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Tran A, Katz D. Variability of fibrinolytic activity in pregnant patients exposed to tissue plasminogen activator: an in vitro study utilizing rotational thromboelastometry. Int J Obstet Anesth 2024:103994. [PMID: 38632015 DOI: 10.1016/j.ijoa.2024.103994] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/05/2024] [Accepted: 03/13/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The investigation into the variability of fibrinolysis in obstetric patients is notably limited despite its relevance to postpartum hemorrhage. We investigate an in vitro model of fibrinolysis measured by rotational thromboelastrometry (ROTEM) in maternal blood samples with lysis stimulated by tissue plasminogen activator (tPA). METHODS Written informed consent was obtained from 19 patients at term pregnancy during admission to the labor and delivery unit. Patients who were taking medication affecting coagulation were excluded. Tissue plasminogen activator was added to whole blood samples to a final concentration of 100 or 220 ng/mL prior to ROTEM testing. RESULTS The addition of tPA produced high intra-individual fibrinolytic variability for clot firmness and lysis parameters. Patients responded differently to each tPA dose ranging from clot lysis within the range of 0 ng/mL tPA group to complete clot lysis. The coefficient of variation (CV) values for the 220 ng/mL tPA group were: EXTEM MCF 0.510, EXTEM LI30 1.601, FIBTEM MCF 0.349, FIBTEM LI30 2.097. CV values for the 100 ng/mL tPA group were: EXTEM MCF 0.144, EXTEM LI30 1.038, FIBTEM MCF 0.096, FIBTEM LI30 1.238. CONCLUSION We demonstrate a wide range of fibrinolytic response in the obstetric population to exogeneous tPA. We found subgroups of patients that were very responsive to tPA and insensitive to tPA. This study represents a preliminary exploration into classifying the obstetric fibrinolytic phenotypes. Further research will integrate relevant coagulation factors to establish a predictive model for testing susceptibility to lysis that can be applied at the point of care.
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Affiliation(s)
- A Tran
- City University of New York School of Medicine, New York, NY 10031, USA; Department of Anesthesiology, Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - D Katz
- Department of Anesthesiology, Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Samuels N, Cohen N, Katz D, Ben-Arye E. Identifying cultural, demographic, personal health and cancer-related barriers to integrative oncology care: a retrospective case-cohort study. J Cancer Res Clin Oncol 2023; 149:10143-10148. [PMID: 37264264 DOI: 10.1007/s00432-023-04912-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/20/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE Integrative oncology (IO) provides complementary and integrative medicine within conventional supportive and palliative cancer care. The present study set out to identify barriers to attending an integrative physician (IP) consultation, provided without charge within an IO treatment program. STUDY METHODS Electronic files of adult oncology patients undergoing chemotherapy were studied. Patient-related characteristics were examined to identify factors associated with attendance at the IP consultation: socio-demographic (age, gender, country of birth, place of residence, primary language spoken); health- related (BMI, smoking, independent functioning); and cancer- related (primary tumor site, localized vs. metastatic). RESULTS Only 257 of the 1912 patients studied (13.4%) attended the IP consultation, with female patients more likely to attend (p < 0.001), as well as younger patients (p = 0.002); those residing outside the Jerusalem municipality (p = 0.008); and patients whose primary language was Hebrew (p < 0.001). Non-smokers and functionally independent patients were also more likely to attend (p = 0.007 and 0.008, respectively), as were those diagnosed with breast/gynecological (p = 0.005) or gastrointestinal tumors (p = 0.002). Multivariate analysis showed a significantly greater likelihood of attending the consultation among females (OR 1.619, 95% CI 1.065-2.460; p = 0.024); younger patients (OR 1.019, 95% CI 1.007-1.031; p = 0.001); non-Arabic speakers (OR 8.220, 95% CI 3.310-20.413; p < 0.001); and patients diagnosed with a tumor other than lung cancer (OR 2.954, 95% CI 1.259-6.933; p = 0.013). CONCLUSION Further prospective research addressing socio-demographic, personal health- and cancer-related characteristics of oncology patients is needed to address potential barriers to the provision of IO care within a diverse, equitable and inclusive setting of care.
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Affiliation(s)
- Noah Samuels
- Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, P.O.B. 3235, 9103102, Jerusalem, Israel.
| | - Neora Cohen
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniela Katz
- Integrated Oncology Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin Carmel, and Zebulun Medical Centers, Clalit Health Services, Haifa, Israel
- Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Babkoff A, Berner-Wygoda Y, Diment J, Kustanovich A, Zick A, Katz D, Grinshpun A. First Female Patient with a Rare CIC-FOXO4-Translocated Sarcoma: A Case Report. Case Rep Oncol 2023; 16:954-962. [PMID: 37900856 PMCID: PMC10601800 DOI: 10.1159/000533519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/04/2023] [Indexed: 10/31/2023] Open
Abstract
Small round cell sarcoma is a group of undifferentiated malignancies arising in the bone and soft tissue, notable for Ewing sarcoma. Recently, a new World Health Organization classification has been introduced, including an additional subset of these sarcomas, named CIC-rearranged sarcoma. Within this group, CIC-FOXO4 translocation is an exceedingly rare fusion that has been reported only 4 times in the literature. Herein, we report in-depth the pathological, clinical, and molecular features of a CIC-FOXO4 translocation-driven tumor in a 46-year-old woman.
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Affiliation(s)
- Aryeh Babkoff
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yael Berner-Wygoda
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Judith Diment
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Anatoli Kustanovich
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Aviad Zick
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniela Katz
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Albert Grinshpun
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Chelales E, Kwan M, Crouch B, Katz D, Sag A, Ramanujam N. Abstract No. 101 Ethanol gel enhances percutaneous intratumoral chemotherapy injection: in vitro and in vivo studies of drug retention, tumor destruction, and overall survival. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.182] [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] Open
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Pan X, Hou Q, Xu J, MA Y, LI J, LI M, Su J, Shi X, Bracken W, Katz D. POS1332 TOWARD SAFER GLUCOCORTICOID THERAPY OF POLYMYALGIA RHEUMATICA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSPI-62 is a potent 11β-hydroxysteroid dehydrogenase type 1 (HSD-1) inhibitor entering Phase 2 development as adjunctive therapy to prednisolone in polymyalgia rheumatica, as well as for treatment of Cushing’s syndrome and autonomous cortisol secretion. HSD-1, an intracellular enzyme, activates glucocorticoids in target tissues in which glucocorticoid medicines are associated with morbidity including liver, adipose, muscle, and skin. In Phase 1 clinical trials SPI-62 was generally well tolerated and associated with maximal liver and brain HSD-1 inhibition.ObjectivesTo demonstrate mitigation by SPI-62 of corticosterone (CORT) adverse effects in mouse.MethodsC57BL/6 male mice (age 7 weeks; n=14 per group) were administered CORT (100 g/mL in drinking water) and SPI-62 (by gavage in 0.5% HPMC; 0, 1, or 10 mg/kg/day or 10 mg/kg twice daily) for 35 days. A control group received no CORT or SPI-62. Body weight was assessed daily and food consumption twice weekly. Whole body muscle and fat amounts were measured at Days 0, 14, and 28 using an EchoMRI-130H body composition analyzer. Blood samples for fasting glucose and insulin were obtained at Days 1 (pre-dose), 15, 29, and 35. An open field test was conducted on Day 22. A grip strength test was performed on Day 28. After sacrifice on Day 36, gonadal, subcutaneous, retroperitoneal, and mesenteric fat, quadriceps, and tibialis anterior were dissected and weighed, and skin was formalin fixed and paraffin embedded.ResultsOne control mouse died due to accidental gavage injury. Two mice who received CORT + 0.5% HPMC died on Days 11 and 19. CORT resulted in increased food consumption which was normalized by SPI-62 in a dose-dependent manner. CORT-treated mice showed reduced body weight gain for 2 weeks then accelerated body weight gain. SPI-62 prevented body weight gain acceleration in a dose-dependent manner. CORT effects on dermal thickness and structure were less prominent in mice who also received SPI-62. No effect of CORT or SPI-62 was observed in the open field test. SPI-62 prevented CORT adverse effects of insulin resistance, increased adiposity, skeletal myoatrophy, and grip strength reduction (Table 1).Table 1.Observed percentage difference of treatment group mean, compared to control group mean, in CORT-treated miceSPI-62 treatmentnone1 mg/kg1x/day10 mg/kg1x/day10 mg/kg2x/dayHOMA-IR Day 15+422+428+104+8HOMA-IR Day 29+788+472+204+14HOMA-IR Day 35+3620+1270+324+92Body fat content Day 14*+110+72-13-7Body fat content Day 28*+166+102+63-12Gonadal fat weight*+151+74+39-1Subcutaneous fat weight*+471+121+83+7Retroperitoneal fat weight*+227+89+36+25Mesenteric fat weight*+240+133+124+71Body muscle content Day 14*-10-70+1Body muscle content Day 28*-15-8-6+3Quadriceps weight*-54-43-24-16Tibialis anterior weight*-35-29-5+5Grip strength-12+16+15+26*Normalized by body weight.ConclusionSPI-62 prevented several CORT adverse effects in mouse, demonstrating that blockade of local intracellular glucocorticoid activation by a HSD-1 inhibitor in target tissues can mitigate glucocorticoid toxicity. These results suggest that SPI-62 has potential to similarly mitigate adverse effects of glucocorticoid medications in human. A placebo-controlled Phase 2 clinical trial has been initiated to compare prednisolone effects with and without SPI-62. Up to 48 patients diagnosed with polymyalgia rheumatica, on stable prednisolone 10 mg daily for at least 2 weeks, and with stable disease inactivity based on acute phase biomarkers will continue prednisolone 10 mg daily for 4 weeks, during which they will receive SPI-62 or placebo for 2 weeks each. Acute phase and other immune function biomarkers, symptom measures, and biomarkers of prednisolone adverse effects will be assessed at baseline and after each 2-week period. After analysis of data from a first cohort of 12 patients the prednisolone dose might be adjusted, in blinded fashion, during the SPI-62 period to maintain equipotency on acute phase biomarker suppression.Disclosure of InterestsXingyu Pan: None declared, Qiongqiong Hou: None declared, Jiahui Xu: None declared, Yake Ma: None declared, Jiawen Li: None declared, Min Li: None declared, Jing Su: None declared, Xuerou Shi: None declared, William Bracken Consultant of: Sparrow Pharmaceuticals, David Katz Shareholder of: Sparrow Pharmaceuticals, Employee of: Sparrow Pharmaceuticals
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Sherwin M, Katz D. Using gastric ultrasound to assess gastric content in the pregnant patient. BJA Educ 2021; 21:404-407. [PMID: 34707884 DOI: 10.1016/j.bjae.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- M Sherwin
- Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - D Katz
- Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
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Maher P, Getrajdman C, Katz D. 82 Heparinase-Native Thromboelastometry Detects Hypercoagulability in COVID-19 Disease. Ann Emerg Med 2021. [PMCID: PMC8335425 DOI: 10.1016/j.annemergmed.2021.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Heijkoop B, Bolton D, Katz D, Ryan A, Epstein J, Appu S. Cystic papillary adenoma of the seminal vesicle – A distinct histological entity. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01082-4] [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: 10/20/2022]
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Abstract
Background Primary Seminal Vesicle (SV) tumours are a rare entity, with most SV masses representing invasion of the SV by malignancy originating in an adjacent organ, most often the prostate. Previously reported primary SV epithelial tumours have included adenocarcinoma and cystadenoma, with limited prior reports of inracystic papillary structures.
