26
|
Zotova R, Yarnold J, Wheatley D, Griffin C, Murray B. PD-0430: Results from the radiotherapy quality assurance programme for the FAST-Forward breast trial. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40426-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Akaza H, Procopio G, Pripatnanont C, Facchini G, Fava S, Wheatley D, Leung K, Butt M, Silva A, Castillo L, Fountzilas G, Hitier S, Ecstein-Fraisse E, Bensfia S, Özgüroğlu M. Treatment Patterns in Patients (Pts) with Metastatic Castration-Resistant Prostate Cancer (Mcrpc) Previously Treated with Docetaxel (Doc)-Based Chemotherapy (Ctx): Proxima. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
28
|
Barrett-Lee PJ, Casbard A, Abraham J, Grieve R, Wheatley D, Simmons P, Coleman R, Hood K, Griffiths G, Murray N. Abstract PD07-09: Zoledronate versus ibandronate comparative evaluation (ZICE) trial - first results of a UK NCRI 1,405 patient phase III trial comparing oral ibandronate versus intravenous zoledronate in the treatment of breast cancer patients with bone metastases. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-pd07-09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction Bone metastases in patients with breast cancer have serious effects on health including pain, poor mobility, skeletal fractures, spinal cord compression and the need for radiotherapy/surgery. The introduction of intravenous (IV) bisphosphonates, such as zoledronic acid (Z) has significantly delayed the onset of skeletal-related events (SRE). However, prolonged IV bisphosphonates place burdens upon patient and hospital, and can also cause renal and acute phase toxicities. Ibandronic acid (I), a third generation amino-bisphosphonate in its oral form has previously been compared with placebo and was shown to be well tolerated and effective. Indirect comparisons with IV Z indicated similar efficacy in reducing bone events, but adverse events were overall comparable with placebo. One might therefore assume that oral ibandronate would be more acceptable to patients, and the ZICE Trial is the only large scale direct randomised comparison between IV Z and oral I to report.
Methods Between January 2006 and October 2010, 1405 newly diagnosed metastatic breast cancer patients with proven bone metastases were randomised 1:1 to IV Z (4mg 15 min infusion every 3–4 weeks) or oral I (50mg per day) for up to 96 weeks. All patients were prescribed daily calcium & vitamin D supplementation, and patients with current active dental problems including infection were excluded. Patients also received chemotherapy, and or endocrine therapy as determined by their physician. The primary objective was to demonstrate non-inferiority of oral I in comparison with IV Z in terms of the SRE rate, defined as the number of SREs reported per year (using multiple event analysis). Secondary endpoints included time to 1st SRE, proportion of patients with SRE, Pain Scores, side effect profiles including ONJ and renal toxicities, quality of life and Health resources and overall survival. The trial was run under the auspices of the NCRI, sponsored by Velindre NHS Trust, coordinated by the Wales Cancer Trials Unit, funded by an educational grant from Roche and peer reviewed/endorsed by Cancer Research UK (CRUKE/04/022).
Results At the time of this analysis the last randomised patient had completed 96 weeks of therapy, median follow up was 18.4 months and total number of SREs was 865 (468 in I and 397 in Z). For the primary objective, the SRE rate was 0.543 and 0.444 in I and Z groups respectively (Hazard ratio, 1.22; 95% CI, 1.04 to 1.45; P = .017). Ibandronate failed to meet the criteria for non-inferiority to Zoledronate, but was similar in delaying time to first SRE (hazard ratio, 1.11; 95% CI, 0.94 to 1.31; P = .233). Overall survival (disease progression), was very similar between groups but renal AEs occurred more frequently with Z than I; Compliance with oral therapy was 82%. ONJ rate was very low in both arms (0.71%, I; 1.29%, Z; P = 0.28).
Conclusion Oral I is inferior to Z in terms of the SRE rate in metastatic breast cancer patients with bone metastases, but is similar to Z in delaying time to first SRE. Both drugs had acceptable safety profiles, with adverse events consistent with those reported previously.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr PD07-09.
