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Patel A, Bhatt N, Prakash SS, Biswas G, Nagarkar R, Roy B, Samal P, Agrawal N, Meshram S, Kaushal A, Satheesh CT, Wategaonkar R, Thiagarajan KV, Jain K, Vijayaveeran P, Mukherjee K, Singh K, Patil T, Jain A, Dolai TK, Jain M, Hingmire S, Gupta TC, Lakshmaiah KC, Rajamanickam D, Nemade B, Goyal V, Mahato P, Mendiratta SK, Doshi M. Rituximab biosimilar for the treatment of diffuse large B-cell lymphoma: a phase 3 randomized study in India. Cancer Chemother Pharmacol 2023; 91:457-468. [PMID: 37093266 PMCID: PMC10124690 DOI: 10.1007/s00280-023-04530-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/22/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE Very few studies have demonstrated the rituximab biosimilarity in terms of efficacy, safety, pharmacokinetics, pharmacodynamics, and immunogenicity in patients with diffuse large B-cell lymphoma (DLBCL) in India. Therefore, we compared the efficacy, safety, pharmacokinetic, pharmacodynamic, and immunogenicity of our biosimilar rituximab with the reference rituximab (Ristova, Roche products [India] Pvt. Ltd) in patients with DLBCL in India. METHODS A phase 3, randomized, assessor-blind, parallel-group, two-arm study was conducted across 28 sites in India. A total of 153 newly diagnosed DLBCL patients were randomized to receive either biosimilar rituximab or reference rituximab. The study drugs were administered at a dose of 375 mg/m2 by intravenous infusion every 3 weeks for six cycles. The primary end point was objective response rate (ORR) at the end of Cycle 6. Secondary end points included: pharmacokinetic, pharmacodynamics, immunogenicity, and safety assessment. RESULTS The ORR at the end of Cycle 6 was 82.14% in the biosimilar rituximab and 85.71% in the reference rituximab group. The risk difference (90% CIs) was - 3.57 (- 14.80, 7.66). It met the non-inferiority margin of - 20%. The pharmacokinetic and pharmacodynamic parameters were comparable between the two treatment groups. The incidence rate of immunogenicity was very low and similar in both the treatment groups. The safety profile of both the treatments was comparable with no major difference in terms of nature, frequency and severity of TEAEs. CONCLUSION The study demonstrated the biosimilarity between the biosimilar rituximab and the reference rituximab. Our biosimilar rituximab could add to the cost-effective treatment alternatives for patients with DLBCL in India.
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Affiliation(s)
- Ankit Patel
- Unique Hospital Multispecialty & Research Institute, Surat, India
| | - Niraj Bhatt
- Kailash Cancer Hospital and Research Center, Vadodara, India
| | | | | | | | - Bodhisatta Roy
- Netaji Subhash Chandra Bose Cancer Hospital, Kolkata, West Bengal, India
| | - Priyanka Samal
- Institute of Medical Sciences (IMS) and SUM Hospital, Bhubaneswar, Odisha, India
| | - Narendra Agrawal
- Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Sushil Meshram
- Government Medical College and Hospital, Nagpur, Maharashtra, India
| | | | - C T Satheesh
- Healthcare Global Enterprises Limited, Bangalore, Karnataka, India
| | | | | | - Kartikeya Jain
- Shree Himalaya Cancer Hospital & Research Institute, Vadodara, Gujarat, India
| | | | - Kalyan Mukherjee
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Kishore Singh
