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El Miedany Y, El Gaafary M, Toth M, Palmer D, Ali A, Bahlas S, Mahran S, Hassan W, Abu-Zaid MH, Saber S, Elwakil W. Beyond the symptoms: Personalizing giant cell arteritis care through multidimensional patient reported outcome measure. Semin Arthritis Rheum 2023; 63:152285. [PMID: 37944298 DOI: 10.1016/j.semarthrit.2023.152285] [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: 05/27/2023] [Revised: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Giant Cell Arteritis (GCA) is the commonest form of systemic vasculitis in people over the age of 50. Published research highlighted the lack of a disease-specific patient reported outcomes (PROMs) for GCA. OBJECTIVES To assess the validity, reliability and responsiveness to change of a devised disease specific patient self-reported outcome measures questionnaire for Giant Cell Arteritis (GCA). METHODS The GCA-PROMs was conceptualized based on frameworks outlined in the OMERACT developed core set of Outcome Measures for Large-Vessel Vasculitis and the guiding principles of the FDA guidance. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction was achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. RESULTS A total of 54 GCA patients completed the questionnaire. The GCA-PROMs questionnaire was reliable as demonstrated by a high standardized alpha (0.878-0.983). Content construct assessment of the GCA-PROMs functional disability and QoL revealed significant correlation (p< 0.01) with both HAQ and EQ-5D. Changes in functional disability, QoL showed significant (p< 0.01) variation with diseases activity status in response to therapy. CONCLUSIONS The developed GCA-PROMs questionnaire is a reliable and valid instrument for assessment of GCA patients. A stratified treatment regimen depending on the individual patient's risk factors as well as preferences and associated comorbidities is the best approach to tailored patient management.
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Affiliation(s)
- Y El Miedany
- Professor Canterbury Christ Church University, England; H. Senior Clinical Lecturer, King's College London, England.
| | - M El Gaafary
- Professor Community and Public Health, Ain Shams University, Cairo, Egypt
| | - M Toth
- H. Senior Clinical Lecturer, King's College London, England; Darent Valley Hospital, Kent, England
| | - D Palmer
- North Middlesex University Hospital, London, England
| | - Ayman Ali
- Darent Valley Hospital, Kent, England
| | - S Bahlas
- Professor of Internal Medicine/Rheumatology, College of Medicine, King Abdulaziz University, Saudi Arabia
| | - S Mahran
- Professor Rheumatology, Physical Medicine and Rehabilitation, Assiut University, Egypt
| | - W Hassan
- Professor Rheumatology and Rehabilitation, Benha University, Benha, Egypt
| | - M H Abu-Zaid
- Assistant Professor Rheumatology and Rehabilitation, Tanta University, Tanta, Egypt
| | - S Saber
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | - W Elwakil
- Lectuer Rheumatology and Rehabilitation, Alexandria University, Alexanrdia, Egypt
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Voetterl H, van Wingen G, Michelini G, Griffiths KR, Gordon E, DeBeus R, Korgaonkar MS, Loo SK, Palmer D, Breteler R, Denys D, Arnold LE, du Jour P, van Ruth R, Jansen J, van Dijk H, Arns M. Brainmarker-I Differentially Predicts Remission to Various Attention-Deficit/Hyperactivity Disorder Treatments: A Discovery, Transfer, and Blinded Validation Study. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:52-60. [PMID: 35240343 DOI: 10.1016/j.bpsc.2022.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder is characterized by neurobiological heterogeneity, possibly explaining why not all patients benefit from a given treatment. As a means to select the right treatment (stratification), biomarkers may aid in personalizing treatment prescription, thereby increasing remission rates. METHODS The biomarker in this study was developed in a heterogeneous clinical sample (N = 4249) and first applied to two large transfer datasets, a priori stratifying young males (<18 years) with a higher individual alpha peak frequency (iAPF) to methylphenidate (N = 336) and those with a lower iAPF to multimodal neurofeedback complemented with sleep coaching (N = 136). Blinded, out-of-sample validations were conducted in two independent samples. In addition, the association between iAPF and response to guanfacine and atomoxetine was explored. RESULTS Retrospective stratification in the transfer datasets resulted in a predicted gain in normalized remission of 17% to 30%. Blinded out-of-sample validations for methylphenidate (n = 41) and multimodal neurofeedback (n = 71) corroborated these findings, yielding a predicted gain in stratified normalized remission of 36% and 29%, respectively. CONCLUSIONS This study introduces a clinically interpretable and actionable biomarker based on the iAPF assessed during resting-state electroencephalography. Our findings suggest that acknowledging neurobiological heterogeneity can inform stratification of patients to their individual best treatment and enhance remission rates.
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Affiliation(s)
- Helena Voetterl
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Guido van Wingen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Giorgia Michelini
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, California; Department of Biological & Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | - Kristi R Griffiths
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Roger DeBeus
- Department of Psychology, University of North Carolina at Asheville, Asheville, North Carolina
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia; School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sandra K Loo
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, California
| | | | - Rien Breteler
- Department of Clinical Psychology, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L Eugene Arnold
- Department of Psychiatry & Behavioral Health, Nisonger Center, Ohio State University, Columbus, Ohio
| | | | | | - Jeanine Jansen
- Open Mind Neuroscience, Eindhoven, the Netherlands; Eindhovens Psychologisch Instituut, Eindhoven, the Netherlands
| | - Hanneke van Dijk
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Martijn Arns
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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Lamarca A, Palmer D, Wasan H, Ross P, Ma Y, Arora A, Falk S, Gillmore R, Wadsley J, Patel K, Anthoney A, Maravellas A, Waters J, Hoobs C, Macdonald T, Ryder D, Ramage J, Davies L, Bridgewater J, Valle J. 54MO Quality of life (QoL) and value of health (V-He) in advanced biliary cancers (ABC) treated with second-line active-symptom-control (ASC) alone or ASC with oxaliplatin/5-FU chemotherapy (ASC+FOLFOX) in the randomised phase III, multi-centre, open-label ABC-06 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.082] [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: 11/01/2022] Open
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Lamarca A, Palmer D, Wasan H, Ross P, Ting Ma Y, Arora A, Falk S, Gillmore R, Wadsley J, Patel K, Anthoney A, Maraveyas A, Waters J, Hoobs C, Macdonald T, Ryder D, Ramage J, Davies L, Bridgewater J, Valle J. P-88 Clinical role of tumour markers in advanced biliary cancers (ABC) treated with second-line active-symptom-control (ASC) alone or ASC with oxaliplatin/5-FU chemotherapy (ASC+mFOLFOX) in the randomised phase III, multi-centre, open-label ABC-06 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Lamarca A, Roberts K, Graham J, Kocher H, Chang D, Ghaneh P, Jamieson N, Propper D, Bridgewater J, Ajithkumar T, Palmer D, Wedgwood K, Grose D, Corrie P, Valle J. P-85 Pre-surgical staging and surveillance after curative treatment for pancreatic ductal adenocarcinoma (PDAC): Survey of practice in the United Kingdom (UK). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.175] [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] Open
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Wacker BK, Bi L, Sorci-Thomas M, Ng P, Palmer D, Tang C, Dichek D. Abstract 430: GFP-tagging Of Rabbit ApoAI Decreases Expression And Cholesterol-efflux Activity. Arterioscler Thromb Vasc Biol 2022. [DOI: 10.1161/atvb.42.suppl_1.430] [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: 12/05/2022]
Abstract
Introduction:
Gene therapy using a helper-dependent adenovirus (HDAd) to express rabbit apolipoprotein (apo) AI in carotids of fat-fed rabbits reduces atherosclerosis. We hypothesize that transgenic apoAI promotes reverse cholesterol transport from the artery wall; however, this could not be tested because the transgenic rabbit apoAI is indistinguishable from endogenous rabbit apoAI. We therefore constructed an HDAd expressing GFP-tagged rabbit apoAI.