Collapse
|
29
|
Coles CE, Brunt AM, Wheatley D, Mukesh MB, Yarnold JR. Breast radiotherapy: less is more? Clin Oncol (R Coll Radiol) 2012. [PMID: 23183306 DOI: 10.1016/j.clon.2012.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A 3 week schedule of whole breast radiotherapy is firmly established in the UK and is becoming more accepted internationally, especially as accelerated partial breast radiotherapy regimens become more common. It seems that a 3 week schedule is unlikely to be the lower limit of whole breast hypofractionation and the partial breast may even be adequately treated with just a single treatment. It is, however, essential that these hypotheses are rigorously tested within well-designed trials to ensure the highest quality of radiotherapy. This overview will address the rationale for hypofractionation in breast cancer, discuss past trials and outline the design of current studies.
Collapse
|
30
|
Miles D, Bridgewater J, Ellis P, Harrison M, Nathan P, Nicolson M, Raouf S, Wheatley D, Plummer C. Using bevacizumab to treat metastatic cancer: UK consensus guidelines. Br J Hosp Med (Lond) 2011; 71:670-7. [PMID: 21135762 DOI: 10.12968/hmed.2010.71.12.670] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Concise guidance is lacking for the use of bevacizumab by practicing oncologists. Eight oncologists with experience of bevacizumab were joined by a cardiologist interested in treating hypertension to develop practical guidelines for managing patients receiving bevacizumab, using available clinical data.
Collapse
|
31
|
Beable R, Collins P, Burli P, Wheatley D. Entero-caval fistula, a complication following chemoradiotherapy for a rectal carcinoma. Clin Radiol 2010; 65:85-8. [DOI: 10.1016/j.crad.2009.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 10/03/2009] [Accepted: 10/08/2009] [Indexed: 11/16/2022]
|
32
|
Kelly S, Wheatley D. Prevention of febrile neutropenia: use of granulocyte colony-stimulating factors. Br J Cancer 2009; 101 Suppl 1:S6-10. [PMID: 19756005 PMCID: PMC2752223 DOI: 10.1038/sj.bjc.6605269] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
There is good evidence to suggest that dose intensity is important when considering the effectiveness of adjuvant chemotherapy in patients with breast cancer. However, the development of chemotherapy-induced febrile neutropenia can lead to reduction in dose intensity and other treatment modifications, which may negatively affect patient outcomes. Febrile neutropenia can be prevented by the use of primary prophylactic treatment, notably with granulocyte colony-stimulating factors. This practice is supported by international guidelines, all of which recommend that primary prophylaxis with granulocyte colony-stimulating factors should be used with chemotherapy where the risk of febrile neutropenia is 20% or greater.
Collapse
|
33
|
Brunt A, Sydenham M, Bliss J, Coles C, Gothard L, Harnett A, Haviland J, Syndikus I, Wheatley D, Yarnold J. 7LBA A 5-fraction regimen of adjuvant radiotherapy for women with early breast cancer: first analysis of the randomised UK FAST trial (ISRCTN62488883, CRUKE/04/015). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)72026-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
34
|
Hickish T, Wheatley D, Lin N, Carey L, Houston S, Mendelson D, Solca F, Uttenreuther-Fischer M, Jones H, Winer E. Use of BIBW 2992, a novel irreversible EGFR/HER2 tyrosine kinase inhibitor (TKI), to treat patients with HER2-positive metastatic breast cancer after failure of treatment with trastuzumab. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1023 Background: BIBW 2992 (Tovok) is an oral, novel, and potent, irreversible dual epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor-2 (HER2) inhibitor, with preclinical activity in trastuzumab-resistant cell lines overexpressing HER2 and phase I clinical activity. A phase II study of BIBW 2992 in patients with HER2-positive breast cancer who have failed treatment with trastuzumab is currently being conducted in the US and the UK. Methods: This is a multi-institutional open label single arm phase II study, planning to recruit 40 patients. Eligibility criteria include stage IIIB or IV HER2-positive