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Stradella A, Johnson M, Goel S, Chandana S, Galsky M, Calvo E, Moreno V, Park H, Arkenau HT, Cervantes A, Madrid LF, Mileshkin L, Plummer R, Evans J, Horvath L, Prawira A, Pelham R, Mu S, Andreu-Vieyra C, Barve M. Updated results of the PARP1/2 inhibitor pamiparib in combination with low-dose (ld) temozolomide (TMZ) in patients (pts) with locally advanced or metastatic solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.013] [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: 11/13/2022] Open
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Pernas S, Goel S, Johnson N, Harrison B, Guerriero J, Hu J, Winship G, Sokolov A, Regan M, Mittendorf E, Overmoyer B. Early on-treatment vs pre-treatment tumour transcriptomes as predictors of response to neoadjuvant therapy for HER2-positive inflammatory breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.031] [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: 11/13/2022] Open
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Hrinczenko B, Spigel D, Iannotti N, Safran H, Taylor M, Bennouna J, Goel S, Leach J, Wong D, Kelly K, Verschraegen C, Bajars M, Manitz J, Ruisi M, Gulley J. Long-term avelumab treatment in patients with advanced non-small cell lung cancer (NSCLC): Post hoc analyses from JAVELIN solid tumour. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mullane KM, Morrison VA, Camacho LH, Arvin A, McNeil SA, Durrand J, Campbell B, Su SC, Chan ISF, Parrino J, Kaplan SS, Popmihajlov Z, Annunziato PW, Cerana S, Dictar MO, Bonvehi P, Tregnaghi JP, Fein L, Ashley D, Singh M, Hayes T, Playford G, Morrissey O, Thaler J, Kuehr T, Greil R, Pecherstorfer M, Duck L, Van Eygen K, Aoun M, De Prijck B, Franke FA, Barrios CHE, Mendes AVA, Serrano SV, Garcia RF, Moore F, Camargo JFC, Pires LA, Alves RS, Radinov A, Oreshkov K, Minchev V, Hubenova AI, Koynova T, Ivanov I, Rabotilova B, Minchev V, Petrov PA, Chilingirov P, Karanikolov S, Raynov J, Grimard D, McNeil S, Kumar D, Larratt LM, Weiss K, Delage R, Diaz-Mitoma FJ, Cano PO, Couture F, Carvajal P, Yepes A, Torres Ulloa R, Fardella P, Caglevic C, Rojas C, Orellana E, Gonzalez P, Acevedo A, Galvez KM, Gonzalez ME, Franco S, Restrepo JG, Rojas CA, Bonilla C, Florez LE, Ospina AV, Manneh R, Zorica R, Vrdoljak DV, Samarzija M, Petruzelka L, Vydra J, Mayer J, Cibula D, Prausova J, Paulson G, Ontaneda M, Palk K, Vahlberg A, Rooneem R, Galtier F, Postil D, Lucht F, Laine F, Launay O, Laurichesse H, Duval X, Cornely OA, Camerer B, Panse J, Zaiss M, Derigs HG, Menzel H, Verbeek M, Georgoulias V, Mavroudis D, Anagnostopoulos A, Terpos E, Cortes D, Umanzor J, Bejarano S, Galeano RW, Wong RSM, Hui P, Pedrazzoli P, Ruggeri L, Aversa F, Bosi A, Gentile G, Rambaldi A, Contu A, Marei L, Abbadi A, Hayajneh W, Kattan J, Farhat F, Chahine G, Rutkauskiene J, Marfil Rivera LJ, Lopez Chuken YA, Franco Villarreal H, Lopez Hernandez J, Blacklock H, Lopez RI, Alvarez R, Gomez AM, Quintana TS, Moreno Larrea MDC, Zorrilla SJ, Alarcon E, Samanez FCA, Caguioa PB, Tiangco BJ, Mora EM, Betancourt-Garcia RD, Hallman-Navarro D, Feliciano-Lopez LJ, Velez-Cortes HA, Cabanillas F, Ganea DE, Ciuleanu TE, Ghizdavescu DG, Miron L, Cebotaru CL, Cainap CI, Anghel R, Dvorkin MV, Gladkov OA, Fadeeva NV, Kuzmin AA, Lipatov ON, Zbarskaya II, Akhmetzyanov FS, Litvinov IV, Afanasyev BV, Cherenkova M, Lioznov D, Lisukov IA, Smirnova YA, Kolomietz S, Halawani H, Goh YT, Drgona L, Chudej J, Matejkova M, Reckova M, Rapoport BL, Szpak WM, Malan DR, Jonas N, Jung CW, Lee DG, Yoon SS, Lopez Jimenez J, Duran Martinez I, Rodriguez Moreno JF, Solano Vercet C, de la Camara R, Batlle Massana M, Yeh SP, Chen CY, Chou HH, Tsai CM, Chiu CH, Siritanaratkul N, Norasetthada L, Sriuranpong V, Seetalarom K, Akan H, Dane F, Ozcan MA, Ozsan GH, Kalayoglu Besisik SF, Cagatay A, Yalcin S, Peniket A, Mullan SR, Dakhil KM, Sivarajan K, Suh JJG, Sehgal A, Marquez F, Gomez EG, Mullane MR, Skinner WL, Behrens RJ, Trevarthe DR, Mazurczak MA, Lambiase EA, Vidal CA, Anac SY, Rodrigues GA, Baltz B, Boccia R, Wertheim MS, Holladay CS, Zenk D, Fusselman W, Wade III JL, Jaslowsk AJ, Keegan J, Robinson MO, Go RS, Farnen J, Amin B, Jurgens D, Risi GF, Beatty PG, Naqvi T, Parshad S, Hansen VL, Ahmed M, Steen PD, Badarinath S, Dekker A, Scouros MA, Young DE, Graydon Harker W, Kendall SD, Citron ML, Chedid S, Posada JG, Gupta MK, Rafiyath S, Buechler-Price J, Sreenivasappa S, Chay CH, Burke JM, Young SE, Mahmood A, Kugler JW, Gerstner G, Fuloria J, Belman ND, Geller R, Nieva J, Whittenberger BP, Wong BMY, Cescon TP, Abesada-Terk G, Guarino MJ, Zweibach A, Ibrahim EN, Takahashi G, Garrison MA, Mowat RB, Choi BS, Oliff IA, Singh J, Guter KA, Ayrons K, Rowland KM, Noga SJ, Rao SB, Columbie A, Nualart MT, Cecchi GR, Campos LT, Mohebtash M, Flores MR, Rothstein-Rubin R, O'Connor BM, Soori G, Knapp M, Miranda FG, Goodgame BW, Kassem M, Belani R, Sharma S, Ortiz T, Sonneborn HL, Markowitz AB, Wilbur D, Meiri E, Koo VS, Jhangiani HS, Wong L, Sanani S, Lawrence SJ, Jones CM, Murray C, Papageorgiou C, Gurtler JS, Ascensao JL, Seetalarom K, Venigalla ML, D'Andrea M, De Las Casas C, Haile DJ, Qazi FU, Santander JL, Thomas MR, Rao VP, Craig M, Garg RJ, Robles R, Lyons RM, Stegemoller RK, Goel S, Garg S, Lowry P, Lynch C, Lash B, Repka T, Baker J, Goueli BS, Campbell TC, Van Echo DA, Lee YJ, Reyes EA, Senecal FM, Donnelly G, Byeff P, Weiss R, Reid T, Roeland E, Goel A, Prow DM, Brandt DS, Kaplan HG, Payne JE, Boeckh MG, Rosen PJ, Mena RR, Khan R, Betts RF, Sharp SA, Morrison VA, Fitz-Patrick D, Congdon J, Erickson N, Abbasi R, Henderson S, Mehdi A, Wos EJ, Rehmus E, Beltzer L, Tamayo RA, Mahmood T, Reboli AC, Moore A, Brown JM, Cruz J, Quick DP, Potz JL, Kotz KW, Hutchins M, Chowhan NM, Devabhaktuni YD, Braly P, Berenguer RA, Shambaugh SC, O'Rourke TJ, Conkright WA, Winkler CF, Addo FEK, Duic JP, High KP, Kutner ME, Collins R, Carrizosa DR, Perry DJ, Kailath E, Rosen N, Sotolongo R, Shoham S, Chen T. Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial. The Lancet Infectious Diseases 2019; 19:1001-1012. [DOI: 10.1016/s1473-3099(19)30310-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
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Janakiram M, Ye H, Carjaval L, Villaorduna A, Ramesh K, Shah U, Kornblum N, Fehn K, Braunschweig I, Ueda K, Thiruthuvanathan V, Will B, Pinchasik D, Aivado M, Goel S, Steidl U, Verma A. EXCEPTIONAL RESPONSE OF REFRACTORY ATLL WITH MDM4 AMPLIFICATION TO NOVEL STAPLED PEPTIDE DUAL MDM4/2 INHIBITOR. Hematol Oncol 2019. [DOI: 10.1002/hon.210_2631] [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: 11/11/2022]
Affiliation(s)
- M. Janakiram
- HOT; University of Minnesota; Minneapolis United States
| | - H.B. Ye
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | | | - A. Villaorduna
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - K. Ramesh
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - U. Shah
- Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - N. Kornblum
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - K. Fehn
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - I. Braunschweig
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - K. Ueda
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | | | - B. Will
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | | | - M. Aivado
- ALRN Therapeutics; MA; United States
| | - S. Goel
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - U. Steidl
- Oncology; Albert Einstein College of Medicine; Bronx United States
| | - A.K. Verma
- Oncology; Albert Einstein College of Medicine; Bronx United States
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Borcoman E, Kanjanapan Y, Champiat S, Kato S, Servois V, Kurzrock R, Goel S, Bedard P, Le Tourneau C. Novel patterns of response under immunotherapy. Ann Oncol 2019. [PMID: 30657859 DOI: 10.1093/annonc/mdz003.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Novel patterns of response and progression to immunotherapy have been reported that are not observed with conventional cytotoxic or targeted anticancer treatments. A major breakthrough with immunotherapy is its potential to achieve durable responses in a subset of patients with advanced cancer that can be maintained several years even after stopping the treatment. No standardized definition of durable response exists in the literature, and the optimal duration of treatment in case of durable response is not clearly established. However, the majority of patients do not respond to immunotherapy. Initially reported in advanced melanoma patients, pseudoprogression occurs when tumor index lesions regress after initial progression, supporting the concept of treating some patients beyond progression. Overall, reported rates of pseudoprogression never exceeded 10%, meaning that the large majority of patients who have a disease progression will not eventually respond to treatment. The decision to pursue treatment beyond progression must therefore only be taken in carefully selected patients with clinical benefit, who did not experience severe toxicities with immunotherapy. Conversely, rapid progressions, called hyperprogressions, were reported by several teams with rates ranging from 4% to 29%. These observations need to be confirmed from randomized trials. It is essential to interrupt the treatment in patients with hyperprogression, in order to switch to another potentially active treatment. Finally, some patients experience dissociated responses, with some lesions shrinking and others growing. Local treatment with surgery or radiotherapy for growing lesions may be considered. Several immune-specific-related response criteria were developed to better capture benefits of immunotherapy. These criteria only address the pseudoprogression pattern of response, and do not capture the other patterns of response such as hyperprogression and dissociated response. The classic RECIST remains a reasonable and meaningful method to assess response to immunotherapy in the clinic.
