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Parkes JP, Wood L, Chadburn AJ, Garman E, Abbas R, Modupe A, Whitehead SJ, Ford C, Thomas OL, Chugh S, Deshpande S, Gama R. The effect of the acute phase response on routine laboratory markers of folate and vitamin B12 status. Int J Lab Hematol 2018; 40:e21-e23. [PMID: 29405641 DOI: 10.1111/ijlh.12778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/08/2018] [Indexed: 11/30/2022]
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Wood L, Firth GB, Potterton J. Short-term outcomes of single event multilevel surgery for children with diplegia in a South African setting. SA ORTHOPAEDIC JOURNAL 2018. [DOI: 10.17159/2309-8309/2018/v17n2a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Carlton-Conway D, Tulloh R, Wood L, Kanabar D. Vitamin D Deficiency and Cardiac Failure in Infancy. J R Soc Med 2017; 97:238-9. [PMID: 15121815 PMCID: PMC1079465 DOI: 10.1177/014107680409700508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Moris G, Wood L, Gonzalez J, Fernandez-Torron R, Lochmüller H, Evangelista T. Quality of life in patients with facioscapulohumeral dystrophy type 1. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bex A, Mulders P, Jewett M, Wagstaff J, van Velthoven R, Laguna Pes P, Wood L, van Melick H, Soetekouw P, Lattouf J, Powles T, Boleti E, de Jong IJ, Rottey S, Tombal B, Marreaud S, Collette L, Collette S, Blank C, Haanen J. Immediate versus deferred cytoreductive nephrectomy (CN) in patients with synchronous metastatic renal cell carcinoma (mRCC) receiving sunitinib (EORTC 30073 SURTIME). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Schlossman N, Brown C, Batra P, de Sa AB, Balan I, Balan A, Gamache MG, Wood L, Pruzensky W, Saltzman E, Roberts SB, Balé C. A Randomized Controlled Trial of Two Ready-to-Use Supplementary Foods Demonstrates Benefit of the Higher Dairy Supplement for Reduced Wasting in Mothers, and Differential Impact in Infants and Children Associated With Maternal Supplement Response. Food Nutr Bull 2017; 38:275-290. [PMID: 28374648 DOI: 10.1177/0379572117700754] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is no consensus over best approaches to reliably prevent malnutrition in rural communities in low-income countries. OBJECTIVE We compared the effectiveness of 2 lipid-based ready-to-use supplementary foods (RUSFs) differing in dairy protein content to improve the nutritional status of mothers and at-risk infants and young children in rural Guinea-Bissau. METHODS A 3-month cluster-randomized controlled pilot trial of 2 RUSFs was conducted with 692 mothers and 580 mildly or moderately malnourished infants (6-23 months) and children (24-59 months) from 13 villages. The RUSFs contained either 478 (mothers, children) or 239 kcal/d (infants) with 15% or 33% of protein from dairy and were distributed at community health centers 5 d/wk. Controls were wait-listed to receive RUSF. Primary outcomes were mid-upper arm circumference (MUAC) in mothers, and weight-for-age and height-for-age z-scores (WAZ and HAZ) in infants and children. RESULTS There was a significant effect of the RUSF-33% on MUAC in mothers ( P = .03). The WAZ and HAZ increased substantially, by ≈1 z-score, in infants and children ( P < .01) independent of group randomization. In children, but not infants, baseline WAZ and change in maternal MUAC were associated with change in WAZ (β = .07, P = .02). CONCLUSION Ready-to-use supplementary foods with higher dairy protein content had a significant benefit in village mothers, supporting a comparable recent finding in preschool children. In addition, supplementation of children <2 years resulted in improved growth independent of family nutritional status, whereas success in older children was associated with change in maternal nutrition, suggesting the need for community-level education about preventing malnutrition in older, as well as younger, children.
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Medendorp A, Chaudhry Z, Oliver J, Wood L, Kim JH, Baxter Z, Raz S. PD17-07 AUTOLOGOUS FASCIA SACROCOLPOPEXY AFTER COMPLETE REMOVAL OF SACROCOLPOPEXY MESH. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.854] [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]
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Schlossman N, Johnson Q, Wood L, Coglianese N, Santoso V, Koeppel L. Accelerated Shelf Life Studies: Testing Micronutrient Stability of New and Upgraded Food Aid Products. FASEB J 2017. [DOI: 10.1096/fasebj.31.1_supplement.lb455] [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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Parameshwar P, Borok J, Wood L, Ackerman AL, Eilber K, Anger J. PD44-05 WRITING IN THE MARGINS OF SEXUAL FUNCTION QUESTIONNAIRES: A QUALITATIVE ANALYSIS FROM WOMEN WITH PELVIC FLOOR DISORDERS. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nikolenko N, Torron F, Jimenez-Moreno A, Wood L, Atalaia A, Hollingsworth K, Turner C, Lochmüller H. Magnetic resonance imaging (MRI) semi-quantitative scoring in a subset of 20 myotonic dystrophy Type 1 patients and correlation with functional outcome measures. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30256-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Moreira S, Wood L, Marini-Bettolo C, Guglieri M, McMacken G, Bailey G, Mayhew A, Muni R, Eglon G, Smith D, Williams M, Lochmüller H, Evangelista T. Respiratory involvement in Facioscapulohumeral Dystrophy. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Grau JM, Castellanos P, Smith EN, Duran PA, Silberman S, Wood L. Psychological Adjustment among Young Puerto Rican Mothers: Perceived Partner Support and the Moderating Role of Latino Cultural Orientation. JOURNAL OF LATINA/O PSYCHOLOGY 2017; 5:45-60. [PMID: 28210534 DOI: 10.1037/lat0000064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adolescent mothers face multiple stressors and are at risk for experiencing high levels of depressive symptoms and parenting stress. This study examined the interplay of Latino cultural orientation and perceived support from romantic partners in protecting the adjustment of young, low-income, Puerto Rican mothers (N = 103; M age = 18.0 yrs; SD = 1.2) during the second year postpartum. In multivariate analyses, perceived partner support was uniquely and negatively associated with both maternal depressive symptoms and parenting stress. However, in the case of parenting stress, this association was moderated by mothers' Latino cultural orientation. Perceived partner support was related to less parenting stress when mothers endorsed a relatively strong Latino cultural orientation; perceived partner support was no longer protective at low levels of Latino orientation. The implications for intervention and for the understanding of the role of culture in social support processes within close relationships are discussed.
