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Dent MP, Vaillancourt E, Thomas RS, Carmichael PL, Ouedraogo G, Kojima H, Barroso J, Ansell J, Barton-Maclaren TS, Bennekou SH, Boekelheide K, Ezendam J, Field J, Fitzpatrick S, Hatao M, Kreiling R, Lorencini M, Mahony C, Montemayor B, Mazaro-Costa R, Oliveira J, Rogiers V, Smegal D, Taalman R, Tokura Y, Verma R, Willett C, Yang C. Paving the way for application of next generation risk assessment to safety decision-making for cosmetic ingredients. Regul Toxicol Pharmacol 2021; 125:105026. [PMID: 34389358 PMCID: PMC8547713 DOI: 10.1016/j.yrtph.2021.105026] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/22/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
Next generation risk assessment (NGRA) is an exposure-led, hypothesis-driven approach that has the potential to support animal-free safety decision-making. However, significant effort is needed to develop and test the in vitro and in silico (computational) approaches that underpin NGRA to enable confident application in a regulatory context. A workshop was held in Montreal in 2019 to discuss where effort needs to be focussed and to agree on the steps needed to ensure safety decisions made on cosmetic ingredients are robust and protective. Workshop participants explored whether NGRA for cosmetic ingredients can be protective of human health, and reviewed examples of NGRA for cosmetic ingredients. From the limited examples available, it is clear that NGRA is still in its infancy, and further case studies are needed to determine whether safety decisions are sufficiently protective and not overly conservative. Seven areas were identified to help progress application of NGRA, including further investments in case studies that elaborate on scenarios frequently encountered by industry and regulators, including those where a ‘high risk’ conclusion would be expected. These will provide confidence that the tools and approaches can reliably discern differing levels of risk. Furthermore, frameworks to guide performance and reporting should be developed.
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Affiliation(s)
- M P Dent
- Unilever Safety and Environmental Assurance Centre, Sharnbrook, Bedfordshire, MK44 1LQ, UK.
| | - E Vaillancourt
- Health Canada, Healthy Environments and Consumer Safety Branch, 269 Laurier Ave. W., Ottawa, ON K1A 0K9, Canada.
| | - R S Thomas
- Center for Computational Toxicology and Exposure, U.S. Environmental Protection Agency, Research, Triangle Park, NC, 27711, USA.
| | - P L Carmichael
- Unilever Safety and Environmental Assurance Centre, Sharnbrook, Bedfordshire, MK44 1LQ, UK.
| | - G Ouedraogo
- l'Oréal, Research and Development, Paris, France.
| | - H Kojima
- National Institute of Health Sciences, 1-18-1 Kamiyoga, Setagaya-ku, 158-8501, Tokyo, Japan.
| | - J Barroso
- European Commission, Joint Research Centre (JRC), Ispra, VA, Italy.
| | - J Ansell
- US Personal Care Products Council (PCPC), 1620 L St. NW, Suite 1200, Washington, D.C, 20036, USA.
| | - T S Barton-Maclaren
- Health Canada, Healthy Environments and Consumer Safety Branch, 269 Laurier Ave. W., Ottawa, ON K1A 0K9, Canada.
| | - S H Bennekou
- National Food Institute, Technical University of Denmark (DTU), Copenhagen, Denmark.
| | - K Boekelheide
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA.
| | - J Ezendam
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - J Field
- Health Canada, Healthy Environments and Consumer Safety Branch, 269 Laurier Ave. W., Ottawa, ON K1A 0K9, Canada.
| | - S Fitzpatrick
- US Food and Drug Administration (US FDA), Center for Food Safety and Applied Nutrition (CFSAN), 5001 Campus Drive, College Park, MD, 20740, USA.
| | - M Hatao
- Japan Cosmetic Industry Association (JCIA), Metro City Kamiyacho 6F, 5-1-5, Toranomon, Minato-ku, Tokyo, 105-0001 Japan.
| | - R Kreiling
- Clariant Produkte (Deutschland) GmbH, Am Unisyspark 1, 65843, Sulzbach, Germany.
| | - M Lorencini
- Grupo Boticário, Research & Development, São José dos Pinhais, Brazil.
| | - C Mahony
- Procter & Gamble Technical Centres Ltd, Reading, RG2 0RX, UK.
| | - B Montemayor
- Cosmetics Alliance Canada, 420 Britannia Road East Suite 102, Mississauga, ON L4Z 3L5, Canada.
| | - R Mazaro-Costa
- Departament of Pharmacology, Universidade Federal de Goiás, Goiânia, GO, 74.690-900, Brazil.
| | - J Oliveira
- Brazilian Health Regulatory Agency (ANVISA), Gerência de Produtos de Higiene, Perfumes, Cosméticos e Saneantes, Setor de Indústria e Abastecimento (SIA), Trecho 5, Área Especial 57, CEP 71205-050, Brasília, DF, Brazil.
| | - V Rogiers
- Vrije Universiteit Brussel, Brussels, Belgium.
| | - D Smegal
- US Food and Drug Administration (US FDA), Center for Food Safety and Applied Nutrition (CFSAN), 5001 Campus Drive, College Park, MD, 20740, USA.
| | - R Taalman
- Cosmetics Europe, Avenue Herrmann-Debroux 40, 1160 Auderghem, Belgium.
| | - Y Tokura
- Allergic Disease Research Center, Chutoen General Medical Center, Kakegawa, Japan.
| | - R Verma
- US Food and Drug Administration (US FDA), Center for Food Safety and Applied Nutrition (CFSAN), 5001 Campus Drive, College Park, MD, 20740, USA.
| | - C Willett
- Humane Society International, Washington, DC, USA.
| | - C Yang
- Taiwan Cosmetic Industry Association (TWCIA), 8F No. 136, Bo'ai Rd., Zhongzheng Dist., Taipei City, 100, Taiwan, ROC.