metastatic breast cancer, progression following receipt of trastuzumab or intolerance of trastuzumab, measurable disease, Eastern Cooperative Oncology Group (ECOG) performance status of 0–2 and adequate organ function. Patients receive 50 mg BIBW 2992 once daily until disease progression. Tumor assessments are performed every two courses (one course = 28 days). The primary endpoint is objective response rate (RECIST criteria). Safety data are also collected. Results: To date, 40 patients have started treatment on the trial. Patients had received a median of three lines of prior therapy. Nine patients discontinued treatment prior to the first assessment at 8 weeks; four due to disease progression, four due to adverse events and one due to withdrawal of consent. Twenty-one patients have had tumor assessment after 8 weeks of treatment. Of these, four patients had a partial response (PR) and 10 patients had stable disease (SD). The PR has been confirmed at 16 weeks in one patient. The most frequently observed side effects to date are rash (Common Toxicity Criteria for Adverse Events [CTCAE] grade 3 in 4 patients) and diarrhea (CTCAE grade 3 in 8 patients). There were 20 dose reductions in 17 patients. Conclusions: BIBW 2992 at 50 mg/day induced responses and seems promising in HER2-positive breast cancer patients who have failed treatment with trastuzumab. Manageable cutaneous adverse events and diarrhea were the main side effects. [Table: see text]
Collapse
|
35
|
Wheatley D. The value of anti-anxiety drugs in the management of cardiac disease. ACTA MEDICA SCANDINAVICA. SUPPLEMENTUM 2009; 660:219-30. [PMID: 6127907 DOI: 10.1111/j.0954-6820.1982.tb00377.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In 3 double-blind randomized trials, clorazepate was compared to placebo in post-infarction and pre-infarction patients, and diazepam was compared to placebo added to verapamil. There was a significant reduction in trinitrate requirement in the first clorazepate study but not in the second nor in the third, although this has not yet been completed. Taking all 3 trials together, there were 5 cases of myocardial infarction in 63 patients treated with placebo but no cases in 64 patients treated with the anti-anxiety drugs (p less than 0.05). Relief of anxiety was accompanied by reduction in the anginal attack rate with both active and placebo medications. In further similar studies in hypertension, relief of anxiety was also accompanied by reduction in blood pressure. However, in a 4-way comparison between lorazepam, bendrofluazide, lorazepam plus bendrofluazide and placebo, mean normotensive levels were only achieved in patients treated with the combination of anti-anxiety and antihypertensive medication.
Collapse
|
36
|
Morris J, Wheatley D, Ingram C. An audit of follow-up clinics for breast cancer patients in Cornwall: is the time and effort worth it? Eur J Cancer Care (Engl) 2008; 17:578-84. [PMID: 18707618 DOI: 10.1111/j.1365-2354.2007.00901.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This paper's aims were to investigate the time and costs of healthcare professionals involved with follow-up clinics for breast cancer patients; and to quantify the numbers of local recurrences detected. An audit of breast cancer patients diagnosed with disease recurrence was conducted, and data were collected from the cancer audit system and from an analysis of relevant case notes. Costs of the time spent in follow-up clinics by clinical staff were also collected. The study found that sixty-nine breast cancer patients were diagnosed with local recurrence between 1 January 1999 and 31 December 2004. Only 15% (10) of recurrences were detected at routine follow up, 48% were first noticed by patients themselves, and 37% were detected at routine mammography. Six separate follow-up clinics were scheduled each week. This involved a total clinic time of approximately 20 h, and a total weekly cost of around pound 4857, with an annual cost of pound 252,564. Our recommendation is that alternative methods of follow up need to be implemented so that healthcare professionals have more time for newly diagnosed patients, those on active treatment and those with relapsed disease.
