in lung cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50318-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chowdhury R, Ganeshan B, Irshad S, Lawler K, Eisenblätter M, Milewicz H, Rodriguez-Justo M, Miles K, Ellis P, Groves A, Punwani S, Ng T. The use of molecular imaging combined with genomic techniques to understand the heterogeneity in cancer metastasis. Br J Radiol 2014; 87:20140065. [PMID: 24597512 PMCID: PMC4075563 DOI: 10.1259/bjr.20140065] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 03/03/2014] [Indexed: 01/10/2023] Open
Abstract
Tumour heterogeneity has, in recent times, come to play a vital role in how we understand and treat cancers; however, the clinical translation of this has lagged behind advances in research. Although significant advancements in oncological management have been made, personalized care remains an elusive goal. Inter- and intratumour heterogeneity, particularly in the clinical setting, has been difficult to quantify and therefore to treat. The histological quantification of heterogeneity of tumours can be a logistical and clinical challenge. The ability to examine not just the whole tumour but also all the molecular variations of metastatic disease in a patient is obviously difficult with current histological techniques. Advances in imaging techniques and novel applications, alongside our understanding of tumour heterogeneity, have opened up a plethora of non-invasive biomarker potential to examine tumours, their heterogeneity and the clinical translation. This review will focus on how various imaging methods that allow for quantification of metastatic tumour heterogeneity, along with the potential of developing imaging, integrated with other in vitro diagnostic approaches such as genomics and exosome analyses, have the potential role as a non-invasive biomarker for guiding the treatment algorithm.
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Affiliation(s)
- R Chowdhury
- Richard Dimbleby Department of Cancer Research, Randall Division of Cell and Molecular Biophysics, King's College London, London, UK
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Guerra P, Kim M, Kinsman L, Ng T, Alaee M, Smyth SA. Parameters affecting the formation of perfluoroalkyl acids during wastewater treatment. J Hazard Mater 2014; 272:148-54. [PMID: 24691135 DOI: 10.1016/j.jhazmat.2014.03.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 02/11/2014] [Accepted: 03/07/2014] [Indexed: 05/26/2023]
Abstract
This study examined the fate and behaviour of perfluoroalkyl acids (PFAAs) in liquid and solid samples from five different wastewater treatment types: facultative and aerated lagoons, chemically assisted primary treatment, secondary aerobic biological treatment, and advanced biological nutrient removal treatment. To the best of our knowledge, this is the largest data set from a single study available in the literature to date for PFAAs monitoring study in wastewater treatment. Perfluorooctanoic acid (PFOA) was the predominant PFAA in wastewater with levels from 2.2 to 150ng/L (influent) and 1.9 to 140ng/L (effluent). Perfluorooctanesulfonic acid (PFOS) was the predominant compound in primary sludge, waste biological sludge, and treated biosolids with concentrations from 6.4 to 2900ng/g dry weight (dw), 9.7 to 8200ng/gdw, and 2.1 to 17,000ng/gdw, respectively. PFAAs were formed during wastewater treatment and it was dependant on both process temperature and treatment type; with higher rates of formation in biological wastewater treatment plants (WWTPs) operating at longer hydraulic retention times and higher temperatures. PFAA removal by sorption was influenced by different sorption tendencies; median log values of the solid-liquid distribution coefficient estimated from wastewater biological sludge and final effluent were: PFOS (3.73)>PFDA (3.68)>PFNA (3.25)>PFOA (2.49)>PFHxA (1.93). Mass balances confirmed the formation of PFAAs, low PFAA removal by sorption, and high PFAA levels in effluents.