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Affiliation(s)
- E Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France
| | - Y Kanjanapan
- Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - S Champiat
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - S Kato
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - V Servois
- Department of Imaging, Institut Curie, Paris, France
| | - R Kurzrock
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - S Goel
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, USA
| | - P Bedard
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada
| | - C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud; Paris-Saclay University, Paris, France.
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Borcoman E, Kanjanapan Y, Champiat S, Kato S, Servois V, Kurzrock R, Goel S, Bedard P, Le Tourneau C. Novel patterns of response under immunotherapy. Ann Oncol 2019; 30:385-396. [PMID: 30657859 DOI: 10.1093/annonc/mdz003] [Citation(s) in RCA: 307] [Impact Index Per Article: 61.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- E Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France
| | - Y Kanjanapan
- Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - S Champiat
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - S Kato
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - V Servois
- Department of Imaging, Institut Curie, Paris, France
| | - R Kurzrock
- Division of Hematology and Oncology, Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, La Jolla, USA
| | - S Goel
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, USA
| | - P Bedard
- Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada
| | - C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud; Paris-Saclay University, Paris, France.
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Pernas S, Goel S, Harrison BT, Hu J, Johnson N, Regan M, Chichester LA, Nakhlis F, Schlosnagle EJ, Winship G, Guerriero JL, Parsons H, Mittendorf EA, Overmoyer B. Abstract PD3-08: Assessment of the tumor immune environment in inflammatory breast cancer treated with neoadjuvant dual-HER2 blockade. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd3-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer that remains relatively understudied. We examined the efficacy of neoadjuvant dual-HER2 blockade (trastuzumab (H) and pertuzumab (P)) combined with paclitaxel (T) in HER2+ IBC, including a planned analysis to elucidate associations between the tumor immune microenvironment profile and response to therapy.
Methods: An IRB-approved, single-arm phase II trial for patients (pts) with newly diagnosed HER2+ IBC was conducted. Pts had a pre-treatment biopsy of the affected breast (D1) followed by a loading dose of HP. A second biopsy was performed 1 week (wk) later (D8), when T (80mg/m2/wk x 16 wks) was added to HP. Responding pts underwent modified radical mastectomy (MRM) where residual disease was collected. The primary objective was to determine the rate of pathologic complete response (pCR) defined as ypT0/isN0. Residual Cancer Burden (RCB) was also determined. Tumor specimens from D1, D8 and MRM were assessed for disease cellularity and scored for percentage of tumor infiltrating lymphocytes (TILs): low=0-10%, intermediate=11-59%, high>60%. RNA-sequencing was performed on tumor tissue from D1 and D8 to explore the impact of short-term HP treatment on the tumor transcriptomic profile and to identify potential predictors of pCR.
Results: 23 pts with HER2+ IBC were enrolled between 8/2013-6/2017. Mean age was 48 years (range 32-74); 11 pts (48%) had estrogen and progesterone receptor (ER/PR) negative disease. Matched tumor biopsies (D1, D8) were obtained in all 23 pts; 21 underwent MRM; 1 was lost to follow-up and 1 had disease progression. In the intent to treat analysis, 10/23 (43%) pts achieved a pCR and 7 (30%) had RCB-1. Ten of the 22 evaluable pts achieved a pCR (45.5%). TILs were evaluable in 20/23 (87%) matched tumor biopsies (D1, D8). Among the D1 biopsy specimens: 19 (95%) had low levels, 2 (10%) had intermediate levels, and none had high levels. When D1 TIL levels were compared with D8 levels, 3(15%) had an increase in TILs, 16(80%) had no change in TIL levels, and 1(5%) had a decrease in the level of TILs. Both samples with intermediate levels and 2 of 3 samples with high levels of TILs on D1 and D8 were seen in ER/PR negative disease. An evaluation of biopsy specimens associated with subsequent pCR using GO enrichment analysis from the RNA-Seq data showed significant upregulation of several immune-process related gene expression signatures both at D1 and D8 (e.g. antigen processing and presentation, TCR signaling, NK cell cytotoxicity, p-value: 2.99E-48 to 1.39E-16) when compared with those associated with residual disease at the time of MRM. Across the entire cohort, D8 biopsies showed evidence of upregulated anti-tumor immunity compared to D1 biopsies (p-value: 9.57E-06 to 0.012). Notably, this change from D1 to D8 was largely restricted to tumors that achieved a pCR.
Conclusion: THP for 16 weeks was a highly effective treatment for HER2+ IBC. Immune activation as determined by gene expression signatures predicted pCR, and moreover upregulation of anti-tumor immunity after 1 wk of HP might further predict a complete pathologic response to therapy. ClinicalTrials.gov identifier: NCT01796197
Citation Format: Pernas S, Goel S, Harrison BT, Hu J, Johnson N, Regan M, Chichester LA, Nakhlis F, Schlosnagle EJ, Winship G, Guerriero JL, Parsons H, Mittendorf EA, Overmoyer B. Assessment of the tumor immune environment in inflammatory breast cancer treated with neoadjuvant dual-HER2 blockade [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD3-08.
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Affiliation(s)
- S Pernas
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - S Goel
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - BT Harrison
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - J Hu
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - N Johnson
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - M Regan
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - LA Chichester
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - F Nakhlis
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - EJ Schlosnagle
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - G Winship
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - JL Guerriero
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - H Parsons
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - EA Mittendorf
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - B Overmoyer
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
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Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. Abstract P6-18-10: A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-10] [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
Introduction:
Despite the success of anti-HER2 therapy, acquired resistance usually develops in the metastatic setting. CDK4/6 pathway activity has been identified as a mediator of this resistance, and in preclinical studies the combination of CDK4/6 and HER2 blockade can be more effective than either therapy alone. We conducted a single-arm phase 1b/2 study of the CDK4/6 inhibitor ribociclib given with trastuzumab or T-DM1 to subjects with advanced, treatment-refractory HER2-positive breast cancer. The results of the trastuzumab cohort are presented below. The primary objective was to determine the clinical benefit rate (CBR) at 24 weeks, and secondary endpoints included objective response rate (ORR), progression-free survival (PFS), and adverse events.