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Hernández-Flores KG, Calderón-Garcidueñas AL, Mellado-Sánchez G, Ruiz-Ramos R, Sánchez-Vargas LA, Thomas-Dupont P, Izaguirre-Hernández IY, Téllez-Sosa J, Martínez-Barnetche J, Wood L, Paterson Y, Cedillo-Barrón L, López-Franco O, Vivanco-Cid H. Evaluation of the safety and adjuvant effect of a detoxified listeriolysin O mutant on the humoral response to dengue virus antigens. Clin Exp Immunol 2017; 188:109-126. [PMID: 27886660 DOI: 10.1111/cei.12906] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2016] [Indexed: 01/14/2023] Open
Abstract
Listeriolysin O (LLO) has been proposed as a potential carrier or adjuvant molecule in the vaccination field. However, the cytotoxic and pro-apoptotic effects of LLO are the major limitations for this purpose. Here, we have performed a preclinical safety evaluation and characterized a new potential adjuvant application for a non-cytolytic LLO mutant (dtLLO) to enhance and modulate the immune response against the envelope (E) protein from dengue virus. In addition, we have studied the adjuvant effects of dtLLO on human immune cells and the role of membrane cholesterol for the binding and proinflammatory property of the toxoid. Our in-vivo results in the murine model confirmed that dtLLO is a safer molecule than wild-type LLO (wtLLO), with a significantly increased survival rate for mice challenged with dtLLO compared with mice challenged with wtLLO (P < 0·001). Histopathological analysis showed non-toxic effects in key target organs such as brain, heart, liver, spleen, kidney and lung after challenge with dtLLO. In vitro, dtLLO retained the capacity of binding to plasma membrane cholesterol on the surface of murine and human immune cells. Immunization of 6-8-week-old female BALB/c mice with a combination of dtLLO mixed with E protein elicited a robust specific humoral response with isotype diversification of immunoglobulin (Ig)G antibodies (IgG1 and IgG2a). Finally, we demonstrated that cholesterol and lipid raft integrity are required to induce a proinflammatory response by human cells. Taken together, these findings support a potential use of the dtLLO mutant as a safe and effective adjuvant molecule in vaccination.
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Gholami S, Wood L, Berry G, Triadafilopoulos G, Visser BC, Dua MM. Recurrent Pyogenic Cholangitis: Got Stones? Dig Dis Sci 2016; 61:3147-3150. [PMID: 26602913 DOI: 10.1007/s10620-015-3973-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/11/2015] [Indexed: 12/09/2022]
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Lalani AK, Li H, Heng D, Wood L, Kalirai A, Bjarnason G, Sim HW, Kollmannsberger C, Kapoor A, Hotte S, Vanhuyse M, Czaykowski P, Reaume M, Soulieres D, Venner P, North S, Basappa N. Real world outcomes of patients with metastatic renal cell carcinoma (mRCC) using first-line sunitinib or pazopanib: the Canadian experience. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Greenhalgh J, Gooding K, Gibbons E, Dalkin S, Wright J, Valderas JM, Black N, Meads D, Wood L. OP09 For whom and in what circumstances does the use of patient reported outcome measures (PROMs) improve patient care? A realist synthesis. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.9] [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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Plank-Bazinet JL, Kornstein SG, Clayton JA, McCaskill-Stevens W, Wood L, Cook N, Tajuddin SM, Brown GM, Harris T, Evans MK, Begg L, Brooks CE, Miller LR, Mistretta AC, Cornelison TL. A Report of the Women's Health Congress Workshop on The Health of Women of Color: A Critical Intersection at the Corner of Sex/Gender and Race/Ethnicity. J Womens Health (Larchmt) 2016; 25:4-10. [PMID: 26771559 PMCID: PMC4741201 DOI: 10.1089/jwh.2015.5666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Women of color face unique health challenges that differ significantly from those of other women and men of color. To bring these issues to light, the National Institutes of Health (NIH) Office of Research on Women's Health sponsored a preconference workshop at the 23rd Annual Women's Health Congress, which was held in Washington, DC, in April 2015. The workshop featured presentations by NIH intramural and extramural scientists who provided insight on the disparities of a wide range of conditions, including cancer, cardiovascular disease, the risk of HIV infection, and disability in an aging population. In this study, we highlight the major points of each presentation and the ensuing discussion.