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Wittwehr C, Amorim MJ, Clerbaux LA, Krebs C, Landesmann B, Macmillan DS, Nymark P, Ram R, Garcia-Reyero N, Sachana M, Sullivan K, Sund J, Willett C. Understanding COVID-19 through adverse outcome pathways - 2nd CIAO AOP Design Workshop. ALTEX 2021; 38:351-357. [PMID: 33677612 DOI: 10.14573/altex.2102221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022]
Abstract
The CIAO project (Modelling the Pathogenesis of COVID-19 using the Adverse Outcome Pathway framework) aims at a holistic assembly of knowledge to deliver a truly transdisciplinary description of the entire COVID-19 physiopathology starting with the initial contact with the SARS-CoV-2 virus and ending with one or several adverse outcomes, e.g., respiratory failure. On 27-28 January 2021, a group of 50+ scientists from numerous organizations around the world met in the 2nd CIAO AOP Design Workshop to discuss the depiction of the COVID-19 disease process as a series of key events (KEs) in a network of AOPs. During the workshop, 74 such KEs forming 13 AOPs were identified, covering COVID-19 manifestations that affect the respiratory, neurological, liver, cardiovascular, kidney and gastrointestinal systems. Modulating factors influencing the course and severity of the disease were also addressed, as was a possible extension of the investigations beyond purely biological phenomena. The workshop ended with the creation of seven working groups, which will further elaborate on the AOPs to be presented and discussed in the 3rd CIAO workshop on 28-29 April 2021.
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Affiliation(s)
| | - Maria João Amorim
- Instituto Gulbenkian de Ciência - Fundação Calouste Gulbenkian, Lisbon, Portugal
| | | | - Catharine Krebs
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | | | | | - Penny Nymark
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Rebecca Ram
- Safer Medicines Trust, Kingsbridge, United Kingdom
| | | | - Magdalini Sachana
- Organisation for Economic Co-operation and Development (OECD), Paris, France
| | - Kristie Sullivan
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Jukka Sund
- European Commission, Joint Research Centre, Ispra, Italy
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Higgins K, Wu Q, Perez B, Czito B, Palta M, Willett C, Das S. TH-E-BRF-10: Interim Esophageal Cancer Response Assessment Via 18FDG-PET Scanning During Radiation Therapy. Med Phys 2014. [DOI: 10.1118/1.4889674] [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: 11/07/2022] Open
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Zhao F, Bowsher J, Palta M, Czito B, Willett C, Yin F. SU-D-9A-02: Relative Effects of Threshold Choice and Spatial Resolution Modeling On SUV and Volume Quantification in F18-FDG PET Imaging of Anal Cancer Patients. Med Phys 2014. [DOI: 10.1118/1.4887918] [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: 11/07/2022] Open
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Li H, Bowsher J, Jiang Y, Pang T, Wu Q, Yan S, Czito B, Willett C, Yin F. Effects of PET Reconstruction Parameters on Region-of-Interest Contouring by SUV Threshold. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Czito B, Willett C, Palta M, Kennedy-Newton P, Uronis H. A Phase I/II Study of Capecitabine (Cape), Oxaliplatin (Ox), Panitumumab (Pmab), and External Beam Radiation Therapy (RT) for Patients With Esophagogastric Carcinoma (EC). Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.321] [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: 10/27/2022]
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Wu Q, McMahon R, Hood R, Willett C, Czito B. SU-E-T-419: Clinical Protocol for the Use of Scrotal Shields in IMRT Treatment of Anal Cancer. Med Phys 2011. [DOI: 10.1118/1.3612373] [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: 11/07/2022] Open
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Czito BG, Willett C, Kennedy-Newton P, Tyler DS, Hurwitz H, Uronis HE. A phase I study of erlotinib, bevacizumab, and external beam radiation therapy (RT) for patients with localized pancreatic carcinoma (PC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
281 Background: Localized PC is commonly managed with chemoradiotherapy, with or without surgical resection. The optimal combination of agents and doses is the subject of continued investigation. This phase I study examines the combination of two targeted radiosensitizing agents in combination with radiation therapy. Methods: Eligible patients had resectable, borderline resectable or locally advanced adenocarcinoma. Patients received RT (1.8 Gy qd to 50.4 Gy) concurrent with bevacizumab and erlotinib. Dose-level 1 was bevacizumab 10 mg/kg weeks 1, 3 and 5 and erlotinib 100 mg daily, RT days only. Drug doses were escalated depending on encountered toxicity. The primary endpoint was determination of the maximally tolerated dose of this combination. Secondary endpoints included toxicity and activity assessment. Results: Nine patients were enrolled in the phase I study. Maximal EUS/CT stage was T2N0 (n=1), T3N0 (n=1), T3N1 (n=2) or T4N0 (n=5). Of 3 patients in dose-level 1, two had radiographic stable disease (SD) and one partial response (PR). One pt underwent exploratory laparotomy and found to be unresectable, experiencing