Methods: Individuals with locally advanced or metastatic, measurable HER2-positive breast cancer were eligible. All subjects must have previously received trastuzumab, pertuzumab, and T-DM1 as (neo)adjuvant or metastatic therapy. There was no limit on the number of prior lines of treatment. Patients with previous CDK4/6 inhibitor exposure, QTcF > 450msec on EKG, or without stable brain metastases were excluded. An initial safety run-in phase (with dose-limiting toxicity (DLT) monitoring) included six subjects who received trastuzumab (8mg/kg loading then 6mg/kg IV three-weekly) and ribociclib 400mg PO daily on a continuous schedule (cycle length 21 days). The study had a two-stage design. The first stage required 20 patients, at least 6 of whom must have demonstrated clinical benefit (CR+PR+ SD>24 weeks) in order to recruit 15 more patients to the second stage. All patients with accessible disease underwent metastatic tumor biopsies at baseline and C2D1.
Results: 13 patients were enrolled (6 in the safety run-in and 7 in the expansion cohort). One patient was found to have HER2-negative disease and did not receive treatment. Patient characteristics are shown in Table 1 No DLTs were observed during the safety run-in phase, and ribociclib was thus used at 400mg po daily for the expansion cohort. Grade 3/4 toxicities were observed in 5 patients (41.7%) and included neutropenia (n=2), and fatigue, pain, and muscle weakness (all n=1). No patient demonstrated QTc prolongation >480 msec, or grade 3/4 LFTs. 1/12 patients ((8.3%); 95% CI 0.2%-38.5%) achieved stable disease>24 weeks; no objective responses were observed, and median PFS was 41.5 days. The trastuzumab portion of study was closed early due to limited clinical activity observed (the T-DM1 with ribociclib cohort remains open).
Table 1Age (median, range)50.5 (42 - 71)Number of prior lines of systemic therapy for metastatic disease (median, range)5.5 (0-14)Number with Hormone receptor-positive disease (%)8 (67 %)Number of metastatic sites (median, range)2.5 (2 - 5)
Conclusions: The combination of trastuzumab and ribociclib (400mg daily continuous schedule) is safe, with no new safety signals observed. The limited activity seen in this heavily pretreated population suggests that future efforts to incorporate CDK4/6 inhibition should be limited to a less extensively treat population.
Citation Format: Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-10.
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Affiliation(s)
- S Goel
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - L Spring
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - R Rees
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - C Andrews
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - RK Tahara
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EL Mayer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - A Bardia
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EP Winer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - SM Tolaney
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
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Goel S. Abstract TS3-2: Modulation of anti-tumor immunity using CDK4/6 inhibitors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ts3-2] [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
Several pharmacological inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) have now been approved for the treatment of metastatic estrogen receptor-positive breast cancer. Although CDK4/6 inhibitors were initially developed to prevent cancer cell proliferation, preclinical studies have now demonstrated that they can also exert other biological effects in solid tumors including augmentation of anti-tumor immunity. The detailed mechanisms underlying this are currently under investigation, and likely include enhanced antigen presentation by tumor cells as well as an increase in the ratio of effector to regulatory T lymphocytes. In this presentation, I will discuss our current understanding of how CDK4/6 inhibitors might stimulate anti-tumor immune responses, focusing on breast cancer. I will also discuss if and how this unexpected phenomenon might be leveraged for therapeutic benefit.
Citation Format: Goel S. Modulation of anti-tumor immunity using CDK4/6 inhibitors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr TS3-2.
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Affiliation(s)
- S Goel
- Dana-Farber Cancer Institute, Boston, MA
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Lim Y, Goel S, Brimacombe JR. The ProSeal™ Laryngeal Mask Airway is an Effective Alternative to Laryngoscope-Guided Tracheal Intubation for Gynaecological Laparoscopy. Anaesth Intensive Care 2019; 35:52-6. [PMID: 17323666 DOI: 10.1177/0310057x0703500106] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We tested the hypothesis that the ProSeal™ laryngeal mask airway is superior to laryngoscope-guided tracheal intubation for gynaecological laparoscopy. One-hundred and eighty consecutive patients (ASA grade 1-2, aged 18-80y) were divided into two equal-sized groups for airway management with the ProSeal™ laryngeal mask airway or tracheal tube. Induction was with fentanyl/propofol, maintenance with sevoflurane and muscle relaxation with atracurium. The following primary variables were tested: time to achieve an effective airway, ventilatory capability, peak airway pressure before and after pneumoperitoneum, duration of surgery and pneumoperitoneum and haemodynamic responses. Data about gastric size, airway trauma and sore throat were collected. The number of attempts for successful insertion were similar, but effective airway time was shorter for the ProSeal™ laryngeal mask airway (20±2s vs 37±3s, P<0.001). All devices were successfully inserted within three attempts. There was no episode of failed ventilation or hypoxia. The haemodynamic stress responses to insertion and removal were greater for the tracheal tube than the ProSeal™ laryngeal mask airway. The duration of surgery, duration of pneumoperitoneum and intraabdominal pressures were similar. Gastric size was similar at the start and end of surgery. There were no differences in the frequency of complications or sore throat. We conclude that the ProSeal™ laryngeal mask airway is a similarly effective airway device to conventional laryngoscope-guided tracheal intubation for gynaecological laparoscopy, but is more rapidly inserted and associated with an attenuated haemodynamic response to insertion and removal.
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Affiliation(s)
- Y Lim
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
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Mau-Sorensen M, van Bussel M, Kuipers M, Nielsen D, Verheul H, Aftimos P, de Jonge M, van Triest B, Falkenius J, Debus J, Troost E, Samuels M, Sarholz B, Budach V, Goel S, Locatelli G, Geertsen P. Safety, clinical activity and pharmacological biomarker evaluation of the DNA-dependent protein kinase (DNA-PK) inhibitor M3814: Results from two phase I trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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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63
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Johnson M, Galsky M, Barve M, Goel S, Park H, Du B, Mu S, Ramakrishnan V, Wood K, Wang V, Lakhani N. Preliminary results of pamiparib (BGB-290), a PARP1/2 inhibitor, in combination with temozolomide (TMZ) in patients (pts) with locally advanced or metastatic solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.409] [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: 11/14/2022] Open
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64
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Glisson B, Leidner R, Ferris R, Powderly J, Rizvi N, Keam B, Schneider R, Goel S, Ohr J, Zheng Y, Eck S, Gribbin M, Townsley D, Chiou V, Patel S. Safety and clinical activity of MEDI0562, a humanized OX40 agonist monoclonal antibody, in adult patients with advanced solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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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65
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Goel S, Ocean A, Parakrama R, Ghalib M, Chaudhary I, Shah U, Coffey M, Kaledzi E, Maitra R. Dose finding and safety study of reovirus (Reo) with irinotecan/ fluorouracil/ leucovorin/ bevacizumab (FOLFIRI/B) in patients with KRAS mutant metastatic colorectal cancer (mCRC): Final results. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.111] [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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66
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Bazhenova L, Carvajal R, Cho B, Eaton K, Goel S, Heist R, Ingham M, Wang D, Werner T, Neuteboom S, Potvin D, Chen I, Christensen J, Chao R, Alva A. Sitravatinib demonstrates activity in patients with novel genetic alterations that inactivate CBL. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.396] [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: 11/14/2022] Open
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67
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Affiliation(s)
- R. Saran
- Division of Nephrology, Department of Internal Medicine, University of Missouri-Columbia, Columbia Missouri Dalton Cardiovascular Research Center, Columbia, Missouri - USA
| | - S. Goel
- Division of Nephrology, Department of Internal Medicine, University of Missouri-Columbia, Columbia Missouri Dalton Cardiovascular Research Center, Columbia, Missouri - USA
| | - R. Khanna
- Division of Nephrology, Department of Internal Medicine, University of Missouri-Columbia, Columbia Missouri Dalton Cardiovascular Research Center, Columbia, Missouri - USA
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Metzger-Filho O, Mandrekar S, Loibl S, Ciruelos E, Gianni L, Lim E, Miller K, Huang C, Koehler M, Francis P, Valagussa P, Goel S, Prat A, Goetz M, Loi S, Krop I, Carey L, Lanzillotti J, Winer E, Tripathy D, DeMichele A. Abstract OT3-05-07: PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2 positive metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-05-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Pre-clinical data and initial results from clinical studies point to the added benefit of CDK4/6 inhibition when combined with anti-HER2 tx. The current study is designed to evaluate the added benefit of palbociclib when given in combination with anti-HER2 and endocrine tx maintenance in the 1st†line setting of metastatic HER2+HR+ breast cancer.
