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Martincuks A, Zhang C, Austria T, Li YJ, Huang R, Lugo Santiago N, Kohut A, Zhao Q, Borrero RM, Shen B, Cristea M, Wang EW, Song M, Rodriguez-Rodriguez L, Yu H. Targeting PARG induces tumor cell growth inhibition and antitumor immune response by reducing phosphorylated STAT3 in ovarian cancer. J Immunother Cancer 2024; 12:e007716. [PMID: 38580335 PMCID: PMC11002370 DOI: 10.1136/jitc-2023-007716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Ovarian cancer is the most lethal gynecological malignancy, with limited treatment options after failure of standard therapies. Despite the potential of poly(ADP-ribose) polymerase inhibitors in treating DNA damage response (DDR)-deficient ovarian cancer, the development of resistance and immunosuppression limit their efficacy, necessitating alternative therapeutic strategies. Inhibitors of poly(ADP-ribose) glycohydrolase (PARG) represent a novel class of inhibitors that are currently being assessed in preclinical and clinical studies for cancer treatment. METHODS By using a PARG small-molecule inhibitor, COH34, and a cell-penetrating antibody targeting the PARG's catalytic domain, we investigated the effects of PARG inhibition on signal transducer and activator of transcription 3 (STAT3) in OVCAR8, PEO1, and Brca1-null ID8 ovarian cancer cell lines, as well as in immune cells. We examined PARG inhibition-induced effects on STAT3 phosphorylation, nuclear localization, target gene expression, and antitumor immune responses in vitro, in patient-derived tumor organoids, and in an immunocompetent Brca1-null ID8 ovarian mouse tumor model that mirrors DDR-deficient human high-grade serous ovarian cancer. We also tested the effects of overexpressing a constitutively activated STAT3 mutant on COH34-induced tumor cell growth inhibition. RESULTS Our findings show that PARG inhibition downregulates STAT3 activity through dephosphorylation in ovarian cancer cells. Importantly, overexpression of a constitutively activated STAT3 mutant in tumor cells attenuates PARG inhibitor-induced growth inhibition. Additionally, PARG inhibition reduces STAT3 phosphorylation in immune cells, leading to the activation of antitumor immune responses, shown in immune cells cocultured with ovarian cancer patient tumor-derived organoids and in immune-competent mice-bearing mouse ovarian tumors. CONCLUSIONS We have identified a novel antitumor mechanism underlying PARG inhibition beyond its primary antitumor effects through blocking DDR in ovarian cancer. Furthermore, targeting PARG activates antitumor immune responses, thereby potentially increasing response rates to immunotherapy in patients with ovarian cancer.
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Affiliation(s)
- Antons Martincuks
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Chunyan Zhang
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Theresa Austria
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Yi-Jia Li
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Rui Huang
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Nicole Lugo Santiago
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA
| | - Adrian Kohut
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA
| | - Qianqian Zhao
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
- City of Hope Irell & Manella Graduate School of Biological Sciences, Duarte, California, USA
| | - Rosemarie Martinez Borrero
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
- City of Hope Irell & Manella Graduate School of Biological Sciences, Duarte, California, USA
| | - Binghui Shen
- Department of Cancer Genetics and Epigenetics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Mihaela Cristea
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California, USA
| | - Edward W Wang
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California, USA
| | - Mihae Song
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA
| | | | - Hua Yu
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Wei CH, Wang EW, Ma L, Zhou Y, Zheng L, Hampel H, Shehayeb S, Lee S, Cohen J, Kohut A, Fan F, Rosen S, Wu X, Shen B, Zhao Y. POLD1 DEDD Motif Mutation Confers Hypermutation in Endometrial Cancer and Durable Response to Pembrolizumab. Cancers (Basel) 2023; 15:5674. [PMID: 38067377 PMCID: PMC10705788 DOI: 10.3390/cancers15235674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Mutations in the DNA polymerase delta 1 (POLD1) exonuclease domain cause DNA proofreading defects, hypermutation, hereditary colorectal and endometrial cancer, and are predictive of immunotherapy response. Exonuclease activity is carried out by two magnesium cations, bound to four highly conserved, negatively charged amino acids (AA) consisting of aspartic acid at amino acid position 316 (p.D316), glutamic acid at position 318 (p.E318), p.D402, and p.D515 (termed DEDD motif). Germline polymorphisms resulting in charge-discordant AA substitutions in the DEDD motif are classified as variants of uncertain significance (VUSs) by laboratories and thus would be considered clinically inactionable. We hypothesize this mutation class is clinically pathogenic. METHODS A review of clinical presentation was performed in our index patient with a POLD1(p.D402N) heterozygous proband with endometrial cancer. Implications of this mutation class were evaluated by a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review, in silico analysis with orthogonal biochemical confirmation, and whole-exome and RNA sequencing analysis of the patient's tumor and engineered cell lines. RESULTS Our systematic review favored a Mendelian disease mutation class associated with endometrial and colorectal cancers. In silico analysis predicted defective protein function, confirmed by biochemical assay demonstrating loss of nuclease activity. A POLD1-specific mutational signature was found in both the patient's tumor and POLD1(p.D402N) overexpressing cell. Furthermore, paired whole-exome/transcriptome analysis of endometrial tumor demonstrated hypermutation and T cell-inflamed gene expression profile (GEP), which are joint predictive biomarkers for pembrolizumab. Our patient showed a deep, durable response to immune checkpoint inhibitor (ICI). CONCLUSION Charge-discordant AA substitution in the DEDD motif of POLD1 is detrimental to DNA proofreading and should be reclassified as likely pathogenic and possibly predictive of ICI sensitivity.