prolonged postoperative incisional healing. Three patients were then enrolled at dose-level 2 (bevacizumab 10 mg/kg, erlotinib 125 mg). Two had SD and one progressive disease (PD). One pt underwent exploratory laparotomy, aborted due to previously undetected hepatic metastases. Three patients were then enrolled at dose-level 3 (bevacizumab 10 mg/kg, erlotinib 150 mg). One pt had SD and two PR. One pt underwent distal pancreatectomy, experiencing postoperative pancreatic leak and abscess formation. All patients with elevated CA 19-9 at baseline had a decrease, with amedian decrease of 69% (R:13-93%). Dose-limiting toxicity (DLT) was not encountered at any dose-level. Primary non-dose limiting toxicities in all cohorts included NCI CTCAE v3.0 grade 1-2 nausea/vomiting, rash, diarrhea, fatigue, and anorexia. Conclusions: Concurrent chemoradiotherapy utilizing erlotinib and bevacizumab is reasonably well-tolerated. The recommended phase II dose is bevacizumab 10 mg/kg weeks 1, 3, and 5 and erlotinib 150 mg RT days only. Phase II accrual is underway. [Table: see text]
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Affiliation(s)
| | - C. Willett
- Duke University Medical Center, Durham, NC
| | | | | | - H. Hurwitz
- Duke University Medical Center, Durham, NC
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Kirkpatrick J, Yoo S, Light K, Antoine P, Walker R, Clough R, Robbins M, Cozart H, Tabor J, Willett C. Implementing a Clinically Driven Electronic Medical Record for Radiation Oncology in a Major Medical Center. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1154] [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: 11/28/2022]
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Palta M, Willett C, Patel P, Uronis H, Tyler D, Czito B. Carcinoma of the Ampulla of Vater: Patterns of Failure after Resection and Possible Benefit of Adjuvant Radiotherapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Czito B, Willett C, Hurwitz H, Kennedy-Newton P, Uronis H. A Phase I Study of Capecitabine, Oxaliplatin, Panitumumab, and External Beam Radiation Therapy (RT) for Patients with Esophagogastric Carcinoma (EC). Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.151] [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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Ben-Josef E, Moughan J, Ajani J, Flam M, Gunderson L, Pollock J, Myerson R, Anne R, Rosenthal S, Willett C. The Impact of Overall Treatment Time on Survival and Local Control in Anal Cancer Patients: A Pooled Data Analysis of RTOG Trials 8704 and 9811. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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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Wang Z, Kirkpatrick J, Wu Q, Chang Z, Willett C, Yin F. SU-FF-T-548: Comparison of Cone-Beam CT and Frame-Based Localizations for Stereotactic Radiosurgery with Fixed Head Rings and Removable Frames. Med Phys 2009. [DOI: 10.1118/1.3182046] [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: 11/07/2022] Open
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Wang Z, Kirkpatrick J, Chang Z, O'Daniel J, Willett C, Yin F. SU-FF-T-545: Feasibility Study for Treatment of Intracranial Multi-Focal Stereotactic Radiosurgery with Multiple Intensity Modulated Arc Technique. Med Phys 2009. [DOI: 10.1118/1.3182043] [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: 11/07/2022] Open
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Yan H, Zhou S, Das S, Yin F, Willett C. Preliminary Clinical Application of Adaptive Artificial Intelligence Technique to Inverse Treatment Planning. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.367] [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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Czito B, Clough R, Pappas T, Tyler D, White R, Hurwitz H, Morse M, Uronis H, Clary B, Willett C. Carcinoma of the Ampulla of Vater: Patterns of Failure after Resection and Possible Benefit of Adjuvant Radiotherapy. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1730] [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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Czito B, Bendell J, Willett C, Kelsey C, Morse M, D'Amico T, Hurwitz H. A Phase I Study of UFT/Leucovorin (LV), Carboplatin and Paclitaxel With External Beam Radiation Therapy (EBRT) for Patients With Esophageal Cancer (EC). Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1328] [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: 10/22/2022]
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Swisher S, Winters K, Komaki R, Ajani J, Wu T, Hofstetter W, Konski A, Willett C. A Phase II Study of a Paclitaxel Based Chemoradiation Regimen With Selective Surgical Salvage for Resectable Locoregionally Advanced Esophageal Cancer: Initial Reporting of RTOG 0246. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Willett C, Duda D, Boucher Y, di Tomaso E, Clark J, Blaszkowsky L, Czito B, Bendell J, Jain R. Phase I/II study of neoadjuvant bevacizumab with radiation therapy and 5-fluorouracil in patients with rectal cancer: initial results. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4041 Background: A phase I/II study of neoadjuvant bevacizumab with 5-fluorouracil and radiation therapy in patients with locally advanced rectal cancer was undertaken to determine whether inhibition of VEGF is safe and has clinical benefits by enhancing chemo- radiation therapy. Methods: 22 patients with endoscopic ultrasound or surface coil MRI staged T3/T4 non-metastatic rectal cancer were enrolled from 2001–2006. All patients completed 4 cycles of neoadjuvant therapy including: 1) bevacizumab infusion (5 or 10 mg/kg) on day 1 of each cycle; 2) peripheral venous infusion 5-FU (225 mg/m2/24 hours) administration each treatment week of cycles 2 - 4; 3) external beam irradiation delivery (50.4 Gy in 28 fractions over 5.5 weeks); and 4) surgery 7 to 9 weeks after completion of all neoadjuvant therapy. Correlative studies were undertaken before and during the trial. We collected serial tumor biopsies, PET-FDG scans, and analyzed blood and urine for potential biomarkers. Results: Mean pre-therapy tumor size was 4.7 cm (2–9 cm). Post-treatment surgical specimens usually had well-demarcated shallow ulcerations with a mean diameter of 2.4 cm (0.7–6 cm). In response to the neoadjuvant regimen, all patients had significantly (p<0.01) decreased FDG-uptake by PET. Histologic examination showed no residual primary cancer in 5 patients (ypT0). Of 17 patients with residual disease, microscopic disease usually occurred as malignant glands embedded in fibrosis (ypT1 in 3 patients, ypT2 in 4 patients, ypT3 in 10 patients). Downstaging was seen in 12/22 tumors. 8 patients had microscopic nodal metastases. Bevacizumab alone and combined treatment were both associated with increased plasma VEGF and PlGF levels in 18/18 patients (P<0.01 at all 4 timepoints compared to baseline). Viable CECs were decreased by VEGF blockade at day 3 (P<0.01 compared to baseline), and peak CEC levels during treatment was correlated with histologic tumor response (2.77 [1.18–3.18] for T3 patients, n=9 versus 1.14 [0.82–1.53] for T0-T2 patients, n=12; p=0.05). Conclusions: Addition of bevacizumab at a dose of 5 mg/kg to standard chemo-radiation is safe in patients with locally advanced rectal cancer. Bevacizumab is active and the combined regimen yields promising results. [Table: see text]
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Affiliation(s)
- C. Willett
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - D. Duda
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - Y. Boucher
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - E. di Tomaso
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - J. Clark
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - L. Blaszkowsky
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - B. Czito
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - J. Bendell
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - R. Jain
- Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
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Wang Z, Nelson J, Yoo S, Wu QJ, Kirkpatrick J, Larrier N, Meyer J, Willett C, Yin F. SU-FF-T-252: Improvement of Localization Accuracy by Using 3D Cone Beam CT for Stereotactic Body Radiation Therapy of Liver, Lung and Spine Lesions. Med Phys 2007. [DOI: 10.1118/1.2760913] [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: 11/07/2022] Open
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Wang Z, Yin F, Czito B, Wu QJ, Zhou S, Willett C. TH-E-M100F-07: Amplitude Gated Breath-Hold Treatment for Upper Abdominal Lesions with On Board Imaging Guidance. Med Phys 2007. [DOI: 10.1118/1.2761753] [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: 11/07/2022] Open
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Willett C. MO-D-M100F-03: Latest Clinical Development for GI. Med Phys 2007. [DOI: 10.1118/1.2761227] [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: 11/07/2022] Open
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Bowsher J, Yin F, Chawla A, Greer K, Song H, Samei E, Willett C. TH-D-M100F-01: An Evaluation of Noise in Radiotracer Emission Imaging Using Flat-Panel Detectors. Med Phys 2007. [DOI: 10.1118/1.2761701] [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: 11/07/2022] Open
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Komaki R, Winter K, Ajani A, Kelsen D, Minsky B, Liao Z, Bradley J, Fromm M, Hornback D, Willett C. 142. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.173] [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]
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Wang Z, Yin F, Yoo S, Wu Q, Willett C, Marks L. SU-EE-A1-04: Verifying Internal Target Volume Using Cone-Beam CT for Stereotactic Body Radiotherapy Treatment. Med Phys 2006. [DOI: 10.1118/1.2240160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wang Z, Yin F, Marks L, Wu Q, Yoo S, Willett C. SU-FF-J-86: Intra- and Inter-Breath-Hold Position Variations for OBI Guided Amplitude Gating Treatment with Breath Hold. Med Phys 2006. [DOI: 10.1118/1.2240863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yin F, Marks L, Wang Z, Kirkpatrick J, Wu J, Yoo S, Larrier N, Meyer J, Willett C. SU-FF-T-66: A Technique for Cone-Beam CT-Guided Stereotactic Body Radiation Therapy. Med Phys 2006. [DOI: 10.1118/1.2240992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Godfrey D, Yin F, Wang Z, Yoo S, Oldham M, Willett C. TH-C-ValB-05: Rapid Low-Dose 3D Image-Guided Treatment Verification of Sites Prone to Respiratory Motion Using Breath-Hold On-Board Digital Tomosynthesis (DTS). Med Phys 2006. [DOI: 10.1118/1.2241856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Czito B, Bendell J, Willett C, Vaccaro G, Morse M, Yu D, Honeycutt W, Franklin A, Hurwitz H. Preliminary results of a phase I study of external beam radiation therapy (EBRT), oxaliplatin (OX), bevacizumab (BV), and capecitabine (CAP) for locally advanced or metastatic adenocarcinoma of the rectum. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3543 Background: BV, a monoclonal antibody against vascular endothelial growth factor, increases survival when added to first and second line chemotherapy for metastatic colorectal cancer. Preclinical studies suggest BV may enhance tumoral radiation sensitivity. Preliminary studies of OX and 5-FU based chemoradiation therapy for rectal cancer have suggested improved pathologic CR rates compared to 5-FU/ radiation alone. CAP allows fluoropyrimidine treatment without the inconvenience of an infusion pump. We investigated CAP + BV + OX + EBRT for pts with rectal cancer to evaluate for the MTD and preliminary efficacy results. Methods: Pts with adenocarcinoma of the rectum and no prior pelvic irradiation received 5040 cGy EBRT (180 cGy/fx), CAP (625–825 mg/m2 PO BID on EBRT days), BEV (15 mg/kg d1 and 10 mg/kg d8 and d22), and OX (50–75 mg/m2/week during radiation, weeks 1–5) in dose-escalating fashion. DLT was defined as any grade 3 heme tox ≥ 7d, grade 4 heme tox, grade 4 non-heme tox during chemoradiation, or inability to deliver >85% of planned treatment. Pts eligible for surgical resection could have surgery 6–8 wks after treatment completion. After recovery from surgery, patients could be treated with CAP, BV, and OX. Results: 11 patients (5 men/6 women) have been enrolled. All have completed chemoradiation and resection. At dose level 1 (CAP 625 mg/m2 BID, OX 50mg/m2) there were no DLT’s in 3 pts. 1/3 pts had G3 subarachnoid hemorrhage during adjuvant chemotherapy. At dose level 2 (CAP 825 mg/m2, OX 50 mg/m2) 2/2 pts had DLT (1 G4 diarrhea; 1 G2 rectal pain, causing treatment hold for study-defined DLT). 6 more pts were treated at dose level 1. 1pt had DLT of G3 diarrhea. G2 toxicities included diarrhea (3/11), fatigue (2/11), skin changes (2/11), and pain (2/11). 9/11 patients were downstaged. 2/11 patients had pCR at surgery and 2/11 microscopic disease only. Conclusions: CAP + BEV + OX + EBRT is a well-tolerated, active regimen for the treatment of rectal cancer. MTD was determined to be CAP 625 mg/m2 BID + BEV 15 mg/kg d1 + 10 mg/kg d 8 and 22 + OX 50 mg/m2/week. Further study of efficacy at the MTD is warranted. [Table: see text]
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Affiliation(s)
- B. Czito
- Duke University Medical Center, Durham, NC
| | - J. Bendell
- Duke University Medical Center, Durham, NC
| | - C. Willett
- Duke University Medical Center, Durham, NC
| | - G. Vaccaro
- Duke University Medical Center, Durham, NC
| | - M. Morse
- Duke University Medical Center, Durham, NC
| | - D. Yu
- Duke University Medical Center, Durham, NC
| | | | | | - H. Hurwitz
- Duke University Medical Center, Durham, NC
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Ajani JA, Winter KA, Gunderson LL, Pedersen J, Benson AB, Thomas C, Mayer RJ, Haddock MG, Willett C, Willett C, Rich TA. Intergroup RTOG 98–11: A phase III randomized study of 5-fluorouracil (5-FU), mitomycin, and radiotherapy versus 5-fluorouracil, cisplatin and radiotherapy in carcinoma of the anal canal. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4009] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4009 Background: An ∼65% 5-year disease-free-survival (DFS) rate from 5-FU/mitomycin/radiation for anal carcinoma needs improvement. Methods: A phase III randomized trial compared 5-FU (1,000mg/m2 days 1–4 and 29–32) plus mitomycin (10mg/m2 days 1 and 29) and radiation (45 to 59 Gy) (Arm A) to 5-FU (1,000mg/m2 days 1–4, 29–32, 57–60 and 85–88) plus cisplatin (75mg/m2 on days 1, 29, 57 and 85) and radiation (45 to 59 Gy; start day=57) (Arm B) in anal carcinoma patients. Stratification included gender, clinical N status and tumor diameter. Primary endpoint was DFS. Statistical power was 80% with two-sided test to detect 10% DFS increase for Arm B. Results: Of 682 patients accrued, 598 were analyzable. Most unanalyzed patients’ data are early. Patient characteristics were balanced. Median age was 55 years, women predominated (69%), 27.5% had >5 cm tumor diameter and 26% had clinically N+ cancer. Preliminary 5-year estimated DFS was 56% for Arm A and 48% for Arm B (p=0.28) and 5-year estimated overall survival was 69% for both arms (p=0.24). Men(p=0.04), clinically N+ cancer (p<0.0001) and tumor diameter >5 cm (p=0.005) independently prognosticated DFS in a multivariate analysis. 5-year colostomy rate was 10% for Arm A and 20% for arm B(p=0.12). Grade 3/4 toxicity rates: non-hematologic=76% for Arm A and 75% for Arm B but hematologic=67% for Arm A and 47% for Arm B(p=0.0004). Conclusions: In Intergroup-98–11, induction 5-FU/cisplatin followed by 5-FU/cisplatin/radiation failed to improve DFS compared to the standard treatment, 5-FU/mitomycin/radiation. Supported by RTOG U10 CA21661, CCOP U10 CA37422, Stat U10 CA32115. No significant financial relationships to disclose.
