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Zhou SQ, Ng C, Wang R, Gasior G, Schrader D, Baliga S, Fox D. Real-World Treatment Patterns of Older Adults with Locally Advanced SCCHN Using SEER-Medicare. Int J Radiat Oncol Biol Phys 2023; 117:e637. [PMID: 37785899 DOI: 10.1016/j.ijrobp.2023.06.2041] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Roughly 50-67% of patients with squamous cell carcinomas of the head and neck (SCCHN) present with locally advanced (LA) disease and 65% of them relapse after initial therapy. The standard of care for LA SCCHN is definitive therapy (DT), a combination of surgery and or radiation therapy (RT), with or without platinum-based chemotherapy/cetuximab (chemo), that has been shown to optimize long term disease control. Few published analyses have characterized recent real-world treatment (Tx) patterns of older adults with LA SCCHN in the US. MATERIALS/METHODS We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, a linkage of cancer registry and claims data, to identify patients diagnosed with LA SCCHN (first and only cancer) from 2010 to 2017 who initiated a relevant Tx (Tx initiation date defined as index date) and were continuously enrolled in Medicare Parts A, B, and D from 12 months pre-index until death or 12 months post-index. We used clinical guidelines regarding timing and frequency of treatments to build an algorithm that used Medicare claims to categorize initial Tx as non-DT, non-surgical DT (concomitant chemo+RT (cCRT) or chemotherapy before RT/cCRT), or surgical DT (surgery then RT/cCRT ± prior chemo). RESULTS We identified 1052 older adults with LA SCCHN (median age 73 years, 37% female, and 81% non-Hispanic white) whose initial treatment was started a median of 26 days after initial diagnosis. Of the 610 patients who received a DT as their initial Tx, 23.3% of patients had a subsequent Tx: 3.8% received immunotherapy-containing regimens (IO), and the most common subsequent Tx were surgery only (7.7%), chemotherapy only (3.6%), and RT only (3.4%). The median time to next Tx (TTNT) differed by DT category and primary tumor site. (Table 1) CONCLUSION: In this descriptive analysis, we provided an update on the Tx patterns of older adults with LA SCCHN in the US, for whom there have been no novel FDA approvals in over a decade. We found that a large proportion (42%) of patients did not receive DT regimens in the real-world setting despite known benefits in LA SCCHN. Roughly a quarter of patients required subsequent Tx. Availability of IO was low due to approvals after 2017. These findings suggest a need for novel therapies that can improve outcomes in LA SCCHN.
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Affiliation(s)
| | - C Ng
- Genentech, Inc., South San Francisco, CA
| | - R Wang
- Genentech, Inc., South San Francisco, CA
| | - G Gasior
- Genentech, Inc., South San Francisco, CA
| | - D Schrader
- Genentech, Inc., South San Francisco, CA
| | - S Baliga
- The Ohio State University, Columbus, OH
| | - D Fox
- Genentech, Inc., South San Francisco, CA
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2
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Coulibaly N, Ng C, Gasior G, Schrader D, Baliga S, Fox D. Racial Disparities in Survival of Patients with High-Risk LA SCCHN in the U.S. Int J Radiat Oncol Biol Phys 2023; 117:e574-e575. [PMID: 37785750 DOI: 10.1016/j.ijrobp.2023.06.1909] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Approximately 50-67% of patients with squamous cell carcinomas of the head and neck (SCCHN) present with locally advanced (LA) disease. Human papillomavirus (HPV) associated SCCHN has improved survival compared to non-HPV SCCHN. Studies have analyzed racial disparities in LA SCCHN but few have adjusted for HPV status and socio-economic status (SES). Our objective was to characterize disparities in LA SCCHN. MATERIALS/METHODS We identified high-risk patients from 2010-2017 with AJCC v8 Stage IVA/IVB SCCHN of the oral cavity, oropharynx (OP), larynx or hypopharynx, or Stage III SCCHN of the OP in the Surveillance, Epidemiology, and End Results (SEER) with HPV Status and Census Tract-level SES/Rurality Combined Database. We excluded OP patients with missing HPV data. SEER-reported treatment was used to classify initial treatment as definitive therapy (DT) categories: surgical DT, non-surgical DT or non-DT. The Kaplan Meier method was used to estimate overall survival (OS) with 95% confidence intervals (CI). Multivariable cox proportional hazard models were used for associations between covariates and hazard ratio (HR) of death, adjusted for age, sex, race, ethnicity, DT category, marital status, rurality, tumor size, cancer stage, and HPV status. We explored the impact of additionally adjusting for Yost SES index quintiles. RESULTS We identified 17,818 eligible patients: 79.3% White, 14.4% Black, 5.8% Asian/Pacific Islander (A/PI), and 0.6% American Indian/Alaska Native (AI/AN). Primary tumor sites were oral cavity (36.8%), larynx (29.0%), OP (24.4%), and hypopharynx (9.9%). 10.4% were HPV-associated. Race and SES quintiles were related (chi-squared, p<0.001) and the majority (56.5%) of black patients were in the lowest SES quintile. mOS was shorter and risk of death was significantly higher for black vs white patients in both the all-site and OP-only cohorts. When we added SES to multivariable analyses, Black race was no longer associated with increased risk of death in the all-site or OP-only cohorts. (Table 1) CONCLUSION: We found that when adjusting for sociodemographic and clinical factors, Black race was independently associated with a higher risk of death compared to white patients. When we adjusted for SES in multivariable analysis the association between Black race and risk of death was no longer significant, consistent with previously published analyses and indicative of a complex relationship between race and SES. Further research is needed to identify and address the causative factors of disparities in LA HNSCC.
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Affiliation(s)
| | - C Ng
- Genentech, Inc., South San Francisco, CA
| | - G Gasior
- Genentech, Inc., South San Francisco, CA
| | - D Schrader
- Genentech, Inc., South San Francisco, CA
| | - S Baliga
- Ohio State University, Columbus, OH
| | - D Fox
- Genentech, Inc., South San Francisco, CA
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3
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Albarmawi H, Ng C, Price R, Shah A, Ogale S, Oxnard G, Lofgren K. PP01.36 Blood-Based Biomarker Testing in Advanced Non-Small Cell Lung Cancer: Adoption, Biomarker Assessment, and Therapy Selection. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.062] [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: 01/30/2023]
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4
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Liu K, Zhao H, Chen X, Chiu P, Ng C, Teoh J. The impact on survival outcomes of different Bacillus Calmette–Guérin strains of non-muscle invasive bladder cancer patients. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00325-1] [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: 02/12/2023]
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5
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Teoh Y, Chan T, Tsang C, Li K, Cheng KC, Cho C, Chan HC, Chiu Y, Ho B, Li T, Law M, Lee Y, Cheng C, Lo K, Lam K, Chan K, So HS, Leung C, Chan C, Yiu M, Ng C, Poon V, Leung C, Chi-Fai N. Transurethral en bloc resection versus standard resection of bladder tumour: A multi-center randomized trial (EB-StaR Study). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00751-0] [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: 02/12/2023]
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6
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Liu K, Zhao H, Chen X, Ng C, Teoh J, Laguna Pes M, De La Rosette J. Segmental resection for ureter urothelial carcinoma is safe as radical nephroureterectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00560-2] [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: 02/12/2023]
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7
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Selenica P, Marra A, Choudhury NJ, Gazzo A, Falcon CJ, Patel J, Pei X, Zhu Y, Ng CKY, Curry M, Heller G, Zhang YK, Berger MF, Ladanyi M, Rudin CM, Chandarlapaty S, Lovly CM, Reis-Filho JS, Yu HA. APOBEC mutagenesis, kataegis, chromothripsis in EGFR-mutant osimertinib-resistant lung adenocarcinomas. Ann Oncol 2022; 33:1284-1295. [PMID: 36089134 PMCID: PMC10360454 DOI: 10.1016/j.annonc.2022.09.151] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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] [Received: 11/02/2021] [Revised: 08/02/2022] [Accepted: 09/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Studies of targeted therapy resistance in lung cancer have primarily focused on single-gene alterations. Based on prior work implicating apolipoprotein b mRNA-editing enzyme, catalytic polypeptide-like (APOBEC) mutagenesis in histological transformation of epidermal growth factor receptor (EGFR)-mutant lung cancers, we hypothesized that mutational signature analysis may help elucidate acquired resistance to targeted therapies. PATIENTS AND METHODS APOBEC mutational signatures derived from an Food and Drug Administration-cleared multigene panel [Memorial Sloan Kettering Cancer Center Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT)] using the Signature Multivariate Analysis (SigMA) algorithm were validated against the gold standard of mutational signatures derived from whole-exome sequencing. Mutational signatures were decomposed in 3276 unique lung adenocarcinomas (LUADs), including 93 paired osimertinib-naïve and -resistant EGFR-mutant tumors. Associations between APOBEC and mechanisms of resistance to osimertinib were investigated. Whole-genome sequencing was carried out on available EGFR-mutant lung cancer samples (10 paired, 17 unpaired) to investigate large-scale genomic alterations potentially contributing to osimertinib resistance. RESULTS APOBEC mutational signatures were more frequent in receptor tyrosine kinase (RTK)-driven lung cancers (EGFR, ALK, RET, and ROS1; 25%) compared to LUADs at large (20%, P < 0.001); across all subtypes, APOBEC mutational signatures were enriched in subclonal mutations (P < 0.001). In EGFR-mutant lung cancers, osimertinib-resistant samples more frequently displayed an APOBEC-dominant mutational signature compared to osimertinib-naïve samples (28% versus 14%, P = 0.03). Specifically, mutations detected in osimertinib-resistant tumors but not in pre-treatment samples significantly more frequently displayed an APOBEC-dominant mutational signature (44% versus 23%, P < 0.001). EGFR-mutant samples with APOBEC-dominant signatures had enrichment of large-scale genomic rearrangements (P = 0.01) and kataegis (P = 0.03) in areas of APOBEC mutagenesis. CONCLUSIONS APOBEC mutational signatures are frequent in RTK-driven LUADs and increase under the selective pressure of osimertinib in EGFR-mutant lung cancer. APOBEC mutational signature enrichment in subclonal mutations, private mutations acquired after osimertinib treatment, and areas of large-scale genomic rearrangements highlights a potentially fundamental role for APOBEC mutagenesis in the development of resistance to targeted therapies, which may be potentially exploited to overcome such resistance.