Trial design
PATINA is an international, open-label, pivotal Phase III study. Primary objective is to demonstrate that the combination of palbociclib with anti-HER2 plus endocrine tx is superior to anti-HER2 plus endocrine tx in prolonging PFS. Sample size is 496 pts. The study starts after completion of 6-8 cycles of chemotherapy-containing anti-HER2 tx for metastatic breast cancer in the 1st line setting. Pts are eligible provided they are without evidence of disease progression by local assessment (i.e. CR, PR or SD). To account for the need for less intense tx regimens for a subset of pts diagnosed with HER2+ER+ disease, clinicians may recommend the combination of trastuzumab with either a taxane or vinorelbine prior to study initiation. Clinicians might also choose a non-pertuzumab option for pts previously treated with pertuzumab in the neo(adjuvant) setting. Secondary objectives include measures of tumor control (OR, CBR, DOR), OS, safety and QOL. The translational science main objective is to compare PFS estimates according to PIK3CA mutation status assessed by cfDNA analysis. Endocrine tx options are AI or fulvestrant. Premenopausal pts must receive ovarian suppression. The study has a 90% power to detect a hazard ratio of 0.667 in favor of the palbociclib arm. Pts approached to participate in AFT-38 will be asked to indicate on the informed consent forms whether remaining biospecimens and clinical data from the control arm of the study can be shared with the Mastering Breast Cancer (MBC) Initiative. The overarching purpose of the MBC is to create a mechanism for understanding the natural history of metastatic breast cancer by cataloguing longitudinally studied tumor-specific markers and treatment effects.
ClinicalTrials.gov Identifier: NCT02947685
Citation Format: Metzger-Filho O, Mandrekar S, Loibl S, Ciruelos E, Gianni L, Lim E, Miller K, Huang C, Koehler M, Francis P, Valagussa P, Goel S, Prat A, Goetz M, Loi S, Krop I, Carey L, Lanzillotti J, Winer E, Tripathy D, DeMichele A. PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2 positive metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-05-07.
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Affiliation(s)
- O Metzger-Filho
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Mandrekar
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Loibl
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Ciruelos
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - L Gianni
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Lim
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - K Miller
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - C Huang
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - M Koehler
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - P Francis
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - P Valagussa
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Goel
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - A Prat
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - M Goetz
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - S Loi
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - I Krop
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - L Carey
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - J Lanzillotti
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - E Winer
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - D Tripathy
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
| | - A DeMichele
- Alliance Foundation Trials; German Breast Group; SOLTI; Australia & New Zealand Breast Cancer Trials Group; Fondazonie Michelangelo; Pfizer; prECOG
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69
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Goel S, Ocean A, Chaudhary I, Ghalib M, Kaledzi E, Shah U, Gutierrez A, Coffey M, Gill G, Maitra R. Mechanism of pelareorep (Pel)-mediated cell death in a Phase I study in combination with irinotecan/fluorouracil/leucovorin/bevacizumab (FOLFIRI/B) in patients with KRAS mutant metastatic colorectal cancer (mCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.049] [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: 11/14/2022] Open
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70
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Atiemo K, Skaro A, Maddur H, Zhao L, Montag S, VanWagner L, Goel S, Kho A, Ho B, Kang R, Holl JL, Abecassis MM, Levitsy J, Ladner DP. Mortality Risk Factors Among Patients With Cirrhosis and a Low Model for End-Stage Liver Disease Sodium Score (≤15): An Analysis of Liver Transplant Allocation Policy Using Aggregated Electronic Health Record Data. Am J Transplant 2017; 17:2410-2419. [PMID: 28226199 PMCID: PMC5769449 DOI: 10.1111/ajt.14239] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/07/2017] [Accepted: 02/12/2017] [Indexed: 01/25/2023]
Abstract
Although the Model for End-Stage Liver Disease sodium (MELD Na) score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7834 adult patients with cirrhosis, we determined whether the cause of cirrhosis or cirrhosis complications was associated with an increased risk of death among patients with a MELD Na score ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT). Over median follow-up of 2.3 years, 3715 patients had a maximum MELD Na score ≤15. Overall, 3.4% were waitlisted for LT. Severe hypoalbuminemia, hepatorenal syndrome, and hepatic hydrothorax conferred the greatest risk of death independent of MELD Na score with 1-year predicted mortality >14%. Approximately 10% possessed these risk factors. Of these high-risk patients, only 4% were waitlisted for LT, despite no difference in nonliver comorbidities between waitlisted patients and those not listed. In addition, risk factors for death among waitlisted patients were the same as those for patients not waitlisted, although the effect of malnutrition was significantly greater for waitlisted patients (hazard ratio 8.65 [95% CI 2.57-29.11] vs. 1.47 [95% CI 1.08-1.98]). Using the MELD Na score for allocation may continue to limit access to LT.
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Affiliation(s)
- K Atiemo
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - A Skaro
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - H Maddur
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine
| | - L Zhao
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - S Montag
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - L VanWagner
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine,Department of Preventive Medicine, Feinberg School of Medicine
| | - S Goel
- Center for Health Information Partnerships, Institute for Public Health and Medicine
| | - A Kho
- Center for Health Information Partnerships, Institute for Public Health and Medicine
| | - B Ho
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - R Kang
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine
| | - JL Holl
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine,Department of Pediatrics, Feinberg School of Medicine
| | - MM Abecassis
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine
| | - J Levitsy
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Division of Hepatology, Department of Medicine
| | - DP Ladner
- Northwestern University Transplant Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine,Center for Healthcare Studies, Institute for Public Health and Medicine
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Metzger O, Mandrekar S, Ciruelos E, Loibl S, Valagussa P, Demichele A, Lim E, Tripathy D, Winer E, Huang C, Khoeler M, Carey L, Francis P, Miller K, Goel S, Goetz M, Prat A, Loi S, Krop I, Gianni L. PATINA: A randomized open label phase III trial to evaluate the efficacy and safety of palbociclib + anti HER2 therapy + endocrine therapy vs anti HER2 therapy + endocrine therapy after induction treatment for hormone receptor positive, HER2-positive metastatic breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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72
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Payton M, Pinchasik D, Mehta A, Goel S, Zain J, Sokol L, Jacobsen E, Patel M, Horwitz S, Meric-Bernstam F, Shustov A, Weinstock D, Aivado M, Annis D. Phase 2a study of a novel stapled peptide ALRN-6924 disrupting MDMX- and MDM2-mediated inhibition of wild-type TP53 in patients with peripheral t-cell lymphoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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73
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Fanari Z, Goel S, Goldstein JA. Successful percutaneous retrieval of embolized transcatheter left atrial appendage closure device (Watchman) using a modified vascular retrieval forceps. Cardiovasc Revasc Med 2017; 18:616-618. [PMID: 28595810 DOI: 10.1016/j.carrev.2017.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
Transcatheter closure of the left atrial appendage (LAA) is increasingly considered as an alternative to oral anticoagulation in patients with previous major bleeding or at high-risk of bleeding. Device embolization with transcatheter LAA closure is a rare complication. Most cases are asymptomatic, but it can be life threatening. Depending on the location of embolization, percutaneous retrieval is feasible. Snares are usually used for retrieval, but other devices may be used. We report the case of a 63-year gentleman who underwent an uneventful LAA closure with Watchman device and routine testing next day showed embolization to the abdominal aorta. Retrieval was performed using a modified Cook vascular retrieval forceps.
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Lofters AK, Vahabi M, Prakash V, Banerjee L, Bansal P, Goel S, Dunn S. Lay health educators within primary care practices to improve cancer screening uptake for South Asian patients: challenges in quality improvement. Patient Prefer Adherence 2017; 11:495-503. [PMID: 28331296 PMCID: PMC5352230 DOI: 10.2147/ppa.s127147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cancer screening uptake is known to be low among South Asian residents of Ontario. The objective of this pilot study was to determine if lay health educators embedded within the practices of primary care providers could improve willingness to screen and cancer screening uptake for South Asian patients taking a quality improvement approach. MATERIALS AND METHODS Participating physicians selected quality improvement initiatives to use within their offices that they felt could increase willingness to screen and cancer screening uptake. They implemented initiatives, adapting as necessary, for six months. RESULTS Four primary care physicians participated in the study. All approximated that at least 60% of their patients were of South Asian ethnicity. All physicians chose to work with a preexisting lay health educator program geared toward South Asians. Health ambassadors spoke to patients in the office and telephoned patients. For all physicians, ~60% of South Asian patients who were overdue for cancer screening and who spoke directly to health ambassadors stated they were willing to be screened. One physician was able to track actual screening among contacted patients and found that screening uptake was relatively high: from 29.2% (colorectal cancer) to 44.6% (breast cancer) of patients came in for screening within six months of the first phone calls. Although physicians viewed the health ambassadors positively, they found the study to be time intensive and resource intensive, especially as this work was additional to usual clinical duties. DISCUSSION Using South Asian lay health educators embedded within primary care practices to telephone patients in their own languages showed promise in this study to increase awareness about willingness to screen and cancer screening uptake, but it was also time intensive and resource intensive with numerous challenges. Future quality improvement efforts should further develop the phone call invitation process, as well as explore how to provide infrastructure for lay health educator training and time.