Methods:
We constructed HDAdGFPapoAI by fusing the GFP sequence to the N-terminus of the rabbit
APOA1
gene with a short linker. Bovine aortic endothelial cells (BAEC) were transduced with HDAdGFPapoAI, washed, and incubated in serum-free medium for 24h. Conditioned medium (CM) was collected and fluorescence measured. Cell extracts and CM were analyzed by western blotting for protein size, expression level, and presence of GFP and apoAI antigens. CM cholesterol-efflux activity was measured using cholesterol-loaded BHK cells expressing ABCA1.
Results:
CM of HDAdGFPapoAI-transduced BAEC had green fluorescence and contained a protein of the size predicted for the GFP-apoAI fusion (~56 kDa), which was detected with antibodies to both GFP and apoAI. A smaller protein (~30 kDa) with GFP and apoAI antigens was also detected. Compared to a vector expressing WT rabbit apoAI, GFP-tagging decreased expression of apoAI protein by ~50% and the percentage of secreted apoAI from 55% to 13%. In combination, this reduced secreted GFP-apoAI to only 12% of levels of secreted WT apoAI. While CM containing WT rabbit apoAI strongly stimulated cholesterol efflux from BHK cells (46%), GFP-apoAI-containing CM did not promote cholesterol efflux compared to CM from untransduced BAEC (7.8% vs 7.4% efflux), even when present in CM at a concentration similar to that of WT apoAI.
Conclusion:
GFP-rabbit apoAI protein has reduced expression and secretion (likely due to misfolding/degradation) and does not promote cholesterol efflux (n-terminal GFP may disrupt the phospholipid/cholesterol organization needed for efflux via ABCA1 to this dynamic apoprotein). It will not be useful to investigate mechanisms of atheroprotection by vessel wall-expressed apoAI. Alternatives include use of a smaller tag or expression of human apoAI.
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Affiliation(s)
| | | | | | - Philip Ng
- Baylor College of Medicine, Houston, TX
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Knox J, McNamara M, Goyal L, Cosgrove D, Springfeld C, Sjoquist K, Park J, Verdaguer H, Braconi C, Ross P, Oh DY, De Gramont A, Shroff R, Zalcberg J, Palmer D, Valle J. 59TiP Phase III study of NUC-1031 + cisplatin vs gemcitabine + cisplatin for first-line treatment of patients with advanced biliary tract cancer (NuTide:121). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.338] [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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8
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Laethem JLV, Borbath I, Karwal M, Verslype C, Van Vlierberghe H, Kardosh A, Zagonel V, Stal P, Sarker D, Palmer D, Vogel A, Edeline J, Cattan S, Kudo M, Cheng AL, Ogasawara S, Siegel A, Chisamore M, Wang A, Zhu A. 933P Updated results for pembrolizumab (pembro) monotherapy as first-line therapy for advanced hepatocellular carcinoma (HCC) in the phase II KEYNOTE-224 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.153] [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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Palmer D, Pou JO, Díaz-Ferrero J, Conesa JA, Ortuño N. Kinetics of the formation and destruction of PCDD/Fs in a laboratory tubular furnace. Chemosphere 2021; 276:130175. [PMID: 33714154 DOI: 10.1016/j.chemosphere.2021.130175] [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] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
A kinetic model has been developed for the formation of selected congeners of PCDD/Fs during the thermal decomposition of different wastes in a horizontal reactor. Previously published data on the decomposition of wastes have been correlated using a kinetic model that only considers process parameters, such as the presence of different amounts of oxygen in the atmosphere of reaction, chlorine and metals in the waste. The effect of both chlorine and metals is modelled through an equation assuming a "saturation effect", i.e., that a certain amount of each substance produces the maximum rate, and that higher amounts do not increase the rate. The presence of oxygen is modelled by a destruction reaction over part of the PCDD/Fs produced. The model, which uses data from more than 64 experiments, correlated the emissions of three selected congeners: 1,2,3,6,7,8-HxCDD, OCDF and 2,3,7,8-TCDF, which are enough to estimate the total amount and toxicity of an emission.
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Affiliation(s)
- D Palmer
- Industrial Engineering Department, Spain.
| | - J O Pou
- Chemical Engineering Department, Spain
| | - J Díaz-Ferrero
- Analytical and Applied Chemistry Department. Institut Químic de Sarrià - Universitat Ramon Llull, Via Augusta, 390, Barcelona, 08017, Spain
| | - Juan A Conesa
- Chemical Engineering Department - Universitat d'Alacant, Carretera de San Vicente del Raspeig, s/n, Alicante, 03690, Spain
| | - N Ortuño
- Chemical Engineering Department - Universitat d'Alacant, Carretera de San Vicente del Raspeig, s/n, Alicante, 03690, Spain
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Edeline J, Lamarca A, McNamara M, Jacobs T, Hubner R, Palmer D, Johnson P, Guiu B, Valle J. P-229 Systematic review and pooled analysis of locoregional therapies in patients with intrahepatic cholangiocarcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.283] [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] Open
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11
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Taieb J, Hammel P, Reni M, Palmer D, Bridgewater J, Cubillo A, Prager G, Bayle S, Hédouin-Biville F, Teng Z, Seufferlein T, Macarulla T. SO-3 Treatment sequences and prognostic factors in metastatic pancreatic ductal adenocarcinoma: Univariate and multivariate analyses of a real-world study in Europe. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.027] [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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12
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El-Miedany Y, El Gaafary M, El Aroussy N, Bahlas S, Palmer D. OP0304-PARE DEVELOPMENT OF INTERACTIVE DECISION AID TOOL FOR MOTHERHOOD AND PARENTHOOD AMONG PATIENTS LIVING WITH AUTOIMMUNE RHEUMATIC DISEASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.513] [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: 11/04/2022]
Abstract
Background:There are clear educational pregnancy-related needs for both women and men living with Autoimmune Rheumatic Diseases (ARDs) who seek specific advice from their health care providers. Most of the time those subjects would seek specific information regarding their chances of pregnancy, impact of the disease, as well as safety of their medications during pregnancy and breast feeding. They also require emotional and physical support as well as advice towards practical coping strategies to manage pain and disease flares particularly during the postnatal period.Objectives:To evaluate the effectiveness of a new interactive pregnancy decision aid (DA) developed for both men and women living with inflammatory arthritis.Methods:Driven by the Cochrane review of patient decision aids (DA) and the International Patient Decision Aids framework (IPDAS), which identify shared decision making (SDM) instrument as evidence-based tools designed to help people engage in deliberative management-related decision making by providing information on the options and outcomes relevant to health status. This project involved an overall three-phase SDM aid development. It has been set up for both men and women and included information on pregnancy, contraception and breast feeding. The first phase included the development of the decision tool and review by expert faculty composed of: decision experts, patient representatives, policy makers, and patients living with RA, PsA, AS and SLE. The second phase was a pilot testing of the tool in both online and paper format styles. The third phase involved an evaluation of the decision support tool and its impact on the patients. The DA adopted an interactive style with embedded video recordings (this was converted into text in the paper format). All the patient completed these questionnaires: the ReproKnow, Decisional Conflict Scale (DCS), Hospital Anxiety and Depression Scale (HADS), and Arthritis Self-Efficacy Scale (ASES) pre- and post-intervention. A control group of 92 patients (19 men and 71 women) managed according to the standard protocols was also included. Comprehensibility of the video recordings were also assessed using VAS (0-10).Results:126 patients shared in this work (101 women and 25 men). The patients who received the DA had an 81% (women) and 83% (men) increase in ReproKnow scores and a 76 % decrease in scores on the decisional conflict (DCS), compared to the control group (10 % and 11 % respectively); p< 0.001. There were no changes in the scores of depression and anxiety symptoms (p= 0.873) indicating no adverse psychological impact detected. There was no significant difference in terms of self-efficacy assessment p=0.481. The patients rated the comprehensibility of the video recording as high (9.4/10)Conclusion:The DA which was developed to support pregnancy and breast feeding decision-making for patients with ARDs. The interactive SDM aid was found to be a simple, user-friendly tool which can be implemented in standard clinical practice. The interactive style made it more comprehensible to the patients. It is consistent with the IPDAS criteria. Results revealed its effectiveness in improving relevant knowledge and reducing decisional conflict without causing distress to the patients.Disclosure of Interests:None declared.