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Affiliation(s)
- J. A. Ajani
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - K. A. Winter
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - L. L. Gunderson
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - J. Pedersen
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - A. B. Benson
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - C. Thomas
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - R. J. Mayer
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - M. G. Haddock
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - C. Willett
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - C. Willett
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
| | - T. A. Rich
- M. D. Anderson Cancer Center, Houston, TX; Radiation Therapy Oncology Group, Philadelphia, PA; Mayo Clinic Scottsdale, Scottsdale, AZ; University of Alberta, Edmonton, AB, Canada; Northwestern University, Chicago, IL; OHSU, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; Mayo Clinic, Rochester, MN; Duke University Medical Center, Durham, NC; University of Virginia Medical Center, Charlottesville, VA
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Bowsher J, Yin F, Greer K, Jaszczak R, Samei E, Willett C. TU-FF-A3-02: Preliminary Investigations Into Combined CT/SPECT Imaging Onboard Therapy Machines. Med Phys 2006. [DOI: 10.1118/1.2241651] [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: 11/07/2022] Open
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Wu Q, Yan H, Yin F, Yoo S, Das S, Willett C. SU-FF-J-16: A Tool for Off-Line Review of 3D Target Verification and Localization with Cone-Beam Computed Tomography. Med Phys 2006. [DOI: 10.1118/1.2240795] [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: 11/07/2022] Open
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Yan H, Yin F, Zhou S, Marks L, Willett C. SU-FF-J-96: Modeling Correlation Between External Surface Motion and Internal Organ Motion Based On 4DCT. Med Phys 2006. [DOI: 10.1118/1.2240872] [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: 11/07/2022] Open
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Czito B, Bendell J, Willett C, Morse M, Tyler D, Fernando N, Mantyh C, Blobe G, Honeycutt W, Yu D, Ludwig K, Hurwitz H. 159 Preliminary results of a phase I study of external beam radiation therapy (EBRT), oxaliplatin (OX), bevacizumab (BV), and capecitabine (CAP) for locally advanced or metastatic adenocarcinoma of the rectum. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80638-9] [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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Czito B, Willett C, Bendell J, Morse M, Dyler D, Fernando N, Mantyh C, Blobe G, Honeycutt W, Yu D, Clary B, Pappas T, Ludwig K, Hurwitz H. 158 Increased toxicity with gefitinib, capecitabine and radiation in pancreatic and rectal cancer: phase I trial results. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80637-7] [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: 11/26/2022]
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Czito B, Clough R, Pappas T, Tyler D, White R, Hurwitz H, Morse M, Fernando N, Clary B, Willett C. Carcinoma of the Ampulla of Vater: Patterns of Failure After Resection and Possible Benefit of Adjuvant Radiotherapy. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Willett C, Wang Z, Marks L, Raidy T, Kelly K, Oldham M, Das S, Zhou S, Kasibhalta M, Yin F. Combining Cardiac/Respiratory Gating to Minimize the Organ Motion Effect. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schwartz GK, Winter K, Minsky B, Janjan N, Schaefer P, Thomson J, Rani A, Gross H, Willett C, Kelsen D. A randomized phase II trial comparing two paclitaxel (P)-cisplatin (C) containing chemoradiation (CRT) regimens as adjuvant therapy in resected gastric cancer (RTOG Intergroup #0114). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. K. Schwartz
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - K. Winter
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - B. Minsky
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - N. Janjan
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - P. Schaefer
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - J. Thomson
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - A. Rani
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - H. Gross
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - C. Willett
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
| | - D. Kelsen
- Memorial Sloan-Kettering Cancer Ctr, New York, NY; RTOG HQ, Philadelphia, PA; M.D. Anderson Cancer Ctr, Houston, TX; Natalie Warren Cancer Ctr, Tulsa, OK; LDS Hosp, Salt Lake City, UT; Thomas Jefferson Univ, Philadelphia, PA; Dayton CCOP, Dayton, OH; Duke Univ Comp Cancer Ctr, Durham, NC
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Wang Z, Yuan H, Willett C, Dewhirst M, Yin F. SU-EE-A4-04: Compartment Modeling Analysis of Cu-ATSM Dynamic PET Images. Med Phys 2005. [DOI: 10.1118/1.1997468] [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: 11/07/2022] Open
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Wang Z, Yin F, Raidy T, Kelly K, Oldham M, Das S, Zhou S, Marks L, Kasibhatla M, Willett C. SU-FF-J-30: Quantification of Normal Organ Motion Due to the Respiratory and Cardiac Cycles. Med Phys 2005. [DOI: 10.1118/1.1997576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mohiuddin M, Winter K, Mitchell E, Hanna N, Yuen A, Nichols C, Shane R, Hayostek C, Willett C. Results of RTOG-0012 randomized phase II study of neoadjuvant combined modality chemoradiation for distal rectal cancer. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.06.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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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Mitchell EP, Winter K, Mohiuddin M, Hanna N, Yuen A, Nichols C, Share R, Hayostek C, Willett C. Randomized phase II trial of preoperative combined modality chemoradiation for distal rectal cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E. P. Mitchell
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - K. Winter
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - M. Mohiuddin
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - N. Hanna
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - A. Yuen
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - C. Nichols
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - R. Share
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - C. Hayostek
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
| | - C. Willett
- Thomas Jefferson University, Philadelphia, PA; RTOG, Philadelphia, PA; University of Kentucky, Lexington, KY; Reading Hospital, Reading, PA; Mass. General Hospital, Boston, MA
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Abstract
BACKGROUND Schwannomatosis is a recently recognized disorder, defined as multiple pathologically proven schwannomas without vestibular tumors diagnostic of neurofibromatosis 2 (NF2). Some investigators have questioned whether schwannomatosis is merely an attenuated form of NF2. METHODS The authors identified eight families in which a proband met their diagnostic criteria for schwannomatosis. Archived and prospectively acquired tumor specimens were studied by mutational analysis at the NF2 locus, loss of heterozygosity analysis along chromosome 22, and fluorescent in situ hybridization analysis of NF2 and the more centromeric probe BCR. Linkage analysis could be performed in six of eight families. RESULTS Clinical characterization of these kindreds showed that no affected family member harbored a vestibular tumor. Molecular analysis of 28 tumor specimens from 17 affected individuals in these kindreds revealed a pattern of somatic NF2 inactivation incompatible with our current understanding of NF2 as an inherited tumor suppressor gene syndrome. Linkage analysis excluded the NF2 locus in two kindreds, and showed a maximum lod score of 6.60 near the more centromeric marker D22S1174. CONCLUSIONS Schwannomatosis shows clinical and molecular differences from NF2 and should be considered a third major form of neurofibromatosis. Further work is needed to identify the inherited genetic element responsible for familial schwannomatosis.