- Maulana Azad Medical College and Lok Nayak Hospital, Delhi, India
| | - Tushar Patil
- Global Hospital & Research Institute, Pune, Maharashtra, India
| | - Amit Jain
- Valentis Cancer Hospital, Uttar Pradesh, Mussoorie, Meerut, India
| | - Tuphan Kanti Dolai
- Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Minish Jain
- Grant Medical Foundation, Pune, Maharashtra, India
| | - Sachin Hingmire
- Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India
| | | | - K C Lakshmaiah
- Srinivasam Cancer Care Multispeciality Hospitals India Pvt. Ltd, Bangalore, Karnataka, India
| | | | | | - Vikash Goyal
- Sanjeevani CBCC Cancer Hospital, Raipur, Chhattisgarh, India
| | | | | | - Maulik Doshi
- Biologics (R & D and Manufacturing), Zydus Research Center, Moraiya, Ahmedabad, 382213, India
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Veldore VH, Patil S, Satheesh CT, Shashidhara HP, Tejaswi R, Prabhudesai SA, Krishnamoorthy N, Hazarika D, Naik R, Rao RM, Ajai Kumar BS. Genomic profiling in a homogeneous molecular subtype of non-small cell lung cancer: An effort to explore new drug targets. Indian J Cancer 2016; 52:243-8. [PMID: 26853422 DOI: 10.4103/0019-509x.175843] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients' who are positive for kinase domain activating mutations in epidermal growth factor receptor (EGFR) gene, constitute 30-40% of non-small cell lung cancer (NSCLC), and are suitable candidates for Tyrosine Kinase Inhibitor based targeted/personalized therapy. In EGFR non-mutated subset, 8-10% that show molecular abnormalities such as EML4-ALK, ROS1-ALK, KIP4-ALK, may also derive the benefit of targeted therapy. However, 40% of NSCLC belong to a grey zone of tumours that are negative for the clinically approved biomarkers for personalized therapy. This pilot study aims to identify and classify molecular subtypes of this group to address the un-met need for new drug targets in this category. Here we screened for known/novel oncogenic driver mutations using a 46 gene Ampliseq Panel V1.0 that includes Ser/Thr/Tyr kinases, transcription factors and tumor suppressors. METHODS NSCLC with tumor burden of at least 40% on histopathology were screened for 29 somatic mutations in the EGFR kinase domain by real-time polymerase chain reaction methods. 20 cases which were EGFR non-mutated for TK domain mutations were included in this study. DNA Quality was verified from each of the 20 cases by fluorimeter, pooled and subjected to targeted re-sequencing in the Ion Torrent platform. Torrent Suite software was used for next generation sequencing raw data processing and variant calling. RESULTS The clinical relevance and pathological role of all the mutations/variants that include SNPs and Indels was assessed using polyphen-2/SIFT/PROVEAN/mutation assessor structure function prediction programs. There were 10 pathogenic mutations in six different oncogenes for which annotation was available in the COSMIC database; C420R mutation in PIK3CA, Q472H mutation in vascular endothelial growth factor receptor 2 (VEGFR2) (KDR), C630W and C634R in RET, K367M mutation in fibroblast growth factor receptor 2 (FGFR2), G12C in KRAS and 4 pathogenic mutations in TP53 in the DNA binding domain (E285K, R213L, R175H, V173G). CONCLUSION Results suggest, a potential role for PIK3CA, VEGFR2, RET and FGFR2 as therapeutic targets in EGFR non-mutated NSCLC that requires further clinical validation.