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Affiliation(s)
- Christina Hsiao Wei
- Department of Pathology, City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA;
| | - Edward Wenge Wang
- Department of Oncology & Therapeutics Research, City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA;
| | - Lingzi Ma
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute at City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA; (L.M.); (Y.Z.); (L.Z.); (B.S.)
| | - Yajing Zhou
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute at City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA; (L.M.); (Y.Z.); (L.Z.); (B.S.)
| | - Li Zheng
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute at City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA; (L.M.); (Y.Z.); (L.Z.); (B.S.)
| | - Heather Hampel
- Clinical Cancer Genetics, City of Hope Medical Center (COHMC), Duarte, CA 91010, USA; (H.H.); (S.S.)
| | - Susan Shehayeb
- Clinical Cancer Genetics, City of Hope Medical Center (COHMC), Duarte, CA 91010, USA; (H.H.); (S.S.)
| | - Stephen Lee
- Division of Gynecologic Oncology and Surgery, City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA; (S.L.); (J.C.); (A.K.)
| | - Joshua Cohen
- Division of Gynecologic Oncology and Surgery, City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA; (S.L.); (J.C.); (A.K.)
| | - Adrian Kohut
- Division of Gynecologic Oncology and Surgery, City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA; (S.L.); (J.C.); (A.K.)
| | - Fang Fan
- Department of Pathology, City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA;
| | - Steven Rosen
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA;
- Beckman Research Institute of City of Hope, Duarte, CA 91010, USA; (X.W.); (Y.Z.)
| | - Xiwei Wu
- Beckman Research Institute of City of Hope, Duarte, CA 91010, USA; (X.W.); (Y.Z.)
| | - Binghui Shen
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute at City of Hope Medical Center (COHNMC), Duarte, CA 91010, USA; (L.M.); (Y.Z.); (L.Z.); (B.S.)
| | - Yuqi Zhao
- Beckman Research Institute of City of Hope, Duarte, CA 91010, USA; (X.W.); (Y.Z.)
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Kohut A, Whitaker T, Walter L, Li SY, Han E, Lee S, Wakabayashi MT, Dellinger TH, Han ES, Rodriguez-Rodriguez L, Chung C. Feasibility of combining pelvic reconstruction with gynecologic oncology-related surgery. Int Urogynecol J 2023; 34:177-183. [PMID: 35501570 DOI: 10.1007/s00192-022-05212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/12/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION AND HYPOTHESIS At our institution, every patient seen by the gynecologic oncology service is screened for pelvic floor dysfunction. This study was aimed at determining if a combined surgical approach by gynecologic oncology and urogynecology services at our institution was feasible and safe for this patient population. METHODS We performed a retrospective review of patients undergoing combined surgery by gynecologic oncology and urogynecology services at our institution from 2013 to 2021. Perioperative variables, postoperative adverse events, and long-term outcomes were assessed, and descriptive statistics were performed. RESULTS From 20 December 2013 to 29 January 2021, a total of 102 patients underwent concurrent surgical repair of pelvic organ prolapse and/or stress urinary incontinence. Seventy-three patients (71.6%) had normal/benign pathologic conditions, and 29 (28.4%) had premalignant/malignant pathologic conditions. Ten patients (9.8%) had a postoperative complication, including reoperation for exposed midurethral sling (4.9%), urinary retention requiring midurethral sling release (2.9%), reoperation for hemoperitoneum (1.0%), and anemia requiring blood transfusion (1.0%). Nine complications occurred in patients with benign/normal pathologic conditions (12.3%), and one complication occurred in patients with pre-malignant/malignant pathologic conditions (3.4%). CONCLUSIONS In our single-institution experience, concurrent gynecologic oncology and pelvic floor reconstructive surgery were safe and feasible in combination with no reported major morbidity events.
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Affiliation(s)
- Adrian Kohut
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA.
| | - Taylor Whitaker
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Logan Walter
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Susan Y Li
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Elinor Han
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Stephen Lee
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Mark T Wakabayashi
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Thanh H Dellinger
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Ernest S Han
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Lorna Rodriguez-Rodriguez
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Christopher Chung
- Department of Surgery, Division of Gynecologic Oncology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
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Kohut A, Santiago NL, Attiyeh M, Malhotra G, Tran T, Cloud T, Lee S, Dellinger T, Tergas A, Hakim A, Kebria M, de Leon M, Lin WC, Wang E, Stewart D, Cristea M, Han E, Song M, Rodriguez-Rodriguez L, Raoof M, Lin J. HIPEC is associated with improved survival in stage III-IV ovarian cancer patients undergoing complete cytoreductive surgery: An NCDB-based analysis (561). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Santiago NL, Wen W, Kohut A, Bensen E, Santini J, Yim J, Fong Y, Han E. Preclinical evaluation of a novel cathepsin-activated fluorescent probe VGT-309 for identification of ovarian cancer in a mouse model (248). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kohut A, Martincuks A, Santiago NL, Austria T, Zhao Q, Lee S, Tergas A, Dellinger T, Han E, Rodriguez-Rodriguez L, Yu H, Song M. STAT3 is a potential therapeutic target in cervical cancer (257). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Girda E, Hou J, Nelson D, Finlayson M, de Meritens AB, Chekmareiva M, Leiser A, Song M, Stephenson R, Chan N, Tergas AI, Vattakalam R, Wright JD, Yu H, Martincuks A, Kohut A, Palmer J, Rodriguez-Rodriguez L. Phase I trial of daily subcutaneous SPL-108 injections in combination with paclitaxel in patients with platinum resistant CD44+ advanced ovarian epithelial cancer. Int J Gynecol Cancer 2022; 32:ijgc-2021-003316. [PMID: 35750354 PMCID: PMC9380511 DOI: 10.1136/ijgc-2021-003316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/31/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Preclinical evidence and early clinical trials have demonstrated the activity of SPL-108, a targeted agent that inhibits CD44 mediated induction of multidrug resistance specifically to paclitaxel and platinum agents. We conducted a phase I, open label, dose escalation study of the safety and tolerability of the combination of SPL-108 with weekly paclitaxel in patients with platinum resistant CD44+ ovarian, primary peritoneal, or fallopian tube cancer. METHODS Patients with platinum resistant histologically proven epithelial ovarian, primary peritoneal, or fallopian tube cancers and measurable disease according to RECIST (Response Evaluation Criteria in Solid Tumours) version 1.1 were selected. Tumors were tested for CD44 expression for eligibility, defined as strong (+++) or moderate (++) staining in ≥20% of the tumor tissue or diffuse + staining. Patients were treated with daily and then twice daily SPL-108 subcutaneous injections and weekly intravenous paclitaxel on days 1, 8, and 15 of a 28 day cycle. Endpoints included safety, determination of maximum tolerated dose, and efficacy. Tumors underwent comprehensive genomic profiling, and cell lines and western blotting were used to study markers of response. RESULTS We screened 16 patients, and 14 were enrolled based on CD44+ expression. A total of 86% of patients had high grade serous tumors and all had received multiple prior therapies. There were no grade 4-5 toxicities. One patient had grade 3 peripheral sensory neuropathy attributed to paclitaxel and one patient developed presumed colonic perforation attributed to the study drug. No dose reductions or treatment discontinuations were required. All patients tolerated the maximum planned dose; no maximum tolerated dose was reached. Overall response rate was 36%; 5 (36%) patients had partial response and 5 (36%) patients had stable disease. CONCLUSIONS The combination of SPL-108 with weekly paclitaxel was safe and well tolerated. Encouraging antitumor activity was observed, with 72% of patients deriving a clinical benefit. TRIAL REGISTRATION NCT03078400.