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Feng T, Wood L, Ramin S. V4-03 CONCOMITANT URETHRAL SLING AT THE TIME OF ROBOTIC PROSTATECTOMY USING AN IN SITU VASCULARIZED ROTATIONAL PERITONEAL FLAP. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wood L, Hendrick P, Boszczyk B, Dunstan E. A review of the surgical conversion rate and independent management of spinal extended scope practitioners in a secondary care setting. Ann R Coll Surg Engl 2016; 98:187-91. [PMID: 26741663 DOI: 10.1308/rcsann.2016.0054] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Spinal orthopaedic triage aims to reduce unnecessary referrals to surgical consultants, thereby reducing waiting times to be seen by a surgeon and to surgical intervention. This paper presents an evaluation of a spinal orthopaedic triage service in the third largest spinal unit in the UK. METHODS A retrospective service evaluation spanning 2012 to 2014 was undertaken by members of the extended scope practitioner (ESP) team to evaluate the ESPs' ability to manage patient care independently and triage surgical referrals appropriately. Data collected included rates of independent management, referral rates for surgical consideration and conversion to surgery. Patient satisfaction rates were evaluated retrospectively from questionnaires given to 5% of discharged patients. RESULTS A total of 2,651 patients were seen. The vast majority (92%) of all referrals seen by ESPs were managed independently. Only 8% required either a discussion with a surgeon to confirm management or for surgical review. Of the latter, 81% were considered to be suitable surgical referrals. A 99% satisfaction rate was reported by discharged patients. CONCLUSIONS ESP services in a specialist spinal service are effective in managing spinal conditions conservatively and identifying surgical candidates appropriately. Further research is needed to confirm ESPs' diagnostic accuracy, patient outcomes and cost effectiveness.
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Batra P, Schlossman N, Balan I, Pruzensky W, Balan A, Brown C, Gamache MG, Schleicher MM, de Sa AB, Saltzman E, Wood L, Roberts SB. A Randomized Controlled Trial Offering Higher- Compared with Lower-Dairy Second Meals Daily in Preschools in Guinea-Bissau Demonstrates an Attendance-Dependent Increase in Weight Gain for Both Meal Types and an Increase in Mid-Upper Arm Circumference for the Higher-Dairy Meal. J Nutr 2016; 146:124-32. [PMID: 26609172 DOI: 10.3945/jn.115.218917] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/30/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Controversy remains over the most effective approaches to prevent childhood malnutrition. OBJECTIVES We tested the feasibility and effectiveness of delivering ready-to-use supplementary foods (RUSFs) as a second daily meal in preschool children aged 3-5 y in Guinea-Bissau, and compared RUSFs with different levels of dairy protein. METHODS This study was a 3 mo cluster-randomized controlled pilot trial of 2 RUSFs differing in dairy protein in 533 boys and girls from 9 preschools. Children receiving RUSFs were compared with wait-listed controls, and all students received a daily school lunch. The RUSFs were delivered 5 d/wk for 3 mo and contained 478 kcal and 11.5 g protein per 92-g daily serving. Deliveries included a ready-to-use supplementary food with 15% of protein from dairy sources (RUSF-15%) or one with 33% of protein from dairy sources (RUSF-33%). Intention-to-treat (ITT) and per-protocol analyses (>50 d of RUSF consumption) were conducted. Changes in the weight-for-age z score (WAZ) and height-for-age z score were primary outcomes. Additional outcomes included changes in mid-upper arm circumference (MUAC), hemoglobin, and retinol binding protein. RESULTS Baseline anthropometry was not different between groups (WAZ, -0.48 ± 1.04) and increased significantly over time (P < 0.01) with no effects of the RUSFs in ITT analyses. However, children consuming RUSFs for >50 d had a significantly greater increase in WAZ relative to the increase in controls (+0.40 and +0.32 for RUSF-15% and RUSF-33%, respectively, compared with +0.24 in controls, P < 0.01 and P < 0.05, respectively). RUSF-33%, but not RUSF-15%, also eliminated a decrease in MUAC observed in controls (-0.01 cm in RUSF-33% compared with -0.34 cm in controls, P < 0.05). The only difference between RUSF-15% and RUSF-33% was a mean decrease in hemoglobin in children receiving RUSF-15% (-0.5 compared with -0.002 g/dL, P = 0.05). CONCLUSIONS Implementation of 2-meal preschool feeding programs is feasible in low-income countries, and there are measurable benefits relative to 1-meal programs in children attending preschool regularly. In addition, MUAC and hemoglobin measurements indicate that meals with 33% compared with 15% of protein from dairy may help prevent wasting and anemia.
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Alsawy S, Wood L, Taylor PJ, Morrison AP. Psychotic experiences and PTSD: exploring associations in a population survey. Psychol Med 2015; 45:2849-2859. [PMID: 25990802 DOI: 10.1017/s003329171500080x] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Extensive evidence has shown that experiencing a traumatic event and post-traumatic stress disorder (PTSD) are associated with experiences of psychosis. However, less is known about specific PTSD symptoms and their relationship with psychotic experiences. This study aimed to examine the relationship between symptoms of PTSD with paranoia and auditory hallucinations in a large-scale sample. METHOD The Adult Psychiatric Morbidity Survey (APMS) was utilized to examine the prevalence of lifetime trauma, symptoms of PTSD, and experiences of paranoia and auditory hallucinations (n = 7403). RESULTS There were significant bivariate associations between symptoms of PTSD and psychotic experiences. Multiple logistic regression analyses indicated that reliving and arousal symptoms were significant predictors for paranoia while reliving, but not arousal symptoms, also significantly predicted auditory hallucinations. A dose-response relationship was found, the greater the number of PTSD symptoms, the greater the odds were of experiencing both paranoia and hallucinations. CONCLUSIONS These findings illustrate that symptoms of PTSD are associated with increased odds of experiencing auditory hallucinations and paranoia. Overlaps appear to be present between the symptoms of PTSD and psychotic experiences. Increasing awareness of this association may advance work in clinical practice.