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Affiliation(s)
- M MacCollin
- Department of Neurology, Massachusetts General Hospital, Charlestown, USA.
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Willett C, Ajani J, Kelsen D, Sigurdson E, Abrams R, Berkey B, Benetz M, Crane C, Gaspar L, Goodyear MD, Gunderson L, Haddock M, Hoffmann J, Janjan N, John M, Kachnic L, Krieg R, Landry J, Meropol N, Minsky B, Mitchell E, Mohiuddin M, Moulder J, Myerson R, Noyes D, Pajak TF, Raben D, Regine W, Rich T, Robertson JM, Russell A, Skibber J, Kim P. Radiation Therapy Oncology Group. Research Plan 2002-2006. Gastrointestinal Cancer Committee. Int J Radiat Oncol Biol Phys 2002; 51:19-27. [PMID: 11641011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Compton CC, Fielding LP, Burgart LJ, Conley B, Cooper HS, Hamilton SR, Hammond ME, Henson DE, Hutter RV, Nagle RB, Nielsen ML, Sargent DJ, Taylor CR, Welton M, Willett C. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 2000. [PMID: 10888773 DOI: 10.1043/0003-9985(2000)124<0979:pficc>2.0.co;2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Under the auspices of the College of American Pathologists, the current state of knowledge regarding pathologic prognostic factors (factors linked to outcome) and predictive factors (factors predicting response to therapy) in colorectal carcinoma was evaluated. A multidisciplinary group of clinical (including the disciplines of medical oncology, surgical oncology, and radiation oncology), pathologic, and statistical experts in colorectal cancer reviewed all relevant medical literature and stratified the reported prognostic factors into categories that reflected the strength of the published evidence demonstrating their prognostic value. Accordingly, the following categories of prognostic factors were defined. Category I includes factors definitively proven to be of prognostic import based on evidence from multiple statistically robust published trials and generally used in patient management. Category IIA includes factors extensively studied biologically and/or clinically and repeatedly shown to have prognostic value for outcome and/or predictive value for therapy that is of sufficient import to be included in the pathology report but that remains to be validated in statistically robust studies. Category IIB includes factors shown to be promising in multiple studies but lacking sufficient data for inclusion in category I or IIA. Category III includes factors not yet sufficiently studied to determine their prognostic value. Category IV includes factors well studied and shown to have no prognostic significance. MATERIALS AND METHODS The medical literature was critically reviewed, and the analysis revealed specific points of variability in approach that prevented direct comparisons among published studies and compromised the quality of the collective data. Categories of variability recognized included the following: (1) methods of analysis, (2) interpretation of findings, (3) reporting of data, and (4) statistical evaluation. Additional points of variability within these categories were defined from the collective experience of the group. Reasons for the assignment of an individual prognostic factor to category I, II, III, or IV (categories defined by the level of scientific validation) were outlined with reference to the specific types of variability associated with the supportive data. For each factor and category of variability related to that factor, detailed recommendations for improvement were made. The recommendations were based on the following aims: (1) to increase the uniformity and completeness of pathologic evaluation of tumor specimens, (2) to enhance the quality of the data needed for definitive evaluation of the prognostic value of individual prognostic factors, and (3) ultimately, to improve patient care. RESULTS AND CONCLUSIONS Factors that were determined to merit inclusion in category I were as follows: the local extent of tumor assessed pathologically (the pT category of the TNM staging system of the American Joint Committee on Cancer and the Union Internationale Contre le Cancer [AJCC/UICC]); regional lymph node metastasis (the pN category of the TNM staging system); blood or lymphatic vessel invasion; residual tumor following surgery with curative intent (the R classification of the AJCC/UICC staging system), especially as it relates to positive surgical margins; and preoperative elevation of carcinoembryonic antigen elevation (a factor established by laboratory medicine methods rather than anatomic pathology). Factors in category IIA included the following: tumor grade, radial margin status (for resection specimens with nonperitonealized surfaces), and residual tumor in the resection specimen following neoadjuvant therapy (the ypTNM category of the TNM staging system of the AJCC/UICC). (ABSTRACT TRUNCATED)
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Compton CC, Fielding LP, Burgart LJ, Conley B, Cooper HS, Hamilton SR, Hammond ME, Henson DE, Hutter RV, Nagle RB, Nielsen ML, Sargent DJ, Taylor CR, Welton M, Willett C. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 2000; 124:979-94. [PMID: 10888773 DOI: 10.5858/2000-124-0979-pficc] [Citation(s) in RCA: 846] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Under the auspices of the College of American Pathologists, the current state of knowledge regarding pathologic prognostic factors (factors linked to outcome) and predictive factors (factors predicting response to therapy) in colorectal carcinoma was evaluated. A multidisciplinary group of clinical (including the disciplines of medical oncology, surgical oncology, and radiation oncology), pathologic, and statistical experts in colorectal cancer reviewed all relevant medical literature and stratified the reported prognostic factors into categories that reflected the strength of the published evidence demonstrating their prognostic value. Accordingly, the following categories of prognostic factors were defined. Category I includes factors definitively proven to be of prognostic import based on evidence from multiple statistically robust published trials and generally used in patient management. Category IIA includes factors extensively studied biologically and/or clinically and repeatedly shown to have prognostic value for outcome and/or predictive value for therapy that is of sufficient import to be included in the pathology report but that remains to be validated in statistically robust studies. Category IIB includes factors shown to be promising in multiple studies but lacking sufficient data for inclusion in category I or IIA. Category III includes factors not yet sufficiently studied to determine