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Affiliation(s)
- Eugenia Girda
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - June Hou
- Gynecologic Oncology, Columbia University, New York City, New York, USA
| | - David Nelson
- Splash Pharmaceuticals, San Diego, California, USA
| | | | | | | | - Aliza Leiser
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Mihae Song
- City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Ruth Stephenson
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Nancy Chan
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Ana I Tergas
- City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | | | - Jason D Wright
- Obstetrics and Gynecology, Columbia University, New York City, New York, USA
| | - Hua Yu
- City of Hope National Medical Center, Duarte, California, USA
| | | | - Adrian Kohut
- City of Hope National Medical Center, Duarte, California, USA
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Kohut A, Santiago NL, Attiyeh M, Malhotra G, Tran T, Cloud T, Lee S, Dellinger T, Tergas A, Hakim A, Kebria M, de Leon M, Lin WC, Wang E, Stewart D, Cristea M, Han E, Song M, Rodriguez-Rodriguez L, Raoof M, Lin J. P12 HIPEC is associated with improved survival in stage III-IV ovarian cancer pat1ients undergoing complete cytoreductive surgery: an NCDB-based analysis. Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)00357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zhao Q, Kohut A, Li YJ, Martincuks A, Austria T, Zhang C, Santiago NL, Borrero RM, Phan XT, Melstrom L, Rodriguez-Rodriguez L, Yu H. Niraparib-induced STAT3 inhibition increases its antitumor effects. Front Oncol 2022; 12:966492. [PMID: 36324587 PMCID: PMC9618811 DOI: 10.3389/fonc.2022.966492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022] Open
Abstract
Recently, poly(ADP-ribosyl)ation polymerase inhibitors (PARPis), which induce synthetic lethality of tumor cells with DNA damage repair defects, have emerged as a promising therapy for ovarian, breast, and pancreatic cancer. Although the PARPi Olaparib is limited to treating cancer patients with DNA repair deficiencies, the PARPi Niraparib is FDA approved to treat ovarian cancer patients regardless of their status in DNA repair pathways. Despite differences in the affinity to PARP enzymes, the rationale behind the clinical use of Niraparib in patients without DNA repair deficiencies is still lacking. Moreover, only Olaparib has been approved for pancreatic ductal adenocarcinoma (PDAC) patients with BRCA mutations, accounting for only 5-7% of total PDACs. It remains unclear whether Niraparib could be beneficial to PDACs without BRCA mutations. We found that Niraparib inhibits ovarian and PDAC tumor cell growth, regardless of BRCA mutational status, more effectively than Olaparib. Unlike Olaparib, which is known to activate STAT3, Niraparib inhibits STAT3 activity in ovarian and PDAC cancer cell lines and patient tumors. Moreover, Niraparib regulates the expression of several STAT3 downstream genes involved in apoptosis. Overexpression of a constitutively activated STAT3 mutant rescues Niraparib-induced cancer cell apoptosis. Our results suggest that Niraparib inhibits pSTAT3 by interfering with SRC tyrosine kinase. Collectively, our studies provide a mechanism underlying Niraparib's ability to induce tumor cell apoptosis without BRCA mutations, suggesting the potential use of Niraparib for treating PDAC patients regardless of BRCA status.
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Affiliation(s)
- Qianqian Zhao
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States.,Irell and Manella Graduate School of Biological Sciences, City of Hope National Medical Center, Duarte, CA, United States
| | - Adrian Kohut
- Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Yi-Jia Li
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Antons Martincuks
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Theresa Austria
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Chunyan Zhang
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Nicole Lugo Santiago
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Rosemarie Martinez Borrero
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States.,Irell and Manella Graduate School of Biological Sciences, City of Hope National Medical Center, Duarte, CA, United States
| | - Xuan Thuy Phan
- Department of Surgery, Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Laleh Melstrom
- Department of Surgery, Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Lorna Rodriguez-Rodriguez
- Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Hua Yu
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
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Martincuks A, Song J, Kohut A, Zhang C, Li YJ, Zhao Q, Mak E, Rodriguez-Rodriguez L, Yu H, Cristea M. PARP Inhibition Activates STAT3 in Both Tumor and Immune Cells Underlying Therapy Resistance and Immunosuppression In Ovarian Cancer. Front Oncol 2021; 11:724104. [PMID: 34956861 PMCID: PMC8693573 DOI: 10.3389/fonc.2021.724104] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022] Open
Abstract
Despite the promising activity of poly(ADP-ribose) polymerase (PARP) inhibitors (PARPi) in many cancer types with defects in the DNA damage response the majority of the treated patients acquire PARPi resistance and succumb to their diseases. Consequently, there is an urgent need to identify the mechanisms of PARPi resistance. Here, we show that PARPi treatment promotes STAT3 activation in ovarian cancer cells, tumor-associated immune cells and fibroblasts, resulting in PARPi resistance and immunosuppression. Comparison of ovarian cancer patient-matched tumor biopsies before and after PARPi therapy revealed that STAT3 activity was significantly higher in tumor cells and tumor-associated immune cells and fibroblasts post PARPi treatment. Moreover, one-time PARPi treatment activated STAT3 both in tumor cells as well as diverse immune subsets and fibroblasts. PARPi-treated immune cells exhibited decreased expression of immunostimulatory interferon (IFN)-γ and Granzyme B while increasing immunosuppressive cytokine IL-10. Finally, we demonstrate that the acquisition of PARPi resistance in ovarian cancer cells was accompanied by increased STAT3 activity. Ablating STAT3 inhibited PARPi-resistant ovarian tumor cell growth and/or restored PARPi sensitivity. Therefore, our study has identified a critical mechanism intrinsic to PARPi that promotes resistance to PARPi and induces immunosuppression during PARPi treatment by activating STAT3 in tumor cells and tumor-associated immune cells/fibroblasts.