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Sangro B, Harding J, Johnson M, Palmer D, Edeline J, Abou-Alfa G, Cheng A, Decaens T, El-Khoueiry A, Finn R, Galle P, Park J, Yau T, Begic D, Shen Y, Neely J, Sama A, Kudo M. Abstract No. 117 A phase 3, double-blind, randomized study of nivolumab and Ipilimumab), nivolumab monotherapy, or placebo plus transarterial chemoembolization in patients with intermediate-stage hepatocellular carcinoma. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.123] [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] Open
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Lee RJ, Wysocki O, Bhogal T, Shotton R, Tivey A, Angelakas A, Aung T, Banfill K, Baxter M, Boyce H, Brearton G, Copson E, Dickens E, Eastlake L, Gomes F, Hague C, Harrison M, Horsley L, Huddar P, Hudson Z, Khan S, Khan UT, Maynard A, McKenzie H, Palmer D, Robinson T, Rowe M, Thomas A, Tweedy J, Sheehan R, Stockdale A, Weaver J, Williams S, Wilson C, Zhou C, Dive C, Cooksley T, Palmieri C, Freitas A, Armstrong AC. Erratum to 'Longitudinal characterisation of haematological and biochemical parameters in cancer patients prior to and during COVID-19 reveals features associated with outcome': [ESMO Open Volume 6, Issue 1, February 2021, 100005]. ESMO Open 2021; 6:100056. [PMID: 33545518 PMCID: PMC7842131 DOI: 10.1016/j.esmoop.2021.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- R J Lee
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK; Tumour Cell Biology Laboratory, The Francis Crick Institute, London, UK.
| | - O Wysocki
- The University of Manchester, Manchester, UK; Digital Experimental Cancer Medicine Team, Cancer Research UK Manchester Institute Cancer Biomarker Centre, The University of Manchester, Alderley Park, UK
| | - T Bhogal
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - R Shotton
- The Christie NHS Foundation Trust, Manchester, UK
| | - A Tivey
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - A Angelakas
- University Hospitals of Morecambe Bay, Kendal, UK
| | - T Aung
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - K Banfill
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - M Baxter
- University of Dundee, Dundee, UK
| | - H Boyce
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - G Brearton
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - E Copson
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - E Dickens
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - L Eastlake
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - F Gomes
- The Christie NHS Foundation Trust, Manchester, UK
| | - C Hague
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - L Horsley
- The Christie NHS Foundation Trust, Manchester, UK
| | - P Huddar
- Lancashire Teaching Hospitals NHS Trust, Preston, UK
| | - Z Hudson
- Bristol Haematology and Oncology Centre, Bristol, UK
| | - S Khan
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK; Oncology Department, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - U T Khan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - A Maynard
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - H McKenzie
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D Palmer
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - T Robinson
- Bristol Haematology and Oncology Centre, Bristol, UK; Sunrise Oncology Centre, Royal Cornwall Hospital, Truro, UK
| | - M Rowe
- National Institute for Biological Standards and Control, Potters Bar, UK
| | - A Thomas
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK; Oncology Department, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - J Tweedy
- Institute of Infection and Global Health, University of Liverpool and Tropical and Infectious Diseases Unit, Royal Liverpool Hospital, Liverpool, UK
| | - R Sheehan
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - A Stockdale
- Cancer Research UK Manchester Institute, Cancer Biomarker Centre, The University of Manchester, Alderley Park, UK
| | - J Weaver
- The Christie NHS Foundation Trust, Manchester, UK
| | - S Williams
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - C Wilson
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - C Zhou
- The University of Bristol, Bristol, UK
| | - C Dive
- The University of Bristol, Bristol, UK
| | - T Cooksley
- The Christie NHS Foundation Trust, Manchester, UK
| | - C Palmieri
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - A Freitas
- The University of Manchester, Manchester, UK; Digital Experimental Cancer Medicine Team, Cancer Research UK Manchester Institute Cancer Biomarker Centre, The University of Manchester, Alderley Park, UK
| | - A C Armstrong
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
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Lee RJ, Wysocki O, Bhogal T, Shotton R, Tivey A, Angelakas A, Aung T, Banfill K, Baxter M, Boyce H, Brearton G, Copson E, Dickens E, Eastlake L, Gomes F, Hague C, Harrison M, Horsley L, Huddar P, Hudson Z, Khan S, Khan UT, Maynard A, McKenzie H, Palmer D, Robinson T, Rowe M, Thomas A, Tweedy J, Sheehan R, Stockdale A, Weaver J, Williams S, Wilson C, Zhou C, Dive C, Cooksley T, Palmieri C, Freitas A, Armstrong AC. Longitudinal characterisation of haematological and biochemical parameters in cancer patients prior to and during COVID-19 reveals features associated with outcome. ESMO Open 2021; 6:100005. [PMID: 33399072 PMCID: PMC7808077 DOI: 10.1016/j.esmoop.2020.100005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/16/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cancer patients are at increased risk of death from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cancer and its treatment affect many haematological and biochemical parameters, therefore we analysed these prior to and during coronavirus disease 2019 (COVID-19) and correlated them with outcome. PATIENTS AND METHODS Consecutive patients with cancer testing positive for SARS-CoV-2 in centres throughout the United Kingdom were identified and entered into a database following local governance approval. Clinical and longitudinal laboratory data were extracted from patient records. Data were analysed using Mann-Whitney U test, Fisher's exact test, Wilcoxon signed rank test, logistic regression, or linear regression for outcomes. Hierarchical clustering of heatmaps was performed using Ward's method. RESULTS In total, 302 patients were included in three cohorts: Manchester (n = 67), Liverpool (n = 62), and UK (n = 173). In the entire cohort (N = 302), median age was 69 (range 19-93 years), including 163 males and 139 females; of these, 216 were diagnosed with a solid tumour and 86 with a haematological cancer. Preinfection lymphopaenia, neutropaenia and lactate dehydrogenase (LDH) were not associated with oxygen requirement (O2) or death. Lymphocyte count (P < 0.001), platelet count (P = 0.03), LDH (P < 0.0001) and albumin (P < 0.0001) significantly changed from preinfection to during infection. High rather than low neutrophils at day 0 (P = 0.007), higher maximal neutrophils during COVID-19 (P = 0.026) and higher neutrophil-to-lymphocyte ratio (NLR; P = 0.01) were associated with death. In multivariable analysis, age (P = 0.002), haematological cancer (P = 0.034), C-reactive protein (P = 0.004), NLR (P = 0.036) and albumin (P = 0.02) at day 0 were significant predictors of death. In the Manchester/Liverpool cohort 30 patients have restarted therapy following COVID-19, with no additional complications requiring readmission. CONCLUSION Preinfection biochemical/haematological parameters were not associated with worse outcome in cancer patients. Restarting treatment following COVID-19 was not associated with additional complications. Neutropaenia due to cancer/treatment is not associated with COVID-19 mortality. Cancer therapy, particularly in patients with solid tumours, need not be delayed or omitted due to concerns that treatment itself increases COVID-19 severity.