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Affiliation(s)
- AK Lofters
- Department of Family and Community Medicine
- Dalla Lana School of Public Health, University of Toronto
- Department of Family and Community Medicine
- Centre for Urban Health Solutions, St Michael’s Hospital
| | - M Vahabi
- Daphne Cockwell School of Nursing, Ryerson University, Toronto
| | - V Prakash
- Screening Saves Lives Program, Canadian Cancer Society, Mississauga
| | - L Banerjee
- Wise Elephant Family Health Team, Brampton
| | - P Bansal
- Mississauga Halton Central West Regional Cancer Program, Mississauga
| | - S Goel
- Wise Elephant Family Health Team, Brampton
- Mississauga Halton Central West Regional Cancer Program, Mississauga
| | - S Dunn
- Department of Family and Community Medicine
- Dalla Lana School of Public Health, University of Toronto
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
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75
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Overmoyer B, Goel S, Regan M, Hirshfield-Bartek J, Schlosnagel E, Yeh E, Qin L, Bellon J, Nakhlis F, Jacene H, Winer E. Abstract OT1-01-07: A phase 2 study of eribulin followed by doxorubicin and cyclophosphamide as preoperative therapy for HER2-negative inflammatory breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-01-07] [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: HER2 negative(neg) inflammatory breast cancer(IBC) exhibits relative resistance to chemotherapy evidenced by pCR(pathologic complete response rate) rates of 12-25% with preoperative taxane/anthracycline regimens. Eribulin(Eisai®) inhibits microtubular function via sequestration of tubulin into nonfunctional aggregates, thus being effective against taxane-resistant cancer. Preclinical data shows 2 mechanisms of action: reversion of EMT(epithelial to mesenchymal transition) and normalization of tumor vascularity. Treatment of triple negative breast cancer(TNBC) cell-lines with eribulin results in downregulation of mesenchymal markers with concomitant increase in expression of classical epithelial markers(Yoshida BJC 2014). In PDX models, eribulin improved blood perfusion in central region of tumors, increased vessel density, reduced vessel diameter, and reduced hypoxia. IBC is highly angiogenic, with increased microvessel density, higher fraction of proliferating endothelial cells and greater expression of pro-angiogenic genes compared with non-IBC(McCarthy CCR 2002). This preoperative study(EAC) exploits the angiogenic properties of IBC with the treatment scheme of eribulin(E) followed by doxorubicin/cyclosphosphamide(AC) in newly diagnosed HER2neg IBC.
Methods: Pts with HER2neg Stage III (cT4d,any N,M0) IBC are eligible if they have not received prior therapy for BC, have adequate organ function, cardiac ejection fraction > 50%, and willing to undergo 2 research biopsies (rbx) of the affected breast. Following baseline rbx, pts receive cycle 1, day(d)1 eribulin 1.4 mg/m2. A 2nd rbx occurs on d8, prior to dosing of E. Following 3 more cycles of E(1.4mg/m2 d1,d8,every 21d), pts receive 4 cycles of dose-dense AC(A-60 mg/m2,C-600mg/m2 every 14d). Pts with adequate disease response undergo mastectomy/axillary lymph node dissection followed by chest wall/regional lymph node radiation. Adjuvant endocrine therapy is used if hormone receptor positive. An imaging sub-study evaluates tumor perfusion via DCE-MRI pre and post 1st dose E.
Correlatives: To investigate whether E induces reversion of EMT in IBC, expression of 10 EMT-related genes are determined in each rbx, and normalization of tumor vessel phenotype are assessed by expression of 15 angiogenesis-related genes in rbx by RT-qPCR. Gene expression will be repeated on residual tumor at mastectomy. An imaging sub-study of DCE-MRI (10 pts) will assess vascular remodeling via changes in Ktrans , ve and vp determination of IBC region of interest, core and rim and changes in the iAUC computed pre and post 1st dose E.
Statistics: The primary endpoint is pCR. A Simon two-stage design is used. If the proportion of pts having pCR is < 0.10 then EAC is considered minimally effective, versus alternative hypothesis that EAC is worthy of further study if proportion pCR > 0.30. In the 1st stage, if < 2/16 pts have pCR, the study is stopped; if > 3 pts have pCR, the study proceeds. In the 2nd stage, EAC is rejected if < 4 of 25 pts have a pCR(α=0.10;β=0.10). Up to 25 pts will be enrolled. Secondary endpoints are residual cancer burden, disease-free survival, time to treatment failure and overall survival. Clinical trial information: NCT02623972.
Citation Format: Overmoyer B, Goel S, Regan M, Hirshfield-Bartek J, Schlosnagel E, Yeh E, Qin L, Bellon J, Nakhlis F, Jacene H, Winer E. A phase 2 study of eribulin followed by doxorubicin and cyclophosphamide as preoperative therapy for HER2-negative inflammatory breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-01-07.
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Affiliation(s)
- B Overmoyer
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - S Goel
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - M Regan
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - J Hirshfield-Bartek
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - E Schlosnagel
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - E Yeh
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - L Qin
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - J Bellon
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - F Nakhlis
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - H Jacene
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - E Winer
- Dana Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA
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Jacene HA, Overmoyer B, Schlosnagle EJ, Abbott A, Yeh E, Paolino J, Goel S, Culhane A, Bellon JR, Nakhlis F, Hirshfield-Bartek J, Van den Abbeele A. Abstract OT2-02-03: Pilot study of zirconium-89 bevacizumab positron emission tomography for imaging angiogenesis in patients with inflammatory breast carcinoma receiving preoperative chemotherapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot2-02-03] [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: Inflammatory breast cancer (IBC) continues to have a poor prognosis despite standard tri-modality treatment with chemotherapy, mastectomy and radiation. Current methods of assessing primary tumor response (i.e., clinical exam and breast magnetic resonance imaging [MRI]) are limited for distinguishing residual tumor from responsive disease because of persistent morphologic changes in the breast. Therefore, the inability to accurately assess tumor response during treatment often results in the continuation of ineffective systemic chemotherapy until definitive pathologic evaluation at mastectomy. IBC has a highly angiogenic phenotype which is believed to play a role in this tumor's aggressiveness. The novel radiotracer Zirconium-89 (89Zr)-bevacizumab was developed for imaging tumor angiogenesis with PET. We hypothesize that, as an imaging biomarker of angiogenesis, 89Zr-bevacizumab-PET/CT is a more specific noninvasive functional imaging modality for detecting the presence of tumor angiogenesis compared to current diagnostic methods and will serve as a predictor of response to therapy in patients (pts) with IBC.
Methods: Pts with newly diagnosed HER2neg IBC who will receive preoperative chemotherapy are eligible for this pilot study. 89Zr-bevacizumab-PET/CT, breast MRI and FDG-PET/CT are performed before, after 2 cycles, and at the completion of preoperative therapy. Biopsies of primary IBC tumors are obtained prior to and after 2 cycles of preoperative therapy. At the completion of preoperative therapy, pts proceed to mastectomy or biopsy if ineligible to proceed to mastectomy based on current standards for assessing primary tumor response, i.e., clinical exam, breast MRI and lack of systemic progression. At the time of mastectomy, standard evaluation of the surgical specimen will determine pathologic response of IBC to preoperative chemotherapy. A research sample will be collected if residual cancer is present at the time of mastectomy for histologic evaluation of tumor angiogenesis.
Objectives/Correlatives: The primary objective is to determine feasibility of 89Zr-bevacizumab-PET/CT imaging in pts with IBC. The primary endpoint is assessment of radiolabeling of chelated bevacizumab and number of successfully acquired 89Zr-bevacizumab-PET/CT scans. Correlative studies will be performed on IBC tissue to assess extent of angiogenesis including microvessel density, vessel diameter, vascular pericyte coverage and tumor VEGF levels. Secondary objectives are: 1) To determine if 89Zr-bevacizumab accumulation in primary IBC tumors correlates with the extent of angiogenesis determined by correlative analysis on IBC tissue; 2) To assess the predictive value of 89Zr-bevacizumab-PET/CT after 2 cycles and at the end of preoperative therapy for determining pathologic response at mastectomy as given by residual cancer burden.
Statistics: This is an accrual, not statistical based, feasibility justification. Planned sample size is 10 in order to make a preliminary statement about feasibility and ability for 89Zr-bevacizumab-PET/CT to serve as a surrogate in vivo biomarker of tumor angiogenesis and response to preoperative chemotherapy.