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Affiliation(s)
- P Selenica
- Memorial Sloan Kettering Cancer Center, New York City
| | - A Marra
- Memorial Sloan Kettering Cancer Center, New York City
| | - N J Choudhury
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York City
| | - A Gazzo
- Memorial Sloan Kettering Cancer Center, New York City
| | - C J Falcon
- Druckenmiller Center for Cancer Research, Memorial Sloan Kettering Cancer Center, New York City, USA
| | - J Patel
- Memorial Sloan Kettering Cancer Center, New York City
| | - X Pei
- Memorial Sloan Kettering Cancer Center, New York City
| | - Y Zhu
- Memorial Sloan Kettering Cancer Center, New York City
| | - C K Y Ng
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - M Curry
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York City
| | - G Heller
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York City
| | - Y-K Zhang
- Department of Medicine, Division of Hematology and Oncology and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville
| | - M F Berger
- Memorial Sloan Kettering Cancer Center, New York City; Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York City; Department of Pathology, Molecular Diagnostics Service, Memorial Sloan Kettering Cancer Center, New York City
| | - M Ladanyi
- Department of Pathology, Molecular Diagnostics Service, Memorial Sloan Kettering Cancer Center, New York City
| | - C M Rudin
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York City; Department of Medicine, Weill Cornell Medical College, New York City, USA
| | - S Chandarlapaty
- Memorial Sloan Kettering Cancer Center, New York City; Department of Medicine, Weill Cornell Medical College, New York City, USA
| | - C M Lovly
- Department of Medicine, Division of Hematology and Oncology and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville
| | | | - H A Yu
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York City; Department of Medicine, Weill Cornell Medical College, New York City, USA.
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8
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Ng C, Michelmore A, Mishra G, Montgomery G, Rogers P, Abbott J. 7923 Establishment of the National Endometriosis Clinical and Scientific Trials (NECST) Registry in Australia. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.347] [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: 11/25/2022]
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9
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Marsh R, Hanson L, Ng C, Mitchell-Whyte M, Dellschaft N, Hoad C, Marciani L, Gowland P, Spiller R, Major G, Smyth A, Rivett D, van der Gast C. 565 Relationships between tezacaftor/ivacaftor administration, gut microbiota composition, and intestinal function in cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01255-3] [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: 11/05/2022]
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10
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Yule A, Ng C, Dellschaft N, Hoad C, Stewart I, Marciani L, Gowland P, Major G, Spiller R, Smyth A. 233 Magnetic resonance imaging metrics in cystic fibrosis before and after elexacaftor/tezacaftor/ivacaftor—the Gut Imaging for Function and Transit in Cystic Fibrosis 3 Study. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00923-7] [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: 11/06/2022]
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11
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Lim G, Ng C, Yule A, Hoad C, Dellschaft N, Stewart I, Marciani L, Gowland P, Major G, Spiller R, Smyth A. P170 An assessment of terminal ileum morphology using magnetic resonance imaging in people with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00501-x] [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: 11/27/2022]
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12
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Marsh R, Hanson L, Ng C, Mitchell-Whyte M, Dellschaft N, Hoad C, Marciani L, Gowland P, Spiller R, Major G, Smyth A, Rivett D, van der Gast C. P116 Effects of SymkeviTM(tezacaftor/ivacaftor) on the lung and gut microbiota in cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00449-0] [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: 10/18/2022]
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13
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Dunnett-Kane V, Ayrton L, Ng C. 759 RELATIONSHIP BETWEEN G8 AND CFS IN A COHORT OF LUNG CANCER PATIENTS REFERRED TO A SPECIALISED ONCO-GERIATRIC CLINIC. Age Ageing 2022. [DOI: 10.1093/ageing/afac037.759] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
The International Society of Geriatric Oncology recommends using screening tools to identify cancer patients who would benefit from a comprehensive geriatric assessment. G8, a tool specifically designed for oncology, has been well validated in this setting (1). Rockwood Clinical frailty score (CFS) is a widely used tool to assess frailty, and has been adopted into standard assessments at many sites (2). However, this tool is less well validated in patients with cancer.
Methods
In this single site observational study we recorded CFS and G8 in 89 patients with lung cancer referred to a local onco-geriatrics clinic between 21/10/20 and 5/2/21. Both scores were available for 82 patients. We aimed to measure the correlation between G8 and CFS in this cohort.
Results
G8 score ≤ 14 is a referral criteria for the clinic, therefore 100% (82/82) of patients were classified as ‘frail’ using G8. Of these, only 23.2% (19/82) were classified as ‘mildly frail’ or worse using CFS (scores ≥5). Using Spearman’s rank correlation we found a very weak/negligible negative correlation between CFS and G8 (−0.2519, p = 0.0224).
Conclusion
The small proportion of patients (23.2%) classified as frail by CFS suggests that a G8 cut off of 14 may overestimate frailty. Previous work by our group has found that using a cut off of 13 is better able to predict chemotherapy outcomes(3). However, considering the lack of evidence for CFS in oncology, this poor correlation between G8 and CFS may question the usefulness of CFS in this context. (1) Decoster L, Puyvelde K, Mohile S, et al. Ann Oncol. 2015 Feb; 26(2): 288–300 (2) NHS Elect. [Online].; 2018 [cited 16/2/21] (3) A. Tivey, M. Ullah, A. Beech, et al. J Geriatr Oncol. 2020 Mar; 11(7).
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Affiliation(s)
- V Dunnett-Kane
- Wythenshawe Hospital, Manchester University NHS Foundation Trust
| | - L Ayrton
- Wythenshawe Hospital, Manchester University NHS Foundation Trust
| | - C Ng
- Wythenshawe Hospital, Manchester University NHS Foundation Trust
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14
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Kirsten F, Marcote B, Nimmo K, Hessels JWT, Bhardwaj M, Tendulkar SP, Keimpema A, Yang J, Snelders MP, Scholz P, Pearlman AB, Law CJ, Peters WM, Giroletti M, Paragi Z, Bassa C, Hewitt DM, Bach U, Bezrukovs V, Burgay M, Buttaccio ST, Conway JE, Corongiu A, Feiler R, Forssén O, Gawroński MP, Karuppusamy R, Kharinov MA, Lindqvist M, Maccaferri G, Melnikov A, Ould-Boukattine OS, Possenti A, Surcis G, Wang N, Yuan J, Aggarwal K, Anna-Thomas R, Bower GC, Blaauw R, Burke-Spolaor S, Cassanelli T, Clarke TE, Fonseca E, Gaensler BM, Gopinath A, Kaspi VM, Kassim N, Lazio TJW, Leung C, Li DZ, Lin HH, Masui KW, Mckinven R, Michilli D, Mikhailov AG, Ng C, Orbidans A, Pen UL, Petroff E, Rahman M, Ransom SM, Shin K, Smith KM, Stairs IH, Vlemmings W. A repeating fast radio burst source in a globular cluster. Nature 2022; 602:585-589. [PMID: 35197615 DOI: 10.1038/s41586-021-04354-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/15/2021] [Indexed: 11/09/2022]
Abstract
Fast radio bursts (FRBs) are flashes of unknown physical origin1. The majority of FRBs have been seen only once, although some are known to generate multiple flashes2,3. Many models invoke magnetically powered neutron stars (magnetars) as the source of the emission4,5. Recently, the discovery6 of another repeater (FRB 20200120E) was announced, in the direction of the nearby galaxy M81, with four potential counterparts at other wavelengths6. Here we report observations that localized the FRB to a globular cluster associated with M81, where it is 2 parsecs away from the optical centre of the cluster. Globular clusters host old stellar populations, challenging FRB models that invoke young magnetars formed in a core-collapse supernova. We propose instead that FRB 20200120E originates from a highly magnetized neutron star formed either through the accretion-induced collapse of a white dwarf, or the merger of compact stars in a binary system7. Compact binaries are efficiently formed inside globular clusters, so a model invoking them could also be responsible for the observed bursts.
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Affiliation(s)
- F Kirsten
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden. .,ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.