Collapse
|
37
|
McGowan A, Broderick AC, Frett G, Gore S, Hastings M, Pickering A, Wheatley D, White J, Witt MJ, Godley BJ. Down but not out: marine turtles of the British Virgin Islands. Anim Conserv 2008. [DOI: 10.1111/j.1469-1795.2007.00152.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
38
|
Cachon M, Cosson J, Wheatley D. “In Memory” of Professor Hidemi Sato: A Franco-Japanese tribute. Cell Biol Int 2006. [DOI: 10.1016/j.cellbi.2006.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
39
|
Sutherland IA, Brown L, Forbes S, Games G, Hawes D, Hostettmann K, McKerrell EH, Marston A, Wheatley D, Wood P. Countercurrent Chromatography (CCC) and its Versatile Application as an Industrial Purification & Production Process. J LIQ CHROMATOGR R T 2006. [DOI: 10.1080/10826079808000491] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
40
|
Wheatley D, Adwani A, Ebbs S, Hanson J, Ross G, Sharma AK, Wells P, Yarnold J. Matching supraclavicular fields to the extent of axillary surgery in women prescribed radiotherapy for early stage carcinoma of the breast. Clin Oncol (R Coll Radiol) 2005; 17:32-8. [PMID: 15714927 DOI: 10.1016/j.clon.2004.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIMS To determine (1) if the lower border of a standard anterior radiotherapy field to the supraclavicular fossa matches the upper limit of level II/III axillary dissection; and (2) whether standard lung blocks in patients prescribed axillary radiotherapy shield target axillary tissue in women with breast cancer. MATERIALS AND METHODS Between 1999 and 2001, 30 women with breast cancer undergoing level II/III axillary dissection had titanium clips placed to define the upper and medial limits of surgery. At radiotherapy planning, a supraclavicular fossa field similar to that described in the UK START trial protocol was simulated, with head twist applied to position the inferior field border (50% isodose) 1 cm below and parallel to the lower border of the clavicle. The field position was recorded on X-ray film. The location of the most superior axillary clip was measured in relation to this inferior field border on the X-ray film. The location of the most medial clip was measured in relation to the lung/chest wall interface. RESULTS The median distance between the most superior clip and the inferior border of the supraclavicular field was 3.6 cm (0.8-6.9 cm), representing significant underlap in all cases. In addition, five out of 30 (17%) patients had surgical clips over 2.0 cm medial to the lung/chest wall interface, suggesting that medial lymph nodes in an undissected axilla would be shielded by standard lung blocks in patients prescribed axillary radiotherapy. CONCLUSION Current standard radiation fields to the supraclavicular fossa, as applied in this study, leave apical axillary lymph nodes untreated in a high proportion of patients. Standard lung shielding, as applied in this study to patients simulated for axillary radiotherapy, protect medial axillary lymph nodes in a few patients. A change in practice is recommended.
Collapse
|
41
|
Wheatley D. Professor Nils Ringertz. Cell Biol Int 2003. [DOI: 10.1016/s1065-6995(03)00076-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
42
|
Wheatley D. The continuing growth and development of CBI. Cell Biol Int 2003. [DOI: 10.1016/s1065-6995(03)00058-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Graham E, Davies M, Holmes J, Muir IFK, Wheatley D. Inhibition of fibroblast growth by dermal extracts: re-examination of the extraction protocol (poster). Clin Exp Dermatol 2002. [DOI: 10.1046/j.1365-2230.2002.104168.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
44
|
Wheatley D. OF RUSSIA AND RUSSIANS. Cell Biol Int 2001. [DOI: 10.1006/cbir.2001.0801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
45
|
Abstract
Kava and valerian are herbal remedies, claimed to have anxiolytic and sedative properties respectively, without dependence potential or any appreciable side-effects. In this pilot study, 24 patients suffering from stress-induced insomnia were treated for 6 weeks with kava 120 mg daily. This was followed by 2 weeks off treatment and then, 5 having dropped out, 19 received valerian 600 mg daily for another 6 weeks. Stress was measured in three areas: social, personal and life-events; insomnia in three areas also: time to fall asleep, hours slept and waking mood. Total stress severity was significantly relieved by both compounds (p < 0.01) with no significant differences between them; as was also insomnia (p < 0.01). The proportion of patients with no side-effects was 58% with each drug respectively and the 'commonest' effect was vivid dreams with valerian (16%), followed by dizziness with kava (12% ). These compounds may be useful in the treatment of stress and insomnia but further studies are required to determine their relative roles for such indications.
Collapse
|
46
|
Wheatley D. 'Know thy cell!' A comment on the UKCCCR guidelines for the use of cell lines. UK Co-ordinating Committee on Cancer Research. Cell Biol Int 2001; 24:857. [PMID: 11185691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
47
|
Wheatley D. 'Know thy cell!' a comment on the UKCCCR guidelines for the use of cell lines. Cell Biol Int 2001; 24:663. [PMID: 11202958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
48
|
Wheatley D. EDITORIAL. Cell Biol Int 2001. [DOI: 10.1006/cbir.2000.0697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
49
|
Wheatley D. Ultradian rhythms in cells: questions regarding their existence and significance. Cell Biol Int 2000; 24:495-8. [PMID: 10924222 DOI: 10.1006/cbir.2000.0564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
50
|
Wheatley D. My thanks, and an offer. Cell Biol Int 2000; 24:597-8. [PMID: 10964449 DOI: 10.1006/cbir.2000.0580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|