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Affiliation(s)
- Vidya H Veldore
- Department of Molecular Pathology, Triesta Reference Laboratory, Triesta Sciences, A Unit of Health Care Global Enterprises Ltd., Bengaluru, Karnataka, India
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Veldore VH, Rao MR, Prabhudesai SA, Tejaswi R, Kakara S, Pattanayak S, Krishnamoorthy N, Tejaswini BN, Hazarika D, Gangoli A, Rahman SM, Dixit J, Naik R, Diwakar RB, Satheesh CT, Shashidhara HP, Patil S, Gopinath KS, Kumar BS. Prevalence of KRAS mutations in metastatic colorectal cancer: A retrospective observational study from India. Indian J Cancer 2016; 51:531-7. [PMID: 26842186 DOI: 10.4103/0019-509x.175371] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND One of the genetic alterations implicated in tumor progression in colorectal cancers (CRCs) are abnormalities in Kristen Rat Sarcoma (KRAS) gene. Evaluation of KRAS mutation status is an important prognostic factor and has predictive value in deciding first line therapy based on monoclonal antibodies such as Cetuximab and Panitumumab in metastatic CRCs. MATERIALS AND METHODS In this retrospective study, we analyzed 7 different somatic mutations in Exon 2 of KRAS gene in 299 unselected incidental CRC patients who visited the hospital for clinical management during the period 2009-2013. Most of the tumors were primarily originating from colon and rectum; nevertheless, there were a few from rectosigmoid, sigmoid, ceacum and anal canal in the study group. Genomic DNA extracted from paraffin embedded tumor tissues was screened for 7 point mutations located in Codons 12 and 13 of KRAS gene, using Scorpions amplified refractory mutation system real time polymerase chain reaction technology. Statistical analysis was performed to assess bivariate relationship between different variables that includes: mutation status, mutation type, tumor location, tumor morphology, age and sex. RESULTS Prevalence of mutation in Codons 12 and 13 was 42.8% in the study group. Well-differentiated tumors had significantly more mutation positivity than moderately and poorly differentiated tumors (P = 0.001). 92% of the mutations were from Codon 12 and 8% in Codon 13. Glycine to Arginine was relatively more common in rectosigmoid followed by ceacum, while Glycine to Alanine mutation was relatively more prevalent in sigmoid, followed by rectum and rectosigmoid. CONCLUSION The results suggest a prevalence of KRAS mutation at 42.8% in Indian population indicating that this testing is very crucial for targeted therapy management in metastatic CRC in India. Further analysis on mutation status of other homologues such as NRAS and downstream partner, v-raf murine sarcoma viral oncogene homolog B1, would add value to understanding the role of anti-epidermal growth factor receptor therapy in CRC management.
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Affiliation(s)
- V H Veldore
- Department of Molecular Pathology, Triesta Reference Laboratory, Triesta Sciences, A unit of Healthcare Global Enterprises Ltd., Bengaluru, Karnataka, India
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Ghosh M, Sheela ML, Choudhury S, Bahadur U, Patil S, Satheesh CT, Murugan K, Nayak R, Sridhar PS, Rao N, Mahesh B, Shashidhara HP, Krishnamoorthy N, Gupta V, Sankaran S, Subramanian K, Ajaikumar BS. Abstract P6-07-01: Multigene profiling to identify clinically relevant actionable mutations in breast cancer: An Indian study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-07-01] [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: Numerous chemotherapeutic agents are available against breast cancer (BC), but a vast majority of patients diagnosed with this disease still develop treatment resistance and eventually succumb to disease. It remains an unmet need to identify specific molecular defects against which targeted therapy are available for improving clinical outcomes in BC. Our study aims to identify frequent hotspot mutations in BCs and determine their clinical impact.
Methods: 200 women with BC(early diagnosed and/or metastatic) aged 26-75 yrs (median age 50.5yrs) diagnosed at HCG from April 2013-15 were consented to be profiled by targeted deep sequencing for hotspot mutations in 48 cancer-related genes using Illumina's TSCAP panel and MiSeq technology in an IRB-approved prospective study in a CLIA compliant laboratory. All the cases had pathology review for stage, histological type, hormonal status and Ki67. The average coverage across 220 hot spots was greater than 1000X. Data was processed using Strand Avadis NGS™. Mutations identified in the tumor were assessed for 'actionability' i.e. response to therapy and impact on prognosis. Results: Somatic variants were detected in 75% of cases with direct impact on therapy or prognosis. Genetic aberrations were identified in PI3K/AKT/ mTOR signalling pathway in substantial fraction (27%) of breast cancer cases, out of which 17% had PIK3CA activating mutations,13 and 5 cases had PTEN and AKT deletions or truncating mutations respectively. Aberration in this pathway was more prevalent in HR+ve (53%) and HER2-ve including TNBC (61%) than in HR+/HER2+ve tumors (10.6%) of IDC histology. However, no correlation was found with stage and Ki67 index of the tumor. Notably 80% of BC cases presented with liver metastasis at the time of diagnosis were detected with PIK3CA mutation indicating its role as a surrogate marker of organ specific metastasis. PIK3CA was found to be co mutated with p53 in 16 cases (9%) of which 4 cases showed npCR post NACT. Also disruptive and non-disruptive mutations in TP53 alone were found in 25% of BC, varying widely among different histologies. A follow up of few cases showed shorter PFS and poor outcome in resected BC treated with NACT indicating its robust prognostic value in NACT setting. Furthermore, two patients were detected with cKIT mutations indicating sensitivity to imatinib and therefore enrolled on a clinical trial. The other variants were found in RB1(n=8),Her2 (n=2),FGFR amplification(n=1), KRAS(n=2),NRAS(n=3)CDH1(n=1),FBXW7(n=2) and EGFR(n=1).All these variants detected indicated resistance to conventional therapy and suggested sensitivity to available targeted therapy, either approved or in clinical trials. The response and outcome are being monitored in about 20 (10%) patients who have been enrolled in clinical trials and receiving mutation specific targeted therapy. Conclusions: This study confirms the utility of multigene profiling in early diagnosed and advanced BC patients, to stratify them on their molecular profile who could potentially benefit from targeted therapy. Prospective studies and randomized clinical trials are ongoing to confirm the independent prognostic and therapeutic value of the mutations in a larger cohort of Indian population.