Clinical Trial Information: NCT01894451.
Citation Format: Jacene HA, Overmoyer B, Schlosnagle EJ, Abbott A, Yeh E, Paolino J, Goel S, Culhane A, Bellon JR, Nakhlis F, Hirshfield-Bartek J, Van den Abbeele A. Pilot study of zirconium-89 bevacizumab positron emission tomography for imaging angiogenesis in patients with inflammatory breast carcinoma receiving preoperative chemotherapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT2-02-03.
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Affiliation(s)
- HA Jacene
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - B Overmoyer
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - EJ Schlosnagle
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - A Abbott
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - E Yeh
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - J Paolino
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - S Goel
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - A Culhane
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - JR Bellon
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - F Nakhlis
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - J Hirshfield-Bartek
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
| | - A Van den Abbeele
- Dana-Farber Cancer Institute; Brigham and Women's Hospital; Co-First Authors Contributing Equally to This Work
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Goel S, Ramachandran A. The suppression of droplet-droplet coalescence in a sheared yield stress fluid. J Colloid Interface Sci 2016; 492:199-206. [PMID: 28110225 DOI: 10.1016/j.jcis.2016.12.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
Efforts to stabilize emulsions against coalescence in flow have often focused on modifying properties of the interface between the continuous and dispersed phases, to create a repulsive barrier against coalescence. But prior to experiencing any interaction force, the liquid film between two colliding drops has to drain, and if this drainage process is arrested, coalescence will be suppressed. In this work, scaling analyses and thin-film lubrication simulations are used to study the hydrodynamic drainage properties of thin films of a Bingham fluid (a yield stress fluid, which flows only when a critical stress is exceeded) created between two drops colliding under the action of a constant force. Our study shows that the hydrodynamic drainage process can be arrested completely when the film reaches a critical thickness, before attractive forces result in the rupture of the film, provided that the film shape is in the dimpled configuration. This critical thickness is hf=6τ02R3/γ2, where τ0 is the yield stress of the suspending medium, R is the drop radius and γ is the interfacial tension between the fluids. The yield stress can thus serve as an independent tuning parameter that sets an upper bound on the drop size beyond which coalescence is turned off in sheared emulsions.
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Affiliation(s)
- Sachin Goel
- Department of Chemical Engineering & Applied Chemistry, University of Toronto, 200 College Street, Toronto, ON M5S 3E5, Canada
| | - Arun Ramachandran
- Department of Chemical Engineering & Applied Chemistry, University of Toronto, 200 College Street, Toronto, ON M5S 3E5, Canada.
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Goel S, Arora J, Mehta V, Sharma M, Suri RK, Rath G, Das S. Adductor accessorius - an unusual supernumerary adductor muscle of thigh. Clin Ter 2016; 166:114-7. [PMID: 26152618 DOI: 10.7417/ct.2015.1840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The knowledge of variant anatomy of medial compartment of thigh is extremely important in surgical procedures requiring obturator nerve block. The nerve block is also recommended for providing additional analgesia following major knee surgeries and for relieving painful adductor muscle spasm. The interfascial injection technique is commonly followed in ultrasound guided obturator nerve block. For this procedure it is imperative to identify the adductor muscles on sonography to inject the anesthetic solution in the intermuscular fascial planes. The presence of an additional muscle can prove useful in myocutaneous flap surgeries for reconstruction especially of perineum. We hereby report a case of such an anomalous supernumerary adductor muscle present between adductor brevis and proximal part of adductor magnus, in an adult Indian male cadaver, recorded during routine dissection in Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital. The muscle was innervated by the posterior division of obturator nerve. The morphology, embryological basis and clinical aspects are also discussed.
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Affiliation(s)
- S Goel
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - J Arora
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - V Mehta
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - M Sharma
- Department of Reproductive Biology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
| | - R K Suri
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - G Rath
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - S Das
- Department of Anatomy, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
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Naing A, Goel S, Curti B, Weise A, Eder J, Marshall S, Morehouse C, Li X, Karakunnel J, Infante J. A Phase 1 first-in-human study of MEDI0680, an anti-PD-1 monoclonal antibody (mAb) in adult patients (pts) with advanced tumors. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.26] [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: 11/14/2022] Open
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Tolaney S, Bourayou N, Goel S, Forrester T, André F. monarcHER: A phase 2 randomized open-label study of abemaciclib plus trastuzumab (T) with or without fulvestrant (F) compared to standard-of-care chemotherapy of physician's choice plus T in women with HR +, HER2+ advanced breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.93] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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81
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Bhardwaj A, Chauhan NS, Goel S, Singh V, Pulikkotil JJ, Senguttuvan TD, Misra DK. Tuning the carrier concentration using Zintl chemistry in Mg3Sb2, and its implications for thermoelectric figure-of-merit. Phys Chem Chem Phys 2016; 18:6191-200. [PMID: 26852729 DOI: 10.1039/c5cp07482g] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Zintl compounds are potential candidates for efficient thermoelectric materials, because typically they are small band gap semiconductors. In addition, such compounds allow fine tuning of the carrier concentration by chemical doping for the optimization of thermoelectric performance. Herein, such tunability is demonstrated in Mg3Sb2-based Zintl compounds via Zn(2+) doping at the Mg(2+) site of the anionic framework (Mg2Sb2)(2-), in the series Mg3-xZnxSb2 (0 ≤ x ≤ 0.1). The materials have been successfully synthesized using the spark plasma sintering (SPS) technique. X-ray diffraction (XRD) analysis confirms a single solid solution phase of Mg3-xZnxSb2 (0 ≤ x ≤ 0.1). The thermoelectric properties are characterized by the Seebeck coefficient, electrical conductivity, and thermal conductivity measurements from 323 K to 773 K. Isoelectronic Zn substitution at the Mg site presents the controlled variation in the carrier concentration for optimizing the high power factor and reduced thermal conductivity. These results lead to a substantial increase in ZT of 0.37 at 773 K for a composition with x = 0.10 which is ∼42% higher than undoped Mg3Sb2. The electronic transport data for the Mg3-xZnxSb2 (0 ≤ x ≤ 0.1) compound are analyzed using a single parabolic band model predicting that Mg2.9Zn0.1Sb2 exhibits a near-optimal carrier concentration for high ZT. The electronic structure of transport properties of these disordered Mg3-xZnxSb2 (0 ≤ x ≤ 0.1) is also studied using density functional theory and the results obtained are in good agreement with experimental results. The low cost, lightness and non-toxicity of the constituent elements make these materials ideal for mid-temperature thermoelectric applications.
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Affiliation(s)
- A Bhardwaj
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - N S Chauhan
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - S Goel
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - Vijeta Singh
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Quantum Phenomena & Applications Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - J J Pulikkotil
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Quantum Phenomena & Applications Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India and Computational and Networking Facility, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - T D Senguttuvan
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
| | - D K Misra
- Academy of Scientific & Innovative Research (AcSIR), CSIR-National Physical Laboratory (CSIR-NPL) Campus, New Delhi-110012, India. and Physics of Energy Harvesting Division, National Physical Laboratory, Council of Scientific and Industrial Research, New Delhi 110012, India
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Chhabra S, Narang T, Joshi N, Goel S, Sawatkar G, Saikia B, Dogra S, Bansal F, Minz R. Circulating T-helper 17 cells and associated cytokines in psoriasis. Clin Exp Dermatol 2016; 41:806-10. [PMID: 27480070 DOI: 10.1111/ced.12845] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Recently, a new population of IL-17-producing CD4 T helper (Th) cells, named Th17, was identified and shown to be involved in various inflammatory and autoimmune diseases, including psoriasis. AIM To determine the frequency of Th17 cells and related cytokines in peripheral blood of patients with psoriasis, and to analyse their association with disease severity. METHODS This was a prospective study comprising 34 patients with psoriasis and 24 healthy controls. Clinicoepidemiological details of patients were recorded, and severity of psoriasis was assessed by means of the Psoriasis Area and Severity Index. Circulating Th1 and Th17 cells in untreated patients with psoriasis and healthy controls were quantified by flow cytometry. In sera collected from patients with psoriasis and healthy controls, concentrations of IL-17A and IL-23 were examined by ELISA. RESULTS Increased frequencies of CD4+ IL-17A+ T cells were seen in peripheral blood of patients with psoriasis vulgaris (P < 0.001). Although serum IL-17A and IL-23 concentrations were higher in patients with psoriasis than in controls, the results did not reach statistical significance. We could not find any correlation between the studied T cells or related cytokines and the disease severity. CONCLUSION Increased serum levels of circulating Th17 cells and related cytokines may contribute to the cutaneous pathology of psoriasis, as well as the inflammatory process that is a hallmark of psoriasis.