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Affiliation(s)
- R J Lee
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK; Tumour Cell Biology Laboratory, The Francis Crick Institute, London, UK.
| | - O Wysocki
- The University of Manchester, Manchester, UK; Digital Experimental Cancer Medicine Team, Cancer Research UK Manchester Institute Cancer Biomarker Centre, The University of Manchester, Alderley Park, UK
| | - T Bhogal
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - R Shotton
- The Christie NHS Foundation Trust, Manchester, UK
| | - A Tivey
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - A Angelakas
- University Hospitals of Morecambe Bay, Kendal, UK
| | - T Aung
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - K Banfill
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - M Baxter
- University of Dundee, Dundee, UK
| | - H Boyce
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - G Brearton
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - E Copson
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - E Dickens
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - L Eastlake
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - F Gomes
- The Christie NHS Foundation Trust, Manchester, UK
| | - C Hague
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - L Horsley
- The Christie NHS Foundation Trust, Manchester, UK
| | - P Huddar
- Lancashire Teaching Hospitals NHS Trust, Preston, UK
| | - Z Hudson
- Bristol Haematology and Oncology Centre, Bristol, UK
| | - S Khan
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK; Oncology Department, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - U T Khan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - A Maynard
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - H McKenzie
- Cancer Sciences Academic Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D Palmer
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - T Robinson
- Bristol Haematology and Oncology Centre, Bristol, UK; Sunrise Oncology Centre, Royal Cornwall Hospital, Truro, UK
| | - M Rowe
- National Institute for Biological Standards and Control, Potters Bar, UK
| | - A Thomas
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK; Oncology Department, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - J Tweedy
- Institute of Infection and Global Health, University of Liverpool and Tropical and Infectious Diseases Unit, Royal Liverpool Hospital, Liverpool, UK
| | - R Sheehan
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - A Stockdale
- Cancer Research UK Manchester Institute, Cancer Biomarker Centre, The University of Manchester, Alderley Park, UK
| | - J Weaver
- The Christie NHS Foundation Trust, Manchester, UK
| | - S Williams
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - C Wilson
- Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - C Zhou
- The University of Bristol, Bristol, UK
| | - C Dive
- The University of Bristol, Bristol, UK
| | - T Cooksley
- The Christie NHS Foundation Trust, Manchester, UK
| | - C Palmieri
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK; The University of Liverpool, Liverpool, UK
| | - A Freitas
- The University of Manchester, Manchester, UK; Digital Experimental Cancer Medicine Team, Cancer Research UK Manchester Institute Cancer Biomarker Centre, The University of Manchester, Alderley Park, UK
| | - A C Armstrong
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
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Nam K, Larholt K, Hirsch G, Beninger P, Fritsche D, Shoda D, Ferguson J, Bourgeois FT, Palmer D, Katz K, Courtney MW. Dynamic Dossier in the Cloud: A Sociotechnical Architecture for a Real-Time and Metrics-Based Data Tracking System with Gene and Cell Therapies as a Case Study. Ther Innov Regul Sci 2020; 55:388-400. [PMID: 33118143 PMCID: PMC7864828 DOI: 10.1007/s43441-020-00227-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/09/2020] [Indexed: 01/19/2023]
Abstract
Background Data sharing among stakeholders in the development, access, and use of drug therapies is critical but the current system and process are inefficient. Methods We take a Systems Engineering approach with a realistic use case to propose a scalable design for multi-stakeholder data sharing. Results We make three major contributions to the drug development and healthcare communities: first, a methodology for developing a multi-stakeholder data sharing system, with its focus on high-level requirements that influence the design of the system architecture and technology choice; second, the development of a realistic use case for long-term patient and therapy data tracking and sharing in the use of potentially curative and durable gene and cell therapies. Further, a bridge for the ‘awareness gap’ was found between the payer (Payer is organization which takes care of financial and operational aspects (which include insurance plans, provider network) of providing health care to US citizens. Or refer to health care insurers.) and the regulator communities by illustrating the common data tracking needs, which highlights the need for coordinated data activities; and third, a proposed system architecture for scalable, multi-stakeholder data sharing. Next steps are briefly discussed. Conclusion We present a system design for multiple stakeholders such as the payer, the regulator, the developer (drug manufacturer), and the healthcare provider to share data for their decision-making. The stakeholder community would benefit from collaboratively moving the system development proposal forward for efficient and cost-effective data sharing.
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Affiliation(s)
- Kevin Nam
- MIT Lincoln Laboratory, Massachusetts Institute of Technology, 244 Wood St., Lexington, MA 02421 USA
| | - Kay Larholt
- MIT Center for Biomedical Innovation, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building E19-604, Cambridge, MA 02139 USA
| | - Gigi Hirsch
- MIT Center for Biomedical Innovation, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building E19-604, Cambridge, MA 02139 USA
| | - Paul Beninger
- Public Health & Community Medicine, Tufts University School of Medicine, Boston, USA
| | - David Fritsche
- MIT Center for Biomedical Innovation, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building E19-604, Cambridge, MA 02139 USA
| | - Diane Shoda
- Greyscaling LLC, 3722 Las Vegas Blvd S, Unit 2111, Las Vegas, NV 89158 USA
| | - John Ferguson
- Pharmacovigilance Specialty Care, Sanofi-Genzyme Business Unit, 50 Binney St., Cambridge, MA 02142 USA
| | - Florence T. Bourgeois
- MIT Lincoln Laboratory, Massachusetts Institute of Technology, 244 Wood St., Lexington, MA 02421 USA
- Harvard Medical School, 300 Longwood Avenue Boston, Boston, MA 02115 USA
| | - Donna Palmer
- MIT Center for Biomedical Innovation, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building E19-604, Cambridge, MA 02139 USA
| | - Karen Katz
- FoCUS Project, NEWDIGS, MIT Center for Biomedical Innovation, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building E19, Cambridge, MA 02139 USA
| | - Matt W. Courtney
- FoCUS Project, NEWDIGS, MIT Center for Biomedical Innovation, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building E19, Cambridge, MA 02139 USA
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Arrow P, Piggott S, Carter S, McPhee R, Atkinson D, Mackean T, Kularatna S, Tonmukayakul U, Brennan D, Nanda S, Palmer D, Jamieson L. Atraumatic Restorative Treatments in Australian Aboriginal Communities: A Cluster-randomized Trial. JDR Clin Trans Res 2020; 6:430-439. [PMID: 33016169 DOI: 10.1177/2380084420963949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The management of early childhood caries (ECC) is challenging. OBJECTIVES A model of care based on Atraumatic Restorative Treatment and the Hall Technique (ART-HT) to manage ECC was evaluated among remote Aboriginal communities in Australia. METHODS Aboriginal communities in the North-West of Western Australia were invited to participate and consenting communities were randomized into early or delayed intervention for the management of ECC. Children were examined at baseline and at the 11-mo follow-up. The early intervention group (test) was provided with the ART-based dental care at baseline while the delayed intervention group (control) was advised to seek care through the usual care options available within the community. At follow-up, both groups were examined by calibrated examiners, and were offered care using the ART-HT approach. Changes from baseline to follow-up in caries experience were tested using paired tests. Multivariate analysis after multiple imputation of missing data used generalised estimating equation (GEE) controlling for clustering within communities. RESULTS A total of 25 communities and 338 children (mean age = 3.6 y, SD 1.7) participated in the study (test = 177). At follow-up, 231 children were examined (68% retention, test = 125). At follow-up, children in the test group had more filled teeth (test filled teeth = 1.2, control filled teeth = 0.2, P < 0.001) and decreased levels of decayed teeth (mean test = 0.7 fewer teeth with decay, mean control = 1.0 more tooth with decay, P < 0.001). GEE analysis controlled for baseline caries experience, age, sex, and community water fluoride levels found increased rates of untreated decayed teeth (RR = 1.4, P = 0.02) and decreased rates of filled teeth (RR = 0.2, P < 0.001) at follow-up among the control group. CONCLUSION A model of care relying on the principles of minimally invasive atraumatic approaches enabled the delivery of effective dental services to young children (<6 y) in remote Aboriginal Australian communities resulting in increased levels of care and improved oral health. KNOWLEDGE TRANSFER STATEMENT This cluster-randomized trial tested a multi-component model of dental care to young children with ECC in remote Aboriginal communities in Australia. The intervention, based on the atraumatic approaches using minimally invasive techniques encompassing preventive care, Atraumatic Restorative Treatment and the Hall Technique (ART-HT), delivered more restorative care and reduced the incidence of caries. This model of care was more effective than available standard care and should be incorporated into mainstream service delivery programs.