| | - B Marcote
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - K Nimmo
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.,Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - J W T Hessels
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.,Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - M Bhardwaj
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - S P Tendulkar
- Department of Astronomy and Astrophysics, Tata Institute of Fundamental Research, Mumbai, India.,National Centre for Radio Astrophysics, Pune, India
| | - A Keimpema
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - J Yang
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - M P Snelders
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - P Scholz
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A B Pearlman
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - C J Law
- Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA, USA.,Owens Valley Radio Observatory, California Institute of Technology, Pasadena, CA, USA
| | - W M Peters
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - M Giroletti
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia, Bologna, Italy
| | - Z Paragi
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - C Bassa
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands
| | - D M Hewitt
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - U Bach
- Max Planck Institute for Radio Astronomy, Bonn, Germany
| | - V Bezrukovs
- Engineering Research Institute Ventspils International Radio Astronomy Centre (ERI VIRAC), Ventspils University of Applied Sciences (VUAS), Ventspils, Latvia
| | - M Burgay
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - S T Buttaccio
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia Radiotelescopio di Noto, Noto, Italy
| | - J E Conway
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - A Corongiu
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - R Feiler
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - O Forssén
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - M P Gawroński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - R Karuppusamy
- Max Planck Institute for Radio Astronomy, Bonn, Germany
| | - M A Kharinov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - M Lindqvist
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - G Maccaferri
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia, Bologna, Italy
| | - A Melnikov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - O S Ould-Boukattine
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - A Possenti
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy.,Dipartimento di Fisica, Università di Cagliari, Monserrato, Italy
| | - G Surcis
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - N Wang
- Xinjiang Astronomical Observatory, Urumqi, China
| | - J Yuan
- Xinjiang Astronomical Observatory, Urumqi, China
| | - K Aggarwal
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - R Anna-Thomas
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - G C Bower
- Academia Sinica Institute of Astronomy and Astrophysics, Hilo, HI, USA
| | - R Blaauw
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands
| | - S Burke-Spolaor
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA.,Canadian Institute for Advanced Research, CIFAR Azrieli Global Scholar, Toronto, Ontario, Canada
| | - T Cassanelli
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,David A. Dunlap Department of Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - T E Clarke
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - E Fonseca
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - B M Gaensler
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,David A. Dunlap Department of Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A Gopinath
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - V M Kaspi
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - N Kassim
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - T J W Lazio
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - C Leung
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - D Z Li
- Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA, USA
| | - H H Lin
- Canadian Institute for Theoretical Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan
| | - K W Masui
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - R Mckinven
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - D Michilli
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A G Mikhailov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - C Ng
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A Orbidans
- Engineering Research Institute Ventspils International Radio Astronomy Centre (ERI VIRAC), Ventspils University of Applied Sciences (VUAS), Ventspils, Latvia
| | - U L Pen
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Canadian Institute for Advanced Research, CIFAR Azrieli Global Scholar, Toronto, Ontario, Canada.,Canadian Institute for Theoretical Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Perimeter Institute for Theoretical Physics, Waterloo, Ontario, Canada.,Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan
| | - E Petroff
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands.,Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - M Rahman
- Sidrat Research, Toronto, Ontario, Canada
| | - S M Ransom
- National Radio Astronomy Observatory, Charlottesville, VA, USA
| | - K Shin
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - K M Smith
- Perimeter Institute for Theoretical Physics, Waterloo, Ontario, Canada
| | - I H Stairs
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Vlemmings
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
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15
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Nestor CC, Ng C, Sepulveda P, Irwin MG. Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review. Anaesthesia 2021; 77:339-350. [PMID: 34904711 DOI: 10.1111/anae.15641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 12/19/2022]
Abstract
Various techniques have been explored to prolong the duration and improve the efficacy of local anaesthetic nerve blocks. Some of these involve mixing local anaesthetics or adding adjuncts. We did a literature review of studies published between 01 May 2011 and 01 May 2021 that studied specific combinations of local anaesthetics and adjuncts. The rationale behind mixing long- and short-acting local anaesthetics to hasten onset and extend duration is flawed on pharmacokinetic principles. Most local anaesthetic adjuncts are not licensed for use in this manner and the consequences of untested admixtures and adjuncts range from making the solution ineffective to potential harm. Pharmaceutical compatibility needs to be established before administration. The compatibility of drugs from the same class cannot be inferred and each admixture requires individual review. Precipitation on mixing (steroids, non-steroidal anti-inflammatory drugs) and subsequent embolisation can lead to serious adverse events, although these are rare. The additive itself or its preservative can have neurotoxic (adrenaline, midazolam) and/or chondrotoxic properties (non-steroidal anti-inflammatory drugs). The prolongation of block may occur at the expense of motor block quality (ketamine) or block onset (magnesium). Adverse effects for some adjuncts appear to be dose-dependent and recommendations concerning optimal dosing are lacking. An important confounding factor is whether studies used systemic administration of the adjunct as a control to accurately identify an additional benefit of perineural administration. The challenge of how best to prolong block duration while minimising adverse events remains a topic of interest with further research required.
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Affiliation(s)
- C C Nestor
- Department of Anaesthesiology, University of Hong Kong, Hong Kong, China
| | - C Ng
- Department of Anaesthesiology, University of Hong Kong, Hong Kong, China
| | | | - M G Irwin
- Department of Anaesthesia and Pain Medicine, Hospital Base San Jose, Los Lagos, Chile
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16
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Marsh R, Gavillet H, Hanson L, Ng C, Major G, Smyth A, Rivett D, van der Gast C. 465: Intestinal function and transit relates to microbial dysbiosis in the CF gut. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01889-0] [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: 10/20/2022]
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17
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Ng C, Dellschaft N, Hoad C, Marciani L, Mainz J, Hill T, Crooks C, Barr H, Spiller R, Gowland P, Major G, Smyth A. 208: Effects of tezacaftor/ivacaftor on gut function and transit in cystic fibrosis: A randomized, double-blind, placebo-controlled, crossover trial. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01633-7] [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: 10/20/2022]
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18
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Chan J, Yu P, Lau R, Ng C. P02.02 Transbronchial Microwave Ablation of Lung Nodules in the Hybrid Operating Room – Mid-Term Follow Up of a Novel Technique. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.265] [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: 11/15/2022]
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19
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Adhikari P, Ajaj R, Alpízar-Venegas M, Amaudruz PA, Auty DJ, Batygov M, Beltran B, Benmansour H, Bina CE, Bonatt J, Bonivento W, Boulay MG, Broerman B, Bueno JF, Burghardt PM, Butcher A, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen M, Chen Y, Cleveland BT, Corning JM, Cranshaw D, Daugherty S, DelGobbo P, Dering K, DiGioseffo J, Di Stefano P, Doria L, Duncan FA, Dunford M, Ellingwood E, Erlandson A, Farahani SS, Fatemighomi N, Fiorillo G, Florian S, Flower T, Ford RJ, Gagnon R, Gallacher D, García Abia P, Garg S, Giampa P, Goeldi D, Golovko V, Gorel P, Graham K, Grant DR, Grobov A, Hallin AL, Hamstra M, Harvey PJ, Hearns C, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings CJ, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Leonhardt A, Levashko N, Li X, Lidgard J, Lindner T, Lissia M, Lock J, Longo G, Machulin I, McDonald AB, McElroy T, McGinn T, McLaughlin JB, Mehdiyev R, Mielnichuk C, Monroe J, Nadeau P, Nantais C, Ng C, Noble AJ, O’Dwyer E, Oliviéro G, Ouellet C, Pal S, Pasuthip P, Peeters SJM, Perry M, Pesudo V, Picciau E, Piro MC, Pollmann TR, Rand ET, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Ruhland JB, Sánchez-García E, Santorelli R, Sinclair D, Skensved P, Smith B, Smith NJT, Sonley T, Soukup J, Stainforth R, Stone C, Strickland V, Stringer M, Sur B, Tang J, Vázquez-Jáuregui E, Viel S, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. Pulse-shape discrimination against low-energy Ar-39 beta decays in liquid argon with 4.5 tonne-years of DEAP-3600 data. Eur Phys J C Part Fields 2021; 81:823. [PMID: 34720726 PMCID: PMC8550104 DOI: 10.1140/epjc/s10052-021-09514-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
The DEAP-3600 detector searches for the scintillation signal from dark matter particles scattering on a 3.3 tonne liquid argon target. The largest background comes from 39 Ar beta decays and is suppressed using pulse-shape discrimination (PSD). We use two types of PSD estimator: the prompt-fraction, which considers the fraction of the scintillation signal in a narrow and a wide time window around the event peak, and the log-likelihood-ratio, which compares the observed photon arrival times to a signal and a background model. We furthermore use two algorithms to determine the number of photons detected at a given time: (1) simply dividing the charge of each PMT pulse by the mean single-photoelectron charge, and (2) a likelihood analysis that considers the probability to detect a certain number of photons at a given time, based on a model for the scintillation pulse shape and for afterpulsing in the light detectors. The prompt-fraction performs approximately as well as the log-likelihood-ratio PSD algorithm if the photon detection times are not biased by detector effects. We explain this result using a model for the information carried by scintillation photons as a function of the time when they are detected.