Citation Format: Ghosh M, Sheela ML, Choudhury S, Bahadur U, Patil S, Satheesh CT, Murugan K, Nayak R, Sridhar PS, Rao N, Mahesh B, Shashidhara HP, Krishnamoorthy N, Gupta V, Sankaran S, Subramanian K, Ajaikumar BS. Multigene profiling to identify clinically relevant actionable mutations in breast cancer: An Indian study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-07-01.
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Affiliation(s)
- M Ghosh
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - ML Sheela
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - S Choudhury
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - U Bahadur
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - S Patil
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - CT Satheesh
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - K Murugan
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - R Nayak
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - PS Sridhar
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - N Rao
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - B Mahesh
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - HP Shashidhara
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - N Krishnamoorthy
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - V Gupta
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - S Sankaran
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - K Subramanian
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - BS Ajaikumar
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
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Ghosh M, ML S, Upasana M, Chodhury S, Mannan AU, Southekal S, Manjima C, Patil S, Murugan K, Mahesh B, Nayak R, Sridhar PSS, Rao N, Krishnamoorthy N, Gupta V, Satheesh CT, Subramanian K, Ajaikumar BS. Abstract P6-06-06: Comprehensive analysis of BRCA (BRCAm) and other germline mutations (GRm) with a clinicopathological association in breast cancer: An Indian study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-06-06] [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: BRCAm and other GRm testing using next generation sequencing (NGS) in early diagnosed and/or metastatic breast cancer (BC) helps in the identification of both unambiguously defined deleterious mutations and sequence variants of unknown clinical significance (VUS). The early detection of these mutations in the proband and the family members help in risk stratification and instituting effective monitoring, surveillance and disease management strategies.
Methods: Out of total 200 patients diagnosed with BC (April 2013-15) 77 unrelated individuals were consented to be profiled by NGS on MiSeq platform using TruSight Cancer panel (consisting of 94 genes including 13 genes highly associated with risk of inherited breast and/or ovarian cancer) in an IRB-approved prospective study in a CLIA compliant laboratory. Paired end sequencing was done with an average coverage of > 450X. Data was processed using STRAND software and interpreted using "Strand Omics" platform. The paired tumor samples were analysed for pathological stage, histological type and hormonal status.