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Affiliation(s)
- S Chhabra
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - T Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Joshi
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Goel
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - G Sawatkar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B Saikia
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - F Bansal
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Minz
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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84
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Khanal S, Baral S, Shrestha P, Puri M, Kandel S, Lamichanne B, Elsey H, Brouwer M, Goel S, Chinnakali P. Yield of intensified tuberculosis case-finding activities using Xpert(®) MTB/RIF among risk groups in Nepal. Public Health Action 2016; 6:136-41. [PMID: 27358808 DOI: 10.5588/pha.16.0015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/12/2016] [Indexed: 11/10/2022] Open
Abstract
SETTING Twenty-two districts of Nepal, where intensified case-finding (ICF) activities for tuberculosis (TB) were implemented among risk groups under the TB REACH initiative in collaboration with the National TB Programme from July 2013 to November 2015. OBJECTIVES To assess the yield of TB screening using an algorithm with smear microscopy followed by Xpert(®) MTB/RIF. DESIGN A descriptive study using routinely collected data. RESULTS Of 145 679 individuals screened, 28 574 (19.6%) had presumptive TB; 1239 (4.3%) of these were diagnosed with TB and 1195 (96%) were initiated on anti-tuberculosis treatment. The yield of screening was highest among people living with the human immunodeficiency virus (PLHIV) (6.1%), followed by household contacts (3.5%) and urban slum dwellers (0.5%). Among other risk groups, such as prisoners, factory workers, refugees and individuals with diabetes, the yield was less than 0.5%. The number needed to screen to diagnose an active TB case was 17 for PLHIV, 29 for household contacts and 197 for urban slum dwellers. Of 11 525 patients from ICF and the routine programme, 112 (1%) were diagnosed with multidrug-resistant TB. CONCLUSION There was a substantial yield of TB cases among risk groups such as PLHIV and household contacts. Although the yield in urban slum dwellers was found to be moderate, some intervention should nonetheless be targeted because of the large population and poor access to care in this group.
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Affiliation(s)
- S Khanal
- Health Research and Social Development Forum (HERD), Kathmandu, Nepal
| | - S Baral
- Health Research and Social Development Forum (HERD), Kathmandu, Nepal
| | - P Shrestha
- Health Research and Social Development Forum (HERD), Kathmandu, Nepal
| | - M Puri
- Health Research and Social Development Forum (HERD), Kathmandu, Nepal
| | - S Kandel
- Health Research and Social Development Forum (HERD), Kathmandu, Nepal
| | - B Lamichanne
- National Tuberculosis Centre, Thimi, Bhaktapur, Nepal
| | - H Elsey
- Nuffield Centre for International Health and Development, Leeds Institute of Health Science, Leeds, UK
| | - M Brouwer
- PHTB Consult, Tilburg, The Netherlands
| | - S Goel
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P Chinnakali
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Nosrati A, Goel S, McGuire J, Grimes B, Singh R, Lee K, Morhenn V, Griffin A, Wei M. 208 Multiple primary melanomas: Prevalence and outcomes. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.236] [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: 10/21/2022]
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Nosrati A, Goel S, Chren M, Linos E, Hegde R, Pagoto S, Walkosz B, Eye R. 213 Melanoma prevention messages currently being used in social media platforms. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.241] [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: 10/21/2022]
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Goel S, Singh RJ, Tripathy JP. Impact of modular training on tobacco control on the knowledge of health workers in two jurisdictions of northern India. Indian J Cancer 2016; 52:685-8. [PMID: 26960519 DOI: 10.4103/0019-509x.178406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND National Tobacco Control Programme was launched in India in year 2007-08. It was realized that community health workers can play an important role of agents for positive change to bring down the tobacco morbidity and mortality in the country. Keeping this in view, a health worker guide was developed by the Government of India, Ministry of Health and Family Welfare (GOI) in collaboration with The Union South-East Asia (The Union) in the year 2010. The guide provides the information needed by the most basic level of health workers to effectively address the problem of tobacco use in the community. A modular training was conducted in two jurisdictions in India (namely, Chandigarh and Hamirpur (Himachal Pradesh)) to assess the usefulness of the guide as training material for community health workers in undertaking tobacco control activities at community and village levels. MATERIALS AND METHODS A total of 271 participants were trained, which included 133 from Chandigarh and 138 from Hamirpur. The pre and post-training assessment of knowledge of health worker was done. RESULTS There was marked increase in post-test scores as compared to the pretest scores. The health workers scoring more than 60% increased from 40% in the pretest to over 80% in the post-test. Only three workers had a post-test score of less than 30% against 54 workers in the pretest. CONCLUSION The understanding on tobacco control had increased significantly after the training in each group. It is strongly recommended that such training should be replicated to all community health workers across all the states in India.
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Affiliation(s)
- S Goel
- Department of Community Medicine, School of Public Health, PGIMER, Chandigarh, India
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Hermann RC, Early S, Goel S, Hart J, Huertas M, Khulman C, Webb L, Wilson BJ, Shroff S. Development of a multidisciplinary program for evaluation and treatment of pancreatic cancer in a community healthcare system. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
303 Background: The incidence and mortality of pancreas cancer is rising in the United States. Only patients who are able to have complete (R0) resection have the potential of cure. Optimal surgical outcomes are influenced by local center volume and multidisciplinary support. We describe the development of a multidisciplinary approach to the evaluation and treatment of pancreas cancer in a community health care system. Methods: This project was initiated by the WellStar Cancer Program, encompassing 5 hospitals. An Institutional Guideline was developed, based upon NCCN, with refinements related to local capabilities and preferences. The Guideline emphasized the review of cases at a weekly tumor board for multidisciplinary coordination of care. Standards for staging evaluations, medical imaging, chemotherapy choices, radiation therapy, and surgical approach were included. A GI Nurse Navigator attended the conferences and assisted in the coordination of care. Specific outcomes were tracked by the Nurse Navigator and the Cancer Registry. Here we describe the program impact related to staging, treatment, nurse navigation, volume and outcomes during the 2011-2014 development phase of the program. Results: A total of 308 cases of pancreas cancer were captured by the registry in 2011-2014. 131 were diagnosed with stage IV disease and offered palliative therapy. 30 Stage I and 139 Stage II-III underwent staging evaluation and consideration of multidisciplinary care, summarized in the table below, and compared to a baseline registry cohort of the 4 preceding years. Conclusions: The development of a Multidisciplinary Team approach to pancreas cancer within a 5 hospital community system has led to improvement in treatment outcomes, including R0 resection rate. Full 2-year results to be updated at the meeting. [Table: see text]
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Tharu MB, Harries AD, Goel S, Srivastava S, Kumar AMV, Adhikari M, Shrestha B, Maharjan B, Khadka H. Screening retreatment tuberculosis patients for drug resistance in mid-west Nepal: how well are we doing? Public Health Action 2015; 4:60-5. [PMID: 26423764 DOI: 10.5588/pha.13.0104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 02/20/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING Multidrug-resistant tuberculosis (MDR-TB, defined as resistance to isoniazid and rifampicin) is poorly detected in Nepal; one reason may be poor functioning of culture and drug susceptibility testing (CDST) services for retreatment tuberculosis (TB) patients. OBJECTIVES To determine, among retreatment TB patients in mid-west Nepal, 1) the number of patients registered for treatment between July 2011 and July 2012; 2) the number submitting sputum specimens for CDST to the Central Reference Laboratory (CRL), Kathmandu, along with the results; and 3) the length of time for submission and receipt of specimens. DESIGN Retrospective cohort study involving the review of treatment and laboratory registers from the Nepalgunj TB Referral Centre and the CRL. RESULTS Of 431 retreatment patients, 66 (15%) submitted sputum samples, of which 63 reached the CRL. Of these, 39 (62%) were culture-positive; 13 (33%) patients had MDR-TB. The CDST results of 19 patients were received back at the TB Referral Centre. The median turnaround time from sending specimens to receipt of results at the TB Referral Centre was 119 days. CONCLUSION Less than 10% of retreatment TB patients in mid-West Nepal had CDST results recorded, leading to the underdiagnosis of MDR-TB in the region. Urgent solutions are needed to rectify this problem.