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Evangelista T, Wood L, Pohlschmidt M, Longman C, Roberts M, Hilton-Jones D, Lunt P, Wills T, Orrell R, Norwood F, Williams M, Smith D, Hudson J, Lochmüller H. Pain and quality of life in the UK FSHD patient registry. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.108] [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]
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Eigl BJ, North S, Winquist E, Finch D, Wood L, Sridhar SS, Powers J, Good J, Sharma M, Squire JA, Bazov J, Jamaspishvili T, Cox ME, Bradbury PA, Eisenhauer EA, Chi KN. A phase II study of the HDAC inhibitor SB939 in patients with castration resistant prostate cancer: NCIC clinical trials group study IND195. Invest New Drugs 2015; 33:969-76. [PMID: 25983041 DOI: 10.1007/s10637-015-0252-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/11/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND SB939 is a potent oral inhibitor of class 1, 2, and 4 histone deacetylases (HDACs). These three HDAC classes are highly expressed in castration resistant prostate cancer (CRPC) and associated with poor clinical outcomes. We designed a phase II study of SB939 in men with metastatic CRPC. METHODS Patients received SB939 60 mg on alternate days three times per week for 3 weeks on a 4-week cycle. Primary endpoints were PSA response rate (RR) and progression-free survival (PFS). Secondary endpoints included objective response rate and duration; overall survival; circulating tumor cell (CTC) enumeration and safety. Exploratory correlative studies of the TMPRSS2-ERG fusion and PTEN biomarkers were also performed. RESULTS Thirty-two patients were enrolled of whom 88 % had received no prior chemotherapy. The median number of SB939 cycles administered was three (range 1-8). Adverse events were generally grade 1-2, with five pts experiencing one or more grade three event. One patient died due to myocardial infarction. A confirmed PSA response was noted in two pts (6 %), lasting 3.0 and 21.6 months. In patients with measurable disease there were no objective responses. Six patients had stable disease lasting 1.7 to 8.0 months. CTC response (from ≥5 at baseline to <5 at 6 or 12 weeks) occurred in 9/14 evaluable patients (64 %). CONCLUSION Although SB939 was tolerable at the dose/schedule given, and showed declines in CTC in the majority of evaluable patients, it did not show sufficient activity based on PSA RR to warrant further study as a single agent in unselected patients with CRPC.
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Schlossman N, Saltzman E, Shea MK, Balan E, Fuss P, Batra P, Pruzensky W, Griffith J, Coglianese N, Wood L, Santoso M, Roberts S. Nutritional Status of Children in Primary Schools in the Oio and Cacheu Regions in Guinea‐Bissau. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.579.18] [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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Jamnagerwalla J, Wood L, Catchpole K, Bresee C, Gross B, Chu S, Eilber K, Anger J. PD21-07 FACTORS AFFECTING ROBOTIC OPERATIVE TIMES IN A LARGE COHORT OF PATIENTS AT A SINGLE INSTITUTION. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1436] [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]
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Sharif Afshar AR, Wood L, Anger J, Bresee C, Gross B, Shkolyar E, Eilber K. PD28-03 TEACHING MID-URETHRAL SLING SURGERY TO RESIDENTS: IS IT SLOWING US DOWN? J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1900] [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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Taylor PJ, Hutton P, Wood L. Are people at risk of psychosis also at risk of suicide and self-harm? A systematic review and meta-analysis. Psychol Med 2015; 45:911-926. [PMID: 25298008 DOI: 10.1017/s0033291714002074] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Suicide and self-harm are prevalent in individuals diagnosed with psychotic disorders. However, less is known about the level of self-injurious thinking and behaviour in those individuals deemed to be at ultra-high risk (UHR) of developing psychosis, despite growing clinical interest in this population. This review provides a synthesis of the extant literature concerning the prevalence of self-harm and suicidality in the UHR population, and the predictors and correlates associated with these events. METHOD A search of electronic databases was undertaken by two independent reviewers. A meta-analysis of prevalence was undertaken for self-harm, suicidal ideation and behaviour. A narrative review was also undertaken of analyses examining predictors and correlates of self-harm and suicidality. RESULTS Twenty-one eligible studies were identified. The meta-analyses suggested a high prevalence of recent suicidal ideation (66%), lifetime self-harm (49%) and lifetime suicide attempts (18%). Co-morbid psychiatric problems, mood variability and a family history of psychiatric problems were among the factors associated with self-harm and suicide risk. CONCLUSIONS Results suggest that self-harm and suicidality are highly prevalent in the UHR population, with rates similar to those observed in samples with diagnosed psychotic disorders. Appropriate monitoring and managing of suicide risk will be important for services working with the UHR population. Further research in this area is urgently needed considering the high rates identified.