Case presentation A 35-year-old male presented with azoospermia, intermittent macroscopic haematuria, and mild right iliac fossa and groin pain. A papillary appearing seminal vesicle mass was found on imaging and seminal vesicoscopy. The mass was robotically excised with diagnosis of benign cystic papillary adenoma made. Conclusion In this manuscript we describe a rare case of a benign cystic papillary adenoma of the seminal vesicle, a unique histological entity differentiated from cystadenoma of the Seminal Vesicle by its papillary component.
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Affiliation(s)
| | - D Bolton
- Austin Health, Melbourne, Australia
| | - D Katz
- Men's Health Melbourne, Melbourne, Australia
| | | | - J Epstein
- Johns Hopkins Hospital, Baltimore, USA
| | - S Appu
- Austin Health, Melbourne, Australia.,Department of Surgery, Monash University, Melbourne, Australia
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Katz D, Farber MK. Can measuring blood loss at delivery reduce hemorrhage-related morbidity? Int J Obstet Anesth 2021; 46:102968. [PMID: 33774489 DOI: 10.1016/j.ijoa.2021.102968] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/03/2021] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
Quantitation of blood loss after vaginal and cesarean delivery has been advocated for the timely detection of postpartum hemorrhage and activation of protocols for resuscitation. Morbidity and mortality from postpartum hemorrhage is considered to be largely preventable and is attributed to delayed recognition with under-resuscitation or inappropriate resuscitation. Optimizing detection of postpartum hemorrhage through refining how blood loss is measured is therefore clinically relevant. In this review on quantitative blood loss for postpartum hemorrhage, recent advances in the methods used to quantitate blood loss will be reviewed, with a comparison of utility and precision for blood loss measurement after vaginal and cesarean delivery. Considerations for the implementation of a quantitative blood loss system on the labor and delivery unit, including its benefits and challenges, will be discussed. The existing evidence for impact of blood loss quantitation in obstetrics on hemorrhage-related morbidity will be delineated, along with knowledge gaps and future research priorities.
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Affiliation(s)
- D Katz
- Icaha School of Medicine at Mount Sinai, New York, NY, USA
| | - M K Farber
- Brigham and Women's Hospital, Boston, MA, USA.
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11
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Shapira-Daniels A, Katz D, Aviel G, Meirovitz A, Gilon D, Shapira OM. Multimodality Treatment for Advanced Cervical Cancer With Isolated Metastasis to Interventricular Septum of the Heart. JACC CardioOncol 2020; 2:519-522. [PMID: 34396262 PMCID: PMC8352254 DOI: 10.1016/j.jaccao.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ayelet Shapira-Daniels
- Department of Cardiothoracic Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Daniela Katz
- Department of Oncology, Shamir Medical Center, Beer Yaacov, Israel
| | - Gal Aviel
- Department of Cardiothoracic Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Amichay Meirovitz
- Department of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Dan Gilon
- Department of Cardiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
- Department of Cardiology, Shamir Medical Center, Beer Yaacov, Israel
| | - Oz M. Shapira
- Department of Cardiothoracic Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Fleishman A, Khwaja K, Schold JD, Comer CD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz D, Jones J, Kaplan B, Pavlakis M, Mandelbrot DA, Rodrigue JR. Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study. Am J Transplant 2020; 20:2522-2529. [PMID: 32185880 PMCID: PMC7483675 DOI: 10.1111/ajt.15861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/14/2020] [Accepted: 03/03/2020] [Indexed: 01/25/2023]
Abstract
Postoperative pain is an outcome of importance to potential living kidney donors (LKDs). We prospectively characterized the prevalence, severity, and patterns of acute or chronic postoperative pain in 193 LKDs at six transplant programs. Three pain measurements were obtained from donors on postoperative Day (POD) 1, 3, 7, 14, 21, 28, 35, 41, 49, and 56. The median pain rating total was highest on POD1 and declined from each assessment to the next until reaching a median pain-free score of 0 on POD49. In generalized linear mixed-model analysis, the mean pain score decreased at each pain assessment compared to the POD3 assessment. Pre-donation history of mood disorder (adjusted ratio of means [95% confidence interval (CI)]: 1.40 [0.99, 1.98]), reporting "severe" on any POD1 pain descriptors (adjusted ratio of means [95% CI]: 1.47 [1.12, 1.93]) and open nephrectomy (adjusted ratio of means [95% CI]: 2.61 [1.03, 6.62]) were associated with higher pain scores across time. Of the 179 LKDs who completed the final pain assessment, 74 (41%) met criteria for chronic postsurgical pain (CPSP), that is, any donation-related pain on POD56. Study findings have potential implications for LKD education, surgical consent, postdonation care, and outcome measurements.