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Affiliation(s)
- M B Tharu
- International Nepal Fellowship, Pokhara, Nepal
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
| | - S Goel
- School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - S Srivastava
- Public Health Foundation of India, New Delhi, India
| | - A M V Kumar
- The Union, South-East Asia Regional Office, New Delhi, India
| | - M Adhikari
- International Nepal Fellowship, Pokhara, Nepal
| | - B Shrestha
- Nepal Anti Tuberculosis Association, GENETUP Central Reference Laboratory, Kathmandu, Nepal
| | - B Maharjan
- Nepal Anti Tuberculosis Association, GENETUP Central Reference Laboratory, Kathmandu, Nepal
| | - H Khadka
- International Nepal Fellowship, Pokhara, Nepal
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Tiwari V, Pande SC, Verma K, Goel S. Spinal metastasis of breast cancer presenting after 25 years: An extremely rare presentation. Gulf J Oncolog 2015; 1:24-27. [PMID: 26499826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2015] [Indexed: 06/05/2023]
Abstract
Breast cancer is the most frequently diagnosed cancer in females of the developed world and is gradually becoming the leading cause in the developing world as well. The innate biology of breast cancer is marked by varied presentations, characteristics, response, recurrence and metastatic phenomenon. Even an early stage breast cancer has the potential to recur and/or metastasize after extremely long duration and this possibility should be borne in the clinician's mind.
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Affiliation(s)
- V Tiwari
- Department of Radiation Oncology, Gandhi Medical College, Bhopal, India
| | - S C Pande
- Department of Radiation Oncology, Artemis Health Institute, Gurgaon, India
| | - K Verma
- Department of Radiation Oncology, Artemis Health Institute, Gurgaon, India
| | - S Goel
- Department of Radiation Oncology, Artemis Health Institute, Gurgaon, India
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91
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Gajendra S, Jha B, Goel S, Sahni T, Sharma R, Shariq M, Jaiswal S, Sachdev R. Leishman and Giemsa stain: a new reliable staining technique for blood/bone marrow smears. Int J Lab Hematol 2015. [DOI: 10.1111/ijlh.12408] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Gajendra
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
| | - B. Jha
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
| | - S. Goel
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
| | - T. Sahni
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
| | - R. Sharma
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
| | - M. Shariq
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
| | - S. Jaiswal
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
| | - R. Sachdev
- Department of Pathology and Lab Medicine; Medanta-The Medicity; Gurgaon India
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92
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Kumar A, Goel S, Arora J, Mehta V, Pakhiddey R, Suri RK, Rath G, Das S. Rare atypical vascular pattern of subscapular artery: Anatomico-clinical insight. Clin Ter 2015; 166:118-20. [PMID: 26152619 DOI: 10.7417/ct.2015.1841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The use of muscles of scapular region in transposition and reparative surgery has made the anatomical knowledge of axillary artery and its branches imperative. The subscapular arterial tree is frequently used as a source of microvascular grafts to replace damaged or diseased portion of arteries especially in upper and lower limbs. This investigation is aimed to study the variation in branching pattern of the third part of axillary artery. MATERIALS AND METHODS Routine educational cadaveric dissection of a young adult Indian male cadaver. RESULTS The present article highlights a rare variation of the subscapular artery and its branches. The subscapular artery displayed a unique pattern of trifurcation. Its branches were seen supplying serratus anterior, subscapularis, latissimus dorsi and teres major muscles. CONCLUSIONS The study focuses on a new variation of the subscapular artery which could prove useful for interventional radiologists and surgeons in reconstructive surgeries.
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Affiliation(s)
- A Kumar
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - S Goel
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - J Arora
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - V Mehta
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - R Pakhiddey
- Department of Anatomy, Santosh Medical College, Ghaziabad - 201009, India
| | - R K Suri
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - G Rath
- Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029, India
| | - S Das
- 3Department of Anatomy, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
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93
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Goel S, Nasa P, Gupta A, Gupta R, Taneja S. Lithium overdose: early hemodialysis is the key! Saudi J Kidney Dis Transpl 2015. [PMID: 25579730 DOI: 10.4103/1319-2442.148758.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 65-year-old gentleman was referred to our hospital with encephalopathy and renal failure. His medications included lithium for the treatment of bipolar disorder. The clinical examination and the laboratory investigations that followed revealed findings classical of lithium overdose. The patient was successfully managed and discharged from the hospital on Day 9 of admission. Clinicians should be aware of this rather unusual and relatively rare differential cause of acute on chronic renal failure with encephalopathy.
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Affiliation(s)
| | - Prashant Nasa
- Department of Critical Care Medicine, Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India
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94
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Abstract
A 65-year-old gentleman was referred to our hospital with encephalopathy and renal failure. His medications included lithium for the treatment of bipolar disorder. The clinical examination and the laboratory investigations that followed revealed findings classical of lithium overdose. The patient was successfully managed and discharged from the hospital on Day 9 of admission. Clinicians should be aware of this rather unusual and relatively rare differential cause of acute on chronic renal failure with encephalopathy.
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Affiliation(s)
| | - Prashant Nasa
- Department of Critical Care Medicine, Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India
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95
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Agarwal C, Goel S, Jacobi A, Fernandes V, Sanz J. Cardiac MRI of a contained ascending aortic rupture extending into the pericardium. Eur Heart J Cardiovasc Imaging 2014; 16:457. [DOI: 10.1093/ehjci/jeu279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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96
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Pandey NU, Gupta AK, Jain AK, Kumar A, Goel S. Factors influencing the propensity of nurses to counsel patients for eye donation: a pilot study in a tertiary care hospital in north India. Public Health 2014; 128:1128-30. [PMID: 25457803 DOI: 10.1016/j.puhe.2014.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 08/04/2014] [Accepted: 10/12/2014] [Indexed: 10/24/2022]
Affiliation(s)
- N U Pandey
- Department of Hospital Administration, PGIMER, Chandigarh, India.
| | - A K Gupta
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - A K Jain
- Department of Opthalmology, PGIMER, Chandigarh, India
| | - A Kumar
- Department of Hospital Administration, PGIMER, Chandigarh, India
| | - S Goel
- Department of Public Health, PGIMER, Chandigarh, India
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97
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Pah AR, Rasmussen-Torvik LJ, Goel S, Greenland P, Kho AN. Big Data: What Is It and What Does It Mean for Cardiovascular Research and Prevention Policy. Curr Cardiovasc Risk Rep 2014. [DOI: 10.1007/s12170-014-0424-3] [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: 01/06/2023]
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98
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Shelke A, Yalagudri S, Saggu D, Goel S, Nair S, Narasimhan C. Radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A novel technique to reduce left ventricular outflow tract gradient. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.211] [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: 11/27/2022] Open
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99
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Goel S, Sachdev R, Gajendra S, Jha B, Sahni T, Dorwal P, Srivastava C, Tiwari AK, Sood N, Gupta S, Raina V, Vaid AK. Picking up myelodysplastic syndromes and megaloblastic anemias on peripheral blood: use of NEUT-X and NEUT-Y in guiding smear reviews. Int J Lab Hematol 2014; 37:e48-51. [PMID: 25132616 DOI: 10.1111/ijlh.12285] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Goel
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - R. Sachdev
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - S. Gajendra
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - B. Jha
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - T. Sahni
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - P. Dorwal
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - C. Srivastava
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - A. K. Tiwari
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - N. Sood
- Department of Medical Oncology and Hematology; Medanta - The Medicity Hospital; Gurgaon India
| | - S. Gupta
- Department of Medical Oncology and Hematology; Medanta - The Medicity Hospital; Gurgaon India
| | - V. Raina
- Departments of Pathology; Lab Medicine and Transfusion Medicine; Medanta - The Medicity Hospital; Gurgaon India
| | - A. K. Vaid
- Department of Medical Oncology and Hematology; Medanta - The Medicity Hospital; Gurgaon India
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Abstract
Context: A growing number of cities, districts, counties and states across the globe are going smoke-free. While an Indian national law namely Cigarettes and Other Tobacco Products Act (COTPA) exists since 2003 and aims at protecting all the people in our country; people still smoke in public places. Aim: This study assessed knowledge and perceptions about smoking, SHS and their support for Smoke-free laws among people residing in Mohali district, Punjab. Materials and Methods: This cross-sectional study was conducted in Mohali district of Punjab, India. A sample size of 1600 people was obtained. Probability Proportional to Size technique was used for selecting the number of individuals to be interviewed from each block and also from urban and rural population. Statistical Analysis Used: We estimated proportions and tested for significant differences by residence, smoking status, literacy level and employment level by means of the chi-square statistics. Statistical software SPSS for Windows version 20 was used for analysing data . Results: The overall prevalence of current smoking among study participants was 25%. Around 96% were aware of the fact that smoking is harmful to health, 45% viewed second-hand smoke to be equally harmful as active smoking, 84.2% knew that smoking is prohibited in public places and 88.3% wanted the government to take strict actions to control the menace of public smoking. Multivariate logistic regression analysis showed that people aged 20 years and above, unemployed, urban, literate and non-smokers had significantly better perception towards harms of smoking. The knowledge about smoke free provisions of COTPA was significantly better among males, employed individuals, urban residents, and literate people. Conclusions: There was high knowledge about deleterious multi-dimensional effects of smoking among residents and a high support for implementation of COTPA. Efforts should be taken to make Mohali a "smoke-free district".
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Affiliation(s)
- S Goel
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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