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Feng T, Perkins C, Wood L, Wang J, Borok J, Hannemann A, Bresee C, Eilber K, Anger J. MP24-15 PREOPERATIVE TESTING FOR STRESS URINARY INCONTINENCE AND PROLAPSE SURGERY: OVERUSE, UNDERUSE, AND COST IMPLICATIONS. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wood L. Christopher Michael Wragg. Assoc Med J 2014. [DOI: 10.1136/bmj.g7360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Burrows T, Williams R, Rollo M, Wood L, Garg M, Jensen M, Collins C. Plasma carotenoid levels as biomarkers of dietary carotenoid consumption: A systematic review of the validation studies. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2014. [DOI: 10.1016/j.jnim.2014.10.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Chapiro J, Wood L, Lin MD, Duran R, Tacher V, Schernthaner R, Geschwind JF. Radiologisch-pathologische Korrelation einer 3D-Quantifizierung des Therapieansprechens nach transarterieller Chemoembolisation (TACE) in Patienten mit hepatozellulärem Karzinom (HCC). ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373477] [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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Ko JJ, Choueiri TK, Rini BI, Lee JL, Kroeger N, Srinivas S, Harshman LC, Knox JJ, Bjarnason GA, MacKenzie MJ, Wood L, Vaishampayan UN, Agarwal N, Pal SK, Tan MH, Rha SY, Yuasa T, Donskov F, Bamias A, Heng DYC. First-, second-, third-line therapy for mRCC: benchmarks for trial design from the IMDC. Br J Cancer 2014; 110:1917-22. [PMID: 24691425 PMCID: PMC3992507 DOI: 10.1038/bjc.2014.25] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/20/2013] [Accepted: 01/08/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Limited data exist on outcomes for metastatic renal cell carcinoma (mRCC) patients treated with multiple lines of therapy. Benchmarks for survival are required for patient counselling and clinical trial design. METHODS Outcomes of mRCC patients from the International mRCC Database Consortium database treated with 1, 2, or 3+ lines of targeted therapy (TT) were compared by proportional hazards regression. Overall survival (OS) and progression-free survival (PFS) were calculated using different population inclusion criteria. RESULTS In total, 2705 patients were treated with TT of which 57% received only first-line TT, 27% received two lines of TT, and 16% received 3+ lines of TT. Overall survival of patients who received 1, 2, or 3+ lines of TT were 14.9, 21.0, and 39.2 months, respectively, from first-line TT (P<0.0001). On multivariable analysis, 2 lines and 3+ lines of therapy were each associated with better OS (HR=0.738 and 0.626, P<0.0001). Survival outcomes for the subgroups were as follows: for all patients, OS 20.9 months and PFS 7.2 months; for those similar to eligible patients in the first-line ADAPT trial, OS 14.7 months and PFS 5.6 months; for those similar to patients in first-line TIVO-1 trial, OS 24.8 months and PFS 8.2 months; for those similar to patients in second-line INTORSECT trial, OS 13.0 months and PFS 3.9 months; and for those similar to patients in the third-line GOLD trial, OS 18.0 months and PFS 4.4 months. CONCLUSIONS Patients who are able to receive more lines of TT live longer. Survival benchmarks provide context and perspective when interpreting and designing clinical trials.
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Chapiro J, Wood L, Cornish T, Lesage D, Charu V, Duran R, Tacher V, Wang Z, Lin M, Geschwind J. Radio-pathological correlation of 3D-quantitative contrast-enhanced and functional MRI in HCC patients after TACE - do we see what we treat? J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Najjar YG, Mittal K, Elson P, Wood L, Garcia JA, Dreicer R, Rini BI. A 2 weeks on and 1 week off schedule of sunitinib is associated with decreased toxicity in metastatic renal cell carcinoma. Eur J Cancer 2014; 50:1084-9. [PMID: 24559686 DOI: 10.1016/j.ejca.2014.01.025] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 01/25/2014] [Accepted: 01/28/2014] [Indexed: 11/24/2022]
Abstract
Treatment of metastatic renal cell carcinoma (mRCC) with sunitinib is often associated with toxicity necessitating dose reduction. Maintaining adequate dosing and drug levels are essential for optimising clinical efficacy. Standard sunitinib schedule is 4 weeks of treatment and 2 weeks of rest (schedule 4/2). Empirically, several mRCC patients at The Cleveland Clinic (CCF) have been changed from schedule 4/2 to 2 weeks of treatment/1 week off (schedule 2/1) after experiencing toxicity, in an attempt to maintain daily dosing. The medical records of 30 mRCC patients on sunitinib who were changed from schedule 4/2 to schedule 2/1 at CCF were retrospectively reviewed. Toxicity on each schedule was recorded during routine clinic visits and graded using Common Toxicity Criteria, version 4.0. 97% of patients on schedule 4/2 had grade 3 or 4 toxicity that led to changing to schedule 2/1. There were no grade 4 toxicities on schedule 2/1, and 27% of patients experienced grade 3 toxicity (p=0.0001). Two of the most common toxicities, fatigue and hand-foot syndrome (HFS), were significantly less frequent on schedule 2/1 than on schedule 4/2 (p=0.0003; p=0.0004, respectively). Median overall treatment duration on schedule 4/2 was 12.6 months (range 1.2 months-5.1 years) and median overall treatment duration on schedule 2/1 was 11.9 months (range 0.9+ to 73.3+ months). Treatment with sunitinib on schedule 2/1 is associated with significantly decreased toxicity in patients who experience grade 3 or greater toxicity on schedule 4/2, and can extend treatment duration considerably. Prospective clinical trials are required to define the optimal sunitinib schedule to balance efficacy and toxicity.
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Sutton AW, Baldwin SP, Wood L, Hoffman BJ. A Meta-Analysis of the Relationship Between Rater Liking and Performance Ratings. HUMAN PERFORMANCE 2013. [DOI: 10.1080/08959285.2013.836523] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Dunn K, Hindley A, Wood L, Sanneh A, Barber D, Whitehead A, Zakiyah Z. Mometasone Furoate Significantly Reduces Radiation Dermatitis in Patients Undergoing Breast Radiation Therapy: A Double-Blind Randomized Control Trial in 120 Patients. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pearce J, Wood L, Stevens L. Portion weights of food served in English schools: have they changed following the introduction of nutrient-based standards? J Hum Nutr Diet 2013; 26:553-62. [PMID: 23808732 DOI: 10.1111/jhn.12067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mandatory food-based and nutrient-based standards for the food provided in English schools were introduced in 2008 (primary) and 2009 (secondary) and have had a positive impact on pupils' food choice and nutrient intake at school. There are no recommendations for portion sizes in England, although anecdotal evidence suggests that portions of food and drink sold in schools have decreased since the standards were introduced. METHODS Data were collected from 136 primary and 80 secondary schools in 2009 and 2010/11, respectively. All food and drink items provided at lunchtime were weighed on five consecutive days at each school. The mean and median weight, SD, and 25th and 75th centile for each individual food were calculated. Data were compared with the results obtained from similar surveys in 2004 and 2005, as well as with portion size recommendations for Scottish schools. RESULTS The proportion of food items that differed in weight since 2004/05 varied from 13% in primary schools to 29% in secondary schools. Changes in weight were equally likely to be positive or negative, with the exception of portions of fruit and vegetables, which had decreased. Primary schools were more likely to meet portion size recommendations than secondary schools. CONCLUSIONS Of the items that were directly comparable over time, a limited number showed a significant change in portion size since the standards for school food were introduced. Portion weight recommendations are based on a balanced healthy diet, and pupils should eat all the components of meals offered by schools to meet dietary recommendations.