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Affiliation(s)
- A Fleishman
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - K Khwaja
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - JD Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - CD Comer
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - P Morrissey
- Transplant Center, Rhode Island Hospital, Providence, RI
| | - J Whiting
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - J Vella
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - LK Kayler
- Montefiore Einstein Center for Transplantation, Bronx, NY,Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY
| | - D Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - J Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - B Kaplan
- Baylor Scott and White Health, Temple, TX
| | - M Pavlakis
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - DA Mandelbrot
- Department of Medicine, University of Wisconsin, Madison, WI
| | - JR Rodrigue
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
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Anderson E, Pascoe C, Sathianathen N, Katz D, Murphy D, Lawrentshuk N. Sub-inguinal orchidectomy: A minimally invasive approach to open surgery. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34107-0] [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: 10/23/2022] Open
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Katz D, Wang R, O'Neil L, Gerber C, Lankford A, Rogers T, Gal J, Sandler R, Beilin Y. The association between the introduction of quantitative assessment of postpartum blood loss and institutional changes in clinical practice: an observational study. Int J Obstet Anesth 2020; 42:4-10. [DOI: 10.1016/j.ijoa.2019.05.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/03/2019] [Accepted: 05/09/2019] [Indexed: 12/17/2022]
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D'Ambrosio L, Touati N, Blay JY, Grignani G, Flippot R, Czarnecka AM, Piperno-Neumann S, Martin-Broto J, Sanfilippo R, Katz D, Duffaud F, Vincenzi B, Stark DP, Mazzeo F, Tuchscherer A, Chevreau C, Sherriff J, Estival A, Litière S, Sents W, Ray-Coquard I, Tolomeo F, Le Cesne A, Rutkowski P, Stacchiotti S, Kasper B, Gelderblom H, Gronchi A. Doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, or doxorubicin alone as a first-line treatment for advanced leiomyosarcoma: A propensity score matching analysis from the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. Cancer 2020; 126:2637-2647. [PMID: 32129883 DOI: 10.1002/cncr.32795] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/05/2020] [Accepted: 01/24/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND The optimal treatment for advanced leiomyosarcoma is still debated. Given histotype-specific prospective controlled data lacking, this study retrospectively evaluated doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, and doxorubicin alone as first-line treatments for advanced/metastatic leiomyosarcoma treated at European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (EORTC-STBSG) sites. METHODS The inclusion criteria were a confirmed histological diagnosis, treatment between January 2010 and December 2015, measurable disease (Response Evaluation Criteria in Solid Tumors 1.1), an Eastern Cooperative Oncology Group performance status ≤2, and an age ≥ 18 years. The endpoints were progression-free survival (PFS), overall survival (OS), and overall response rate (ORR). PFS was analyzed with methods for interval-censored data. Patients were matched according to their propensity scores, which were estimated with a logistic regression model accounting for histology, grade, age, sex, performance status, tumor site, and tumor extent. RESULTS Three hundred three patients from 18 EORTC-STBSG sites were identified. One hundred seventeen (39%) received doxorubicin plus dacarbazine, 71 (23%) received doxorubicin plus ifosfamide, and 115 (38%) received doxorubicin. In the 2:1:2 propensity score-matched population (205 patients), the estimated median PFS was 9.2 months (95% confidence interval [CI], 5.2-9.7 months), 8.2 months (95% CI, 5.2-10.1 months), and 4.8 months (95% CI, 2.3-6.0 months) with ORRs of 30.9%, 19.5%, and 25.6% for doxorubicin plus dacarbazine, doxorubicin plus ifosfamide, and doxorubicin alone, respectively. PFS was significantly longer with doxorubicin plus dacarbazine versus doxorubicin (hazard ratio [HR], 0.72; 95% CI, 0.52-0.99). Doxorubicin plus dacarbazine was associated with longer OS (median, 36.8 months; 95% CI, 27.9-47.2 months) in comparison with both doxorubicin plus ifosfamide (median, 21.9 months; 95% CI, 16.7-33.4 months; HR, 0.65; 95% CI, 0.40-1.06) and doxorubicin (median, 30.3 months; 95% CI, 21.0-36.3 months; HR, 0.66; 95% CI, 0.43-0.99). Adjusted analyses retained an effect for PFS but not for OS. None of the factors selected for multivariate analysis had a significant interaction with the received treatment for both PFS and OS. CONCLUSIONS This is the largest retrospective study of first-line treatment for advanced leiomyosarcoma. In the propensity score-matched population, doxorubicin and dacarbazine showed favorable activity in terms of both ORR and PFS and warrants further evaluation in prospective trials.
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Affiliation(s)
- Lorenzo D'Ambrosio
- Department of Oncology, University of Turin, Turin, Italy.,Sarcoma Unit, Division of Medical Oncology, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Nathan Touati
- European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - Jean-Yves Blay
- Leon Berard Center and Claude Bernard Lyon I University, EURACAN, LYRICAN, Lyon, France
| | - Giovanni Grignani
- Sarcoma Unit, Division of Medical Oncology, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Ronan Flippot
- Department of Medicine, Gustave Roussy, Villejuif Cedex, France
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Gliwice, Poland.,Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | | | - Javier Martin-Broto
- Virgen del Rocio University Hospital, Institute of Biomedicine Research/CSIC/University of Seville, Seville, Spain
| | - Roberta Sanfilippo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniela Katz
- Oncology Department, Sharett Institute of Oncology, Hadassah-Hebrew University, Jerusalem, Israel
| | - Florence Duffaud
- Medical Oncology - University Hospital Timone, Aix-Marseille University, Marseille, France
| | - Bruno Vincenzi
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Daniel P Stark
- St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals National Health Service Trust, Leeds, United Kingdom
| | - Filomena Mazzeo
- Medical Oncology, Clinique Universitaire Saint-Luc, Woluwe-Saint-Lambert, Belgium
| | - Armin Tuchscherer
- Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | - Christine Chevreau
- Claudius Regaud Institute, University Cancer Institute of Toulouse, Toulouse, France
| | - Jenny Sherriff
- Cancer Centre, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | | | - Saskia Litière
- European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - Ward Sents
- European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - Isabelle Ray-Coquard
- Leon Berard Center and Claude Bernard Lyon I University, EURACAN, LYRICAN, Lyon, France
| | - Francesco Tolomeo
- Sarcoma Unit, Division of Medical Oncology, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Axel Le Cesne
- Department of Medicine, Gustave Roussy, Villejuif Cedex, France
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Gliwice, Poland.,Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Silvia Stacchiotti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Bernd Kasper
- Sarcoma Unit, Interdisciplinary Tumor Center, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Cheung F, Fathollahi A, Vertosick E, Jarvis TR, Katz D, Sandhu JS, Favorito LA. Editorial Comment: Dorsolateral fibromuscular tissue preservation during artificial urinary sphincter cuff placement is associated with low infection and erosion rates. Int Braz J Urol 2020; 46:124-125. [PMID: 31851469 PMCID: PMC6968916 DOI: 10.1590/s1677-5538.ibju.2020.01.04] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- F Cheung
- Memorial Sloan Kettering Cancer Center, USA
| | | | | | - TR Jarvis
- Prince of Wales Clinical School, Australia
| | - D Katz
- Men's Health Melbourne, USA
| | - JS Sandhu
- Memorial Sloan Kettering Cancer Center, USA
| | - Luciano A Favorito
- Universidade Estadual do Rio de Janeiro - Uerj, Brasil; Hospital Federal da Lagoa, Brasil
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17
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Stemmer SM, Steiner M, Rizel S, Ben-Baruch N, Uziely B, Jakubowski DM, Baron J, Shak S, Soussan-Gutman L, Bareket-Samish A, Fried G, Rosengarten O, Itay A, Nisenbaum B, Katz D, Leviov M, Tokar M, Liebermann N, Geffen DB. Ten-year clinical outcomes in N0 ER+ breast cancer patients with Recurrence Score-guided therapy. NPJ Breast Cancer 2019; 5:41. [PMID: 31728408 PMCID: PMC6841708 DOI: 10.1038/s41523-019-0137-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/25/2019] [Indexed: 01/20/2023] Open
Abstract
The 21-gene Recurrence Score (RS) assay is a validated prognosticator/predictor of chemotherapy (CT) benefit in early-stage estrogen receptor (ER)-positive breast cancer (BC). Long-term data from real-life clinical practice where treatment was guided by the RS result are lacking. We performed exploratory analysis of the Clalit Health Services (CHS) registry, which included all CHS patients with node-negative ER+ HER2-negative BC who underwent RS testing between 1/2006 and 12/2009 to determine 10-year Kaplan-Meier estimates for distant recurrence/BC-specific mortality (BCSM) in this cohort. The analysis included 1365 patients. Distribution of RS results: RS 0-10, 17.8%; RS 11-25, 62.5%; RS 26-100, 19.7%. Corresponding CT use: 0, 9.4, and 69.9%. Ten-year distant recurrence rates in patients with RS 0-10, 11-25, and 26-100: 2.6% (95% confidence interval [CI], 1.1-6.2%), 6.1% (95% CI, 4.4-8.6%), and 13.1% (95% CI, 9.4-18.3%), respectively (P < 0.001); corresponding BCSM rates: 0.7% (95% CI 0.1-5.1%), 2.2% (95% CI, 1.3-3.7%), and 9.5% (95% CI, 6.0-14.9%) (P < 0.001). When the analysis included patients treated with endocrine therapy alone (95.5/87.5% of patients with RS 0-10/11-25), 10-year distant recurrence and BCSM rates for RS 0-10 patients were 2.7% (95% CI, 1.1-6.5%) and 0.8% (95% CI, 0.1-5.3%), respectively, and for RS 11-25 patients, 5.7% (95% CI, 3.9-8.3%) and 2.0% (95% CI, 1.1-3.7%), respectively. For RS 11-25 patients, no statistically significant differences were observed in 10-year distant recurrence/BCSM rates between CT-treated and untreated patients; however, this should be interpreted cautiously since the number of events was low and patients were not randomized. In conclusion, in node-negative ER+ HER2-negative BC patients, where treatment decisions in real-life clinical practice incorporated the RS, patients with RS 0-25 (~80% of patients, <10% CT use) had excellent outcomes at 10 years. Patients with RS 26-100 had high distant recurrence risk despite CT use and are candidates for new treatment approaches.