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Affiliation(s)
- P. Adhikari
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - R. Ajaj
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Alpízar-Venegas
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
| | | | - D. J. Auty
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Batygov
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
| | - B. Beltran
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - H. Benmansour
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. E. Bina
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Bonatt
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | | | - M. G. Boulay
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - B. Broerman
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. F. Bueno
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - P. M. Burghardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - A. Butcher
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | | | - B. Cai
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Cárdenas-Montes
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - S. Cavuoti
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
- INAF-Astronomical Observatory of Capodimonte, Salita Moiariello 16, 80131 Naples, Italy
| | - M. Chen
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Y. Chen
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - B. T. Cleveland
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - J. M. Corning
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - D. Cranshaw
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. Daugherty
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
| | - P. DelGobbo
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - K. Dering
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. DiGioseffo
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Di Stefano
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - L. Doria
- PRISMA+ Cluster of Excellence and Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | | | - M. Dunford
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - E. Ellingwood
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - A. Erlandson
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - S. S. Farahani
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | | | - G. Fiorillo
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
| | - S. Florian
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. Flower
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - R. J. Ford
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - R. Gagnon
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - D. Gallacher
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. García Abia
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - S. Garg
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Giampa
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - D. Goeldi
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - V. Golovko
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - P. Gorel
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - K. Graham
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - D. R. Grant
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. Grobov
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. L. Hallin
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - M. Hamstra
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. J. Harvey
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Hearns
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. Hugues
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
| | - A. Ilyasov
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. Joy
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Jigmeddorj
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - C. J. Jillings
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - O. Kamaev
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - G. Kaur
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - A. Kemp
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - I. Kochanek
- INFN Laboratori Nazionali del Gran Sasso, 67100 Assergi, AQ Italy
| | - M. Kuźniak
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Lai
- Physics Department, Università degli Studi di Cagliari, 09042 Cagliari, Italy
- INFN Cagliari, Cagliari, 09042 Italy
| | - S. Langrock
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Lehnert
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Present Address: Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - A. Leonhardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N. Levashko
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - X. Li
- Physics Department, Princeton University, Princeton, NJ 08544 USA
| | - J. Lidgard
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | | | - M. Lissia
- INFN Cagliari, Cagliari, 09042 Italy
| | - J. Lock
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - G. Longo
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
| | - I. Machulin
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. B. McDonald
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. McElroy
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - T. McGinn
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. B. McLaughlin
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - R. Mehdiyev
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Mielnichuk
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - J. Monroe
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - P. Nadeau
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Nantais
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Ng
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. J. Noble
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - E. O’Dwyer
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - G. Oliviéro
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Ouellet
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - S. Pal
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - P. Pasuthip
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. J. M. Peeters
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH UK
| | - M. Perry
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - V. Pesudo
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - E. Picciau
- Physics Department, Università degli Studi di Cagliari, 09042 Cagliari, Italy
- INFN Cagliari, Cagliari, 09042 Italy
| | - M.-C. Piro
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. R. Pollmann
- Department of Physics, Technische Universität München, 80333 Munich, Germany
- Present Address: Nikhef and the University of Amsterdam, Science Park, 1098 XG Amsterdam, The Netherlands
| | - E. T. Rand
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - C. Rethmeier
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | | | - I. Rodríguez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - L. Roszkowski
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- BP2, National Centre for Nuclear Research, ul. Pasteura 7, 02-093 Warsaw, Poland
| | - J. B. Ruhland
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - E. Sánchez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - R. Santorelli
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - D. Sinclair
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Skensved
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Smith
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - N. J. T. Smith
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - T. Sonley
- SNOLAB, Lively, ON P3Y 1M3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Soukup
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - R. Stainforth
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Stone
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - V. Strickland
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - M. Stringer
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Sur
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - J. Tang
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - E. Vázquez-Jáuregui
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
| | - S. Viel
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Walding
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - M. Waqar
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Ward
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. Westerdale
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- INFN Cagliari, Cagliari, 09042 Italy
| | - J. Willis
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. Zuñiga-Reyes
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
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Evans R, Ng C. 668 The Consequences to Emergency Surgery During COVID19 Pandemic in a UK District General Hospital in The North East of England. Br J Surg 2021. [PMCID: PMC8135887 DOI: 10.1093/bjs/znab134.075] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Aim COVID19 pandemic has significantly affected surgical services. We aim to review its effects on our theatre output and risk of encountering COVID 19 cases. Method Serial record of operations performed locally were reviewed from start of UK COVID19 pandemic lockdown on 23rd March 2020 to 13th July 2020 after it was lifted. A weekly average by month of operations and the percentage of COVID19 cases diagnosed within 30 days of the procedure were noted. Results 733 operations performed through this period. In March, 33 operations/week performed, 88.4% emergency and 7% diagnosed with COVID19. April, 31 operations /week performed, 95.9% emergency and 10.6% diagnosed with COVID19. May 46 operations /week performed, 94.5% emergency and 3.3% diagnosed with COVID19. June 56 operations /week, 80.9% emergency and less than 0.01% diagnosed with COVID19. By July 80 operations/week, 59.4% emergency and none diagnosed with COVID 19. Since testing capacity increased, only 6 of the 27 operated were diagnosed with COVID19. Conclusions There was initial reduction to non-emergency workload. However, this has gradually shifted as protocols are in place improve public confidence to return for surgical treatment. Mandatory admission testing allows early identification and remains essential for planning of services and protecting the workforce.
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Affiliation(s)
- R Evans
- County Durham and Darlington Foundation Trust, Durham, United Kingdom
| | - C Ng
- County Durham and Darlington Foundation Trust, Durham, United Kingdom
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21
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Chan J, Ng C, Yu P, Lim K, Siu I, Yuan E, Liu S, Choi J, Chu C, Lau R. MA02.04 Initial Experience of Hybrid Operating Room Cone-Beam CT Guided Bronchoscopic Microwave Thermal Ablation of Peripheral Small Lung Lesions. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.208] [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: 11/29/2022]
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22
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Milner I, Ng C. MA04.03 Impact of Frailty Screening and Geriatrician-Led Comprehensive Geriatric Assessment in Frail Older Adults With Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.225] [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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Brooke J, Safavi S, Prayle A, Ng C, Alappadan J, Bradley C, Cooper A, Munidasa S, Zanette B, Santyr G, Barr H, Major G, Smyth A, Gowland P, Francis S, Hall I. P109 Regional assessment of lung function using non-contrast MRI in people with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01135-8] [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: 10/21/2022]
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Abstract
This review is based on a lecture presented at the Craig H. Neilsen Foundation sponsored Spinal Cord Injury Training Program at Ohio State University. We discuss the advantages and challenges of injury models in rodents and theory relation to various behavioral outcome measures. We offer strategies and advice on experimental design, behavioral testing, and on the challenges, one will encounter with animal testing. This review is designed to guide those entering the field of spinal cord injury and/or involved with in vivo animal testing.
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Affiliation(s)
- K Fouad
- University of Alberta, Faculty of Rehabilitation Medicine, Dept of Physical Therapy, 3-48 Corbett Hall, Edmonton T6G 2G4, Canada; University of Alberta, Neuroscience and Mental Health Institute, 2-132 Li Ka Shing, Edmonton T6G 2E1, Canada.
| | - C Ng
- University of Alberta, Neuroscience and Mental Health Institute, 2-132 Li Ka Shing, Edmonton T6G 2E1, Canada
| | - D M Basso
- Ohio State University, College of Medicine, School of Health and Rehabilitation Sciences, 106A Atwell Hall, 453 W. 10th Ave, Columbus, OH 43210, USA
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25
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Cheung CKY, Tsang SSL, Ho O, Lam N, Lam ECL, Ng C, Sun F, Yu B, Kwan N, Leung GKK. Cardiovascular risk in bus drivers. Hong Kong Med J 2020; 26:451-456. [PMID: 33089795 DOI: 10.12809/hkmj198087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- C K Y Cheung
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - S S L Tsang
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - O Ho
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - N Lam
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - E C L Lam
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - C Ng
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - F Sun
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - B Yu
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - N Kwan
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - G K K Leung
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.,Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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26
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Mastboom MJL, Lips W, van Langevelde K, Mifsud M, Ng C, McCarthy CL, Athanasou NA, Gibbons CLMH, van de Sande MAJ. The effect of Imatinib Mesylate in diffuse-type Tenosynovial Giant Cell Tumours on MR imaging and PET-CT. Surg Oncol 2020; 35:261-267. [PMID: 32932224 DOI: 10.1016/j.suronc.2020.08.030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Recurrence rates remain high after surgical treatment of diffuse-type Tenosynovial Giant Cell Tumour (TGCT). Imatinib Mesylate (IM) blocks Colony Stimulating Factor1 Receptor (CSF1R), the driver mechanism in TGCT. The aim of this study was to determine if IM reduces the tumour metabolic activity evaluated by PET-CT and to compare this response with the response seen on MR imaging. MATERIALS AND METHODS 25 Consecutive patients treated with IM (off label use) for locally advanced (N = 12) or recurrent (N = 13) diffuse-type TGCT were included, 15 male and median age at diagnosis 39 (IQR 31-47) years. The knee was most frequently affected (n = 16; 64%). The effect of IM was assessed pre- and post-IM treatment by comparing MR scans and PET-CT. MR scans were assessed by Tumour Volume Score (TVS), an estimation of the tumour volume as a percentage of the total synovial cavity. PET-CT scans were evaluated based on maximum standardized uptake value (SUV-max). Partial response was defined as more than 50% tumour reduction with TVS and a decrease of at least 30% on SUV-max. RESULTS Median duration of IM treatment was 7.0 (IQR 4.2-11.5) months. Twenty patients (80%) discontinued IM treatment for poor response or intended surgery. Twenty patients experienced an adverse event grade 1-2, three patients grade 3 (creatinine increment, neutropenic sepsis, liver dysfunction). MR assessment of all joints showed 32% (6/19) partial response and 63% (12/19) stable disease, with a mean difference of 12% (P = 0.467; CI -22.4-46.0) TVS between pre- and post-IM and a significant mean difference of 23% (P = 0.021; CI 4.2-21.6) in all knee lesions. PET-CT, all joints, showed a significantly decreased mean difference of 5.3 (P = 0.004; CI 1.9-8.7) SUV-max between pre- and post-IM treatment (58% (11/19) partial response, 37% (7/19) stable disease). No correlation between MR imaging and PET-CT could be appreciated in 15 patients with complete radiological data. CONCLUSION This study confirms the moderate radiological response of IM in diffuse-type TGCT. PET-CT is a valuable additional diagnostic tool to quantify response to tyrosine kinase inhibitor treatment. Its value should be assessed further to validate its efficacy in the objective measurement of biological response in targeted systemic treatment of TGCT.
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Affiliation(s)
- M J L Mastboom
- Orthopaedics Oncology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - W Lips
- Orthopaedics Oncology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - K van Langevelde
- Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
| | - M Mifsud
- Orthopaedic Department, Mater Dei Hospital, Triq Dun Karm, Msida, Malta.
| | - C Ng
- Orthopaedic Department, Mater Dei Hospital, Triq Dun Karm, Msida, Malta.
| | - C L McCarthy
- Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
| | - N A Athanasou
- Histopathology, NDORMS, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
| | - C L M H Gibbons
- Orthopaedics Oncology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
| | - M A J van de Sande
- Orthopaedics Oncology, Leiden University Medical Centre, Leiden, the Netherlands.