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Dru C, Movassaghi M, Koopman S, Sharif Afshar AR, Wood L, Fuchs G. 2315 TRENDS IN BODY MASS INDEX AFTER DONOR NEPHRECTOMY. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.2256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Savović J, Jones H, Altman D, Harris R, Jűni P, Pildal J, Als-Nielsen B, Balk E, Gluud C, Gluud L, Ioannidis J, Schulz K, Beynon R, Welton N, Wood L, Moher D, Deeks J, Sterne J. Influence of reported study design characteristics on intervention effect estimates from randomised controlled trials: combined analysis of meta-epidemiological studies. Health Technol Assess 2013; 16:1-82. [PMID: 22989478 DOI: 10.3310/hta16350] [Citation(s) in RCA: 490] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The design of randomised controlled trials (RCTs) should incorporate characteristics (such as concealment of randomised allocation and blinding of participants and personnel) that avoid biases resulting from lack of comparability of the intervention and control groups. Empirical evidence suggests that the absence of such characteristics leads to biased intervention effect estimates, but the findings of different studies are not consistent. OBJECTIVES To examine the influence of unclear or inadequate random sequence generation and allocation concealment, and unclear or absent double blinding, on intervention effect estimates and between-trial heterogeneity, and whether or not these influences vary with type of clinical area, intervention, comparison and outcome measure. DATA SOURCES AND METHODS Data were combined from seven contributing meta-epidemiological studies (collections of meta-analyses in which trial characteristics are assessed and results recorded). The resulting database was used to identify and remove overlapping meta-analyses. Outcomes were coded such that odds ratios < 1 correspond to beneficial intervention effects. Outcome measures were classified as mortality, other objective or subjective. We examined agreement between assessments of trial characteristics in trials assessed in more than one contributing study. We used hierarchical Bayesian bias models to estimate the effect of trial characteristics on average bias [quantified as ratios of odds ratios (RORs) with 95% credible intervals (CrIs) comparing trials with and without a characteristic] and in increasing between-trial heterogeneity. RESULTS The analysis data set contained 1973 trials included in 234 meta-analyses. Median kappa statistics for agreement between assessments of trial characteristics were: sequence generation 0.60, allocation concealment 0.58 and blinding 0.87. Intervention effect estimates were exaggerated by an average 11% in trials with inadequate or unclear (compared with adequate) sequence generation (ROR 0.89, 95% CrI 0.82 to 0.96); between-trial heterogeneity was higher among such trials. Bias associated with inadequate or unclear sequence generation was greatest for subjective outcomes (ROR 0.83, 95% CrI 0.74 to 0.94) and the increase in heterogeneity was greatest for such outcomes [standard deviation (SD) 0.20, 95% CrI 0.03 to 0.32]. The effect of inadequate or unclear (compared with adequate) allocation concealment was greatest among meta-analyses with a subjectively assessed outcome intervention effect (ROR 0.85, 95% CrI 0.75 to 0.95), and the increase in between-trial heterogeneity was also greatest for such outcomes (SD 0.20, 95% CrI 0.02 to 0.33). Lack of, or unclear, double blinding (compared with double blinding) was associated with an average 13% exaggeration of intervention effects (ROR 0.87, 95% CrI 0.79 to 0.96), and between-trial heterogeneity was increased for such studies (SD 0.14, 95% CrI 0.02 to 0.30). Average bias (ROR 0.78, 95% CrI 0.65 to 0.92) and between-trial heterogeneity (SD 0.37, 95% CrI 0.19 to 0.53) were greatest for meta-analyses assessing subjective outcomes. Among meta-analyses with subjectively assessed outcomes, the effect of lack of blinding appeared greater than the effect of inadequate or unclear sequence generation or allocation concealment. CONCLUSIONS Bias associated with specific reported study design characteristics leads to exaggeration of beneficial intervention effect estimates and increases in between-trial heterogeneity. For each of the three characteristics assessed, these effects were greatest for subjectively assessed outcomes. Assessments of the risk of bias in RCTs should account for these findings. Further research is needed to understand the effects of attrition bias, as well as the relative importance of blinding of patients, care-givers and outcome assessors, and thus separate the effects of performance and detection bias. FUNDING National Institute for Health Research Health Technology Assessment programme.