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Affiliation(s)
- P Guerra
- Science and Technology Branch, Environment Canada, 867 Lakeshore Road, Burlington, Ontario L7R 4A6, Canada
| | - M Kim
- Science and Technology Branch, Environment Canada, 867 Lakeshore Road, Burlington, Ontario L7R 4A6, Canada
| | - L Kinsman
- Science and Technology Branch, Environment Canada, 867 Lakeshore Road, Burlington, Ontario L7R 4A6, Canada
| | - T Ng
- Science and Technology Branch, Environment Canada, 867 Lakeshore Road, Burlington, Ontario L7R 4A6, Canada
| | - M Alaee
- Science and Technology Branch, Environment Canada, 867 Lakeshore Road, Burlington, Ontario L7R 4A6, Canada
| | - S A Smyth
- Science and Technology Branch, Environment Canada, 867 Lakeshore Road, Burlington, Ontario L7R 4A6, Canada.
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Irshad S, Lawler K, Evans R, Flores-Borja F, Monypenny J, Grigoriadis A, Fruhwith G, Poland S, Barber P, Vojnovic B, Ellis P, Tutt A, Ng T. Abstract P5-01-01: Lymphoid tissue inducer cells: Identification of a novel immune cell within the breast tumour microenvironment and its role in promoting tumour cell invasion. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-01-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Within breast cancers, trans-endothelial migration of tumour cells through lymphatic vessels is the first step to tumour dissemination and lympho-vascular invasion has been shown to stratify breast cancer phenotypes into distinct prognostic groups. The exact molecular mechanisms mediating tumor cell entry and persistence within the lymphatic system remain unclear. Lymphoid tissue inducer (LTi) cells are members of the emerging family of retinoic acid related orphan receptor (ROR)gt+ innate lymphoid cells (ILCs), and their interaction with stromal cells induces production by the stromal cells of VEGF-C and “lymphoid” chemokines, essential for lymphoid organogenesis. We hypothesized that tumour cells manipulate the normal processes that govern chemokine-dependent, trans-lymphatic migration of immune cells, including LTi cells; shaping its microenvironment. Results: We analyzed the expression of lymphoid chemokines genes (CXCL12, CXCL13, CCL19, CCL20 and CCL21) and their corresponding receptors (CXCR4, CXCR5, CCR6 and CCR7) within the METABRIC (Molecular Taxonomy of Breast Cancer International Consortium) Tissue Bank. An unsupervised hierarchical cluster analysis revealed co-expression of these genes, categorizing breast tumors as relatively high/low expressors. Tumors exhibiting relatively high expression of these genes were found to be enriched for “basal-like” breast cancers according to PAM50 intrinsic subtype assignments. Immunofluorescence of the primary tumour sections identified cells that were comparable in phenotype to LTi cells. In a blinded study, we observed that patients with high LTi counts within the tumour microenvironment were also likely to have a gene expression corresponding to high expression for the lymphoid chemokines. IHC for the lymphatic marker, podoplanin found that the LTi count correlated with both an increased lymphatic vessel density and tumor invasion into lymphatic vessels. Within the basal and HER2+ve subtypes, patients with more than 4 lymph nodes were found to exhibit higher numbers of intratumoural LTi cells. In vitro studies, alongside multi-photon in vivo imaging were performed to investigate the interaction between intra-tumoural LTi and mesenchymal stromal cells. CXCL13 was shown to be essential for LTi clustering around stromal cells in vitro, and, the administration of a blocking antibody in vivo delayed the onset of lymph node metastasis in a murine mammary tumour (4T1.2) model. CXCLl3 has been identified as having independent prognostic significance in breast cancer, but we and others report that breast cancer cell lines are not the source of CXCL13. We show that an increase in stromal CXCL13 concentration within the tumour microenvironment following LTi recruitment promotes an EMT phenotype in the 4T1.2 cancer cell line, possibly via activation of the RANKL/RANK axis promoting tumorigenesis. We report for the first time, the identification of LTi cells within the human breast cancer tumour microenvironment and propose a pivotal role for these cells, through stromal cell interactions in the tumour microenvironment, in facilitating lymphatic invasion of tumour cells by modulation of the local lymphoid chemokine profile.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-01-01.