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Ng C, Mentias Y, Abdelgalil A. Imaging features of non-epithelial tumours of the larynx. Clin Radiol 2020; 75:711.e5-711.e12. [DOI: 10.1016/j.crad.2020.01.013] [Citation(s) in RCA: 2] [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: 07/10/2019] [Accepted: 01/23/2020] [Indexed: 12/27/2022]
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Hui PW, Ng C, Cheung KW, Lai CL. Acceptance of antiviral treatment and enhanced service model for pregnant patients carrying hepatitis B. Hong Kong Med J 2020; 26:318-322. [PMID: 32801216 DOI: 10.12809/hkmj208451] [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] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION A service model was established for pregnant women with positive screening results for hepatitis B surface antigen (HBsAg) at Queen Mary Hospital in Hong Kong. All women were offered a blood test for hepatitis B virus (HBV) DNA level during the first antenatal visit. Women with HBV DNA levels of ≥200 000 IU/mL received counselling from hepatologists regarding treatment with antenatal tenofovir disoproxil fumarate (TDF) 300 mg daily. METHODS This retrospective review included women attending our antenatal clinic who exhibited positive HBsAg screening results from 15 May 2017 to 31 December 2019. The proportions of women with positive HBsAg, DNA test acceptance, hepatological review, and TDF acceptance during pregnancy were reviewed. RESULTS In total, 375 (2.9%) of 13 082 pregnant women had positive HBsAg screening results. Blood tests for HBV DNA and hepatological reviews were offered to 273 women who had not undergone hepatological review prior to pregnancy; the acceptance rate was 97.8%. Sixty (22.6%) pregnant women were hepatitis B carriers with high viral loads of ≥200 000 IU/mL. Among 58 women with high viral loads, 57 received antenatal counselling regarding TDF and 56 (96.6%) agreed to take the drug; 92.9% of these 56 women had commenced TDF at or before 32 weeks of gestation. CONCLUSIONS This study indicated broad acceptance of HBV DNA tests by pregnant women. Triage allowed early review and commencement of antiviral medication. This service model serves as a framework for enhanced antenatal service to prevent mother-to-child-transmission in public maternity units.
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Affiliation(s)
- P W Hui
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - C Ng
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - K W Cheung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - C L Lai
- Department of Medicine, The University of Hong Kong, Hong Kong
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De Mattos-Arruda L, Vazquez M, Finotello F, Lepore R, Porta E, Hundal J, Amengual-Rigo P, Ng CKY, Valencia A, Carrillo J, Chan TA, Guallar V, McGranahan N, Blanco J, Griffith M. Neoantigen prediction and computational perspectives towards clinical benefit: recommendations from the ESMO Precision Medicine Working Group. Ann Oncol 2020; 31:978-990. [PMID: 32610166 PMCID: PMC7885309 DOI: 10.1016/j.annonc.2020.05.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [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] [Received: 01/22/2020] [Revised: 05/01/2020] [Accepted: 05/07/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The use of next-generation sequencing technologies has enabled the rapid identification of non-synonymous somatic mutations in cancer cells. Neoantigens are mutated peptides derived from somatic mutations not present in normal tissues that may result in the presentation of tumour-specific peptides capable of eliciting antitumour T-cell responses. Personalised neoantigen-based cancer vaccines and adoptive T-cell therapies have been shown to prime host immunity against tumour cells and are under clinical trial development. However, the optimisation and standardisation of neoantigen identification, as well as its delivery as immunotherapy are needed to increase tumour-specific T-cell responses and, thus, the clinical efficacy of current cancer immunotherapies. METHODS In this recommendation article, launched by the European Society for Medical Oncology (ESMO), we outline and discuss the available framework for neoantigen prediction and present a systematic review of the current scientific evidence. RESULTS A number of computational pipelines for neoantigen prediction are available. Most of them provide peptide major histocompatibility complex (MHC) binding affinity predictions, but more recent approaches incorporate additional features like variant allele fraction, gene expression, and clonality of mutations. Neoantigens can be predicted in all cancer types with high and low tumour mutation burden, in part by exploiting tumour-specific aberrations derived from mutational frameshifts, splice variants, gene fusions, endogenous retroelements and other tumour-specific processes that could yield more potently immunogenic tumour neoantigens. Ongoing clinical trials will highlight those cancer types and combinations of immune therapies that would derive the most benefit from neoantigen-based immunotherapies. CONCLUSIONS Improved identification, selection and prioritisation of tumour-specific neoantigens are needed to increase the scope of benefit from cancer vaccines and adoptive T-cell therapies. Novel pipelines are being developed to resolve the challenges posed by high-throughput sequencing and to predict immunogenic neoantigens.
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Affiliation(s)
- L De Mattos-Arruda
- IrsiCaixa, Hospital Universitari Trias i Pujol, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.
| | - M Vazquez
- Barcelona Supercomputing Center, Barcelona, Spain
| | - F Finotello
- Biocenter, Institute of Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria
| | - R Lepore
- Barcelona Supercomputing Center, Barcelona, Spain
| | - E Porta
- Barcelona Supercomputing Center, Barcelona, Spain; Josep Carreras Leukaemia Research Institute (IJC), Badalona, Spain
| | - J Hundal
- The McDonnell Genome Institute, Washington University in St Louis, USA
| | | | - C K Y Ng
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - A Valencia
- Barcelona Supercomputing Center, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - J Carrillo
- IrsiCaixa, Hospital Universitari Trias i Pujol, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - T A Chan
- Center for Immunotherapy and Precision-Immuno-Oncology, Cleveland Clinic, Cleveland, USA
| | - V Guallar
- Barcelona Supercomputing Center, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - N McGranahan
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College, London, UK; Cancer Genome Evolution Research Group, University College London Cancer Institute, University College London, London, UK
| | - J Blanco
- IrsiCaixa, Hospital Universitari Trias i Pujol, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Vic, Spain
| | - M Griffith
- Department of Medicine, Washington University School of Medicine, St. Louis, USA
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Teoh J, Chan E, Cheuk A, Chan R, Qin J, Ng C. A newly developed computer-aided endoscopic diagnostic system for bladder cancer detection. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33498-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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31
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Burger B, Ghosh A, Ng CKY, Piscuoglio S, Spoerri I, Itin PH, Greer K, Elbaum D. Discovery of heterozygous KRT10 alterations in MAUIE cases underlines the importance of regular skin cancer screening in ichthyosis with confetti. Br J Dermatol 2020; 183:954-955. [PMID: 32407542 DOI: 10.1111/bjd.19218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B Burger
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - A Ghosh
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland.,Competence Center Personalized Medicine, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - C K Y Ng
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - S Piscuoglio
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland.,Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - I Spoerri
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - P H Itin
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland.,Dermatology, University Hospital Basel, Basel, Switzerland
| | - K Greer
- Department of Dermatology, University of Virginia, Charlottesville, VA, USA
| | - D Elbaum
- Mercy Hospitals of Bakersfield, Bakersfield, CA, USA
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32
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Djan PM, Ng C, Sills D, Smyth A. P271 An assessment of Pancreatic Enzyme Replacement Therapy (PERT) knowledge in children and adults with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30603-2] [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: 11/25/2022]