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Affiliation(s)
- Antons Martincuks
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Jieun Song
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Adrian Kohut
- Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Chunyan Zhang
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Yi-Jia Li
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Qianqian Zhao
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Edward Mak
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Lorna Rodriguez-Rodriguez
- Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Hua Yu
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope National Medical Center (COH), Duarte, CA, United States
| | - Mihaela Cristea
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center (COH), Duarte, CA, United States
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Raoof M, Malhotra G, Kohut A, O'Leary M, Frankel P, Tran T, Fakih M, Chao J, Lim D, Woo Y, Paz IB, Lew M, Cristea MC, Rodriguez-Rodriguez L, Fong Y, Blakely A, Whelan R, Reymond MA, Merchea A, Dellinger TH. PIPAC for the Treatment of Gynecologic and Gastrointestinal Peritoneal Metastases: Technical and Logistic Considerations of a Phase 1 Trial. Ann Surg Oncol 2021; 29:175-185. [PMID: 34387765 DOI: 10.1245/s10434-021-10505-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/07/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Peritoneal metastases (PM) from ovarian, gastric, appendiceal, or colorectal origin can be treated via cytoreductive surgery with or without the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) for selected patients. Unfortunately, not all patients are candidates for aggressive surgical debulking. For these patients, pressurized intraperitoneal aerosolized chemotherapy (PIPAC) has emerged as an alternative method for intraperitoneal (IP) chemotherapy administration. This report presents the design and implementation of the first phase 1 trial to evaluate the safety and efficacy of PIPAC in the United States. METHODS This is an ongoing prospective phase 1 clinical trial of PIPAC for patients who have histologically confirmed ovarian, uterine, gastric, appendiceal, or colorectal cancer with PM and have progressed to at least one evidence-based chemotherapeutic regimen. The trial has two clinical arms. The patients in arm 1 have gynecologic and gastric malignancies treated with IP cisplatin and doxorubicin, and the arm 2 patients have colorectal and appendiceal malignancies treated with intravenous fluorouracil and leucovorin followed by IP oxaliplatin. All the patients are monitored for dose-limiting toxicities and adverse events. RESULTS Practical and technical considerations for the phase 1 PIPAC trial are presented. These considerations include patient selection, operating room setup, and technical details for successful aerosolized chemotherapy delivery. The phase 1 study results will be reported separately at completion of the trial. CONCLUSIONS The PIPAC treatment is a feasible, minimally invasive approach that permits IP delivery of chemotherapy. Once completed, the ongoing phase 1 trial will help to provide safety and initial efficacy data.
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Affiliation(s)
- Mustafa Raoof
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA.
| | - Gautam Malhotra
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Adrian Kohut
- Division of Gynecologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center (COH), Duarte, CA, USA
| | - Michael O'Leary
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Paul Frankel
- Biostatistics Core, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Thuy Tran
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Marwan Fakih
- Department of Medical Oncology, COH, Duarte, CA, USA
| | - Joseph Chao
- Department of Medical Oncology, COH, Duarte, CA, USA
| | - Dean Lim
- Department of Medical Oncology, COH, Duarte, CA, USA
| | - Yanghee Woo
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Isaac B Paz
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Michael Lew
- Department of Anesthesiology, COH, Duarte, CA, USA
| | | | - Lorna Rodriguez-Rodriguez
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Yuman Fong
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | | | | | | | | | - Thanh H Dellinger
- Division of Gynecologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center (COH), Duarte, CA, USA.
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Kohut A, Martincuks A, Dellinger T, Yu H, Rodriguez-Rodriguez L. Abstract 2432: Somatic mutations in the STAT3 activation pathway are associated with improved survival in gynecologic malignancies and provide a molecular rationale for therapeutic targeting. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-2432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Signal transducer and activator of transcription 3 (STAT3) activation promotes tumor cell survival, immune evasion, metastasis, and drug resistance in PARP inhibitors and platinum-based chemotherapy.
Objective: Based on our in-vitro findings of the tumoricidal potential of STAT3 inhibition in BRCAwild-type and PARP inhibitor-resistant tumor cells, we sought to evaluate whether ovarian and uterine cancer patients with somatic mutations in the STAT3 activation pathway had improved overall survival (OS) compared to those with intact STAT3 activation pathway-related genes.
Method: We induced Olaparib resistance in BRCAwild-type ovarian cancer cell lines (OVCAR8 and A2780) and treated both parental and PARP inhibitor-resistant cell lines with various STAT3 inhibitors. We then attempted to establish clinical correlations of our in-vitro studies and queried the Cancer Genome Atlas (TCGA) Pan-Cancer Atlas for uterine and ovarian cancers. OS in patients with somatic mutations in the STAT3 gene and/or associated STAT3 activation genes (IL6ST, GNAS, JAK1, JAK2) was compared to OS in patients with intact STAT3 pathway-related genes. Kaplan-Meier survival curves were compared using the log-rank test.
Results: In-vitro, STAT3 inhibition demonstrated potent, tumoricidal propensity in all cell lines (EC50: 0.34uM-0.46uM) including A2780parental, A2780parpi-resistant, OVCAR8parental, and OVCAR8parpi-resistant. Clinically, 1,154 total patients were identified in TCGA, including 571 high-grade serous ovarian carcinoma, 397 uterine endometrioid adenocarcinomas, 109 uterine serous carcinoma/uterine papillary serous carcinomas, 56 uterine carcinosarcomas/uterine malignant mixed Mullerian tumors, and 21 uterine mixed endometrial carcinomas. When pooling all uterine and ovarian cancer patients, median survival (MS) was 52 months (0-185) in patients with intact STAT3 (n=1,007) compared to not reached (NR, 0-225) in the STAT3 mutated group (n=147) with a Hazard Ratio (HR) of 0.25 and Confidence Interval (CI) 0.20-0.32 (p<0.001). In ovarian cancer patients, MS was 45 months (0-180) in patients with intact STAT3 (n=551) compared to 95 months (0-145) in the STAT3 mutated group (n=20) with a HR of 0.48 and CI 0.29-0.80 (p=0.038). In uterine cancer patients, MS was 112 months (0-185) in patients with intact STAT3 (n=456) compared to NR (0-225) in the STAT3 mutated group (n=127) with a HR of 0.40 and CI 0.25-0.64 (p=0.003).
Conclusion: Pharmacologic and genetic (siRNA) inhibition of the STAT3 activation pathway killed PARP inhibitor-resistant ovarian cancer cells in-vitro. Clinically, somatic mutations in the STAT3 activation pathway were associated with improved OS in both ovarian and uterine cancer. These findings provide a rationale for the therapeutic targeting of this pathway in gynecologic malignancies.
Citation Format: Adrian Kohut, Antons Martincuks, Thanh Dellinger, Hua Yu, Lorna Rodriguez-Rodriguez. Somatic mutations in the STAT3 activation pathway are associated with improved survival in gynecologic malignancies and provide a molecular rationale for therapeutic targeting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2432.
