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Kiernan M, Chalmers A, Griffiths G. Waiting for test results before isolating patients with Clostridium difficiledisease may be associated with increased transmission. Antimicrob Resist Infect Control 2015. [PMCID: PMC4474795 DOI: 10.1186/2047-2994-4-s1-p26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dreyer B, Dreyer S, Griffiths G. Post-operative fluid prescribing: Is teaching adequate in the undergraduate curriculum? Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hillen M, Seymour J, Yeo J, Griffiths G, Howd A. A prospective study to establish whether the malnutrition universal screening tool (MUST) score can independently predict outcomes of patients undergoing reconstructive surgery or amputation for critical limb ischaemia (CLI). Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Rees J, Hurt CN, Gollins S, Mukherjee S, Maughan T, Falk SJ, Staffurth J, Ray R, Bashir N, Geh JI, Cunningham D, Roy R, Bridgewater J, Griffiths G, Nixon LS, Blazeby JM, Crosby T. Patient-reported outcomes during and after definitive chemoradiotherapy for oesophageal cancer. Br J Cancer 2015; 113:603-10. [PMID: 26203761 PMCID: PMC4647690 DOI: 10.1038/bjc.2015.258] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/07/2015] [Accepted: 06/15/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Limited data describe patient-reported outcomes (PROs) of localised oesophageal cancer treated with definitive chemoradiotherapy(CRT). The phase 2/3 SCOPE-1 trial assessed the effectiveness of CRT±cetuximab. The trial for the first time provided an opportunity to describe PROs from a multi-centre group of patients treated with CRT that are presented here. METHODS Patients undergoing CRT±cetuximab within the SCOPE-1 trial (258 patients from 36 UK centres) completed generic-, disease- and treatment-specific health-related quality of life (HRQL) questionnaires (EORTC QLQ-C30, QLQ-OES18, Dermatology Life-Quality Index (DLQI)) at baseline and at 7, 13, 24, 52 and 104 weeks. Mean EORTC functional scale scores (>15 point change significant), DLQI scores (>4 point change significant) and proportions of patients (>15% significant) with 'minimal' or 'severe' symptoms are presented. RESULTS Questionnaire response rates were good. At baseline, EORTC functional scores were high (>75%) and few symptoms were reported except for severe problems with fatigue, insomnia and eating-related symptoms (e.g., appetite loss, dysphagia, dry mouth) in both groups(>15%). Functional aspects of health deteriorated and symptoms increased with treatment and by week 13 global quality of life, physical, role and social function significantly deteriorated and more problems with fatigue, dyspnoea, appetite loss and trouble with taste were reported. Recovery occurred by 6 months (except severe fatigue and insomnia in >15% of patients) and maintained at follow-up with no differences between groups. CONCLUSIONS CRT for localised oesophageal cancer has a significant detrimental impact on many aspects of HRQL; however, recovery is achieved by 6 months and maintained with the exception of persisting problems with severe fatigue and insomnia. The data suggest that the HRQL recovery after definitive CRT is quicker, and there is little lasting deficit compared with treatment including surgery. These data need to be compared with HRQL data from studies evaluating treatments including surgery for oesophageal cancer.
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Neal R, Hurt C, Roberts K, Rogers T, Hamilton W, Edwards RT, Tod A, Parker D, Jones ET, Nelson A, Prout H, Hood K, Griffiths G. 220 A feasibility randomised controlled trial looking at the effect on lung cancer diagnosis of giving a chest X-ray to smokers aged over 60 with new chest symptoms – the ELCID trial. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70220-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nixon L, Mukherjee S, Wills L, Millin T, Bridges S, Abrams R, Joseph G, Griffiths G, Hurt C, Staffurth J. The SCALOP Trial Plan Assessment Form (PAF) as a Tool for Radiation Therapy Trials Quality Assurance (RTTQA). Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.804] [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]
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Griffiths G, Herwig A, Schneider WX. Stimulus localization interferes with stimulus recognition: Evidence from an attentional blink paradigm. J Vis 2013; 13:13.7.7. [DOI: 10.1167/13.7.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
Application for a Certificate of Completion of Training (CCT) in general surgery includes assessment of a validated logbook. The content of a satisfactory logbook has long been an area of contention. The logbook allows trainees to record their operative experience and to show the level of supervision. It is tempting to set a specific number of procedures to be completed by the end of training. However, such a number must be evidence based rather than chosen subjectively.
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Stimpson A, Griffiths G, Murray J. An unusual case of hip pain in a keen runner. Br J Hosp Med (Lond) 2013; 74:110-1. [PMID: 23411982 DOI: 10.12968/hmed.2013.74.2.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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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.