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Zhong X, Kieras E, Sousa E, D'Antona A, Baber JC, He T, Desharnais J, Wood L, Luxenberg D, Stahl M, Kriz R, Lin L, Somers W, Fitz LJ, Wright JF. Pyroglutamate and O-linked glycan determine functional production of anti-IL17A and anti-IL22 peptide-antibody bispecific genetic fusions. J Biol Chem 2013; 288:1409-19. [PMID: 23184956 PMCID: PMC3543023 DOI: 10.1074/jbc.m112.417717] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 11/13/2012] [Indexed: 01/05/2023] Open
Abstract
Protein biosynthesis and extracellular secretion are essential biological processes for therapeutic protein production in mammalian cells, which offer the capacity for correct folding and proper post-translational modifications. In this study, we have generated bispecific therapeutic fusion proteins in mammalian cells by combining a peptide and an antibody into a single open reading frame. A neutralizing peptide directed against interleukin-17A (IL17A) was genetically fused to the N termini of an anti-IL22 antibody, through either the light chain, the heavy chain, or both chains. Although the resulting fusion proteins bound and inhibited IL22 with the same affinity and potency as the unmodified anti-IL22 antibody, the peptide modality in the fusion scaffold was not active in the cell-based assay due to the N-terminal degradation. When a glutamine residue was introduced at the N terminus, which can be cyclized to form pyroglutamate in mammalian cells, the IL17A neutralization activity of the fusion protein was restored. Interestingly, the mass spectroscopic analysis of the purified fusion protein revealed an unexpected O-linked glycosylation modification at threonine 5 of the anti-IL17A peptide. The subsequent removal of this post-translational modification by site-directed mutagenesis drastically enhanced the IL17A binding affinity and neutralization potency for the resulting fusion protein. These results provide direct experimental evidence that post-translational modifications during protein biosynthesis along secretory pathways play critical roles in determining the structure and function of therapeutic proteins produced by mammalian cells. The newly engineered peptide-antibody genetic fusion is promising for therapeutically targeting multiple antigens in a single antibody-like molecule.
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Jewett M, Finelli A, Kollmannsberger C, Wood L, Legere L, Basiuk J, Canil C, Heng D, Reaume N, Tanguay S, Atkins M, Bjarnason G, Dancey J, Evans M, Fleshner N, Haider M, Kapoor A, Uzzo R, Maskens D, Soulieres D, Yousef G, Basappa N, Bendali N, Black P, Blais N, Cagiannos I, Care M, Chow R, Chung H, Czaykowski P, Derosa D, Durrant K, Ellard S, Farquharson G, Filion-Brulotte C, Gingerich J, Godbout L, Grant R, Hamilton W, Kassouf W, Kurban G, Lane K, Lattouf J, Lau D, Leveridge M, McCarthy J, Moore R, North S, O'brien P, Pituskin E, Racine P, Rendon R, So A, Sridhar S, Stubbs K, Su Z, Taylor L, Udall T, Venner P, Vogel W, Yap S, Yau P, Cooper M, Giroux N, Miron D, Mosher D, Ross K, Willacy J. Management of kidney cancer: canadian kidney cancer forum consensus update 2011. Can Urol Assoc J 2012; 6:16-22. [PMID: 22396361 DOI: 10.5489/cuaj.11273] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Foster S, Christian H, Wood L, Giles-Corti B. PLANNING SAFER SUBURBS? THE INFLUENCE OF CHANGE IN THE BUILT ENVIRONMENT ON RESDIENTS' PERCEIVED SAFETY FROM CRIME. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580a.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Woollard E, Wood L, Woollard K, Briffa T. Bypass Surgery Versus Coronary Angioplasty: Experienced Patients’ Preference. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Heng DY, Mackenzie MJ, Vaishampayan UN, Bjarnason GA, Knox JJ, Tan MH, Wood L, Wang Y, Kollmannsberger C, North S, Donskov F, Rini BI, Choueiri TK. Primary anti-vascular endothelial growth factor (VEGF)-refractory metastatic renal cell carcinoma: clinical characteristics, risk factors, and subsequent therapy. Ann Oncol 2011; 23:1549-55. [PMID: 22056973 DOI: 10.1093/annonc/mdr533] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A subset of patients treated with initial anti-vascular endothelial growth factor (VEGF) therapy exhibit progressive disease (PD) as the best response per RECIST criteria. METHODS Data from patients with metastatic renal cell carcinoma (mRCC) treated with anti-VEGF therapy were collected through the International mRCC Database Consortium from 12 centers. RESULTS One thousand and fifty-six assessable patients received initial VEGF inhibitors and 272 (26%) of these patients had PD as best response. Initial treatment included sunitinib (n = 203), sorafenib (n = 51), or bevacizumab (n = 18). Six percent of patients were at favorable risk, 55% at intermediate risk, and 39% at poor risk. On multivariable analysis, predictors of PD were Karnofsky performance status < 80% [odds ratio (OR) = 2.3, P < 0.0001], diagnosis to treatment < 1 year (OR = 2.1, P < 0.0001), neutrophilia (OR = 1.9, P = 0.0021), thrombocytosis (OR = 1.7, P = 0.0068), and anemia (OR = 1.6, P = 0.0058). Median progression-free survival (PFS) in patients with PD versus without PD was 2.4 versus 11 months (P < 0.0001) and overall survival (OS) was 6.8 versus 29 months (P < 0.0001), respectively. One hundred and eight (40%) VEGF-refractory patients proceeded to receive further systemic therapies. Response rate, PFS, and OS for subsequent therapy were 9%, 2.5 months, and 7.4 months, respectively, with no statistical differences between patients who received VEGF versus mammalian target of rapamycin (mTOR) inhibitors. CONCLUSIONS Primary anti-VEGF-refractory mRCC patients have a dismal prognosis. Second-line anti-mTOR and anti-VEGF agents produce similar outcomes.
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Hotte S, Bjarnason G, Heng D, Jewett M, Kapoor A, Kollmannsberger C, Maroun J, Mayhew L, North S, Reaume M, Ruether J, Soulieres D, Venner P, Winquist E, Wood L, Yong J, Saad F. Progression-free survival as a clinical trial endpoint in advanced renal cell carcinoma. Curr Oncol 2011; 18 Suppl 2:S11-9. [PMID: 21969807 PMCID: PMC3176905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Traditionally, overall survival (os) has been considered the "gold standard" for evaluating new systemic oncologic therapies, because death is easy to define, is easily compared across disease sites, and is not subject to investigator bias. However, as the available options for continuing therapy increase, the use of os as a clinical trial endpoint has become problematic because of the increasing crossover and contamination of trials. As a result, the approval of promising new therapies may be delayed.Many clinicians believe that progression-free survival (pfs) is a more viable option for evaluating new therapies in metastatic and advanced renal cell carcinoma. As with all endpoints, pfs has inherent biases, and those biases must be addressed to ensure that trial results are not compromised and that they will be accepted by regulatory authorities. In this paper, we examine the issues surrounding the use of pfs as a clinical trial endpoint, and we suggest solutions to ensure that data integrity is maintained.