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Affiliation(s)
- Adrian Kohut
- City of Hope National Medical Center, Duarte, CA
| | | | | | - Hua Yu
- City of Hope National Medical Center, Duarte, CA
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Jodry D, Blemur D, Nguyen ML, Kuhn T, Easley K, Wang H, Ramaswamy M, Birdsong G, Kohut A, Manobianco B, Flowers L. Criminal Justice Involvement and Abnormal Cervical Cancer Screening Results Among Women in an Urban Safety Net Hospital. J Low Genit Tract Dis 2021; 25:81-85. [PMID: 33631779 DOI: 10.1097/lgt.0000000000000589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to elucidate the risk factors underlying abnormal cytology-based cervical cancer screening (Pap testing) in justice-involved women (JIW) compared with non-JIW in an urban safety net hospital. METHODS Retrospective chart review of women with a history of correctional involvement who received care at Grady Health System between 2010 and 2018 and had a Pap test was performed (n = 191). An age-matched cohort of women with no correctional involvement and had a Pap test at Grady served as the control (n = 394). Variables of interest were age, HIV, smoking, race, mental health history, and history of incarceration. Outcomes of interests were rate of abnormal Pap tests and follow-up. χ2 and logistic regression models evaluated associations between the variables of interest and outcomes. RESULTS Rates of abnormal Pap tests were significantly higher in JIW (35.6%) than controls (18.5%, p < .0001). Compared with controls, JIW were significantly more likely to have high-grade cervical cytology (odds ratio [OR] = 3.89, p < .0005) and be lost to gynecologic follow-up (OR = 8.75, p < .0001) and a history of severe mental illness (29.5% vs 4.3%, p < .0001). Those with abnormal Pap tests were likely to be HIV-positive (OR = 20.7, p < .001) and have a history of incarceration (OR = 2.33, p < .001). Predictors of high-grade Pap test were smoking history (OR = 0.16, p = .014), HIV-positive (OR = 3.66, p = .025), and history of incarceration (OR = 3.96, p < .0005). CONCLUSIONS Justice-involved women represent a high-risk subpopulation with significantly increased rates of high-grade cytology and lost to follow-up. This underscores the need for attention to screening programs and follow-up interventions for JIW.
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Affiliation(s)
- Dominique Jodry
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | | | - Minh Ly Nguyen
- Department of Infectious Disease, Emory University School of Medicine, Atlanta, GA
| | - Theresa Kuhn
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - Kirk Easley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA
| | - Heqiong Wang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS
| | - George Birdsong
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
| | - Adrian Kohut
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - Brittany Manobianco
- Department of Gynecology and Obstetrics, University of South Florida Morsani College of Medicine, Tampa, FL
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Kohut A, Booher M, Naumova A, Kuhn T, Southern G, Flowers L, Conrad L, Gordon A, Khanna N. Citation classics in gynecologic oncology: A bibliometric analysis. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Kohut A, Kuhn T, Booher M, Naumova A, Southern G, Flowers L, Conrad L, Gordon A, Rodriguez L, Khanna N. Evaluating risk factors for surgical site infection following minimally invasive surgery for endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Balica A, Kohut A, Tsai TJ, Groszmann YS, Brandt JS. A Bibliometric Analysis of Citation Classics in the Journal of Ultrasound in Medicine. J Ultrasound Med 2020; 39:1289-1297. [PMID: 31944354 DOI: 10.1002/jum.15220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/23/2019] [Accepted: 12/28/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES A bibliometric analysis of articles in the Journal of Ultrasound in Medicine (JUM) identified the journals' most impactful articles. METHODS A bibliometric analysis of citation classics that were published in the JUM from its inception in 1982 to 2019 was performed. All citation classics, defined as articles cited 100 or more times, were evaluated for the number of citations, citations per year, publication year, subspecialty, design, and country of origin. Characteristics were compared before and after 1998 by the Mann-Whitney test for unpaired data and 2-sample z tests of sample proportions. The Kruskal-Wallis test for nonparametric continuous data was used to compare the median number of citations per year by decade of publication. RESULTS A total of 7868 articles were published in the JUM between 1982 and 2019; 54 (0.7%) were citation classics. The median citation classics year of publication was 1998 (interquartile range [IQR], 1991-2003). Most citation classics originated from the United States (36 of 54 [66.7%]), were observational (47 of 54 [87%]), and were related to obstetric and gynecologic topics (16 of 54 [29.6%]). Citation classics after 1998 received significantly more citations per year (9.3 versus 4.7; P < .001), with no other differences noted. The median number of citations per year increased for each decade, with medians of 4 citations (IQR, 3.6-4.7) in 1982 to 1991 and 11.2 citations (IQR, 9-13.9) in 2002 to 2012 (P < .001). CONCLUSIONS This list provides insight into the most influential articles that were published in the JUM. Most citation classics were observational, were from the United States, and covered obstetric and gynecologic topics. Citation classics received more citations per year after 1998.
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Affiliation(s)
- Adrian Balica
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Adrian Kohut
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Te-Jung Tsai
- Department of Radiology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Yvette S Groszmann
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Diagnostic Ultrasound Associates, Brookline, Massachusetts, USA
| | - Justin S Brandt
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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Kundu K, Kuhn T, Kohut A, Staley C, Hanley K, Khanna N. Primary colonic extrauterine endometrial stromal sarcoma: A case and review of the literature. Gynecol Oncol Rep 2020; 32:100578. [PMID: 32382649 PMCID: PMC7200303 DOI: 10.1016/j.gore.2020.100578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022] Open
Abstract
Primary colonic extrauterine endometrial stromal sarcoma is a rare entity and diagnosis of this tumor can be challenging. There is a common gene translocation specific to the tumors, our case was confirmed by identifying it. Classifying these tumors correctly is important for treatment.