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Affiliation(s)
- P Arrow
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Piggott
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - S Carter
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - R McPhee
- Kimberley Aboriginal Medical Services, Broome, Australia
| | - D Atkinson
- Rural Clinical School of Western Australia, University of Western Australia, Broome, Australia
| | - T Mackean
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
| | - S Kularatna
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - U Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Nanda
- Health Department Western Australia, Office of Chief Dental Officer, Perth, Australia
| | - D Palmer
- Community Development, Community Development, Murdoch University, Perth, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
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18
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Knox J, McNamara M, Goyal L, Doherty M, Cosgrove D, Springfeld C, Sjoquist K, Park J, Verdaguer H, Braconi C, Ross P, De Gramont A, Zalcberg J, Palmer D, Valle J. 80TiP Global phase III study of NUC-1031 plus cisplatin vs gemcitabine plus cisplatin for first-line treatment of patients with advanced biliary tract cancer (NuTide:121). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.058] [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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19
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Vollebregt MA, Kenemans JL, Buitelaar JK, Deboer T, Cain SW, Palmer D, Elliott GR, Gordon E, Fallahpour K, Arns M. Annual variation in attentional response after methylphenidate treatment. Eur Child Adolesc Psychiatry 2020; 29:1231-1236. [PMID: 31748987 DOI: 10.1007/s00787-019-01434-1] [Citation(s) in RCA: 1] [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] [Received: 06/12/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022]
Abstract
Prevalence rates of attention-deficit/hyperactivity disorder (ADHD) differ with geographical areas varying in sunlight intensity. Sun- or daylight reaching the retina establishes entrainment of the circadian clock to daylight. Changes herein, hence, alterations in clock alignment, could be reflected indirectly in inattention via sleep duration. We here studied (1) annual variation in inattention at treatment initiation; (2) annual variation in response to ADHD treatment [methylphenidate (MPH)] by day of treatment initiation; and (3) dose dependence. We predicted least baseline inattention during a period of high sunlight intensity implying more room for improvement (i.e., a better treatment response) when sunlight intensity is low. These hypotheses were not confirmed. High-dose treated patients, however, had significantly better attention after treatment than low-dosed treated patients, only when treated in the period from winter to summer solstice. Change in solar irradiance (SI) during low-dosed treatment period was negatively related to attentional improvement. The above described findings were primarily found in inattention ratings and replicated in omission errors on a continuous performance task. Daylight and inattention have been proposed to be related via mediation of the circadian system. One mechanism of MPH may be to enhance sensitivity to the diurnal entrainment to sunlight and the question can be raised whether appropriate lighting could potentiate the effects of stimulants.
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Affiliation(s)
- Madelon A Vollebregt
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, The Netherlands.
| | - J Leon Kenemans
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Tom Deboer
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sean W Cain
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Clayton, VIC, Australia
| | - Donna Palmer
- Brain Resource Ltd, Sydney, NSW, Australia.,Brain Resource Ltd, San Francisco, CA, USA.,Brain Dynamics Center, Sydney Medical School and Westmead Millenium Institute, University of Sydney, Sydney, NSW, Australia
| | - Glen R Elliott
- Children's Health Council, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA
| | - Evian Gordon
- Brain Resource Ltd, Sydney, NSW, Australia.,Brain Resource Ltd, San Francisco, CA, USA
| | - Kamran Fallahpour
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Brain Resource Center, New York, NY, USA
| | - Martijn Arns
- Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, The Netherlands.,Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands.,neuroCare Group, Munich, Germany
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20
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Corrie PG, Qian W, Basu B, Valle JW, Falk S, Lwuji C, Wasan H, Palmer D, Scott-Brown M, Wadsley J, Arif S, Bridgewater J, Propper D, Gillmore R, Gopinathan A, Skells R, Bundi P, Brais R, Dalchau K, Bax L, Chhabra A, Machin A, Dayim A, McAdam K, Cummins S, Wall L, Ellis R, Anthoney A, Evans J, Ma YT, Isherwood C, Neesse A, Tuveson D, Jodrell DI. Scheduling nab-paclitaxel combined with gemcitabine as first-line treatment for metastatic pancreatic adenocarcinoma. Br J Cancer 2020; 122:1760-1768. [PMID: 32350413 PMCID: PMC7283477 DOI: 10.1038/s41416-020-0846-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Nab-paclitaxel plus gemcitabine (nabP+gemcitabine) offers modest survival gains for patients with metastatic pancreatic ductal adenocarcinoma (PDAC). Sequential scheduling of nabP+gemcitabine in a PDAC mouse model improved efficacy; this hypothesis was tested in a clinical trial. METHODS Patients with previously untreated metastatic PDAC were randomised to receive nabP+gemcitabine administered either concomitantly on the same day, or sequentially, with gemcitabine administered 24 h after nabP. The primary outcome measure was progression-free survival (PFS). Secondary outcome measures were objective response rate (ORR), overall survival (OS), safety, quality of life (QoL) and predictive biomarkers. RESULTS In total, 71 patients received sequential (SEQ) and 75 concomitant (CON) treatment. Six-month PFS was 46% with SEQ and 32% with CON scheduling. Median PFS (5.6 versus 4.0 months, hazard ratio [HR] 0.67, 95% confidence interval [95% CI] 0.47-0.95, p = 0.022) and ORR (52% versus 31%, p = 0.023) favoured the SEQ arm; median OS was 10.2 versus 8.2 months (HR 0.93, 95% CI 0.65-1.33, p = 0.70). CTCAE Grade ≥3 neutropaenia incidence doubled with SEQ therapy but was not detrimental to QoL. Strongly positive tumour epithelial cytidine deaminase (CDA) expression favoured benefit from SEQ therapy (PFS HR 0.31, 95% CI 0.13-0.70). CONCLUSIONS SEQ delivery of nabP+gemcitabine improved PFS and ORR, with manageable toxicity, but did not significantly improve OS. CLINICAL TRIAL REGISTRATION ISRCTN71070888; ClinialTrials.gov (NCT03529175).