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Affiliation(s)
- S Irshad
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - K Lawler
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - R Evans
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - F Flores-Borja
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - J Monypenny
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - A Grigoriadis
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - G Fruhwith
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - S Poland
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - P Barber
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - B Vojnovic
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - P Ellis
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - A Tutt
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
| | - T Ng
- Breakthrough Breast Cancer Research Unit, London, England, United Kingdom; Randall Division & Division of Cancer Studies, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, Oxford, United Kingdom
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Kuchuk I, Hutton B, Moretto P, Ng T, Addison CL, Clemons M. Incidence, consequences and treatment of bone metastases in breast cancer patients-Experience from a single cancer centre. J Bone Oncol 2013; 2:137-44. [PMID: 26909284 PMCID: PMC4723382 DOI: 10.1016/j.jbo.2013.09.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [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: 06/27/2013] [Revised: 09/06/2013] [Accepted: 09/15/2013] [Indexed: 11/17/2022] Open
Abstract
Background There is a paucity of literature about the benefits of bone-targeted agents for breast cancer patients with bone metastases treated in the non-trial setting. We explored the incidence, consequences, and treatment of bone metastases at a single cancer centre. Methods Electronic records of metastatic breast cancer patients were reviewed and pertinent information was extracted. Results Of 264 metastatic breast cancer patients, 195 (73%) developed bone metastases. Of these patients, 176 were eligible for analysis. Median age at bone metastases diagnosis was 56.9 years (IQR 48–67) and initial presentation of bone metastases included asymptomatic radiological findings (58%), bone pain (40%), or a SRE (12.5%). Most patients (88%) received a bone-targeted agent, starting a median of 1.5 months (IQR 0.8–3.30) after bone metastasis diagnosis. 62% of patients had ≥1 SRE. The median time from bone metastasis diagnosis to first SRE was 1.8 months (IQR 0.20–8.43 months). Median number of SREs per patient was 1.5 (IQR 0–3). Overall, 26.8% of all SREs were clinically asymptomatic. Within the entire cohort, 51% required opioids and 20% were hospitalized due to either an SRE or bone pain. Conclusions Despite extensive use of bone-targeted agents, the incidence of SREs remains high. Nearly half of SREs occur prior to starting a bone-targeted agent. Use of opioids and hospitalizations secondary to bone metastases remain common. More effective treatment options are clearly needed.
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Affiliation(s)
- I Kuchuk
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre & Department of Medicine, University of Ottawa, Ottawa, Canada
| | - B Hutton
- Ottawa Hospital Research Institute, Ottawa University, Department of Epidemiology and Community Medicine, Ottawa, Canada
| | - P Moretto
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre & Department of Medicine, University of Ottawa, Ottawa, Canada
| | - T Ng
- Division of Internal Medicine, Department of Medicine, University of Ottawa, Ottawa, Canada
| | - C L Addison
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - M Clemons
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre & Department of Medicine, University of Ottawa, Ottawa, Canada; Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada
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Warrell G, Gautam B, Shvydka D, Subramanian M, Ng T, Parsai E. WE-A-108-04: Experimental Verification of the Thermal Properties of a Novel LDR Thermo-Brachytherapy Seed. Med Phys 2013. [DOI: 10.1118/1.4815497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
The multifunctional roles of BRCA1 include its ability to regulate transcriptional processes that control differentiation at multiple levels, as well as functioning as a tumor suppressor. Data herein demonstrate that germline mutations in Brca1 impair luminal cell lineage and mammary development, with its deficiency converting ER-positive luminal tumors into basal-like cancers. Heterozygous mutations in Brca1 lead to downregulation of a number of luminal differentiation genes, explaining how it suppresses basal-like tumors, also highlighting its importance outside of its known highly publicized role in DNA repair.