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Rosenthal VD, Bat-Erdene I, Gupta D, Belkebir S, Rajhans P, Zand F, Myatra SN, Afeef M, Tanzi VL, Muralidharan S, Gurskis V, Al-Abdely HM, El-Kholy A, AlKhawaja SAA, Sen S, Mehta Y, Rai V, Hung NV, Sayed AF, Guerrero-Toapanta FM, Elahi N, Morfin-Otero MDR, Somabutr S, De-Carvalho BM, Magdarao MS, Velinova VA, Quesada-Mora AM, Anguseva T, Ikram A, Aguilar-de-Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di-Silvestre G, Furova K, Gamar-Elanbya MO, Gupta U, Abidi K, Raka L, Guo X, Luque-Torres MT, Jayatilleke K, Ben-Jaballah N, Gikas A, Sandoval-Castillo HR, Trotter A, Valderrama-Beltrán SL, Leblebicioglu H, Riera F, López M, Maurizi D, Desse J, Pérez I, Silva G, Chaparro G, Golschmid D, Cabrera R, Montanini A, Bianchi A, Vimercati J, Rodríguez-del-Valle M, Domínguez C, Saul P, Chediack V, Piastrelini M, Cardena L, Ramasco L, Olivieri M, Gallardo P, Juarez P, Brito M, Botta P, Alvarez G, Benchetrit G, Caridi M, Stagnaro J, Bourlot I, García M, Arregui N, Saeed N, Abdul-Aziz S, ALSayegh S, Humood M, Mohamed-Ali K, Swar S, Magray T, Aguiar-Portela T, Sugette-de-Aguiar T, Serpa-Maia F, Fernandes-Alves-de-Lima L, Teixeira-Josino L, Sampaio-Bezerra M, Furtado-Maia R, Romário-Mendes A, Alves-De-Oliveira A, Vasconcelos-Carneiro A, Anjos-Lima JD, Pinto-Coelho K, Maciel-Canuto M, Rocha-Batista M, Moreira T, Rodrigues-Amarilo N, Lima-de-Barros T, Guimarães KA, Batista C, Santos C, de-Lima-Silva F, Santos-Mota E, Karla L, Ferreira-de-Souza M, Luzia N, de-Oliveira S, Takeda C, Azevedo-Ferreira-Lima D, Faheina J, Coelho-Oliveira L, do-Nascimento S, Machado-Silva V, Bento-Ferreira, Olszewski J, Tenorio M, Silva-Lemos A, Ramos-Feijó C, Cardoso D, Correa-Barbosa M, Assunção-Ponte G, Faheina J, da-Silva-Escudero D, Servolo-Medeiros E, Andrade-Oliveira-Reis M, Kostadinov E, Dicheva V, Petrov M, Guo C, Yu H, Liu T, Song G, Wang C, Cañas-Giraldo L, Marin-Tobar D, Trujillo-Ramirez E, Andrea-Rios P, Álvarez-Moreno C, Linares C, González-Rubio P, Ariza-Ayala B, Gamba-Moreno L, Gualtero-Trujill S, Segura-Sarmiento S, Rodriguez-Pena J, Ortega R, Olarte N, Pardo-Lopez Y, Luis Marino Otela-Baicue A, Vargas-Garcia A, Roncancio E, Gomez-Nieto K, Espinosa-Valencia M, Barahona-Guzman N, Avila-Acosta C, Raigoza-Martinez W, Villamil-Gomez W, Chapeta-Parada E, Mindiola-Rochel A, Corchuelo-Martinez A, Martinez A, Lagares-Guzman A, Rodriguez-Ferrer M, Yepes-Gomez D, Muñoz-Gutierrez G, Arguello-Ruiz A, Zuniga-Chavarria M, Maroto-Vargas L, Valverde-Hernández M, Solano-Chinchilla A, Calvo-Hernandez I, Chavarria-Ugalde O, Tolari G, Rojas-Fermin R, Diaz-Rodriguez C, Huascar S, Ortiz M, Bovera M, Alquinga N, Santacruz G, Jara E, Delgado V, Salgado-Yepez E, Valencia F, Pelaez C, Gonzalez-Flores H, Coello-Gordon E, Picoita F, Arboleda M, Garcia M, Velez J, Valle M, Unigarro L, Figueroa V, Marin K, Caballero-Narvaez H, Bayani V, Ahmed S, Alansary A, Hassan A, Abdel-Halim M, El-Fattah M, Abdelaziz-Yousef R, Hala A, Abdelhady K, Ahmed-Fouad H, Mounir-Agha H, Hamza H, Salah Z, Abdel-Aziz D, Ibrahim S, Helal A, AbdelMassih A, Mahmoud AR, Elawady B, El-sherif R, Fattah-Radwan Y, Abdel-Mawla T, Kamal-Elden N, Kartsonaki M, Rivera D, Mandal S, Mukherjee S, Navaneet P, Padmini B, Sorabjee J, Sakle A, Potdar M, Mane D, Sale H, Abdul-Gaffar M, Kazi M, Chabukswar S, Anju M, Gaikwad D, Harshe A, Blessymole S, Nair P, Khanna D, Chacko F, Rajalakshmi A, Mubarak A, Kharbanda M, Kumar S, Mathur P, Saranya S, Abubakar F, Sampat S, Raut V, Biswas S, Kelkar R, Divatia J, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Thejasvini A, Rangaswamy S, Saini N, Bhattacharya C, Das S, Sanyal S, Chaudhury B, Rodrigues C, Khanna G, Dwivedy A, Binu S, Shetty S, Eappen J, Valsa T, Sriram A, Todi S, Bhattacharyya M, Bhakta A, Ramachandran B, Krupanandan R, Sahoo P, Mohanty N, Sahu S, Misra S, Ray B, Pattnaik S, Pillai H, Warrier A, Ranganathan L, Mani A, Rajagopal S, Abraham B, Venkatraman R, Ramakrishnan N, Devaprasad D, Siva K, Divekar D, Satish Kavathekar M, Suryawanshi M, Poojary A, Sheeba J, Patil P, Kukreja S, Varma K, Narayanan S, Sohanlal T, Agarwal A, Agarwal M, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Nirkhiwale S, Gehlot G, Bhattacharya S, Pandya N, Raphel A, Zala D, Mishra S, Patel M, Aggarwal D, Jawadwal B, Pawar N, Kardekar S, Manked A, Tamboli A, Manked A, Khety Z, Singhal T, Shah S, Kothari V, Naik R, Narain R, Sengupta S, Karmakar A, Mishra S, Pati B, Kantroo V, Kansal S, Modi N, Chawla R, Chawla A, Roy I, Mukherjee S, Bej M, Mukherjee P, Baidya S, Durell A, Vadi S, Saseedharan S, Anant P, Edwin J, Sen N, Sandhu K, Pandya N, Sharma S, Sengupta S, Palaniswamy V, Sharma P, Selvaraj M, Saurabh L, Agarwal M, Punia D, Soni D, Misra R, Harsvardhan R, Azim A, Kambam C, Garg A, Ekta S, Lakhe M, Sharma C, Singh G, Kaur A, Singhal S, Chhabra K, Ramakrishnan G, Kamboj H, Pillai S, Rani P, Singla D, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Shafiee E, Nikandish R, Paydar S, Khalili H, Moradi A, Sadeghi P, Bolandparvaz S, Mubarak S, Makhlouf M, Awwad M, Ayyad O, Shaweesh A, Khader M, Alghazawi A, Hussien N, Alruzzieh M, Mohamed Y, ALazhary M, Abdul Aziz O, Alazmi M, Mendoza J, De Vera P, Rillorta A, de Guzman M, Girvan M, Torres M, Alzahrani N, Alfaraj S, Gopal U, Manuel M, Alshehri R, Lessing L, Alzoman H, Abdrahiem J, Adballah H, Thankachan J, Gomaa H, Asad T, AL-Alawi M, Al-Abdullah N, Demaisip N, Laungayan-Cortez E, Cabato A, Gonzales J, Al Raey M, Al-Darani S, Aziz M, Al-Manea B, Samy E, AlDalaton M, Alaliany M, Alabdely H, Helali N, Sindayen G, Malificio A, Al-Dossari H, Kelany A, Algethami A, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar S, Al-Zaydani M, Ahmed H, Al Jarie A, Al-Qathani A, Al-Alkami H, AlDalaton M, Alih S, Alaliany M, Gasmin-Aromin R, Balon-Ubalde E, Diab H, Kader N, Hassan-Assiry I, Kelany A, Albeladi E, Aboushoushah S, Qushmaq N, Fernandez J, Hussain W, Rajavel R, Bukhari S, Rushdi H, Turkistani A, Mushtaq J, Bohlega E, Simon S, Damlig E, Elsherbini S, Abraham S, Kaid E, Al-Attas A, Hawsawi G, Hussein B, Esam B, Caminade Y, Santos A, Abdulwahab M, Aldossary A, Al-Suliman S, AlTalib A, Albaghly N, HaqlreMia M, Kaid E, Altowerqi R, Ghalilah K, Alradady M, Al-Qatri A, Chaouali M, Shyrine E, Philipose J, Raees M, AbdulKhalik N, Madco M, Acostan C, Safwat R, Halwani M, Abdul-Aal N, Thomas A, Abdulatif S, Ali-Karrar M, Al-Gosn N, Al-Hindi A, Jaha R, AlQahtani S, Ayugat E, Al-Hussain M, Aldossary A, Al-Suliman S, Al-Talib A, Albaghly N, Haqlre-Mia M, Briones S, Krishnan R, Tabassum K, Alharbi L, Madani A, Al-Hindi A, Al-Gethamy M, Alamri D, Spahija G, Gashi A, Kurian A, George S, Mohamed A, Ramapurath R, Varghese S, Abdo N, Foda-Salama M, Al-Mousa H, Omar A, Salama M, Toleb M, Khamis S, Kanj S, Zahreddine N, Kanafani Z, Kardas T, Ahmadieh R, Hammoud Z, Zeid I, Al-Souheil A, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Dagys A, Mitrev Z, Bogoevska-Miteva Z, Jankovska K, Guroska S, Petrovska M, Popovska K, Ng C, Hoon Y, Hasan YM, Othman-Jailani M, Hadi-Jamaluddin M, Othman A, Zainol H, Wan-Yusoff W, Gan C, Lum L, Ling C, Aziz F, Zhazali R, Abud-Wahab M, Cheng T, Elghuwael I, Wan-Mat W, Abd-Rahman R, Perez-Gomez H, Kasten-Monges M, Esparza-Ahumada S, Rodriguez-Noriega E, Gonzalez-Diaz E, Mayoral-Pardo D, Cerero-Gudino A, Altuzar-Figueroa M, Perez-Cruz J, Escobar-Vazquez M, Aragon D, Coronado-Magana H, Mijangos-Mendez J, Corona-Jimenez F, Aguirre-Avalos G, Lopez-Mateos A, Martinez-Marroquin M, Montell-Garcia M, Martinez-Martinez A, Leon-Sanchez E, Gomez-Flores G, Ramirez M, Gomez M, Lozano M, Mercado V, Zamudio-Lugo I, Gomez-Gonzalez C, Miranda-Novales M, Villegas-Mota I, Reyes-Garcia C, Ramirez-Morales M, Sanchez-Rivas M, Cureno-Diaz M, Matias-Tellez B, Gonzalez-Martinez J, Juarez-Vargas R, Pastor-Salinas O, Gutierrez-Munoz V, Conde-Mercado J, Bruno-Carrasco G, Manrique M, Monroy-Colin V, Cruz-Rivera Z, Rodriguez-Pacheco J, Cruz N, Hernandez-Chena B, Guido-Ramirez O, Arteaga-Troncoso G, Guerra-Infante F, Lopez-Hurtado M, Caleco JD, Leyva-Medellin E, Salamanca-Meneses A, Cosio-Moran C, Ruiz-Rendon R, Aguilar-Angel L, Sanchez-Vargas M, Mares-Morales R, Fernandez-Alvarez L, Castillo-Cruz B, Gonzalez-Ma M, Zavala-Ramír M, Rivera-Reyna L, del-Moral-Rossete L, Lopez-Rubio C, Valadez-de-Alba M, Bat-Erdene A, Chuluunchimeg K, Baatar O, Batkhuu B, Ariyasuren Z, Bayasgalan G, Baigalmaa S, Uyanga T, Suvderdene P, Enkhtsetseg D, Suvd-Erdene D, Chimedtseye E, Bilguun G, Tuvshinbayar M, Dorj M, Khajidmaa T, Batjargal G, Naranpurev M, Bat-Erdene A, Bolormaa T, Battsetseg T, Batsuren C, Batsaikhan N, Tsolmon B, Saranbaatar A, Natsagnyam P, Nyamdawa O, Madani N, Abouqal R, Zeggwagh A, Berechid K, Dendane T, Koirala A, Giri R, Sainju S, Acharya S, Paul N, Parveen A, Raza A, Nizamuddin S, Sultan F, Imran X, Sajjad R, Khan M, Sana F, Tayyab N, Ahmed A, Zaman G, Khan I, Khurram F, Hussain A, Zahra F, Imtiaz A, Daud N, Sarwar M, Roop Z, Yusuf S, Hanif F, Shumaila X, Zeb J, Ali S, Demas S, Ariff S, Riaz A, Hussain A, Kanaan A, Jeetawi R, Castaño E, Moreno-Castillo L, García-Mayorca E, Prudencio-Leon W, Vivas-Pardo A, Changano-Rodriguez M, Castillo-Bravo L, Aibar-Yaranga K, Marquez-Mondalgo V, Mueras-Quevedo J, Meza-Borja C, Flor J, Fernandez-Camacho Y, Banda-Flores C, Pichilingue-Chagray J, Castaneda-Sabogal A, Caoili J, Mariano M, Maglente R, Santos S, de-Guzman G, Mendoza M, Javellana O, Tajanlangit A, Tapang A, Sg-Buenaflor M, Labro E, Carma R, Dy A, Fortin J, Navoa-Ng J, Cesar J, Bonifacio B, Llames M, Gata H, Tamayo A, Calupit H, Catcho V, Bergosa L, Abuy M, Barteczko-Grajek B, Rojek S, Szczesny A, Domanska M, Lipinska G, Jaroslaw J, Wieczoreka A, Szczykutowicza A, Gawor M, Piwoda M, Rydz-Lutrzykowska J, Grudzinska M, Kolat-Brodecka P, Smiechowicz K, Tamowicz B, Mikstacki A, Grams A, Sobczynski P, Nowicka M, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Vasiljevic S, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Simic A, Hlinkova S, Lesnakova A, Kadankunnel S, Abdo-Ali M, Pimathai R, Wanitanukool S, Supa N, Prasan P, Luxsuwong M, Khuenkaew Y, Lamngamsupha J, Siriyakorn N, Prasanthai V, Apisarnthanarak A, Borgi A, Bouziri A, Cabadak H, Tuncer G, Bulut C, Hatipoglu C, Sebnem F, Demiroz A, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Oncul O, Gorenek L, Erdem H, Yildizdas D, Horoz O, Guclu E, Kaya G, Karabay O, Altindis M, Oztoprak N, Sahip Y, Uzun C, Erben N, Usluer G, Ozgunes I, Ozcelik M, Ceyda B, Oral M, Unal N, Cigdem Y, Bayar M, Bermede O, Saygili S, Yesiler I, Memikoglu O, Tekin R, Oncul A, Gunduz A, Ozdemir D, Geyik M, Erdogan S, Aygun C, Dilek A, Esen S, Turgut H, Sungurtekin H, Ugurcan D, Yarar V, Bilir Y, Bayram N, Devrim I, Agin H, Ceylan G, Yasar N, Oruc Y, Ramazanoglu A, Turhan O, Cengiz M, Yalcin A, Dursun O, Gunasan P, Kaya S, Senol G, Kocagoz A, Al-Rahma H, Annamma P, El-Houfi A, Vidal H, Perez F, D-Empaire G, Ruiz Y, Hernandez D, Aponte D, Salinas E, Vidal H, Navarrete N, Vargas R, Sanchez E, Ngo Quy C, Thu T, Nguyet L, Hang P, Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Ali J, Kaul P, Osman M, Bartnik A, Taghavi J, Tsui S, Ng C, Jenkins D. Pulmonary Endarterectomy: Improving Outcomes over Time with Increased Institutional Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1180] [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: 10/24/2022] Open