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Affiliation(s)
- P G Corrie
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK.
| | - W Qian
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - B Basu
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
- Cancer Research UK-Cambridge Institute, University of Cambridge, Cambridge, UK
| | - J W Valle
- University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - S Falk
- Bristol Haematology and Oncology Centre, Bristol, UK
| | - C Lwuji
- Leicester Royal Infirmary, Leicester, UK
| | - H Wasan
- Hammersmith Hospital, Imperial College, London, UK
| | - D Palmer
- Clatterbridge Cancer Centre, Liverpool, UK
| | - M Scott-Brown
- University Hospital Coventry and Warwickshire, Coventry, UK
| | | | - S Arif
- Velindre Cancer Centre, Cardiff, UK
| | | | | | | | - A Gopinathan
- Cancer Research UK-Cambridge Institute, University of Cambridge, Cambridge, UK
| | - R Skells
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - P Bundi
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - R Brais
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - K Dalchau
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - L Bax
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - A Chhabra
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - A Machin
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - A Dayim
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
| | - K McAdam
- Peterborough City Hospital, Peterborough, UK
| | - S Cummins
- Royal Surrey County Hospital, Guildford, UK
| | - L Wall
- Western General Hospital, Edinburgh, UK
| | - R Ellis
- Royal Cornwall Hospitals, Truro, UK
| | - A Anthoney
- St. James's University Hospitals, Leeds, UK
| | - J Evans
- Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, UK
| | - Y T Ma
- Queen Elizabeth Hospital, Birmingham, UK
| | - C Isherwood
- Cancer Research UK-Cambridge Institute, University of Cambridge, Cambridge, UK
| | - A Neesse
- Gastroenterology and Gastrointestinal Cancer Clinic, University of Göttingen, Göttingen, Germany
| | - D Tuveson
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, USA
| | - D I Jodrell
- Cambridge University Hospitals NHS Foundation Trust (Addenbrooke's Hospital), Cambridge, UK
- Cancer Research UK-Cambridge Institute, University of Cambridge, Cambridge, UK
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21
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Greeff JC, Liu S, Palmer D, Martin GB. Temporal changes in circulatory blood cell parameters of sheep genetically different for faecal worm egg count and diarrhoea from late summer to spring in a Mediterranean environment. Anim Prod Sci 2020. [DOI: 10.1071/an19038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Differences in haematology traits were investigated in worm-resistant and worm-susceptible Merino sheep that were genetically prone or less prone to developing diarrhoea in a winter rainfall region. The experiment was a 2 × 2 × 2 × 5 design. Male and female sheep aged 8–9 months old identified as having high (H) or low (L) breeding values for dags (breech soiling) and for worm egg counts (WEC) were allocated to one of four genetic groups: HH, HL, LH and LL (the first letter refers to dags and the second to WEC). The animals were sampled five times from autumn through winter to spring, in March, May, June (ewes only), July (rams only), August and in September after exposure to a natural paddock infection dominated by Trichostrongylus, Teladorsagia, Chabertia and Oesophagostomum. Measurements were packed cell volume, haemoglobin, red blood cell count, differential white cell counts, WEC and faecal consistency score. At all sampling times, there were large (P < 0.01) differences between groups within sex for both the faecal consistency score and WEC. The genetic effect for WEC was large (P < 0.01), as worm-susceptible sheep shed 10- (ewes) and 6-fold (rams) as many worm eggs at their WEC peak as the worm-resistant sheep at the end of the experiment. In the high-dag groups, the faecal consistency score was ~0.5 units higher for rams and 0.4 units higher for ewes, throughout the experiment. The optimum time to measure dags and WEC in this environment appears to be 6–8 weeks after the start of the winter rain. No differences were found among any of the treatment groups for any haematology trait. The haematogram changed significantly throughout the experiment, but genetic selection for low-dag score (reduced diarrhoea) or low WEC did not provide an acceptable discriminator in circulatory haematology traits between these genetically distinct groups of Merino sheep. It was concluded that circulatory haematology traits do not offer opportunities to select against diarrhoea or increased worm resistance in sheep.
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Palmer D, Møller AS, Greenhalf B, Ma Y, Valle J, Gjertsen T, Kuryk L. Multiple KRAS mutations detected by cancer related DNA in patients with resected pancreas adenocarcinoma during treatment with TG01/GM-CSF and gemcitabine (CT TG01-01). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz447.022] [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: 11/14/2022] Open
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23
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Gerrits B, Vollebregt MA, Olbrich S, van Dijk H, Palmer D, Gordon E, Pascual-Marqui R, Kessels RPC, Arns M. Probing the "Default Network Interference Hypothesis" With EEG: An RDoC Approach Focused on Attention. Clin EEG Neurosci 2019; 50:404-412. [PMID: 31322000 DOI: 10.1177/1550059419864461] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Studies have shown that specific networks (default mode network [DMN] and task positive network [TPN]) activate in an anticorrelated manner when sustaining attention. Related EEG studies are scarce and often lack behavioral validation. We performed independent component analysis (ICA) across different frequencies (source-level), using eLORETA-ICA, to extract brain-network activity during resting-state and sustained attention. We applied ICA to the voxel domain, similar to functional magnetic resonance imaging methods of analyses. The obtained components were contrasted and correlated to attentional performance (omission errors) in a large sample of healthy subjects (N = 1397). We identified one component that robustly correlated with inattention and reflected an anticorrelation of delta activity in the anterior cingulate and precuneus, and delta and theta activity in the medial prefrontal cortex and with alpha and gamma activity in medial frontal regions. We then compared this component between optimal and suboptimal attentional performers. For the latter group, we observed a greater change in component loading between resting-state and sustained attention than for the optimal performers. Following the National Institute of Mental Health Research Domain Criteria (RDoC) approach, we prospectively replicated and validated these findings in subjects with attention deficit/hyperactivity disorder. Our results provide further support for the "default mode interference hypothesis."
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Affiliation(s)
- Berrie Gerrits
- 1 Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands.,2 Research Institute Brainclinics, Nijmegen, the Netherlands
| | - Madelon A Vollebregt
- 2 Research Institute Brainclinics, Nijmegen, the Netherlands.,3 Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Sebastian Olbrich
- 2 Research Institute Brainclinics, Nijmegen, the Netherlands.,4 Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland
| | | | - Donna Palmer
- 5 Brain Resource Inc, Sydney, New South Wales, Australia
| | | | - Roberto Pascual-Marqui
- 7 The KEY Institute for Brain-Mind Research, University Hospital of Psychiatry, Zurich, Switzerland.,8 Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Roy P C Kessels
- 1 Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands.,9 Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Martijn Arns
- 2 Research Institute Brainclinics, Nijmegen, the Netherlands.,10 Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands.,11 neuroCare Group, Munich, Germany
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Alabraba E, Joshi H, Bird N, Griffin R, Sturgess R, Stern N, Sieberhagen C, Cross T, Camenzuli A, Davis R, Evans J, O'Grady E, Palmer D, Diaz-Nieto R, Fenwick S, Poston G, Malik H. Increased multimodality treatment options has improved survival for Hepatocellular carcinoma but poor survival for biliary tract cancers remains unchanged. Eur J Surg Oncol 2019; 45:1660-1667. [DOI: 10.1016/j.ejso.2019.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/25/2019] [Accepted: 04/01/2019] [Indexed: 12/18/2022] Open
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Griffiths KR, Jurigova BG, Leikauf JE, Palmer D, Clarke SD, Tsang TW, Teber ET, Kohn MR, Williams LM. A Signature of Attention-Elicited Electrocortical Activity Distinguishes Response From Non-Response to the Non-Stimulant Atomoxetine in Children and Adolescents With ADHD. J Atten Disord 2019; 23:744-753. [PMID: 28974127 PMCID: PMC8215986 DOI: 10.1177/1087054717733044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/16/2022]
Abstract
OBJECTIVE Atomoxetine has several characteristics that make it an attractive alternative to stimulants for treating ADHD, but there are currently no tests identifying individuals for whom the medication should be a first-line option. METHOD Within the ADHD Controlled Trial Investigation Of a Non-stimulant (ACTION) study, we examined neuro-cortical activity in 52 youth with ADHD. Baseline event-related potentials (ERP) were compared between those who subsequently responded to 6 weeks of atomoxetine versus those who did not. RESULTS Responders were distinguished by significantly lower auditory oddball N2 amplitudes than both non-responders and typically developing controls, particularly in the right frontocentral region ( p = .002, Cohen's d = 1.1). Leave-one-out cross validation determined that N2 amplitude in this region was able to accurately predict non-responders with a specificity of 80.8%. There were no P3 differences between responders and non-responders. CONCLUSION The N2 amplitude is a biomarker that may have utility in predicting response to atomoxetine for youth with ADHD.