their prognostic value. Category IV includes factors well studied and shown to have no prognostic significance. MATERIALS AND METHODS The medical literature was critically reviewed, and the analysis revealed specific points of variability in approach that prevented direct comparisons among published studies and compromised the quality of the collective data. Categories of variability recognized included the following: (1) methods of analysis, (2) interpretation of findings, (3) reporting of data, and (4) statistical evaluation. Additional points of variability within these categories were defined from the collective experience of the group. Reasons for the assignment of an individual prognostic factor to category I, II, III, or IV (categories defined by the level of scientific validation) were outlined with reference to the specific types of variability associated with the supportive data. For each factor and category of variability related to that factor, detailed recommendations for improvement were made. The recommendations were based on the following aims: (1) to increase the uniformity and completeness of pathologic evaluation of tumor specimens, (2) to enhance the quality of the data needed for definitive evaluation of the prognostic value of individual prognostic factors, and (3) ultimately, to improve patient care. RESULTS AND CONCLUSIONS Factors that were determined to merit inclusion in category I were as follows: the local extent of tumor assessed pathologically (the pT category of the TNM staging system of the American Joint Committee on Cancer and the Union Internationale Contre le Cancer [AJCC/UICC]); regional lymph node metastasis (the pN category of the TNM staging system); blood or lymphatic vessel invasion; residual tumor following surgery with curative intent (the R classification of the AJCC/UICC staging system), especially as it relates to positive surgical margins; and preoperative elevation of carcinoembryonic antigen elevation (a factor established by laboratory medicine methods rather than anatomic pathology). Factors in category IIA included the following: tumor grade, radial margin status (for resection specimens with nonperitonealized surfaces), and residual tumor in the resection specimen following neoadjuvant therapy (the ypTNM category of the TNM staging system of the AJCC/UICC). (ABSTRACT TRUNCATED)
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Minsky BD, Coia L, Haller DG, Hoffman J, John M, Landry J, Pisansky TM, Willett C, Mahon I, Owen J, Berkey B, Katz A, Hanks G. Radiation therapy for rectosigmoid and rectal cancer: results of the 1992-1994 Patterns of Care process survey. J Clin Oncol 1998; 16:2542-7. [PMID: 9667276 DOI: 10.1200/jco.1998.16.7.2542] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the US national practice standards for patients with adenocarcinoma of the rectum treated in radiation oncology facilities. MATERIALS AND METHODS A national survey of 57 institutions identified 507 eligible patients who received radiation therapy as a component of their treatment for rectal cancer. A stratified two-stage cluster sampling with simple random sampling at each stage for each stratum was used and on-site surveys were performed. RESULTS Of the 507 patients, 378 (75%) received postoperative therapy, 110 (22%) received preoperative therapy, 17 (2%) received both preoperative and postoperative therapy, and less than 0.5% received intraoperative radiation alone. To more accurately assess the utilization of modern radiation techniques as well as recommendations of the National Cancer Institute (NCI)-sponsored, randomized, postoperative, adjuvant combined modality therapy rectal cancer trials into current practice, the analysis was limited to the 243 (48%) patients with tumor, node, and metastasis staging system classification T3 and/or N1-2M0 disease who underwent conventional surgery with negative margins. Although only 7% were treated on a clinical trial, 90% received chemotherapy for a median of 21 weeks. Most were treated with modern radiation treatment techniques. In contrast, techniques to identify and help exclude the small bowel from the radiation field were not routinely used. CONCLUSION Despite the fact that only 7% of patients with T3 and/or N1-2M0 disease were treated on a clinical trial, such trials appear to have resulted in a positive influence on the standard of practice within the oncology community. Although there are still some deficiencies, the majority of these patients received combined modality therapy and were treated with modern radiation therapy techniques.
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Affiliation(s)
- B D Minsky
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Minsky BD, Coia L, Haller D, Hoffman J, John M, Landry J, Pisansky TM, Willett C, Mahon I, Owen J, Hanks G. Treatment systems guidelines for primary rectal cancer from the 1996 Patterns of Care Study. Int J Radiat Oncol Biol Phys 1998; 41:21-7. [PMID: 9588913 DOI: 10.1016/s0360-3016(98)00027-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The Patterns of Care Rectal Cancer Committee was formed to develop consensus recommendations for patients with adenocarcinoma of the rectum limited to the pelvis. METHODS AND MATERIALS The Committee was composed of a multidisciplinary group of oncologists, and clinical scenarios were chosen to address most of the major treatment controversies in the combined modality treatment of rectal cancer. A literature search was then conducted and the major articles were identified. A modified Delphi technique was used to arrive at consensus. Serial surveys were conducted by distributing questionnaires to the Committee members to consolidate expert opinion. Voting was conducted using a scoring system and opinions were unified to the highest degree possible. RESULTS Consensus voting was performed for 4 clinical scenarios. Acceptability ratings for treatment were grouped into 3 broad categories: not acceptable, acceptable, and most acceptable. Based on the treatment options, a decision tree was developed that reflects the consensus of the committee. CONCLUSION These options may help guide treatment decisions in rectal cancer.
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Affiliation(s)
- B D Minsky
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA
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Willett C, Warland G, Coen J, Shellito P, Compton C. Rectal cancer: the influence of tumor proliferation on response to preoperative irradiation. Int J Radiat Oncol Biol Phys 1994. [DOI: 10.1016/0360-3016(94)90667-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: 10/20/2022]
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