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Affiliation(s)
- Salomon M. Stemmer
- Davidoff Center, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Beatrice Uziely
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | | | | | | | | | - Georgeta Fried
- Oncology Dept., Rambam Health Care Campus, Haifa, Israel
| | - Ora Rosengarten
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Amit Itay
- Oncology Dept., Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel
| | | | - Daniela Katz
- Oncology Dept., Assaf Harofeh Medical Center, Zerifin, Israel
| | | | - Margarita Tokar
- Department of Oncology, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | - David B. Geffen
- Department of Oncology, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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18
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Maher P, Katz D, Afzal O, Richardson L. 47 Clotting Differences Using ROTEM Testing for Early Prediction of Adverse Pregnancy Outcomes. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.050] [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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19
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Bernie H, Nascimento B, Katz D, Tin A, Benfante N, Sjoberg D, Carlsson S, Vickers A, Mulhall J. 160 Predictors of Worsening Erectile Function in Men With Functional Erections Early After Radical Prostatectomy. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.169] [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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20
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Groenland SL, Katz D, Huitema ADR, Steeghs N. Harnessing soft tissue sarcoma with low-dose pazopanib - a matter of blood levels. BMC Cancer 2018; 18:1200. [PMID: 30509247 PMCID: PMC6276240 DOI: 10.1186/s12885-018-5043-9] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/05/2018] [Indexed: 11/14/2022] Open
Abstract
Background Pazopanib is a tyrosine kinase inhibitor indicated for the treatment of renal cell carcinoma and soft tissue sarcoma. Despite the high inter-patient variability in pharmacokinetic exposure, pazopanib is administered at a fixed dose of 800 mg once daily (QD). Pharmacokinetic exposure is linked to both efficacy and toxicity. In this case report, we illustrate the value of therapeutic drug monitoring by describing two patients with adequate pazopanib trough concentrations (Cmin) at an eight times lower than standard dose. Case presentation Patient A is a 69-year-old woman with metastatic leiomyosarcoma who had significant toxicities and a high Cmin on the standard dose. While dose reductions to 200 mg QD and later 200 mg every other day were made, pazopanib Cmin remained above the efficacy threshold. Patient B is a 50-year-old male with metastatic angiosarcoma and a history of Gilbert syndrome. Pazopanib treatment was initiated at the standard dose of 800 mg QD, but was reduced to 200 mg QD 1-week-on - 1-week-off due to total bilirubin elevation. Pazopanib Cmin was adequate in this patient as well. Conclusion It could be valuable to measure pazopanib levels in case of dose reductions due to toxicity, as exposure could still be adequate at considerably lower than standard doses.
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Affiliation(s)
- Stefanie L Groenland
- Department of Medical Oncology and Clinical Pharmacology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Daniela Katz
- Department of Oncology, Assaf Harofeh Medical Center, Zrifin, Israel
| | - Alwin D R Huitema
- Department of Clinical Pharmacy, University Medical Center, Utrecht University, Utrecht, The Netherlands. .,Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands.
| | - Neeltje Steeghs
- Department of Medical Oncology and Clinical Pharmacology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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21
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Cohen JE, Eleyan F, Zick A, Peretz T, Katz D. Intratumoral immune-biomarkers and mismatch repair status in leiyomyosarcoma -potential predictive markers for adjuvant treatment: a pilot study. Oncotarget 2018; 9:30847-30854. [PMID: 30112112 PMCID: PMC6089390 DOI: 10.18632/oncotarget.25747] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 08/09/2017] [Accepted: 06/23/2018] [Indexed: 12/21/2022] Open
Abstract
Leiomyosarcoma is the second most frequent soft-tissue sarcoma. Tumor lymphocytic infiltration (TIL) and programed cell death ligand-1 (PD-L1) have been associated with prognosis in different malignancies while DNA mismatch-repair deficiency (MMR-D) has been associated with response to check-point inhibitors. In this pilot study, we sought to examine TIL, PD-L1 and mismatch-repair (MMR) protein expression in 11 leiomyosarcoma and its association with outcome as potential biomarkers for adjuvant treatment. Eleven primary leiomyosarcoma archived-tissues were analyzed for expression of MMR proteins (MSH2, MLH1, MSH6 and PSM2), PD-L1 expression and PD-1, CD3 or CD8. MMR-D was detected in tumor tissue from 2/11 leiomyosarcoma patients. CD3 T-cells were present in all samples, whereas CD8 staining was positive in all but one. PDL-1 was positive in 4/11 and PD-L1 in 6/11. Interestingly, the three patients with the poorest outcome had strongly positive staining for PD-L1 and CD8 while in the two patients who are alive and recurrence-free, both PD-L1 and CD8 infiltration were lacking. We found an association between tumor infiltrating CD8 cytotoxic lymphocytes, strong PD-L1 staining and survival; suggesting a role as biomarkers for treatment decisions regarding peri-operative chemotherapy. We also identified MMR-D in two patients with leiomyosarcoma comprising 18% of our sample.
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Affiliation(s)
- Jonathan E Cohen
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Feras Eleyan
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Aviad Zick
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Tamar Peretz
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Daniela Katz
- Institute of Oncology, Assaf Harofeh Medical Center Zrifin, Beer Yaacov, Israel
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22
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Rodrigue JR, Schold JD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz D, Jones J, Kaplan B, Fleishman A, Pavlakis M, Mandelbrot DA. Mood, body image, fear of kidney failure, life satisfaction, and decisional stability following living kidney donation: Findings from the KDOC study. Am J Transplant 2018; 18:1397-1407. [PMID: 29206349 PMCID: PMC5988866 DOI: 10.1111/ajt.14618] [Citation(s) in RCA: 22] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 01/25/2023]
Abstract
Prior studies demonstrate that most living kidney donors (LKDs) report no adverse psychosocial outcomes; however, changes in psychosocial functioning at the individual donor level have not been routinely captured. We studied psychosocial outcomes predonation and at 1, 6, 12, and 24 months postdonation in 193 LKDs and 20 healthy controls (HCs). There was minimal to no mood disturbance, body image concerns, fear of kidney failure, or life dissatisfaction, indicating no incremental changes in these outcomes over time and no significant differences between LKDs and HCs. The incidence of any new-onset adverse outcomes postdonation was as follows: mood disturbance (16%), fear of kidney failure (21%), body image concerns (13%), and life dissatisfaction (10%). Multivariable analyses demonstrated that LKDs with more mood disturbance symptoms, higher anxiety about future kidney health, low body image, and low life satisfaction prior to surgery were at highest risk of these same outcomes postdonation. It is important to note that some LKDs showed improvement in psychosocial functioning from pre- to postdonation. Findings support the balanced presentation of psychosocial risks to potential donors as well as the development of a donor registry to capture psychosocial outcomes beyond the mandatory 2-year follow-up period in the United States.
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Affiliation(s)
- JR Rodrigue
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - JD Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - P Morrissey
- Transplant Center, Rhode Island Hospital, Providence, RI
| | - J Whiting
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - J Vella
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - LK Kayler
- Montefiore Einstein Center for Transplantation, Bronx, NY,Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY
| | - D Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - J Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - B Kaplan
- Department of Medicine, University of Arizona, Tucson, AZ,School for the Science of Health Care Delivery, Arizona State University, Phoenix, AZ
| | - A Fleishman
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - M Pavlakis
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - DA Mandelbrot
- Department of Medicine, University of Wisconsin, Madison, WI
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23
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Katz D, Palmerini E, Pollack SM. More Than 50 Subtypes of Soft Tissue Sarcoma: Paving the Path for Histology-Driven Treatments. Am Soc Clin Oncol Educ Book 2018; 38:925-938. [PMID: 30231352 DOI: 10.1200/edbk_205423] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 06/08/2023]
Abstract
Sarcomas are a diverse group of cancers with mesenchymal origin. Although sarcomas comprise less than 1% of cancers, there are more than 50 different subtypes that are quite different from one another in terms of both their biology and clinical behavior. Historically, the need for adequate patient numbers in clinical trials has pushed sarcoma researchers to lump these very different malignancies together and treat the patients using a "one-size-fits-all" approach. However, with improvements in our scientific understanding, we are finally ready for a histology-tailored therapeutic approach to these complex diseases. In this review, we discuss key advances in our understanding of the biology underlying selected sarcoma subtypes and how targeting these subtypes is relevant therapeutically with respect to both molecularly targeted agents as well as immunotherapy.