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Affiliation(s)
- Kristi R. Griffiths
- Brain Dynamics Centre, The Westmead Institue for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Barbora G. Jurigova
- Brain Dynamics Centre, The Westmead Institue for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - John E. Leikauf
- Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Donna Palmer
- Brain Resource, Sydney, New South Wales, Australia
| | - Simon D. Clarke
- Brain Dynamics Centre, The Westmead Institue for Medical Research, The University of Sydney, Westmead, New South Wales, Australia,Adolescent & Young Adult Medicine, Westmead Hospital, Westmead, New South Wales, Australia,Centre for Research into Adolescents Health, Westmead, New South Wales, Australia
| | - Tracey W. Tsang
- Brain Dynamics Centre, The Westmead Institue for Medical Research, The University of Sydney, Westmead, New South Wales, Australia,Discipline of Child & Adolescent Health, Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Erdahl T. Teber
- Children's Medical Research Institute, Westmead, New South Wales, Australia
| | - Michael R. Kohn
- Brain Dynamics Centre, The Westmead Institue for Medical Research, The University of Sydney, Westmead, New South Wales, Australia,Adolescent & Young Adult Medicine, Westmead Hospital, Westmead, New South Wales, Australia,Centre for Research into Adolescents Health, Westmead, New South Wales, Australia
| | - Leanne M. Williams
- Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
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Hillson J, Mant T, Rosano M, Huntenburg C, Alai-Safar M, Darne S, Palmer D, Pavlova BG, Doralt J, Reeve R, Goel N, Weilert D, Rhyne PW, Chance K, Caminis J, Roach J, Ganguly T. Pharmacokinetic equivalence, comparable safety, and immunogenicity of an adalimumab biosimilar product (M923) to Humira in healthy subjects. Pharmacol Res Perspect 2018; 6. [PMID: 29417761 PMCID: PMC5817835 DOI: 10.1002/prp2.380] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 11/27/2017] [Indexed: 12/13/2022] Open
Abstract
The aims of this randomized, double-blind, three-arm, single-dose study were to demonstrate pharmacokinetic (PK) equivalence of the adalimumab biosimilar M923 (hereafter referred to as "M923") to each of 2 reference products, and to assess M923's safety and immunogenicity. Primary PK endpoints were maximum observed concentration (Cmax ), area under the curve (AUC) from time 0 extrapolated to infinity (AUC0-inf ), and AUC from time 0 to 336 hours (AUC0-336 ). Secondary endpoints included safety and immunogenicity assessments. Healthy subjects were randomized 1:1:1 to receive a 40-mg dose of M923 (n = 107); adalimumab US Humira (n = 105), hereafter referred to as "US Humira"; or adalimumab EU Humira (n = 103), hereafter referred to as "EU Humira." PK equivalence was demonstrated for all primary PK endpoints. Geometric least squares means ratios (GMRs) for Cmax , AUC0-inf , and AUC0-336 were 99.4, 100.9, and 100.5, respectively, between the M923 and EU Humira arms and 102.6, 104.2, and 102.9 between the M923 and US Humira arms. The 90% confidence intervals of the GMRs for all PK endpoints were within prespecified confidence bounds of 80%-125%. Adverse event rates were similar across the M923 (47.7%), US Humira (50.9%), and EU Humira (53.3%) arms and were generally mild (73.7%) or moderate (22.0%). The proportion of subjects with a confirmed antidrug antibody (ADA) response was similar across study arms. This study demonstrated bioequivalent PK among M923, US Humira, and EU Humira and demonstrated that the PK parameters were consistent with similar safety and tolerability profile and ADA response rates.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - James Roach
- Momenta Pharmaceuticals, Inc., Cambridge, MA, USA
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Stamatikos A, Dronadula N, Ng P, Palmer D, Knight E, Wacker BK, Tang C, Kim F, Dichek DA. ABCA1 Overexpression in Endothelial Cells In Vitro Enhances ApoAI-Mediated Cholesterol Efflux and Decreases Inflammation. Hum Gene Ther 2018; 30:236-248. [PMID: 30079772 DOI: 10.1089/hum.2018.120] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Atherosclerosis, a disease of blood vessels, is driven by cholesterol accumulation and inflammation. Gene therapy that removes cholesterol from blood vessels and decreases inflammation is a promising approach for prevention and treatment of atherosclerosis. In previous work, we reported that helper-dependent adenoviral (HDAd) overexpression of apolipoprotein A-I (apoAI) in endothelial cells (ECs) increases cholesterol efflux in vitro and reduces atherosclerosis in vivo. However, the effect of HDAdApoAI on atherosclerosis is partial. To improve this therapy, we considered concurrent overexpression of ATP-binding cassette subfamily A, member 1 (ABCA1), a protein that is required for apoAI-mediated cholesterol efflux. Before attempting combined apoAI/ABCA1 gene therapy, we tested whether an HDAd that expresses ABCA1 (HDAdABCA1) increases EC cholesterol efflux, whether increased cholesterol efflux alters normal EC physiology, and whether ABCA1 overexpression in ECs has anti-inflammatory effects. HDAdABCA1 increased EC ABCA1 protein (∼3-fold; p < 0.001) and apoAI-mediated cholesterol efflux (2.3-fold; p = 0.007). Under basal culture conditions, ABCA1 overexpression did not alter EC proliferation, metabolism, migration, apoptosis, nitric oxide production, or inflammatory gene expression. However, in serum-starved, apoAI-treated EC, ABCA1 overexpression had anti-inflammatory effects: decreased inflammatory gene expression (∼50%; p ≤ 0.02 for interleukin [IL]-6, tumor necrosis factor [TNF]-α, and vascular cell adhesion protein-1); reduced lipid-raft Toll-like receptor 4 (80%; p = 0.001); and a trend towards increased nitric oxide production (∼55%; p = 0.1). In ECs stimulated with lipopolysaccharide, ABCA1 overexpression markedly decreased inflammatory gene expression (∼90% for IL-6 and TNF-α; p < 0.001). Therefore, EC ABCA1 overexpression has no toxic effects and counteracts the two key drivers of atherosclerosis: cholesterol accumulation and inflammation. In vivo testing of HDAdABCA1 is warranted.
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Affiliation(s)
- Alexis Stamatikos
- 1 Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Nagadhara Dronadula
- 1 Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Philip Ng
- 2 Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Donna Palmer
- 2 Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Ethan Knight
- 1 Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Bradley K Wacker
- 1 Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Chongren Tang
- 1 Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Francis Kim
- 1 Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - David A Dichek
- 1 Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
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McNamara M, Bridgewater J, Palmer D, Wasan H, Ryder W, Gnanaranjan C, Ghazaly E, Evans T, Valle J. A new ProTide, NUC-1031, combined with cisplatin for the first-line treatment of advanced biliary tract cancer (ABC-08). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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29
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Arns M, Vollebregt MA, Palmer D, Spooner C, Gordon E, Kohn M, Clarke S, Elliott GR, Buitelaar JK. Electroencephalographic biomarkers as predictors of methylphenidate response in attention-deficit/hyperactivity disorder. Eur Neuropsychopharmacol 2018; 28:881-891. [PMID: 29937325 DOI: 10.1016/j.euroneuro.2018.06.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 08/16/2017] [Revised: 05/22/2018] [Accepted: 06/02/2018] [Indexed: 11/29/2022]
Abstract
UNLABELLED EEG biomarkers have shown promise in predicting non-response to stimulant medication in ADHD and could serve as translational biomarkers. This study aimed to replicate and extend previous EEG biomarkers. The international Study to Predict Optimized Treatment for ADHD (iSPOT-A), a multi-center, international, prospective open-label trial, enrolled 336 children and adolescents with ADHD (11.9 yrs; 245 males; prescribed methylphenidate) and 158 healthy children. Treatment response was established after six weeks using the clinician rated ADHD-Rating Scale-IV. Theta/Beta ratio (TBR) and alpha peak frequency (APF) were assessed at baseline as predictors for treatment outcome. No differences between ADHD and controls were found for TBR and APF. 62% of the ADHD group was classified as a responder. Responders did not differ from non-responders in age, medication dosage, and baseline severity of ADHD symptoms. Male-adolescent non-responders exhibited a low frontal APF (Fz: R = 9.2 Hz vs. NR = 8.1 Hz; ES = 0.83), whereas no effects were found for TBR. A low APF in male adolescents was associated with non-response to methylphenidate, replicating earlier work. Our data suggest that the typical maturational EEG changes observed in ADHD responders and controls are absent in non-responders to methylphenidate and these typical changes start emerging in adolescence. CLINICAL TRIALS REGISTRATION www.clinicaltrials.gov; NCT00863499 (https://clinicaltrials.gov/ct2/show/NCT00863499).