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Affiliation(s)
- T Ng
- Richard Dimbleby Department of Cancer Research, Randall Division and Division of Cancer Studies, Kings College London, Guy's Medical School Campus, London, UK
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48
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Irshad S, Flores-Borja FF, Evans R, Fruhwirth G, Pitmilly JM, Poland S, Ameer-Beg S, Tutt A, Ng T. Use of Live In-Vivo Lymphatic Imaging Techniques to Study the Effects of Immune Cell Interactions in a Syngeneic Mouse Model of Breast Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt144.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sheeba I, Kelleher M, Lawler K, Festy F, Barber P, Shamill E, Gargi P, Weitsman G, Barrett J, Fruhwirth G, Huang L, Tullis I, Woodman N, Pinder S, Ofo E, Fernandes L, Beutler M, Ameer-Beg S, Holmberg L, Purushotham A, Fraternali F, Condeelis J, Hanby A, Gillett C, Ellis P, Vojnovic B, Coolen A, Ng T. Abstract P2-10-29: Time dependent breast cancer metastasis prediction using novel biological imaging, clinico-pathological and genomic data combined with Bayesian modeling to reduce over-fitting and improve on inter-cohort reproducibility. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-10-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer heterogeneity demands that prognostic models must be biologically driven and recent clinical evidence indicates that future prognostic signatures need evaluation in the context of early versus late metastatic risk prediction. The aim of our work was to identify biologically validated quantitative imaging parameters with improved correlation to clinical outcome, and to address some of the remaining obstacles for a truly robust prognostic model in clinical use.
Method: We identified 4 seed proteins (ezrin/radixin/moesin-cofilin), along with several kinases as biologically relevant subnetwork of proteins that control tumor cell motility and metastasis. Patient-derived breast cancer tumour samples were used to perform a combination of imaging methods such as Fluoresecence lifetime imaging microscopy, automated segmentation and co-localisation intensity analysis. A complexity optimized Bayesian proportional hazard regression model was performed on a total of 419 breast cancer patients to validate time dependent predictions using traditional clinicopathological, genomic and our novel optical imaging-derived parameters. An independent dataset of 300 patient samples from the Leeds Institute of Molecular Medicine is currently being evaluated, representing a large cross centre validation of our integrated model.
Results: We demonstrate that the traditional gold standard clinico-pathological variables are poor predictors for patients that survive long periods, and that their predictive significance (in terms of hazard ratios) varies significantly between two temporal cohorts where the adjuvant treatments are vastly different. Moreover, we investigate the predictive accuracy of a combined imaging/clinicopathological model compared with genomic/clinicopathological models. We demonstrate how to reduce over-fitting to help improve the performance of prognostic models. Results of an integrated model combining genomic and imaging parameters are still awaited.
Discussion: We have produced the first optical imaging-derived multivariate tumour metastatic signature, which measures underlying key biological variables involved in regulating cancer cell motility. Using Bayesian proportional hazards regression in a time-dependent manner, we highlight the inadequacies of existing prediction tools and present a model combining the clinicopathological parameters with our imaging-based metastatic signature, as an integrative reproducible prognostic tool across different temporal cohorts.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-29.
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Affiliation(s)
- I Sheeba
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - M Kelleher
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - K Lawler
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - F Festy
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - P Barber
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - E Shamill
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - P Gargi
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - G Weitsman
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - J Barrett
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - G Fruhwirth
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - L Huang
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - I Tullis
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - N Woodman
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - S Pinder
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - E Ofo
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - L Fernandes
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - M Beutler
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - S Ameer-Beg
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - L Holmberg
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - A Purushotham
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - F Fraternali
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - J Condeelis
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - A Hanby
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - C Gillett
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - P Ellis
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - B Vojnovic
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - A Coolen
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
| | - T Ng
- Kings College London, Guy's Medical School Campus, London, England, United Kingdom; King's College London, Strand Campus, London, England, United Kingdom; Guy's and St Thomas Foundation Trust, London, England, United Kingdom; Gray Institute for Radiation Oncology & Biology, University of Oxford, England, United Kingdom; Leeds Institute of Molecular Medicine, Leeds, England, United Kingdom
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Kemp S, Achan A, Ng T, Dexter M. Rosette-forming glioneuronal tumour of the lateral ventricle in a patient with neurofibromatosis 1. J Clin Neurosci 2012; 19:1180-1. [DOI: 10.1016/j.jocn.2011.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 11/28/2011] [Accepted: 12/03/2011] [Indexed: 10/28/2022]
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