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Affiliation(s)
- Daniela Katz
- From the Institute of Oncology, Assaf Harofeh Medical Center, Zrifin, Beer Yaakov, Israel; Medical Oncology, Istituto Ortopedico Rizzoli, Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University, Bologna, Italy; Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
| | - Emanuela Palmerini
- From the Institute of Oncology, Assaf Harofeh Medical Center, Zrifin, Beer Yaakov, Israel; Medical Oncology, Istituto Ortopedico Rizzoli, Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University, Bologna, Italy; Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
| | - Seth M Pollack
- From the Institute of Oncology, Assaf Harofeh Medical Center, Zrifin, Beer Yaakov, Israel; Medical Oncology, Istituto Ortopedico Rizzoli, Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University, Bologna, Italy; Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
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24
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D'Ambrosio L, Touati N, Blay JY, Grignani G, Flippot R, Czarnecka AM, Piperno-Neumann S, Martin Broto J, Sanfilippo R, Katz D, Duffaud F, Vincenzi B, Kasper B, Stark DP, Mazzeo F, Tuchscherer A, Litiere S, Sents W, Gelderblom H, Gronchi A. Doxorubicin plus dacarbazine (DoDa), doxorubicin plus ifosfamide (DI) or doxorubicin alone (Do) as first line treatment for advanced leiomyosarcoma (LMS): A retrospective study from the EORTC Soft Tissue and Bone Sarcoma Group (STBSG). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.11574] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Lorenzo D'Ambrosio
- University of Torino, Department of Oncology, Torino, Italy, Torino, Italy
| | - Nathan Touati
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Jean-Yves Blay
- University Claude Bernard Lyon I, Centre Leon Berard, Lyon, France
| | - Giovanni Grignani
- Sarcoma Unit, Division of Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Italy
| | | | | | | | - Javier Martin Broto
- Virgen del Rocio University Hospital, Institute of Biomedicine Research (IBIS)/CSIC/Universidad de Sevilla, Seville, Spain
| | - Roberta Sanfilippo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniela Katz
- Oncology Institute, Assaf Harofeh Medical Center, Zrifin, Israel
| | | | - Bruno Vincenzi
- Department of Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy
| | - Bernd Kasper
- University of Heidelberg, Mannheim University Medical Center, ITM - Interdisciplinary Tumor Center Mannheim, Sarcoma Unit, Mannheim, Germany
| | - Daniel P. Stark
- St James's Institute of Oncology, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James's Hospital, Leeds, United Kingdom
| | - Filomena Mazzeo
- Medical Oncology, Clinique Universitaire Saint-Luc, Institut Roi Albert II, Brussels, Belgium
| | - Armin Tuchscherer
- Department I of Internal Medicine, University Hospital Cologne, Köln, Germany
| | - Saskia Litiere
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Ward Sents
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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25
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Katz D, Tengekyon AJ, Kahan NR, Calderon-Margalit R. Patient and physician characteristics affect adherence to screening mammography: A population-based cohort study. PLoS One 2018; 13:e0194409. [PMID: 29584742 PMCID: PMC5870964 DOI: 10.1371/journal.pone.0194409] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 02/19/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Screening mammograms are widely recommended biennially for women between the ages of 50 and 74. Despite the benefits of screening mammograms, full adherence to recommendations falls below 75% in most developed countries. Many studies have identified individual (obesity, smoking, socio-economic status, and co-morbid conditions) and primary-care physician parameters (physician age, gender, clinic size and cost) that influence adherence, but little data exists from large population studies regarding the interaction of these individual factors. METHODS We performed a historical cohort study of 44,318 Israeli women age 56-74 using data captured from electronic medical records of a large Israeli health maintenance organization. Univariate analysis was used to examine the association between each factor and adherence (none, partial or full) with screening recommendations between 2008-2014. Multivariate analysis was used to examine the significance of these factors in combination, using binary and multinomial logistic regression. RESULTS Among 44,318 women, 42%, 43% and 15% were fully, partially and non-adherent to screening recommendations, respectively. Factors associated with inferior adherence identified in our population included: smoking, obesity, low body weight, low socio-economic status, depression, diabetes mellitus and infrequent physician visits, while, women with ischemic heart disease, female physicians, physicians between the ages of 40 and 60, and medium-sized clinics were associated with higher screening rates. Most factors remained significant in the multivariate analysis. CONCLUSIONS Both individual and primary-care physician factors contribute to adherence to mammography screening guidelines. Strategies to improve adherence and address disparities in mammography utilization will need to address these factors.
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Affiliation(s)
- Daniela Katz
- Institute of Oncology, Assaf Harofeh Medical Center, Zrifin, Israel
| | - Angela J. Tengekyon
- The Joseph H. and Belle R. Braun Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel
| | - Natan R. Kahan
- Medical Division, Leumit Health Services, Tel-Aviv, Israel, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ronit Calderon-Margalit
- The Joseph H. and Belle R. Braun Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel
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Berenstein-Weyel T, Lebel E, Katz D, Applbaum Y, Peyser A. Chondromyxoid fibroma of the distal fibula treated by percutaneous radiofrequency ablation. J Orthop Surg (Hong Kong) 2018; 25:2309499017720830. [PMID: 28731366 DOI: 10.1177/2309499017720830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Percutaneous radiofrequency ablation (RFA) has been shown to be an effective treatment for soft tissue lesions and also benign bone tumors, especially osteoid osteoma. There are limited data regarding this technique in other bone tumors, specifically larger and more aggressive ones. PURPOSES To describe the use of RFA as a definitive treatment and an alternative to traditional open surgery for the treatment of chondromyxoid fibroma (CMF), a benign but locally aggressive bone tumor. CASE PRESENTATION An 11.5-year-old girl was diagnosed with a 4-cm lytic bone lesion of the distal fibula. Evaluation, including biopsy, revealed CMF. It was managed by fluoroscopy-guided RFA only. Six-year follow-up demonstrated complete healing without damage to the adjacent distal fibular growth plate. DISCUSSION AND CONCLUSIONS RFA induces local heat in the ablation field and causes tissue necrosis. The depth of heat penetration and the size of heated sphere are accurately controlled by modern types of ablation probes and accurate positioning. The current report demonstrates the ability to use this percutaneous technique for larger and more aggressive bone tumors than has been indicated previously.
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Affiliation(s)
- Tamar Berenstein-Weyel
- 1 Pediatric Orthopedic Unit, Department of Orthopedic Surgery, Hadassah-Hebrew University School of Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ehud Lebel
- 1 Pediatric Orthopedic Unit, Department of Orthopedic Surgery, Hadassah-Hebrew University School of Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Daniela Katz
- 2 Department of Oncology, Oncology institute, Assaf Harofeh Medical Center, Zrifin
| | - Yaakov Applbaum
- 3 Department of Radiology, Hadassah-Hebrew University School of Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Amos Peyser
- 4 Department of Orthopedic Surgery, Hadassah-Hebrew University School of Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
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27
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Gelderblom H, Judson IR, Benson C, Merimsky O, Grignani G, Katz D, Freivogel KW, Stein D, Jobanputra M, Mungul A, Manson SC, Sanfilippo R. Treatment patterns and clinical outcomes with pazopanib in patients with advanced soft tissue sarcomas in a compassionate use setting: results of the SPIRE study . Acta Oncol 2017; 56:1769-1775. [PMID: 28723233 DOI: 10.1080/0284186x.2017.1332779] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND A named patient program (NPP) was designed to provide patients with advanced soft-tissue sarcoma (aSTS) access to pazopanib, a multitargeted tyrosine kinase inhibitor. The SPIRE study was a retrospective chart review of participating patients. PATIENTS AND METHODS Eligibility criteria for the NPP and SPIRE mirrored those of the pivotal phase-III study, PALETTE, which compared pazopanib with placebo in patients ≥18 years with aSTS and whose disease had progressed during or following prior chemotherapy or were otherwise unsuitable for chemotherapy. Outcomes of interest included treatment patterns, treatment duration, relative dose intensity, progression-free survival (PFS), overall survival (OS), clinical benefit rate, adverse events (AEs) and reasons for treatment discontinuation. RESULTS A total of 211 patients were enrolled (median age 56 years; 60% female). Most patients received pazopanib in second- and third-line therapy (28.0% and 28.4%, respectively), followed by fourth line (19.0%) and ≥ fifth line (18.5%). The median duration of pazopanib treatment was 3.1 months (95% CI: 2.8-3.8), with a mean daily dose of 715 mg equating to 92% of recommended dose. Median OS was 11.1 months and clinical benefit rate was 46%. There was evidence of some clinical benefit across most histological subtypes. At study end, 40% of patients were alive and of these, 18% remained on pazopanib. Thirteen percent (13%) of patients discontinued pazopanib due to AEs. CONCLUSIONS The SPIRE study demonstrated activity of pazopanib in heavily pretreated aSTS patients in a compassionate use setting. No new safety concerns were noted. Reassuringly, the relative dose intensity of pazopanib was 92%.
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Affiliation(s)
- Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Ian R. Judson
- Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Charlotte Benson
- Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Ofer Merimsky
- Unit of Bone and Soft Tissue Oncology, Tel-Aviv Sourasky Medical Center and Tel-Aviv University Sackler School of Medicine, Tel-Aviv, Israel
| | - Giovanni Grignani
- Divisione Oncologia Medica, Candiolo Cancer Institute – FPO I.R.C.C.S., Candiolo, Italy
| | - Daniela Katz
- Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Dara Stein
- United BioSource Corporation, Quebec, Canada
| | | | | | | | - Roberta Sanfilippo
- Adult Mesenchymal Tumor Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Westerman K, Reaver A, Blander G, Nogal B, Ward C, Benard T, Katz D, Blumberg J. An Algorithm-based Personalized Nutrition Platform Improves Metabolic Biomarkers. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.379] [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: 11/29/2022]
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Jones RL, Katz D, Loggers ET, Davidson D, Rodler ET, Pollack SM. Clinical benefit of antiangiogenic therapy in advanced and metastatic chondrosarcoma. Med Oncol 2017; 34:167. [PMID: 28852958 PMCID: PMC5574947 DOI: 10.1007/s12032-017-1030-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 08/22/2017] [Indexed: 01/23/2023]
Abstract
Chondrosarcoma is the most common bone sarcoma in adults. Conventional chondrosarcoma, the commonest histological subtype, is largely resistant to anthracycline-based chemotherapy. There have been anecdotal reports of durable clinical benefit with antiangiogenic agents in this disease. A retrospective search of patients treated at three sarcoma referral centers was performed to identify patients with advanced chondrosarcoma treated with antiangiogenic agents. The aim of this study was to evaluate the efficacy and safety of antiangiogenic agents in advanced chondrosarcoma. Ten patients were identified; seven with conventional, one each with clear cell, extraskeletal mesenchymal chondrosarcoma and extraskeletal myxoid chondrosarcoma. The median progression-free survival for patients with conventional and clear cell sarcoma was 22.6 months. Median overall survival has not been met. Antiangiogenic therapy was well tolerated in this series of patients. Our retrospective data suggest that antiangiogenic therapy can provide prolonged clinical benefit in advanced chondrosarcoma patients. Further prospective trials are required to precisely define the role of this class of agent in advanced chondrosarcoma.