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Affiliation(s)
- Kuhali Kundu
- Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA, United States
| | - Theresa Kuhn
- Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA, United States
| | - Adrian Kohut
- Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA, United States
| | - Charles Staley
- Emory University School of Medicine, Department of Surgery, Division of Surgical Oncology, Atlanta, GA, United States
| | - Krisztina Hanley
- Emory University School of Medicine, Department of Pathology, Atlanta, GA, United States
| | - Namita Khanna
- Emory University School of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Atlanta, GA, United States
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Kohut A, Earnhardt MC, Cuccolo NG, Kim CS, Song M, Girda E, De Meritens AB, Stephenson R, Balica A, Leiser A, Demissie K, Rodriguez-Rodriguez L. Evaluating unplanned readmission and prolonged length of stay following minimally invasive surgery for endometrial cancer. Gynecol Oncol 2019; 156:162-168. [PMID: 31839339 DOI: 10.1016/j.ygyno.2019.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/17/2019] [Accepted: 08/23/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate risk factors for 30-day unplanned readmission and increased length of stay (LOS) following minimally invasive surgery (MIS) for endometrial cancer. METHODS This was a retrospective, case-control study using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Multivariable logistic regression was used to assess perioperative variables associated with readmission and increased LOS after MIS for endometrial cancer. RESULTS The study population included 10,840 patients who met the criteria of having undergone MIS with a resultant endometrial malignancy confirmed on postoperative pathology. Common reasons for readmission included organ/space surgical site infection (65 cases), sepsis/septic shock (19 cases), and venous thromboembolism (20 cases). Notable risk factors for readmission included (Odds Ratio, Confidence Interval, p-value): dialysis dependence (6.77, 2.51-17.80, <0.01), increased length of stay (3.00, 2.10-4.10, <0.01), and preoperative weight loss (2.80, 1.06-7.17, 0.03); notable risk factors for increased LOS: ascites (8.51, 2.00-36.33, <0.01), operation duration >5 h (6.93, 5.29-9.25, <0.01), and preoperative blood transfusion (5.37, 2.05-14.04, <0.01). CONCLUSIONS Identification of risk factors for adverse postoperative outcomes is necessary to inform and improve standards of care in MIS for endometrial cancer. Using nationally reported data from the ACS NSQIP, this study identifies independent risk factors for unplanned readmission and prolonged LOS, and in doing so, highlights potential avenues for quality improvement.
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Affiliation(s)
- Adrian Kohut
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Winship Cancer Institute, United States of America
| | - Mary Cathryn Earnhardt
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Nicholas G Cuccolo
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Chi-Son Kim
- Department of Obstetrics and Gynecology, The Mount Sinai Hospital, New York, NY, United States of America
| | - Mihae Song
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Eugenia Girda
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Alexandre Buckley De Meritens
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Ruth Stephenson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Adrian Balica
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Aliza Leiser
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - Kitaw Demissie
- School of Public Health, State University of New York Downstate Medical Center, Brooklyn, NY, United States of America
| | - Lorna Rodriguez-Rodriguez
- Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center Duarte, CA, United States of America.
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Kohut A, Ludvigsson L, Meuller BO, Deppert K, Messing ME, Galbács G, Geretovszky Z. From plasma to nanoparticles: optical and particle emission of a spark discharge generator. Nanotechnology 2017; 28:475603. [PMID: 28952969 DOI: 10.1088/1361-6528/aa8f84] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The increased demand for high purity nanoparticles (NPs) of defined geometry necessitates the continuous development of generation routes. One of the most promising physical techniques for producing metal, semiconductor or alloy NPs in the gas phase is spark discharge NP generation. The technique has a great potential for up-scaling without altering the particles. Despite the simplicity of the setup, the formation of NPs in a spark discharge takes place via complex multi-scale processes, which greatly hinders the investigation via conventional NP measurement techniques. In the present work, time-resolved optical emission spectroscopy (OES) was used to provide information on the species present in the spark from as early as approximately 100 ns after the initiation of the discharge. We demonstrate that operando emission spectroscopy can deliver valuable insights into NP formation. The emission spectra of the spark are used to identify, among others, the main stages of material erosion and to calculate the quenching rate of the generated metal vapour. We demonstrate that the alteration of key control parameters, that are typically used to optimize NP generation, clearly affect the emission spectra. We report for Cu and Au NPs that the intensity of spectral lines emitted by metal atoms levels off when spark energy is increased above an energy threshold, suggesting that the maximum concentration of metal vapour produced in the generator is limited. This explains the size variation of the generated NPs. We report a strong correlation between the optical and particle emission of the spark discharge generator, which demonstrate the suitability of OES as a valuable characterization tool that will allow for the more deliberate optimization of spark-based NP generation.
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Affiliation(s)
- A Kohut
- Department of Optics and Quantum Electronics, University of Szeged, Dóm tér 9, Szeged H-6720, Hungary
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Orfanelli T, Chung S, Kohut A, Gibbon D, Leiser A. Ogilvie's Syndrome after Robotic-Assisted Radical Hysterectomy for Cervical Cancer. J Minim Invasive Gynecol 2017; 25:175-179. [PMID: 28711762 DOI: 10.1016/j.jmig.2017.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/05/2017] [Accepted: 07/07/2017] [Indexed: 12/16/2022]
Abstract
Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is defined by poor peristaltic activity of the colon that mimics mechanical obstruction in the absence of any mechanical occlusive gut lesion. This case report is the first to be published on ACPO occurring after robotic-assisted radical hysterectomy. Given that robotic-assisted laparoscopic surgery has become the next major stage of advancement for a range of operations, especially in gynecologic oncology surgery, this report emphasizes the importance of recognizing precipitating factors associated with this syndrome, including minimally invasive surgery.