Results: GRm were detected in 61 cases (79%). Among all mutations detected, BRCA1/2 were found in 51% (31% in BRCA1, 20% in BRCA2) of cases. BRCA1 was found to be co-mutated with BRCA2 in 2 cases. Out of 37 deleterious mutations in BRCA1/2 genes only 10 were reported to be pathogenic (6 in BRCA1 and 4 in BRCA2) and rest were VUS. Mutation frequencies were higher among high grade IDC with HER2-ve tumors including TNBC (53%, p<0.05) with an early onset of the disease. TNBC with BRCAm were found to have no/incomplete pCR on conventional TAC regimen , subsequently started with platinum therapy and the outcome being monitored. Interestingly, 4 BRCA1 mutations including 3 non-sense and 1 frameshift mutation were found in two unrelated individuals suggesting them to be founder mutations in Indian population. The other GRm frequency (alone/ co-mutated with BRCA) was also found to be significantly high (49%) and include BRIP1, CHEK2, ERCC2, CDH1, SDHB, APC, MSH6, TP53, PALB2 and RAD51C. Stratification based on age of diagnosis(dx) showed a detection rate significantly higher in the age group of 25-50 yrs (74%) as compared to the 50-75 yrs (26%). Also a strong association of GRm status with the family history(Hx) of BC in 1st or 2nd degree relatives was indicated.
Table 1: Correlation of GRm with Dx and HxGenen%Age at dx(yrs)Family Hx (Yes=Y, No=N,Unknown=UK)BRCA1193125-50 (n=23) 50-75(n=8)Y(n=13) N(n=3) UK(n=3)BRCA2122025-50(n=21) 50-75(n=9)Y(n=8) N(n=2) UK(n=2)PALB211.7>50YCHEK258.825-50 (n=4) 50-75(n=1)YATM610.525-50 (n=4) 50-75(n=2)Y(n=5) N(n=1)RAD5111.7<50Y
Conclusions: Our study in a small cohort clearly highlighted the significance of germline testing and classifying the variant in larger cohort of BC patients with a strong family Hx of cancer particularly in BRCA1/2 positive families , and in women <50yrs for early detection and risk assessment. The study also indicates BRCAm to be an important contributor to the etiology of high grade HER2-/ TNBC in Indian patients. Expanded testing of this subtype is warranted to impact management of the disease with PARP inhibitors and/or platinum therapy.
Citation Format: Ghosh M, ML S, Upasana M, Chodhury S, Mannan AU, Southekal S, Manjima C, Patil S, Murugan K, Mahesh B, Nayak R, Sridhar PSS, Rao N, Krishnamoorthy N, Gupta V, Satheesh CT, Subramanian K, Ajaikumar BS. Comprehensive analysis of BRCA (BRCAm) and other germline mutations (GRm) with a clinicopathological association in breast cancer: An Indian study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-06-06.
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Affiliation(s)
- M Ghosh
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - S ML
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - M Upasana
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - S Chodhury
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - AU Mannan
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - S Southekal
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - C Manjima
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - S Patil
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - K Murugan
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - B Mahesh
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - R Nayak
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - PSS Sridhar
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - N Rao
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - N Krishnamoorthy
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - V Gupta
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - CT Satheesh
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - K Subramanian
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
| | - BS Ajaikumar
- Triesta Sciences , Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Health Care Global Enterprises Ltd., Bangalore, Karnataka, India; Strand Center for Genomics and Personalized Medicine, Bangalore, Karnataka, India
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Patil S, Thippeswamy R, Shashidara HP, Satheesh CT, Vittal H, Mishra S. Eribulin mesylate in Indian patients: A single center experience. Indian J Cancer 2015; 52:297-8. [DOI: 10.4103/0019-509x.176735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Raghavendra RM, Usharani MR, Kavya M, Aishvarrya S, Nandini P, Patil S, Ravi DB, Shashidhara HP, Satheesh CT, Radheshyam N, Ajaikumar BS. Comparison of yoga versus relaxation on chemotherapy-induced nausea and vomiting (CINV) outcomes a mechanism of action study. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.6624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6624 Background: Chemotherapy induced nausea and vomiting is a common distressing symptom. In this study we evaluated the effects of Yoga vs. Jacobson’s relaxation training on CINV outcomes in chemotherapy naive patients undergoing moderately to highly emetogenic chemotherapy. Methods: One hundred and twenty patients who satisfied the selection criteria and gave written consent to participate were randomized to receive Yoga or Jacobson’s relaxation or serve as waitlist controls for first 4 cycles of chemotherapy. Assessments for nausea and emesis including functional living index emesis, nausea diary and cardiac autonomic function and electrogastrogram were carried out at baseline, six days after 1st cycle, after 2nd and 3rd cycle of chemotherapy. Assessments for mood states such as anxiety and depression using HADS, and perceived stress were carried out at baseline and after 3rd cycle of chemotherapy. Both interventions were for a duration of 25 minutes imparted by a trained instructor. Data were analysed using repeated measures ANOVA with post hoc Bonferroni tests. Results: There was a significant decrease in acute and delayed nausea severity in Yoga compared to control group (p=0.001) and Jacobson’s group (p=0.004) after 1st cycle of chemotherapy. There was a significant decrease in self reported anxiety and depression in Yoga (p=0.03) and Jacobson’s relaxation (p=0.004) compared to control group following 3rd cycle of chemotherapy.There was significant decrease in LF/HF ratio in Yoga group compared to control group (p=0.06) after 3rd cycle of chemotherapy. There was a significant decrease in bradygastria (p=0.002) and tachygastria percentage (p=0.03) in Yoga group compared to Jacobson’s and control group becoming more evident after 3rd cycle of chemotherapy. Conclusions: Both Yoga and Jacobson’s intervention conferred beneficial effects in reducing chemotherapy induced nausea and vomiting. Yoga helps normalise gastric motility and enhances cardiac and gastric parasympathetic activity in subjects undergoing chemotherapy. Clinical trial information: NCT01387841.
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Affiliation(s)
| | | | - Mahesh Kavya
- HCG Bangalore Institute of Oncology, Bangalore, India
| | - S Aishvarrya
- HCG Bangalore Institute of Oncology, Bengaluru, India
| | - Pkl Nandini
- HCG Bangalore Institute of Oncology, Bengaluru, IN, India
| | - Shekhar Patil
- HCG Bangalore Institute of Oncology, Bangalore, India
| | | | | | - C T Satheesh
- HCG Bangalore Institute of Oncology, Bengaluru, India
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Veldore VH, Rao RM, Pattanayak S, Tejaswi R, Sahoo R, Venkataswamy E, Prabhudesai SA, Tejaswini BN, Rahman SM, Satheesh CT, Shashidhar SP, Patil S, Kakara S, Krishnamoorthy N, Hazarika D, Gangoli SA, Naik R, Diwakar RB, Ajai Kumar BS. Epidermal growth factor receptor mutation in non-small-cell lung carcinomas: A retrospective analysis of 1036 lung cancer specimens from a network of tertiary cancer care centers in India. Indian J Cancer 2013; 50:87-93. [DOI: 10.4103/0019-509x.117013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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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Affiliation(s)
- K C Lakshmaiah
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore - 560 030, India
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Singh T, Satheesh CT, Appaji L, Aruna Kumari BS, Mamatha HS, Giri GV, Rama Rao C. Langerhan's cell histiocytosis: A single institutional experience. Indian J Med Paediatr Oncol 2011; 31:51-3. [PMID: 21209764 PMCID: PMC2970934 DOI: 10.4103/0971-5851.71655] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Langerhans cell histiocytosis (LCH) is a disease that primarily affects bone but can be associated with a clinical spectrum that ranges from a solitary bone lesion with a favorable natural history to a multisystem, life-threatening disease process. Aim: We analyzed our single institutional experience of managing children with LCH. Settings and Design: A total of 40 children of LCH, managed in tertiary cancer center in South India in the period from 2001 to 2005, were evaluated retrospectively. Materials and Methods: Clinicopathological features, laboratory findings, treatment modalities and long-term outcome were analyzed. Results: Children were aged between 2 months and 12 years, with a mean of 3 years. Majority of the children were below 5 years of age. Group B constituted a bulk of children. Disseminated cases were less (five patients). Liver function dysfunction was seen in four (10%) children. Pulmonary interstitial infiltrates were seen in two (5%) cases. Diabetes insipidus manifested in three patients. There was one death. Conclusion: A better understanding of the etiology and pathogenesis of LCH will result in more directed and efficacious treatment regimens.