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Kahai R, Ullah M, Beech A, Cove-Smith L, Lyons J, Ng C. Are there any benefits to consumption of an oral nutritional supplement (ONS) ice lolly in lung cancer patients? Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30218-x] [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: 11/30/2022]
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Dunnett-Kane V, Ng C. Provision of a specialist onco-geriatric service for lung cancer patients in South Manchester. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30229-4] [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: 11/30/2022]
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Mateo J, Chakravarty D, Dienstmann R, Jezdic S, Gonzalez-Perez A, Lopez-Bigas N, Ng CKY, Bedard PL, Tortora G, Douillard JY, Van Allen EM, Schultz N, Swanton C, André F, Pusztai L. A framework to rank genomic alterations as targets for cancer precision medicine: the ESMO Scale for Clinical Actionability of molecular Targets (ESCAT). Ann Oncol 2019; 29:1895-1902. [PMID: 30137196 DOI: 10.1093/annonc/mdy263] [Citation(s) in RCA: 382] [Impact Index Per Article: 76.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background In order to facilitate implementation of precision medicine in clinical management of cancer, there is a need to harmonise and standardise the reporting and interpretation of clinically relevant genomics data. Methods The European Society for Medical Oncology (ESMO) Translational Research and Precision Medicine Working Group (TR and PM WG) launched a collaborative project to propose a classification system for molecular aberrations based on the evidence available supporting their value as clinical targets. A group of experts from several institutions was assembled to review available evidence, reach a consensus on grading criteria and present a classification system. This was then reviewed, amended and finally approved by the ESMO TR and PM WG and the ESMO leadership. Results This first version of the ESMO Scale of Clinical Actionability for molecular Targets (ESCAT) defines six levels of clinical evidence for molecular targets according to the implications for patient management: tier I, targets ready for implementation in routine clinical decisions; tier II, investigational targets that likely define a patient population that benefits from a targeted drug but additional data are needed; tier III, clinical benefit previously demonstrated in other tumour types or for similar molecular targets; tier IV, preclinical evidence of actionability; tier V, evidence supporting co-targeting approaches; and tier X, lack of evidence for actionability. Conclusions The ESCAT defines clinical evidence-based criteria to prioritise genomic alterations as markers to select patients for targeted therapies. This classification system aims to offer a common language for all the relevant stakeholders in cancer medicine and drug development.
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Affiliation(s)
- J Mateo
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - D Chakravarty
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - R Dienstmann
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - S Jezdic
- European Society for Medical Oncology, Lugano, Switzerland
| | | | - N Lopez-Bigas
- Institute for Research in Biomedicine (IRB), Barcelona; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - C K Y Ng
- University Hospital Basel, Basel, Switzerland
| | - P L Bedard
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - G Tortora
- University of Verona, Verona; Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - J-Y Douillard
- European Society for Medical Oncology, Lugano, Switzerland
| | - E M Van Allen
- Harvard Medical School Dana-Farber Cancer Center and Broad Institute, Boston, USA
| | - N Schultz
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Swanton
- The Francis Crick Institute, London, UK
| | - F André
- Institut Gustave Roussy, Villejuif, France.
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Ng CKY, Di Costanzo GG, Tosti N, Paradiso V, Coto-Llerena M, Roscigno G, Perrina V, Quintavalle C, Boldanova T, Wieland S, Marino-Marsilia G, Lanzafame M, Quagliata L, Condorelli G, Matter MS, Tortora R, Heim MH, Terracciano LM, Piscuoglio S. Genetic profiling using plasma-derived cell-free DNA in therapy-naïve hepatocellular carcinoma patients: a pilot study. Ann Oncol 2019; 29:1286-1291. [PMID: 29509837 DOI: 10.1093/annonc/mdy083] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Hepatocellular carcinomas (HCCs) are not routinely biopsied, resulting in a lack of tumor materials for molecular profiling. Here we sought to determine whether plasma-derived cell-free DNA (cfDNA) captures the genetic alterations of HCC in patients who have not undergone systemic therapy. Patients and methods Frozen biopsies from the primary tumor and plasma were synchronously collected from 30 prospectively recruited, systemic treatment-naïve HCC patients. Deep sequencing of the DNA from the biopsies, plasma-derived cfDNA and matched germline was carried out using a panel targeting 46 coding and non-coding genes frequently altered in HCCs. Results In 26/30 patients, at least one somatic mutation was detected in biopsy and/or cfDNA. Somatic mutations in HCC-associated genes were present in the cfDNA of 63% (19/30) of the patients and could be detected 'de novo' without prior knowledge of the mutations present in the biopsy in 27% (8/30) of the patients. Mutational load and the variant allele fraction of the mutations detected in the cfDNA positively correlated with tumor size and Edmondson grade. Crucially, among the seven patients in whom the largest tumor was ≥5 cm or was associated with metastasis, at least one mutation was detected 'de novo' in the cfDNA of 86% (6/7) of the cases. In these patients, cfDNA and tumor DNA captured 87% (80/92) and 95% (87/92) of the mutations, suggesting that cfDNA and tumor DNA captured similar proportions of somatic mutations. Conclusion In patients with high disease burden, the use of cfDNA for genetic profiling when biopsy is unavailable may be feasible. Our results support further investigations into the clinical utility of cfDNA in a larger cohort of patients.
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Affiliation(s)
- C K Y Ng
- Institute of Pathology, University Hospital Basel, Basel; Hepatology Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland.
| | - G G Di Costanzo
- Department of Transplantation - Liver Unit, Cardarelli Hospital, Naples
| | - N Tosti
- Institute of Pathology, University Hospital Basel, Basel
| | - V Paradiso
- Institute of Pathology, University Hospital Basel, Basel
| | - M Coto-Llerena
- Hepatology Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - G Roscigno
- Department of Molecular Medicine and Medical Biotechnology, "Federico II" University of Naples, Naples, Italy
| | - V Perrina
- Institute of Pathology, University Hospital Basel, Basel
| | - C Quintavalle
- Institute of Pathology, University Hospital Basel, Basel
| | - T Boldanova
- Hepatology Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland; Division of Gastroenterology and Hepatology, University Hospital Basel, Basel, Switzerland
| | - S Wieland
- Hepatology Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - M Lanzafame
- Institute of Pathology, University Hospital Basel, Basel
| | - L Quagliata
- Institute of Pathology, University Hospital Basel, Basel
| | - G Condorelli
- Department of Molecular Medicine and Medical Biotechnology, "Federico II" University of Naples, Naples, Italy
| | - M S Matter
- Institute of Pathology, University Hospital Basel, Basel
| | - R Tortora
- Department of Transplantation - Liver Unit, Cardarelli Hospital, Naples
| | - M H Heim
- Hepatology Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland; Division of Gastroenterology and Hepatology, University Hospital Basel, Basel, Switzerland
| | | | - S Piscuoglio
- Institute of Pathology, University Hospital Basel, Basel.