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Griffiths G, Schneider WX. Memory-guided saccading and letter encoding in visual working memory share attentional resources: Evidence from SOA-based interference effects. J Vis 2012. [DOI: 10.1167/12.9.1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Byrne A, Adamson D, Sivell S, Griffiths G, Crosby T, Staffurth J, Cohen D, Blazeby J, Fitzgibbon J, Nelson A. Palliative radiotherapy in addition to self-expanding metal stent for improving outcomes of dysphagia and survival in advanced oesophageal cancer: ROCS (Radiotherapy after Oesophageal Cancer Stenting) Study. BMJ Support Palliat Care 2012. [DOI: 10.1136/bmjspcare-2012-000264.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lester J, Nixon L, Mayles P, Mayles H, Tsang Y, Ionescu A, Courtier N, Nahum A, Fenwick J, Eswar C, Malik Z, Mohammed N, Griffiths G. 156 The I-START trial: ISoToxic Accelerated RadioTherapy in locally advanced non-small cell lung cancer. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70157-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gwynne S, Spezi E, Staffurth J, Palaniappan N, Wills L, Hurt C, Nixon L, Evans M, Griffiths G, Crosby T. Inter-observer Variation in Outlining of Pre-trial Test Case in the SCOPE1 Trial: A United Kingdom Definitive Chemoradiotherapy Trial for Esophageal Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Fortes AD, Griffiths G, Needs RJ, Pickard CJ, Hansen T. High-pressure polymorphism of ammonia hydrates. Acta Crystallogr A 2011. [DOI: 10.1107/s010876731109934x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Thomas AL, Wilson RH, Steward WP, Adams RA, Bridges SE, Casbard AC, Maughan T, Griffiths G. A randomized phase II study of irinotecan, 5-fluorouracil, and folinic acid (FOLFIRI) with or without the addition of an endothelin receptor antagonist in patients with metastatic colorectal cancer after failure of oxaliplatin-containing chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps161] [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] Open
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Barrett-Lee PJ, Murray N, Abraham J, Casbard A, Clements H, Maughan TS, Griffiths G. Interim safety data on the ZICE trial: A randomized phase III, open-label, multicener, parallel group clinical trial to evaluate and compare the efficacy, safety profile, and tolerability of oral ibandronate versus intravenous zoledronate in the treatment of patients with breast cancer with bone metastases. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1085] [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] Open
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Mukherjee S, Hurt C, Griffiths G, Crosby T, Staffurth J, Bridges S, Bridgewater JA, Mcdonald A, Falk S, Maughan TS. A Cancer Research UK multicenter randomized phase II study of induction chemotherapy followed by gemcitabine- or capecitabine-based chemoradiotherapy for locally advanced nonmetastatic pancreatic cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps222] [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] Open
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Koch F, Pagel J, Ehl S, Griffiths G, Hennies HC, Beutel K, Horstmann M, zur Stadt U. Functional characterisation of Munc18–2 missense mutations in patients with familial hemophagocytic lymphohistiocytosis type 5 (FHL-5). KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1254490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Young J, Mofidi R, Howd A, Griffiths G. An Unusual Cause of Recurrent Pulmonary Emboli. Eur J Vasc Endovasc Surg 2009. [DOI: 10.1016/j.ejvs.2009.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Highley M, Griffiths G, Uscinska B, Huddart R, Barber J, Parmar M, Harper P. A Phase II Trial of Continuous 5-Fluorouracil in Recurrent or Metastatic Transitional Cell Carcinoma of the Urinary Tract. Clin Oncol (R Coll Radiol) 2009; 21:394-400. [DOI: 10.1016/j.clon.2009.01.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2008] [Revised: 12/15/2008] [Accepted: 01/28/2009] [Indexed: 11/30/2022]
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Dorman S, Jolley C, Abernethy A, Currow D, Johnson M, Farquhar M, Griffiths G, Peel T, Moosavi S, Byrne A, Wilcock A, Alloway L, Bausewein C, Higginson I, Booth S. Researching breathlessness in palliative care: consensus statement of the National Cancer Research Institute Palliative Care Breathlessness Subgroup. Palliat Med 2009; 23:213-27. [PMID: 19251835 DOI: 10.1177/0269216309102520] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breathlessness is common in advanced disease and can have a devastating impact on patients and carers. Research on the management of breathlessness is challenging. There are relatively few studies, and many studies are limited by inadequate power or design. This paper represents a consensus statement of the National Cancer Research Institute Palliative Care Breathlessness Subgroup. The aims of this paper are to facilitate the design of adequately powered multi-centre interventional studies in breathlessness, to suggest a standardised, rational approach to breathlessness research and to aid future 'between study' comparisons. Discussion of the physiology of breathlessness is included.