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Affiliation(s)
- Tejinder Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore - 560 030, India
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Abstract
Colorectal cancers have potential for lymphatic and hematogenous metastases. Surgery is the definitive treatment, but the prognosis can be improved with the addition of chemotherapy, radiotherapy or both. However, the incidence of recurrence, both local and distant, remains significant. Distant metastases occur most often in the liver and lung; however, metastases to bone, adrenals, lymph nodes, brain, skin and the oral region have been reported. Metastases to the oral region are uncommon and may occur in the oral soft tissues or jaw bones. The prognosis in such patients is usually very poor. We report a case of colorectal carcinoma with metastasis to the floor of the mouth. This is probably the first reported case of metastasis to the floor of the mouth in a patient with colorectal cancer.
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Affiliation(s)
- Tejinder Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India
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Singh T, Satheesh CT, Lakshmaiah KC, Suresh TM, Babu GK, Lokanatha D, Jacob LA, Halkud R. Primary bone lymphoma: a report of two cases and review of the literature. J Cancer Res Ther 2010; 6:296-8. [PMID: 21119256 DOI: 10.4103/0973-1482.73366] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Primary bone lymphoma (PBL) is an uncommon tumor accounting for approximately 4-5% of extra nodal lymphoma and less than 1% of all non-Hodgkin's lymphoma. Disease may be complicated at presentation by pathological fracture or spinal cord compression. Diffuse large-B-cell lymphoma (DLBCL) accounts for the majority of cases of PBL. Owing to its rarity, only a few retrospective studies have been published addressing the prognosis and treatment of primary bone lymphoma. In this paper, we report our experience with two cases of PBL treated with chemotherapy and radiotherapy and review literature to elucidate the optimal treatment of primary bone lymphoma.
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Affiliation(s)
- Tejinder Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore 560 030, India.
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Abstract
BACKGROUND The cornerstones of successful treatment of hepatoblastoma (HB) include preoperative chemotherapy followed by complete anatomical resection of tumor, followed by chemotherapy. Advances in chemotherapy in the last 2 decades have been associated with a higher rate of tumor response and possibly a greater potential for resectability. AIMS We analyzed our single center experience with neoadjuvant chemotherapy (NACT) and surgery in HBs. SETTINGS AND DESIGN Our study included all children with HBs who received NACT and underwent surgical excision from January 1997 to July 2004. MATERIALS AND METHODS Patient characteristics, clinical features, clinical course, treatment modalities, and long-term outcome were analyzed. RESULTS There were 9 boys and 3 girls, aged 5-60 months (median age at tumor diagnosis was 24 months). All received NACT containing cisplatin and doxorubicin. Of the 12 children, 9 underwent hepatectomy and among them, 4 patients each had right and left hepatectomy and 1 patient underwent right extended hepatectomy. After surgery, all patients completed rest of the chemotherapy course (total 6 cycles). R0 resection was carried out in all the 9 cases with no life-threatening complications. CONCLUSIONS Our experience of the 9 cases, although less in number, reaffirms the advantages of NACT followed by surgery. The prognosis for patients with resectable tumors is fairly good in combination with chemotherapy.
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Affiliation(s)
- T Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore - 560 030, India
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Singh T, Premalatha CS, Satheesh CT, Lakshmaiah KC, Suresh TM, Babu KG, Ramachandra C. Rectal carcinoma metastasizing to the breast: a case report and review of literature. J Cancer Res Ther 2010; 5:321-3. [PMID: 20160374 DOI: 10.4103/0973-1482.59904] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Extramammary breast metastases (from non-breast primaries) are rare, constituting only about 2% of all breast metastases, although autopsy studies show that it may occur in up to 6% of cases. Lymphoma, metastatic melanoma, and bronchial carcinoma are the malignancies that account for the majority of breast metastases. Breast metastases from a colorectal carcinoma have been described in only a small number of cases in the literature. We present a case of a 42-year-old woman with an incidental finding of a breast lump. She had a history of Dukes C rectal carcinoma for which she had undergone an anterior resection 11 months earlier. The breast deposit was the first clinical indication of relapse. The patient subsequently developed liver and brain metastases and deteriorated rapidly; she died 2 months after presenting with the breast mass.