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Gomes F, Baker K, Woods J, Bruce J, Eaton M, Higham P, Cove-Smith L, Garbett A, Cree A, Ng C, Blackhall F, Bayman N. MA19.09 Assessing Clinical Frailty in Advanced Lung Cancer Patients - An Opportunity to Improve Patient Outcomes? J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Munjal I, Ng C, Imtiaz Z, Cooper R, Cope L. Adequacy of trauma c-spine X-rays: a case for ;straight to CT?’. Clin Radiol 2019. [DOI: 10.1016/j.crad.2019.09.110] [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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Tsao M, Shi R, Radulovich N, Ng C, Notsuda H, Cabanero M, Martins-Filho S, Raghavan V, Li Q, Mer A, Liu N, Pham N, Haibe-Kains B, Liu G, Moghal N. OA08.01 Organoid Cultures as Novel Preclinical Models of Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.447] [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: 10/25/2022]
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Affiliation(s)
- S Piscuoglio
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - C K Y Ng
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland; Department of Biomedicine, University of Basel, Basel, Switzerland
| | - B Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - S Chandarlapaty
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA.
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Matos I, Goyal L, Cleary J, Voss M, Oh D, Bernstam FM, Ng C, Iyer G, Ishii N, Hu Y, Chessex AV, Pokorska-Bocci A, Nicolas V, Kirpicheva Y, Zanna C, Flaherty K, Tabernero J, Hyman D. Debio 1347 in patients with gastrointestinal cancers harboring an FGFR gene fusion: preliminary results. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.002] [Citation(s) in RCA: 3] [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: 11/14/2022] Open
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Kashyap P, Ng C, Wang Z, Li B, Arif Pavel M, Martin H, Yu Y. Corrigendum to "A PKD1L3 splice variant in taste buds is not cleaved at the G protein-coupled receptor proteolytic site" [Biochem. Biophys. Res. Commun. 512 (2019) 812-818]. Biochem Biophys Res Commun 2019; 514:565. [PMID: 31056259 DOI: 10.1016/j.bbrc.2019.04.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- P Kashyap
- Department of Biological Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
| | - C Ng
- Department of Biological Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
| | - Z Wang
- Department of Biological Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
| | - B Li
- Department of Biological Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
| | - M Arif Pavel
- Department of Biological Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
| | - H Martin
- Department of Biological Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
| | - Y Yu
- Department of Biological Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA.
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Lim J, Huang D, Tang T, Cai Q, Tan D, Laurensia Y, Chia B, Rou-Jun P, Pang W, Cheah D, Ng C, Hong H, Tan J, Feng L, Chen J, Han B, Guo Y, Goh Y, Rötzschke O, Cheng C, Au-Yeung R, Chan T, Ng S, Kwong Y, Hwang W, Chng W, Tousseyn T, Tan P, Teh B, Khor C, Rozen S, Bei J, Lin T, Lim S, Ong C. WHOLE-GENOME SEQUENCING REVEALS IMMUNOTHERAPEUTIC OPTIONS FOR NATURAL-KILLER/T CELL LYMPHOMA PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.19_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ng C, Dellschaft N, Marciani L, Hoad C, Gowland P, Major G, Smyth A. WS17-6 Gut imaging for function and transit in cystic fibrosis: can we use MRI as a measure of gut problems in people with cystic fibrosis? J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30222-x] [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: 11/29/2022]
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Andre F, Filleron T, Ng C, Bertucci F, Letourneau C, Jacquet A, Piscuoglio S, Jimenez M, Bachelot T. Abstract GS1-08: Genomic characterisation of metastatic breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs1-08] [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
Rationale: while large efforts have been done to characterize early breast cancer, little is known about the genomic landscape of metastatic breast cancer. In the present study, we performed whole exome sequencing of 800 metastatic breast cancers, in order to identify new candidate targets and better stratify patients eligible for innovative therapies.
Patients and Methods: Patients were selected to present a metastatic breast cancer and to have received a biopsy in the context of precision medicine trials (SAFIR01, SAFIR02, PERMED, MOSCATO, SHIVA). Samples with >30% cancer cells, and normal DNA, were sequenced using Hiseq and Novaseq. Drivers were identified using MutSigCV. Actionability of somatic genetic alterations was determined based on OncoKB. Decomposition of mutational signatures was performed using deconstructSigs. Prognostic value was assessed using a cox model. TCGA database was used as comparator to identify gene alterations enriched in metastatic samples.
Results: results presented in the current abstract are based on the first 629 patients analyzed.Sequencing was performed in 387 patients with HR+/Her2- breast cancer, 186 triple negative breast cancers, and 32 Her2-overexpressing breast cancers. only 9 patients received a pretreatment with a CDK4 inhibitor. 24 driver genes were significantly mutated. In patients with HR+/Her2- breast cancer, 11 genes were found more frequently mutated in the metastatic setting as compared to early stage breast cancer. This includes TP53 (29%), KMT2C (13%), NCOR1 (8%), NF1 (7%), RB1 (4%), C16orf3 (2%), FRG1 (6%), ESR1 (21%), RIC8A (4%), AKT1 (7%), PLSCR5 (2%). In addition, in the whole population, KRAS was found mutated in 3% of samples (G12A/C/R/V) while its frequency of mutation in early breast cancer is <1%. No gene alteration was found enriched in metastatic Her2+++ and TNBC. Copy number alterations were compared between metastatic and early breast cancer. 18 amplicons were found more frequently in HR+/Her2- metastatic breast cancers as compared to eBC. Among the genes enriched in metastatic samples, mutations in RB1 or NF1 were associated with a poor outcome ( median OS 9 and 13 months respectively, p=0.0038 and 0.01 respectively). 73% of patients presenting HR+/Her2- mBC had an actionable alteration, as compared to 55% of patients presenting HR+/Her2- eBC (p<0.01). Patients with HR+/Her2- mBC presented an enrichment of gene alterations in the MAPK/ERK pathway (37% vs 22%) and in the HRD pathway (22% vs 10%). When the analysis focuses on mTNBC; the proportion of patient presenting an actionable alteration was comparable to the eTNBC. 11 (6%) and 16 (9%) patients presented a somatic mutation or homozygous gene deletion on BRCA1 and PTEN respectively.
We further assessed the mutational signatures in order to better understand which mutational processes could drive cancer progression. Metastatic HR+/Her2- mBC presented an increase in APOBEC, S3 (HRD), S10 (POLE-associated signature), S17 signatures as compared to early HR+/Her2- BC.
Conclusion: the present study, based on 629 patients, identifies 11 driver gene alterations and four mutational processes enriched in HR+/Her2- metastatic breast cancers. Final results on 800 patients will be presented.
Citation Format: Andre F, Filleron T, Ng C, Bertucci F, Letourneau C, Jacquet A, Piscuoglio S, Jimenez M, Bachelot T. Genomic characterisation of metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS1-08.
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Affiliation(s)
- F Andre
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - T Filleron
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - C Ng
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - F Bertucci
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - C Letourneau
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - A Jacquet
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - S Piscuoglio
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - M Jimenez
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
| | - T Bachelot
- Institut Gustave Roussy, Villejuif, France; Centre Claudius Regaut, Toulouse, France; University of Basel, Basel, Switzerland; Institut Curie, Paris, France; Institut Paoli Calmette, Marseille, France; UNICANCER, Paris, France; Centre Leon Berard, Lyon, France
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Chen H, Bhat A, Makarious D, Ng C, Khanna S, Gan G, Tan T. Characterisation of Right Heart Function in Patients with Non-Ischaemic Cardiomyopathy. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.251] [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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49
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Mak LY, Lau CW, Hui YT, Ng C, Shan E, Li MK, Lau JY, Chiu PW, Leong HT, Ho J, Wu JC, Lee CK, Leung WK. Joint recommendations on management of anaemia in patients with gastrointestinal bleeding in Hong Kong. Hong Kong Med J 2018; 24:416-422. [PMID: 30100584 DOI: 10.12809/hkmj187348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The demand for blood products continues to grow in an unsustainable manner in Hong Kong. While anaemia associated with gastrointestinal bleeding (GIB) is the leading indication for transfusion, there is no local recommendation regarding best practices for transfusion. We aimed to provide evidence-based recommendations regarding management of anaemia in patients with acute and chronic GIB. We reviewed all original papers, meta-analyses, systematic reviews, or guidelines that were available in PubMed. For acute GIB, a restrictive transfusion strategy, targeting a haemoglobin threshold of 7 to 8 g/dL, should be adopted because overtransfusion is associated with significantly higher all-cause mortality and re-bleeding. A liberal transfusion strategy should only be considered in patients with co-existing symptomatic coronary artery disease, targeting a haemoglobin threshold of 9 to 10 g/dL. When acute GIB settles, patients should be prescribed iron supplements if iron deficiency is present. For chronic GIB, iron stores should be replenished aggressively via iron supplementation before consideration of blood transfusion, except in patients with symptoms of severe anaemia. Oral iron replacement is the preferred first-line therapy, while intravenous iron is indicated for patients with inflammatory bowel disease, poor response or poor tolerability to oral iron, and in whom a rapid correction of iron deficit is preferred. Intravenous iron is underutilised and the risk of anaphylactic reaction to current preparations is extremely low. These recommendations are provided to local clinicians to facilitate judicious and appropriate use of red cell products and iron replacement therapy in patients with GIB.
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Affiliation(s)
- L Y Mak
- Hong Kong Society of Gastroenterology.,Hong Kong IBD Society
| | - C W Lau
- Hong Kong Red Cross Blood Transfusion Service
| | | | | | | | | | - J Yw Lau
- Hong Kong Society of Digestive Endoscopy
| | - P Wy Chiu
- Hong Kong Society of Digestive Endoscopy
| | - H T Leong
- Hong Kong Society of Digestive Endoscopy
| | - J Ho
- Hong Kong Society of Gastroenterology
| | - J Cy Wu
- Hong Kong Society of Gastroenterology
| | - C K Lee
- Hong Kong Red Cross Blood Transfusion Service
| | - W K Leung
- Hong Kong Society of Gastroenterology.,Hong Kong IBD Society
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Ng C, Cai X, Wong G. HELP-SEEKING DIFFICULTY AND BURDEN IN DEMENTIA CAREGIVERS UPON REACHING AN EARLY DETECTION SERVICE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Ng
- The University of Hong Kong
| | - X Cai
- The University of Hong Kong
| | - G Wong
- The University of Hong Kong
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