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Affiliation(s)
- Robin L Jones
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA.
- Sarcoma Unit, Royal Marsden Hospital/Institute of Cancer Research, Fulham Road, London, SW3 6JJ, UK.
| | - Daniela Katz
- Institute of Oncology, Assaf Harofeh Medical Center, Zrifin, Israel
| | - Elizabeth T Loggers
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
- Division of Oncology, University of Washington, Seattle, WA, USA
| | - Darin Davidson
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Eve T Rodler
- Division of Oncology, University of California Davis, Sacramento, CA, USA
| | - Seth M Pollack
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
- Division of Oncology, University of Washington, Seattle, WA, USA
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Guthrie KM, Rohan L, Rosen RK, Vargas SE, Shaw JG, Katz D, Kojic EM, Ham AS, Friend D, Buckheit KW, Buckheit RW. Vaginal film for prevention of HIV: using visual and tactile evaluations among potential users to inform product design. Pharm Dev Technol 2017; 23:311-314. [PMID: 28592183 DOI: 10.1080/10837450.2017.1339085] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 12/15/2022]
Abstract
Topical prevention of HIV and other STIs is a global health priority. To provide options for users, developers have worked to design safe, effective and acceptable vaginal dissolving film formulations. We aimed to characterize user experiences of vaginal film size, texture and color, and their role in product-elicited sensory perceptions (i.e. perceptibility), acceptability and willingness to use. In the context of a user-centered product evaluation study, we elicited users' 'first impressions' of various vaginal film formulation designs via visual and tactile prototype inspection during a qualitative user evaluation interview. Twenty-four women evaluated prototypes. Participants considered size and texture to be important for easy insertion. Color was more important following dissolution than prior to insertion. When asked to combine and balance all properties to arrive at an ideal film, previously stated priorities for individual characteristics sometimes shifted, with the salience of some individual characteristics lessening when multiple characteristics were weighted in combination. While first impressions alone may not drive product uptake, users' willingness to initially try a product is likely impacted by such impressions. Developers should consider potential users' experiences and preferences in vaginal film design. This user-focused approach is useful for characterizing user sensory perceptions and experiences relevant to early design of prevention technologies.
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Affiliation(s)
- K M Guthrie
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital , Providence , RI , USA.,b Department of Psychiatry and Human Behavior , The Warren Alpert Medical School of Brown University , Providence , RI , USA.,c Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , RI , USA
| | - L Rohan
- d Magee-Womens Research Institute , Pittsburgh , PA , USA.,e University of Pittsburgh , Pittsburgh , PA , USA
| | - R K Rosen
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital , Providence , RI , USA.,c Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , RI , USA
| | - S E Vargas
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital , Providence , RI , USA.,b Department of Psychiatry and Human Behavior , The Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - J G Shaw
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital , Providence , RI , USA
| | - D Katz
- f Biomedical Engineering and Obstetrics/Gynecology, Duke University , Durham , NC , USA
| | - E M Kojic
- g Division of Immunology , The Miriam Hospital , Providence , RI , USA
| | - A S Ham
- h ImQuest BioSciences, Inc , Frederick , MD , USA
| | | | - K W Buckheit
- h ImQuest BioSciences, Inc , Frederick , MD , USA
| | - R W Buckheit
- h ImQuest BioSciences, Inc , Frederick , MD , USA
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Hunter S, Katz D, Goldberg A, Lin HM, Pasricha R, Benesh G, Le Grand B, DeMaria S. Use of an anaesthesia workstation barrier device to decrease contamination in a simulated operating room. Br J Anaesth 2017; 118:870-875. [DOI: 10.1093/bja/aex097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 12/12/2022] Open
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Katz D, Feldhamer I, Greenberg-Dotan S, Hammerman A. Duration of second-line T-DM1 therapy: Is it associated with duration of first-line anti-Her2 therapy in metastatic HER2 + breast cancer? J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e12512] [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
e12512 Background: Tumors with HER2 overexpression usually respond to HER2-targeted therapies. Since the CLEOPATRA and EMILIA trials, a taxane plus trastuzumab and pertuzumab (TTP) are the first-line standard for the management of HER2 + metastatic breast cancer (MBC) and trastuzumab emtansine (TDM-1) is the second-line standard. Intrinsic subtypes existing within HER2+ tumors may impact the degree of a patient’s response to anti HER2 therapy; however HER2 subtyping for predicting response is still experimental and not in routine clinical use. In this retrospective population-based study, we aimed to assess whether duration of treatment (DOT) of second-line TDM1 is associated with the DOT of first-line TTP, and might serve as a hint for a HER2 subtype. Methods: Clalit Health Services (CHS) manages health care of 52% of the Israeli population. We identified 113 HER2+ CHS MBC patients, treated with TTP as first-line treatment that initiated TDM1 as second-line, until Dec. 31, 2016. Patient's (pts) demography, HER2 and HR status were recorded. A Cox proportional hazard model, stratified by HR status, adjusted for age and prior adjuvant trastuzumab, was used to explore the association between second-line and first-line DOT in HR positive and negative pts. Results: Pts baseline characteristics and DOT in first- and second-line treatment are presented in the table. A statistically significant association between DOT of both treatment lines was found in HR positive pts with a trend also in HR negative pts. Conclusions: The observed association between first- and second-line DOT, unrelated to hormonal status, may result from a primary characteristic of the intrinsic tumor subtype, that impacts acquired resistance. Longer observations in larger patient cohorts are required to confirm this observation. [Table: see text]
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Affiliation(s)
| | - Ilan Feldhamer
- Chief Physician's Office, Clalit Health Services Headquarters, Tel-Aviv, Israel
| | | | - Ariel Hammerman
- Chief Physician's Office, Clalit Health Services Headquarters, Tel-Aviv, Israel
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Zick A, Peretz T, Lotem M, Hubert A, Katz D, Temper M, Rottenberg Y, Uziely B, Nechushtan H, Meirovitz A, Sonnenblick A, Sapir E, Edelman D, Goldberg Y, Lossos A, Rosenberg S, Fried I, Finklstein R, Pikarsky E, Goldshmidt H. Treatment inferred from mutations identified using massive parallel sequencing leads to clinical benefit in some heavily pretreated cancer patients. Medicine (Baltimore) 2017; 96:e6931. [PMID: 28514312 PMCID: PMC5440149 DOI: 10.1097/md.0000000000006931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Molecular portraits of numerous tumors have flooded oncologists with vast amounts of data. In parallel, effective inhibitors of central pathways have shown great clinical benefit. Together, this promises potential clinical benefits to otherwise end-stage cancer patients. Here, we report a clinical service offering mutation detection of archived samples using the ion Ampliseq cancer panel coupled with clinical consultation.A multidisciplinary think tank consisting of oncologists, molecular-biologists, genetic counselors, and pathologists discussed 67 heavily pretreated, advanced cancer patient cases, taking into account mutations identified using ion Ampliseq cancer panel, medical history, and relevant literature.The team generated a treatment plan, targeting specific mutations, for 41 out of 64 cases. Three patients died before results were available. For 32 patients, the treating oncologists chose not to include the panel recommendation in the treatment plan for various reasons. Nine patients were treated as recommended by the panel, 5 with clinical benefit, and 4 with disease progression.This study suggests that routine use of massive parallel tumor sequencing is feasible and can judiciously affect treatment decisions when coupled with multidisciplinary team-based decision making. Administration of personalized based therapies at an earlier stage of disease, expansion of genetic alterations examined, and increased availability of targeted therapies may lead to further improvement in the clinical outcome of metastatic cancer patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alexander Lossos
- Leslie and Michael Gaffin Center for Oncology, Departments of Oncology and Neurology, Hebrew University-Hadassah Medical Center
| | - Shai Rosenberg
- Leslie and Michael Gaffin Center for Oncology, Departments of Oncology and Neurology, Hebrew University-Hadassah Medical Center
| | - Iris Fried
- Department of Pediatrics, Hadassah Medical Center, Division of Pediatric Hematology and Oncology
| | - Ruth Finklstein
- Lautenberg Center for Immunology, IMRIC, The Hebrew University-Hadassah Medical School
| | - Eli Pikarsky
- Lautenberg Center for Immunology, IMRIC, The Hebrew University-Hadassah Medical School
- Department of Pathology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Hanoch Goldshmidt
- Department of Pathology, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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Grizzle RE, Ward KM, Peter CR, Cantwell M, Katz D, Sullivan J. Growth, morphometrics, and nutrient content of farmed eastern oysters, Crassostrea virginica (Gmelin), in New Hampshire, USA. Aquac Res 2017; 48:1525-1537. [PMID: 30123043 PMCID: PMC6093306 DOI: 10.1111/are.12988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
When harvested, oysters represent a removal from the ecosystem of nutrients such as nitrogen (N) and carbon (C). A number of factors potentially affect nutrient content, but a quantitative understanding across the geographic range of the eastern oysters is lacking. The present study was designed to quantify the relationships among various metrics of farmed eastern oysters near its northern geographic range focusing on nutrient content. Hatchery-reared oysters were deployed in polyethylene bags at six sites, and were measured on multiple occasions from 2010-2012. A quadratic polynomial fit to the combined datasets for shell height indicated that on average a 'cocktail' size oyster (63 mm shell height) would be reached after 2 yr, and 'regular' size (76 mm) would require 3 yr. There were significant differences in growth rates and oyster nutrient content among the sites; means for %N in soft tissue ranged from 6.9 to 8.6, and 0.07 to 0.18 in shell. Percent N in soft tissue and shell were highest at two sites at the mouths of rivers with elevated dissolved inorganic N concentrations in the water. Grand means (all sites, seasons and years combined) of soft tissue N and C for regular size oysters were 7.3% and 38.5%, respectively; and for shell N and C were 0.13% and 12.0%, respectively. Our study extends the range of data on nutrient content of the eastern oyster to northern New England, and indicates that oyster size, seasonality, and nutrient concentration in ambient water potentially affect %N and %C content of oysters.