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Affiliation(s)
- Theofano Orfanelli
- Department of Obstetrics, Gynecology, and Reproductive Science, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
| | - Stephanie Chung
- Department of Obstetrics, Gynecology, and Reproductive Science, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Adrian Kohut
- Department of Obstetrics, Gynecology, and Reproductive Science, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | | | - Aliza Leiser
- Department of Obstetrics, Gynecology, and Reproductive Science, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
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Kohut A, Orfanelli T, Buckley De Meritens A, Balica A, Gibbon D, Leiser A. Determining risk of postoperative pulmonary embolism in the gynecologic oncology population. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Orfanelli T, Kohut A, Sisti G, Doulaveris G, Gibbon D. High-grade serous carcinoma of ovary and fallopian tube after the new protocol of assignment of primary site: An analysis of incidence, demographics, and clinical features. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kohut A, Orfanelli T, Richard S, Gibbon D, Sisti G, Poggio J. Morbidity and mortality risk assessment in gynecologic oncology surgery using the ACS NSQIP database. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Popadyuk N, Popadyuk A, Kohut A, Voronov A. Thermoresponsive latexes for fragrance encapsulation and release. Int J Cosmet Sci 2015; 38:139-47. [DOI: 10.1111/ics.12267] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/25/2015] [Indexed: 11/30/2022]
Affiliation(s)
- N. Popadyuk
- Coatings and Polymeric Materials Department; North Dakota State University; Fargo ND 58108 USA
| | - A. Popadyuk
- Coatings and Polymeric Materials Department; North Dakota State University; Fargo ND 58108 USA
| | - A. Kohut
- Organic Chemistry Department; Lviv Polytechnic National University; Lviv 79013 Ukraine
| | - A. Voronov
- Coatings and Polymeric Materials Department; North Dakota State University; Fargo ND 58108 USA
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Varvarenko S, Voronov A, Samaryk V, Tarnavchyk I, Roiter Y, Minko S, Nosova N, Kohut A, Voronov S. Polyolefin surface activation by grafting of functional polyperoxide. REACT FUNCT POLYM 2011. [DOI: 10.1016/j.reactfunctpolym.2010.11.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sieburg L, Kohut A, Kislenko V, Voronov A. Amphiphilic invertible polymers for adsolubilization on hydrophilic and hydrophobized silica nanoparticles. J Colloid Interface Sci 2010; 351:116-21. [DOI: 10.1016/j.jcis.2010.07.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 07/23/2010] [Accepted: 07/24/2010] [Indexed: 10/19/2022]
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Varvarenko S, Voronov A, Samaryk V, Tarnavchyk I, Nosova N, Kohut A, Voronov S. Covalent grafting of polyacrylamide-based hydrogels to a polypropylene surface activated with functional polyperoxide. REACT FUNCT POLYM 2010. [DOI: 10.1016/j.reactfunctpolym.2010.05.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Budishevska O, Dronj I, Voronov A, Solomko N, Kohut A, Kudina O, Voronov S. Amphiphilic polyperoxide based on an alternating copolymer of 1-octene and maleic anhydride for interface modification. REACT FUNCT POLYM 2009. [DOI: 10.1016/j.reactfunctpolym.2009.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cizmarikova M, Wagnerova M, Schonova L, Habalova V, Kohut A, Linkova A, Sarissky M, Mojzis J, Mirossay L, Mirossay A. MDR1 (C3435T) polymorphism: relation to the risk of breast cancer and therapeutic outcome. Pharmacogenomics J 2009; 10:62-9. [PMID: 19752884 DOI: 10.1038/tpj.2009.41] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
P-glycoprotein (PGP), the product of the MDR1 gene, is a transmembrane active efflux pump for a variety of carcinogens and cytostatics. It has been suggested that MDR1 polymorphisms contribute to the variability in cancer risk and therapeutic outcome. We examined the relevance of C3435T polymorphism in relation to breast cancer susceptibility, clinical and pathological characteristics of breast carcinoma, the therapeutic response and hematologic toxicities after anthracycline-based chemotherapy. A significant association between allele frequencies and histological type, stage and histological grade was observed (P=0.024, 0.014, 0.006, respectively, chi(2)-test or Fisher's exact test). We also found significantly higher (P=0.019, chi(2)-test) T allele frequency in breast cancer patients (n=221) than in controls (n=113). A significantly enhanced therapeutic outcome after neoadjuvant therapy (n=38; P=0.021, Fisher's exact test) and longer time to progression after anthracycline-based chemotherapy (n=102; P=0.049, log-rank test) were observed in CC homozygotes. However, no significant association between hematologic toxicities and C3435T polymorphism was detectable.
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Affiliation(s)
- M Cizmarikova
- Department of Pharmacology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovak Republic
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Samaryk V, Tarnavchyk I, Voronov A, Varvarenko S, Nosova N, Kohut A, Voronov S. A New Acrylamide-Based Peroxide Monomer: Synthesis and Copolymerization with Octyl Methacrylate. Macromolecules 2009. [DOI: 10.1021/ma901211s] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- V. Samaryk
- Department of Organic Chemistry, Lviv Polytechnic National University, 12 Bandera str., Lviv 79013, Ukraine
| | - I. Tarnavchyk
- Department of Organic Chemistry, Lviv Polytechnic National University, 12 Bandera str., Lviv 79013, Ukraine
| | - A. Voronov
- Department of Coatings and Polymeric Materials, North Dakota State University, NDSU Dept. 2760, P.O. Box 6050, Fargo, North Dakota 58108-6050
| | - S. Varvarenko
- Department of Organic Chemistry, Lviv Polytechnic National University, 12 Bandera str., Lviv 79013, Ukraine
| | - N. Nosova
- Department of Organic Chemistry, Lviv Polytechnic National University, 12 Bandera str., Lviv 79013, Ukraine
| | - A. Kohut
- Department of Coatings and Polymeric Materials, North Dakota State University, NDSU Dept. 2760, P.O. Box 6050, Fargo, North Dakota 58108-6050
| | - S. Voronov
- Department of Organic Chemistry, Lviv Polytechnic National University, 12 Bandera str., Lviv 79013, Ukraine
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Voronov A, Kohut A, Vasylyev S, Peukert W. Mechanism of silver ion reduction in concentrated solutions of amphiphilic invertible polyesters in nonpolar solvent at room temperature. Langmuir 2008; 24:12587-12594. [PMID: 18828624 DOI: 10.1021/la801769v] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Fast formation and efficient stabilization of silver nanoparticles from [Ag(NH3)2]OH are achieved in concentrated nonpolar solutions of amphiphilic invertible polyesters based on poly(ethylene oxide) (PEO) and aliphatic dicarboxylic acids. Surface-modified silver nanoparticles able to be dispersed in both a polar and nonpolar medium are developed in the form of a ready-to-use colloidal solution with an enhanced silver concentration. The PEO fragments of polyesters form cavities (also called pseudo-crown ester structures) that can bind metal ions. The reduction of bound metal ions proceeds via oxidation of polyoxyethylene fragments. No chemical reducing agents are necessary in this approach. The polyesters act simultaneously as an efficient reducing agent and stabilizer. The main focus of the present research is to clarify the chemical mechanism of silver ion reduction in amphiphilic polyester solutions. A one-electron reduction mechanism is proposed to explain the formation of silver nanoparticles. The effect of the poly(ethylene oxide) fragment length and the polyester concentration are explored by examining several amphiphilic polyesters.
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Affiliation(s)
- A Voronov
- Coatings and Polymeric Materials, North Dakota State University, 1735 NDSU Research Park Drive, Fargo, North Dakota 58105, USA.