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Affiliation(s)
- Tejinder Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India
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15
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Singh T, Amirtham U, Satheesh CT, Sajeevan KV, Jain A, Lakshmaiah KC, Babu KG, Lokanatha D. Primary B cell non-Hodgkin's lymphoma of tongue. Indian J Cancer 2010; 47:84-6. [PMID: 20071804 DOI: 10.4103/0019-509x.58873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Satheesh CT, Tejinder S, Ankit J, Sajeevan KV, Lakshmaiah KC, Lokanatha D, Govind Babu K, Suresh TM. To analyze efficacy and safety of pegfilgrastim versus filgrastim in patients with breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20587 Background: We evaluated the safety and efficacy of a single fixed 6 mg dose of pegfilgrastim (a pegylated version of filgrastim) per cycle of chemotherapy, compared with daily administration of filgrastim, in the provision of neutrophil support. Methods: Patients with carcinoma of breast, less than 65 yrs with ECOG performance status 0 or 1 treated at our institution were randomized to receive either a single 6 mg subcutaneous (s.c.) injection of pegfilgrastim or daily 5 mg/kg s.c. injections of filgrastim, after adjuvant or neoadjuvant chemotherapy with doxorubicin, cyclophosphamide and docetaxel (60 mg/m, 600 mg/m2 and 75 mg/m2, respectively)q3 wk. Duration of grade 4 neutropenia (DSN), incidence of febrile neutropenia (FN), grade 4 neutropenia (SN), IV anti-infective use (IV), hospitalization and adverse events like bony pain (BP), anemia & thrombocytopenias were assessed as safety endpoints. Results: 71 patients were analyzed from Aug 2007 to Dec 2008. The median age in pegfilgrastim group is 58 years and filgrastim is 57 years respectively. Results are shown ( Table ). The mean duration of grade 4 neutropenia (DSN) in cycle 1 was 2.0 and 1.7 days for the pegfilgrastim and filgrastim groups, respectively. Results for all efficacy end points in cycles 2–6 were consistent with the results from cycle 1. A trend towards a lower incidence of febrile neutropenia was noted across all cycles with pegfilgrastim compared with filgrastim (10.7% versus 18.6%, respectively). Conclusions: A single fixed dose of pegfilgrastim administered once per cycle of chemotherapy was comparable to multiple daily injections of filgrastim. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- C. T. Satheesh
- Kidai Memorial Institution of Oncology, Bangalore, India
| | - S. Tejinder
- Kidai Memorial Institution of Oncology, Bangalore, India
| | - J. Ankit
- Kidai Memorial Institution of Oncology, Bangalore, India
| | - K. V. Sajeevan
- Kidai Memorial Institution of Oncology, Bangalore, India
| | | | - D. Lokanatha
- Kidai Memorial Institution of Oncology, Bangalore, India
| | - K. Govind Babu
- Kidai Memorial Institution of Oncology, Bangalore, India
| | - T. M. Suresh
- Kidai Memorial Institution of Oncology, Bangalore, India
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Singh T, Sajeevan KV, Jain A, Batra U, Saini KS, Satheesh CT, Lakshmaiah KC, Babu KG, Lokanatha D. Blindness as an initial presentation of rectal cancer with brain metastases. Saudi J Gastroenterol 2009; 15:63-4. [PMID: 19568562 PMCID: PMC2702959 DOI: 10.4103/1319-3767.45065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tejinder Singh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - K. V. Sajeevan
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - Ankit Jain
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - Ullas Batra
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - K. S. Saini
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - C. T. Satheesh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - K. C. Lakshmaiah
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - K. Govind Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
| | - D. Lokanatha
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore-560 030, India. E-mail:
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Singh T, Sajeevan KV, Satheesh CT, Ankith J, Batra U, Saini K, Anupama G, Govindbabu K, Lakshmiah KC, Lokanatha D. Use of long term venous access in cancer patients: Experience from a tertiary cancer centre in South India. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20710] [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: 11/20/2022] Open
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