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Affiliation(s)
- R E Grizzle
- University of New Hampshire, Jackson Estuarine Laboratory, Durham, NH 03824 USA
| | - K M Ward
- University of New Hampshire, Jackson Estuarine Laboratory, Durham, NH 03824 USA
| | - C R Peter
- University of New Hampshire, Jackson Estuarine Laboratory, Durham, NH 03824 USA
| | - M Cantwell
- United States Environmental Protection Agency, Office of Research and Development, National Human and Environmental Effects Research Lab, Atlantic Ecology Division, Narragansett, RI 02882 USA
| | - D Katz
- United States Environmental Protection Agency, Office of Research and Development, National Human and Environmental Effects Research Lab, Atlantic Ecology Division, Narragansett, RI 02882 USA
| | - J Sullivan
- United States Environmental Protection Agency, Office of Research and Development, National Human and Environmental Effects Research Lab, Atlantic Ecology Division, Narragansett, RI 02882 USA
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Alagheband S, Malet P, Katz D, Davis-Lorton M. Angioedema of the small intestine: A great imitator. Clin Res Hepatol Gastroenterol 2017; 41:121-122. [PMID: 27825635 DOI: 10.1016/j.clinre.2016.09.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/09/2016] [Accepted: 09/22/2016] [Indexed: 02/04/2023]
Affiliation(s)
- S Alagheband
- Winthrop University Hospital, Department of Internal Medicine, First Street, Mineola, NY 11501, United States.
| | - P Malet
- Winthrop University Hospital, Department of Gastroenterology, 222 Station Plz N Building, Suite 429, Mineola, NY 11501, United States.
| | - D Katz
- Winthrop University Hospital, Department of Radiology, First Street, Mineola, NY 11501, United States.
| | - M Davis-Lorton
- Winthrop University Hospital, Department of Allergy-Immunology, 120 Mineola Blvd, Suite 410, Mineola, NY 11501, United States.
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Ravi V, Madison R, Schrock AB, Cote G, Millis S, Alvarez R, Choy E, Katz D, Chung J, Gay L, Miller VA, Ross JS, Ali SM, Schnitt S. Abstract P2-12-01: Comprehensive genomic profiling of 34 cases of breast angiosarcoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-12-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Angiosarcoma of the breast (BAS) is a rare but lethal neoplasia, either arising de novo or secondary to radiation therapy, with incidence of the latter disease increasing. We queried a database of more than 70,000 advanced cancer patients assayed with comprehensive genomic profiling (CGP) in the course of clinical care to uncover the frequency, type and associated genomic alterations (GA) in BAS and to highlight possible routes to benefit from targeted therapy.
Methods: CGP was performed for 34 BAS cases using a hybrid-capture, adaptor ligation based next generation sequencing assay of up to 315 genes to a mean coverage depth of >500X. The results were analyzed for base substitutions, short insertions and deletions, selected rearrangements, and copy number changes. RNA sequencing for 265 genes was also performed for 24 cases. Limited clinical histories from submitted pathology reports were reviewed under IRB permission.
Results: Clinical specimens from 34 BAS patients, all females, were assayed. The cases harbored 87 total GA for a mean of 2.59 per case, 25% of which were copy number amplifications. The most commonly altered genes were MYC (41%, 14/34), PIK3CA (26%, 9/34), and KDR (26%, 9/34). All MYC alterations were amplifications with a mean copy number of 39, and alterations in other MYC family members (MYCN and MYCL1) were not observed. KDR was recurrently altered as T771R (7/9) and T771K (1/9) and amplified in one case (1/9).
MYC and KDR alterations were mutually exclusive (p<0.0001). 6/14 MYC amplified cases had prior histories of breast carcinoma, with 3/6 noted as being treated with radiation therapy. For the remainder of MYC amplified cases (8/14), no relevant clinical history was available.
Two cases harboring gene fusions were identified including CIC-MEGF8 and NTRK1-PEAR1. Two rearrangements of potential functional significance including CIC-DEDD2 and HT-ALK (exon1 HT - exon5-29 ALK including kinase domain) were also observed. The case harboring HT-ALK also had MYC amplification and known prior radiation therapy. Two other MYC amplified cases also harbored targetable kinase alterations, including FLT4 amplification (described as targetable in Ravi et al JNCCN 2016) and FGFR3 S249C, a known activating mutation.
Conclusions: MYC amplification defines over 40% (14/34) of advanced BAS cases. Of MYC amplified cases, 28% (4/14) harbored targetable alterations of tyrosine kinases including a potential novel ALK fusion. FLT4 amplification only co-occurred with MYC amplification, but this result was not statistically significant in this small series. KDR and MYC alteration were mutually exclusive, and 45% of non-MYC altered cases (9/20) harbored KDR alterations, which were predominantly mutations of T771. Further clinico-pathologic correlation, particularly history of radiation therapy, will be explored in this series, as well defining BAS that harbor neither MYC nor KDR alterations.
Citation Format: Ravi V, Madison R, Schrock AB, Cote G, Millis S, Alvarez R, Choy E, Katz D, Chung J, Gay L, Miller VA, Ross JS, Ali SM, Schnitt S. Comprehensive genomic profiling of 34 cases of breast angiosarcoma [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-12-01.
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Affiliation(s)
- V Ravi
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - R Madison
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - AB Schrock
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - G Cote
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - S Millis
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - R Alvarez
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - E Choy
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - D Katz
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - J Chung
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - L Gay
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - VA Miller
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - JS Ross
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - SM Ali
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
| | - S Schnitt
- Foundation Medicine, Inc; Massachusetts General Hospital; Dana Farber Cancer Institute; Southeastern Regional Medical Center; Beth Israel Deaconness Medical Center; Hadassah-Hebrew University Medical Center
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Techasith T, Hoang D, Reposar A, Kuo W, Hovsepian D, Katz D, Hofmann L. Ovarian vein embolization for treatment of lower extremity edema in patients with ovarian vein enlargement/reflux: A single-institution feasibility study. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1184] [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] Open
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Baadh A, Katz D, Islam S, Baadh P. Interventional radiology and the Sunshine Act: Two -year analysis of the open payments database and comparison with related specialties. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.978] [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] Open
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Kollár A, Jones RL, Stacchiotti S, Gelderblom H, Guida M, Grignani G, Steeghs N, Safwat A, Katz D, Duffaud F, Sleijfer S, van der Graaf WT, Touati N, Litière S, Marreaud S, Gronchi A, Kasper B. Pazopanib in advanced vascular sarcomas: an EORTC Soft Tissue and Bone Sarcoma Group (STBSG) retrospective analysis. Acta Oncol 2017; 56:88-92. [PMID: 27838944 DOI: 10.1080/0284186x.2016.1234068] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Pazopanib is a multitargeted tyrosine kinase inhibitor approved for the treatment of patients with selective subtypes of advanced soft tissue sarcoma (STS) who have previously received standard chemotherapy including anthracyclines. Data on the efficacy in vascular sarcomas are limited. The main objective of this study was to investigate the activity of pazopanib in vascular sarcomas. PATIENTS AND METHODS A retrospective study of patients with advanced vascular sarcomas, including angiosarcoma (AS), epithelioid hemangioendothelioma (HE) and intimal sarcoma (IS) treated with pazopanib in real life practice at EORTC centers as well as patients treated within the EORTC phase II and III clinical trials (62043/62072) was performed. Patient and tumor characteristics were collected. Response was assessed according to RECIST 1.1. and survival analysis was performed. RESULTS Fifty-two patients were identified, 40 (76.9%), 10 (19.2%) and two (3.8%) with AS, HE and IS, respectively. The response rate was eight (20%), two (20%) and two (100%) in the AS, HE and IS subtypes, respectively. There was no significant difference in response rate between cutaneous and non-cutaneous AS and similarly between radiation-associated and non-radiation-associated AS. Median progression-free survival (PFS) and median overall survival (OS; from commencing pazopanib) were three months (95% CI 2.1-4.4) and 9.9 months (95% CI 6.5-11.3) in AS, respectively. CONCLUSION The activity of pazopanib in AS is comparable to its reported activity in other STS subtypes. In this study, the activity of pazopanib was similar in cutaneous/non-cutaneous and in radiation/non-radiation-associated AS. In addition, pazopanib showed promising activity in HE and IS, worthy of further evaluation.