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Voronov A, Vasylyev S, Kohut A, Peukert W. Surface activity of new invertible amphiphilic polyesters based on poly(ethylene glycol) and aliphatic dicarboxylic acids. J Colloid Interface Sci 2008; 323:379-85. [DOI: 10.1016/j.jcis.2008.04.053] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Revised: 04/16/2008] [Accepted: 04/17/2008] [Indexed: 11/24/2022]
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Tomalino LM, Voronov A, Kohut A, Peukert W. Study of Amphiphilic Polyester Micelles by Hyper-Rayleigh Scattering: Invertibility and Phase Transfer. J Phys Chem B 2008; 112:6338-43. [DOI: 10.1021/jp710499z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L. Martinez Tomalino
- Institute of Particle Technology, Friedrich-Alexander University, Erlangen-Nuremberg, Germany, and Coatings and Polymeric Materials, North Dakota State University, Fargo, North Dakota 58105
| | - A. Voronov
- Institute of Particle Technology, Friedrich-Alexander University, Erlangen-Nuremberg, Germany, and Coatings and Polymeric Materials, North Dakota State University, Fargo, North Dakota 58105
| | - A. Kohut
- Institute of Particle Technology, Friedrich-Alexander University, Erlangen-Nuremberg, Germany, and Coatings and Polymeric Materials, North Dakota State University, Fargo, North Dakota 58105
| | - W. Peukert
- Institute of Particle Technology, Friedrich-Alexander University, Erlangen-Nuremberg, Germany, and Coatings and Polymeric Materials, North Dakota State University, Fargo, North Dakota 58105
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Kohut A, Voronov A, Peukert W. Synthese und Stabilisierung von Nanopartikeln mit „smart” amphiphilen Polymeren. CHEM-ING-TECH 2007. [DOI: 10.1002/cite.200750191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
This article offers a new approach to building up self-adjustable invertible polymer coatings at solid surfaces. The approach is based on a two-step process. In the first step, the surface of dispersed TiO2 has been functionalized with the aid of toluene diisocyanate (TDI) as a coupling agent. In the second step, the chains of amphiphilic oligoester have been covalently grafted to the titanium dioxide surface functionalized with isocyanate groups. It is shown that the titania modified in this way can form stable suspensions in both polar (water) and nonpolar (toluene) media. Multiple redispersion cycles show the ability of the modified titanium dioxide particles, after their removal from one type of dispersion and consequent drying, to be redispersed in dispersing media strongly differing by polarity from the previous.
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Affiliation(s)
- A Kohut
- Institute of Particle Technology, Friedrich-Alexander University Erlangen-Nuremberg, Cauerstr. 4, 91058 Erlangen, Germany
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Kohut A, Ranjan S, Voronov A, Peukert W, Tokarev V, Bednarska O, Gevus O, Voronov S. Design of a new invertible polymer coating on a solid surface and its effect on dispersion colloidal stability. Langmuir 2006; 22:6498-506. [PMID: 16830990 DOI: 10.1021/la060162u] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This article presents a new approach to building up self-adjustable invertible polymer coatings at solid surfaces. The approach is based on a two-step process. In the first step, the surface of dispersed TiO2 or silicon wafers was functionalized with the aid of a reactive copolymer, viz., poly(styrene-alt-maleic anhydride) (PSM), to which, in the second step, the chains of amphiphilic oligoester have been tethered. The latter contains both hydrophilic poly(ethylene glycol) and hydrophobic aliphatic dibasic acid moieties being alternately distributed along the oligomer chains. It is shown that the titania modified in this way can form stable suspensions in both polar (water) and nonpolar (toluene) media. Moreover, multiple drying/redispersion cycles demonstrate the ability of the modified titania particles, after their removal from one type of dispersion and consequent drying, to be redispersed in dispersing media strongly differing by polarity from that of the previous medium. An environmentally induced switching of the surface properties has been observed via the measurement of the wetting contact angles and scanning force microscopy (SFM) of silicon wafers covered by PSM with tethered oligoester chains. These experiments give strong support for the predicted capability of such polymer coatings to switch their environmental appearance (i.e., to behave as a self-adjustable invertible interface because of the ability of the tethered amphiphilic oligoester chains to change their conformations in response to environmental changes in such a manner so as to adapt and enhance their compatibility with the surrounding media).
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Affiliation(s)
- A Kohut
- Institute of Particle Technology, Friedrich Alexander University Erlangen-Nuremberg, Cauerstrasse 4, 91058 Erlangen, Germany
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Biros E, Kalina I, Biros I, Kohut A, Bogyiová E, Salagovic J, Stubna J. Polymorphism of the p53 gene within the codon 72 in lung cancer patients. Neoplasma 2002; 48:407-11. [PMID: 11845987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
We tested the codon 72 single nucleotide polymorphism (SNP) of the tumor suppressor gene p53 for association with lung cancer. In our hospital-based case-control study, 168 lung cancer patients (134 males and 34 females) and 148 controls without malignant diseases were recruited. The genotype characteristics were determined by PCR-based RFLP method using DNA extracted from peripheral blood. Only in lung cancer patients but not in the controls we found both significant decrease of A1 allele of the p53 codon 72 (p=0.024, OR 0.56, 95% CI 0.43-0.72) and A1/A1 homozygous genotype (p=0.006, OR 0.27,95% CI 0.15-0.51). The results of this study suggest a protective effect of A1 allele against lung cancer.
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Affiliation(s)
- E Biros
- Department of Medical Biology, School of Medicine, P.J. Safárik University, Kosice, Slovakia.
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Keeter S, Miller C, Kohut A, Groves RM, Presser S. Consequences of reducing nonresponse in a national telephone survey. Public Opin Q 2000; 64:125-148. [PMID: 10984330 DOI: 10.1086/317759] [Citation(s) in RCA: 302] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Critics of public opinion polls often claim that methodological shortcuts taken to collect timely data produce biased results. This study compares two random digit dial national telephone surveys that used identical questionnaires but very different levels of effort: a "Standard" survey conducted over a 5-day period that used a sample of adults who were home when the interviewer called, and a "Rigorous" survey conducted over an 8-week period that used random selection from among all adult household members. Response rates, computed according to AAPOR guidelines, were 60.6 percent for the Rigorous and 36.0 percent for the Standard study. Nonetheless, the two surveys produced similar results. Across 91 comparisons, no difference exceeded 9 percentage points, and the average difference was about 2 percentage points. Most of the statistically significant differences were among demographic items. Very few significant differences were found on attention to media and engagement in politics, social trust and connectedness, and most social and political attitudes, including even those toward surveys.
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Affiliation(s)
- R J Blendon
- Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115
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Kohut A, Nygreen N. Rising costs concern physicians...and the general public. Am Med News 1979; 22:suppl 2-3. [PMID: 10244808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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