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Hotte S, Bjarnason G, Heng D, Jewett M, Kapoor A, Kollmannsberger C, Maroun J, Mayhew L, North S, Reaume M, Ruether J, Soulieres D, Venner P, Winquist E, Wood L, Yong J, Saad F. Progression-Free Survival as a Clinical Trial Endpoint in Advanced Renal Cell Carcinoma. Curr Oncol 2011. [DOI: 10.3747/co.v18is2.958] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Traditionally, overall survival (os) has been considered the “gold standard” for evaluating new systemic oncologic therapies, because death is easy to define, is easily compared across disease sites, and is not subject to investigator bias. However, as the available options for continuing therapy increase, the use of os as a clinical trial endpoint has become problematic because of the increasing crossover and contamination of trials. As a result, the approval of promising new therapies may be delayed. Many clinicians believe that progression-free survival (pfs) is a more viable option for evaluating new therapies in metastatic and advanced renal cell carcinoma. As with all endpoints, pfs has inherent biases, and those biases must be addressed to ensure that trial results are not compromised and that they will be accepted by regulatory authorities. In this paper, we examine the issues surrounding the use of pfs as a clinical trial endpoint, and we suggest solutions to ensure that data integrity is maintained.
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Mita AC, Papadopoulos K, de Jonge MJA, Schwartz G, Verweij J, Mita MM, Ricart A, Chu QSC, Tolcher AW, Wood L, McCarthy S, Hamilton M, Iwata K, Wacker B, Witt K, Rowinsky EK. Erlotinib 'dosing-to-rash': a phase II intrapatient dose escalation and pharmacologic study of erlotinib in previously treated advanced non-small cell lung cancer. Br J Cancer 2011; 105:938-44. [PMID: 21878940 PMCID: PMC3185947 DOI: 10.1038/bjc.2011.332] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/22/2011] [Accepted: 08/01/2011] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND To evaluate the anticancer activity of erlotinib in patients with previously treated, advanced non-small cell lung cancer (NSCLC) whose dose is increased to that associated with a maximal level of tolerable skin toxicity (i.e., target rash (TR)); to characterise the pharmacokinetics (PK) and pharmacodynamics (PD) of higher doses of erlotinib. METHODS Patients initially received erlotinib 150 mg per day. The dose was successively increased in each patient to that associated with a TR. Anticancer activity was evaluated. Plasma, skin, and hair were sampled for PK and PD studies. RESULTS Erlotinib dose escalation to 200-475 mg per day was feasible in 38 (90%) of 42 patients. Twenty-four (57%) patients developed a TR, but 19 (79%) did so at 150 mg per day. Five (12%) patients, all of whom developed a TR, had a partial response. Median progression-free survival (PFS) was 2.3 months (95% CI: 1.61, 4.14); median PFS was 3.5 months and 1.9 months, respectively, for patients who did and did not experience a TR (hazard ratio, 0.51; P=0.051). Neither rash severity nor response correlated with erlotinib exposure. CONCLUSION Intrapatient dose escalation of erlotinib does not appreciably increase the propensity to experience a maximal level of tolerable skin toxicity, or appear to increase the anticancer activity of erlotinib in NSCLC.
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Price J, Shaarbaf R, Wood L. Sunitinib causes macrocytosis in patients with advanced renal cell carcinoma. ACTA ACUST UNITED AC 2011; 17:30-3. [PMID: 20404975 DOI: 10.3747/co.v17i2.470] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sunitinib is approved for treatment of advanced renal cell carcinoma (RCC). Based on a clinical observation that patients receiving sunitinib developed macrocytosis, we undertook a study to further define this observation. METHODS In a retrospective review of RCC patients treated at a single centre, data on treatment duration, hematology parameters, concomitant medications, vitamin B₁₂and folate levels, and thyroid function were recorded. RESULTS The 43 patients reviewed had received a median of 5 cycles of sunitinib. Overall, 21 patients (49%) developed macrocytosis after a median of 3 cycles. Of the 9 patients that received 2 or fewer cycles, none developed macrocytosis. Among patients with macrocytosis, 9 (43%) had anemia at the time macrocytosis was first documented. In patients who did not develop macrocytosis, 82% showed a trend of increasing mean corpuscular volume. CONCLUSIONS Treatment with sunitinib in patients with RCC can cause macrocytosis. The frequency of macrocytosis increases with duration of treatment. The mechanism of sunitinib-associated macrocytosis remains to be elucidated.
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Heng DYC, Xie W, Harshman LC, Bjarnason GA, Vaishampayan UN, Lebert J, Wood L, Donskov F, Tan M, Rha SY, Wells C, Wang Y, Kollmannsberger CK, Rini BI, Choueiri TK. External validation of the International Metastatic Renal Cell Carcinoma (mRCC) Database Consortium prognostic model and comparison to four other models in the era of targeted therapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4560] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Al-Marrawi MY, Rini BI, Harshman LC, Bjarnason GA, Wood L, Vaishampayan UN, MacKenzie MJ, Knox JJ, Agarwal N, Kollmannsberger CK, Tan M, Rha SY, Donskov F, North SA, Choueiri TK, Heng DYC. The association of clinical outcome to front-line VEGF-targeted therapy with clinical outcome to second-line VEGF-targeted therapy in metastatic renal cell carcinoma (mRCC) patients (Pts). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4555] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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