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Affiliation(s)
- A. Kollár
- Sarcoma Unit, Department of Medical Oncology, University Hospital of Bern, Bern, Switzerland
| | - R. L. Jones
- Sarcoma Unit, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
| | - S. Stacchiotti
- Sarcoma Unit, Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - H. Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, RC Leiden, The Netherlands
| | - M. Guida
- Oncology Department, National Cancer Institute "Giovanni Paolo II", Bari, Italy
| | - G. Grignani
- Division of Medical Oncology, Candiolo Cancer Institue–FPO, IRCCS, Candiolo, Italy
| | - N. Steeghs
- Department of Medical Oncology, Pharmacology the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A. Safwat
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - D. Katz
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Kiryat Hadassah, Jerusalem, Israel
| | - F. Duffaud
- La Timone University Hospital & Aix-Marseille University (AMU), Marseille, France
| | - S. Sleijfer
- Department of Medical Oncology, Erasmus MC–Cancer Institute, Erasmus University Medical Center, CE Rotterdam, The Netherlands
| | - W. T. van der Graaf
- Sarcoma Unit, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
- Department of Medical Oncology, Radboud University Medical Center, GA Nijmegen, The Netherlands
| | - N. Touati
- European Organization for Research and Treatment of Cancer (EORTC), Bruxelles, Belgium
| | - S. Litière
- European Organization for Research and Treatment of Cancer (EORTC), Bruxelles, Belgium
| | - S. Marreaud
- European Organization for Research and Treatment of Cancer (EORTC), Bruxelles, Belgium
| | - A. Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - B. Kasper
- Sarcoma Unit, Interdisciplinary Tumor Center, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
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Katz D, Katz I, Porat-Katz BS, Shoenfeld Y. Medical cannabis: Another piece in the mosaic of autoimmunity? Clin Pharmacol Ther 2016; 101:230-238. [DOI: 10.1002/cpt.568] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/09/2016] [Indexed: 02/07/2023]
Affiliation(s)
- D Katz
- The Zabludowicz Center for Autoimmune Diseases; Chaim Sheba Medical Center; Tel-Hashomer Israel
- Faculty of Medicine; The Hebrew University of Jerusalem; Israel
| | - I Katz
- The Zabludowicz Center for Autoimmune Diseases; Chaim Sheba Medical Center; Tel-Hashomer Israel
- Faculty of Medicine; The Hebrew University of Jerusalem; Israel
| | - BS Porat-Katz
- The Robert H. Smith Faculty of Agriculture, Food and Environment School of Nutritional Sciences; The Hebrew University of Jerusalem; Rehovot Israel
| | - Y Shoenfeld
- The Zabludowicz Center for Autoimmune Diseases; Chaim Sheba Medical Center; Tel-Hashomer Israel
- Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine; Tel-Aviv University; Israel
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Alagheband S, Katz D, Davis-Lorton M. P092 Angiotensin-converting enzyme-inhibitor-induced small bowel angioedema. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.101] [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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Zick A, Peretz T, Lotem M, Hubert A, Katz D, Temper M, Rottenberg Y, Uziely B, Nechushtan H, Meirovitz A, Sonnenblick A, Sapir E, Edelman D, Goldberg Y, Lossos A, Rosenberg S, Fried I, Finklstein R, Pikarsky E, Goldshmidt H. Treatment inferred from mutations identified using massive parallel sequencing leads to clinical benefit in some heavily pretreated cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.36] [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: 11/13/2022] Open
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Kollar A, Jones R, Stacchiotti S, Gelderblom H, Guida M, Boccone P, Steeghs N, Safwat A, Katz D, Duffaud F, Sleijfer S, van sder Graaf W, Touati N, Litière S, Marreaud S, Gronchi A, Kasper B. Pazopanib in advanced vascular sarcomas: an EORTC Soft Tissue and Bone Sarcoma Group retrospective analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw388.16] [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: 11/12/2022] Open
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Katz D, Azraq Y, Eleyan F, Gill S, Peretz T, Merimsky O. Pazolimus: pazopanib plus sirolimus following progression on pazopanib, a retrospective case series analysis. BMC Cancer 2016; 16:616. [PMID: 27501793 PMCID: PMC4977830 DOI: 10.1186/s12885-016-2618-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 04/29/2016] [Accepted: 07/26/2016] [Indexed: 11/16/2022] Open
Abstract
Background To explore the activity of pazopanib (P) + sirolimus (S) in patients who progressed after previous clinical benefit on pazopanib. Methods Eight patients with progressing metastatic high grade soft tissue sarcoma (STS) whose disease advanced on P following a response duration of at least 4 months were offered re-challenge of P supplemented by off-label S and a single patient with progressing metastatic chondrosarcoma was offered the combination as compassionate treatment. Patients were treated in two centers: Hadassah Medical Center and Tel Aviv Medical Center. Patients received oral P 200–600 mg once a day supplemented by S 3–4 mg taken separately, 12 h after the P dose. Results Patients received treatment from December 2012 to February 2016. Four progressed on the combination and their treatment was terminated. Two patients were undergoing treatment when data was summarized. Best Response Evaluation Criteria in Solid Tumour (RECIST) responses were: one partial response (PR), four stable disease (SD), and four progressive disease (PD), corresponding to five PR and four PD on the Choi criteria. Median progression free survival was 5.5 months (range 4–17). Conclusions Our series showed that the combination of P + S has activity in STS patients selected by previous response to P and in a patient with chondrosarcoma, suggesting this can serve as a mechanism to reverse resistance to P and extend the chemotherapy-free window.
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Affiliation(s)
- D Katz
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
| | - Y Azraq
- Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - F Eleyan
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - S Gill
- Boston University School of Medicine, Boston, USA
| | - T Peretz
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - O Merimsky
- The Unit of Bone and Soft Tissue Oncology, Division of Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Affiliated with Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Katz D, Peretz T, Eleyan F, Azraq Y, Merimsky O. Pazopanib plus sirolimus following escape from pazopanib alone: An intriguing observation—A series of 8 metastatic STS patients. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e22538] [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)
| | - Tamar Peretz
- Sharett Institute of Oncology, Hadassah and Hebrew University Medical Center, Jerusalem, Israel
| | - Feras Eleyan
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yusef Azraq
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Love C, Katz D. 143 Medium-term Outcomes of the MINT Technique for IPP Surgery in 180 Consecutive Patients. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.149] [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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Rodrigue JR, Schold JD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz D, Jones J, Kaplan B, Fleishman A, Pavlakis M, Mandelbrot DA. Direct and Indirect Costs Following Living Kidney Donation: Findings From the KDOC Study. Am J Transplant 2016; 16:869-76. [PMID: 26845630 DOI: 10.1111/ajt.13591] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/11/2015] [Accepted: 09/23/2015] [Indexed: 01/25/2023]
Abstract
Some living kidney donors (LKDs) incur costs associated with donation, although these costs are not well characterized in the United States. We collected cost data in the 12 mo following donation from 182 LKDs participating in the multicenter prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 167, 92%) had one direct cost or more following donation, including ground transportation (86%), health care (41%), meals (53%), medications (36%), lodging (23%), and air transportation (12%). LKDs missed 33 072 total work hours, 40% of which were unpaid and led to $302 175 in lost wages (mean $1660). Caregivers lost $68 655 in wages (mean $377). Although some donors received financial assistance, 89% had a net financial loss in the 12-mo period, with one-third (33%) reporting a loss exceeding $2500. Financial burden was higher for those with greater travel distance to the transplant center (Spearman's ρ = 0.26, p < 0.001), lower household income (Spearman's ρ = -0.25, p < 0.001), and more unpaid work hours missed (Spearman's ρ = 0.52, p < 0.001). Achieving financial neutrality for LKDs must be an immediate priority for the transplant community, governmental agencies, insurance companies, nonprofit organizations, and society at large.
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Affiliation(s)
- J R Rodrigue
- Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - J D Schold
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - P Morrissey
- Transplant Center, Rhode Island Hospital, Providence, RI
| | - J Whiting
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - J Vella
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - L K Kayler
- Montefiore Einstein Center for Transplantation, Bronx, NY.,Regional Center of Excellence for Transplantation and Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY
| | - D Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - J Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - B Kaplan
- Department of Medicine, University of Arizona, Tucson, AZ.,School for the Science of Health Care Delivery, Arizona State University, Phoenix, AZ
| | - A Fleishman
- Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - M Pavlakis
- Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.,Harvard Medical School, Boston, MA
| | - D A Mandelbrot
- Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.,Department of Medicine, University of Wisconsin, Madison, WI
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Affiliation(s)
- H Meldrum
- a Australasian Society for Lifestyle Medicine , Northcote , Melbourne, Australia
| | - D Katz
- b American College of Lifestyle Medicine , Woodburn , OR , USA
| | - G Egger
- a Australasian Society for Lifestyle Medicine , Northcote , Melbourne, Australia
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Mazzola C, Berookhim B, Katz D, Deveci S, Mulhall J. Arrêter un traitement par citrate de clomiphène pour commencer un traitement par testostérone transdermique : impact sur la symptomatologie de l’hypogonadisme. Prog Urol 2015; 25:815-6. [DOI: 10.1016/j.purol.2015.08.200] [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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