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Capala J, Kramer-Marek G, Lee S, Hassan M, Kiesewetter DO, Puri A, Chernomordik V, Gandjbakhche A, Griffiths G, Blumenthal R. Molecular targeting of HER2 for diagnosis and therapy of breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-6004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #6004
Background: Expression of HER2 receptors in breast cancer is correlated with poor prognosis and may be different in distant metastases as compared to the primary tumor. We are developing methods to assess global expression of HER2 in vivo and to deliver therapeutic agents specifically to HER2-positve cells.
 Materials and Methods: As the targeting agent we use an Affibody molecule (http://www.affibody.com). These very stable and highly soluble proteins are relatively small (8.3 kDa) and bind to HER2 receptors with high affinity (22 pM). For imaging with PET, SPECT, or optical methods, an appropriate group containing the imaging beacon can be attached by a selective chemical reaction to a unique C-terminal cysteine residue of Affibody. For therapeutic purposes, they can be conjugated to multifunctional nanoparticles containing both imaging and therapeutic agents. We have conjugated affibody molecules with thermo-sensitive liposomes or gold nanoparticles (subsequently activated with neutrons) and characterized their biodistribution using optical imaging and SPECT, respectively. We used PET imaging with 18F-ZHER2-Affibody to monitor the down-regulation of HER2 following four doses (50 mg/kg) of 17-dimethylaminoethylamino-17-demethoxy-geldanamycin, 17-DMAG, an inhibitor of Hsp90 known to decrease HER2 expression. Animals were scanned before and after treatment. Immediately after the last scan, the mice were euthanized and tumors were frozen for ex-vivo analysis of receptor expression. For optical imaging, we used AlexaFluor dyes conjugated with affibody molecules containing an albumin binding domain that extended their circulation time. We have attached nanoparticles (liposomes and gold) to Affibody molecules using the same type of maleimide chemistry.
 Results: Our results showed that Affibody molecules do not affect the targeted cells and that their binding does not interfere with either the binding or the effectiveness of trastuzumab. 18F-ZHER2-Affibody was eliminated quickly from blood and normal tissues, providing high tumor/blood and tumor/muscle ratios by 1h post injection. The signal obtained from PET and optical imaging correlated well with the number of receptors expressed in the studied tumors as assessed by western blot, ELISA, and IHC. Following 17-DMAG treatment, the level of HER2 expression, estimated by PET imaging, in BT474 and Mcf-7/clone18 tumors decreased 70% and 30%. This change was confirmed by the biodistribution studies, ELISA and western blot.
 Discussion: This strategy, involving assessment of target presence and distribution in an individual patient followed by optimized, target-specific drug delivery, may significantly improve efficacy of breast cancer treatment while reducing side effects.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6004.
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Lundberg BB, Griffiths G, Hansen HJ. Cellular Association and Cytotoxicity of Doxorubicin-Loaded Immunoliposomes Targeted via Fab' Fragments of an Anti-CD74 Antibody. Drug Deliv 2008; 14:171-5. [PMID: 17454037 DOI: 10.1080/10717540601036831] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The purpose of our research was to evaluate in vitro therapeutic efficacy of doxorubicin (DXR)-loaded immunoliposomes with Fab' fragments of the anti-CD74 antibody LL1 attached to the surface. LL1 is well suited for targeting purposes because it is internalized very fast by B-lymphoma cells. However, at in vivo application whole antibodies show fast clearance in circulation. Taking this fact into consideration, this study was initiated to elucidate the prospects of using Fab' fragments of LL1 in stead of the whole antibody for future targeting in vivo of DXR-loaded liposomes. The Fab' fragments were covalently attached to the surface of sterically stabilized liposomes by use of a PEG-based heterobifunctinal coupling agent. LL1 Fab' conjugated sterically stabilized DXR liposomes showed approximately six times faster accumulation of the drug in Raji human B-lymphoma cells than nontargeted liposomes. In vitro cytotoxicity, quantitated by a tetrazolium assay, against Raji cells gave IC(50) values of 0.13, 0.45, and 0.11 microM for DXR-loaded immunoliposomes, DXR-loaded liposomes and free drug, respectively. The results from this study suggest that DXR-loaded immunoliposomes targeted with Fab' fragments from the anti-CD74 antibody LL1 could be a useful system for future in vivo experiments.
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