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Affiliation(s)
- Martijn Arns
- Research Institute Brainclinics, Bijleveldsingel 34, 6524 AD Nijmegen, The Netherlands; Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands.
| | - Madelon A Vollebregt
- Research Institute Brainclinics, Bijleveldsingel 34, 6524 AD Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Donna Palmer
- Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA; Brain Dynamics Center, Sydney Medical School and Westmead Millenium Institute, University of Sydney, NSW, Australia
| | | | - Evian Gordon
- Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA
| | - Michael Kohn
- Brain Dynamics Center, Sydney Medical School and Westmead Millenium Institute, University of Sydney, NSW, Australia; CRASH (Centre for Research into Adolescent'S Health) Westmead Hospital, Sydney Australia
| | - Simon Clarke
- Brain Dynamics Center, Sydney Medical School and Westmead Millenium Institute, University of Sydney, NSW, Australia; CRASH (Centre for Research into Adolescent'S Health) Westmead Hospital, Sydney Australia
| | - Glen R Elliott
- Children's Health Council, Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, CA, USA
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
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30
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Palmer D, Pou JO, Gonzalez-Sabaté L, Díaz-Ferrero J. Multiple linear regression based congener profile correlation to estimate the toxicity (TEQ) and dioxin concentration in atmospheric emissions. Sci Total Environ 2018; 622-623:510-516. [PMID: 29223077 DOI: 10.1016/j.scitotenv.2017.11.344] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 06/07/2023]
Abstract
The formation of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) is governed by complex chemical reactions with complex kinetic models. The simulation of Municipal Solid Waste incinerators, or other industrial thermal processes, is a powerful tool that can be used to optimize and control them, and reducing the number of components to simulate is mandatory for a proper use. In this study it has been determined that only the formation of 3 of the 17 main PCDD/F congeners can be considered as linearly independent. This fact has been used to establish linear regression models that are able to estimate properly the total amount and toxicity of a sample considering only the amount of 1,2,3,6,7,8-HxCDD, OCDF and 2,3,7,8-TCDF. All models have been validated using new samples performing a close approach to the real values provided by complete analytical studies. The average relative error is 3.5% and the maximum relative error is below 9% for these new testing samples. The main goal of our investigation is to build a dynamic simulation process of a MSW facility and include the dioxins formation on it using these models.
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Affiliation(s)
- D Palmer
- Industrial Engineering Department, Institut Químic de Sarrià - Universitat Ramon Llull, Via Augusta, 390, Barcelona 08017, Spain
| | - J O Pou
- Industrial Engineering Department, Institut Químic de Sarrià - Universitat Ramon Llull, Via Augusta, 390, Barcelona 08017, Spain
| | - L Gonzalez-Sabaté
- Quantitative Methods Department, Institut Químic de Sarrià - Universitat Ramon Llull, Via Augusta, 390, Barcelona 08017, Spain
| | - J Díaz-Ferrero
- Analytical and Applied Chemistry Department, Institut Químic de Sarrià - Universitat Ramon Llull, Via Augusta, 390, Barcelona 08017, Spain.
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Stamatikos A, Dronadula N, Ng P, Palmer D, Knight E, Wacker B, Tang C, Kim F, Dichek D. Abstract 628: Overexpression of ABCA1 in Cultured Endothelial Cells Using Helper-Dependent Adenovirus Enhances ApoAI-Mediated Cholesterol Efflux and has Anti-Inflammatory Effects. Arterioscler Thromb Vasc Biol 2018. [DOI: 10.1161/atvb.38.suppl_1.628] [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
Background:
ABCA1 removes cholesterol from vascular wall cells via apoAI-mediated efflux, generating HDL that transports cholesterol to the liver for excretion. This process of reverse cholesterol transport is atheroprotective; therefore, strategies that increase vascular wall ABCA1 may prevent or reverse atherosclerosis. Cholesterol efflux mediated by ABCA1 and apoAI can also have anti-inflammatory effects; however, excess depletion of cellular cholesterol can cause cell stress and apoptosis. We tested whether transducing endothelial cells (EC) with a helper-dependent adenoviral vector that expresses ABCA1 (HDAdABCA1) enhances apoAI-mediated cholesterol efflux and reduces inflammatory markers without causing cellular toxicity.
Methods:
We cloned rabbit ABCA1, constructed HDAdABCA1, transduced bovine aortic EC (BAEC) with either HDAdABCA1 or empty vector (HDAdNull). We measured ABCA1 protein by immunoblotting and apoAI-mediated cholesterol efflux by loading EC with
3
[H] cholesterol, then adding apoAI protein to serum-free medium. We assessed EC phenotype using MTT (metabolic activity), BrdU (proliferation), wound-healing assay (migration), and flow cytometry (apoptosis). We measured ICAM-1, VCAM-1, IL-6, and TNFα mRNA in transduced EC by qRT-PCR both under basal conditions and after serum-starvation, addition of apoAI, and LPS challenge.
Results:
We observed a ~3-fold increase in ABCA1 protein in EC transduced with HDAdABCA1 and a ~2-fold increase in apoAI-mediated cholesterol efflux (P<0.01 for both). This level of ABCA1 overexpression did not alter EC metabolic activity, proliferation, migration, or apoptosis. Under basal conditions, HDAdABCA1 had no effect on inflammatory markers. However, after serum starvation and addition of apoAI, HDAdABCA1-transduced EC had reduced expression of inflammatory markers both before and after LPS treatment.
Conclusions:
HDAdABCA1 increases EC ABCA1 expression and enhances apoAI-mediated cholesterol efflux, but does not cause toxicity or increase inflammatory markers. In contrast, ABCA1 overexpression appears to have anti-inflammatory effects. Future studies will test if HDAdABCA1 decreases lipid rafts, and whether overexpression of ABCA1 in EC in vivo is atheroprotective.
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Affiliation(s)
| | | | - Philip Ng
- Baylor College of Medicine, Houston, TX
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Palmer D, Snaith B, Harris MA. Assistant radiographer practitioners: Creating capacity or challenging professional boundaries? Radiography (Lond) 2018; 24:247-251. [PMID: 29976338 DOI: 10.1016/j.radi.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 12/22/2017] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Over the last 2 decades the assistant radiographer practitioner (ARP) role has been introduced into NHS diagnostic imaging departments as a strategy to expand the workforce and create capacity. This skill mix initiative has not been implemented in a standardised way and there is limited knowledge of the current role scope within general radiography (X-Ray). METHOD An electronic survey of ARPs working within UK diagnostic imaging departments was conducted. Both open and closed questions sought information regarding basic demographic data (age category; gender; geographic region), scope of practice (patient groups; anatomical regions; imaging outside of the diagnostic imaging department), limitations placed on practice, supervision and additional roles. RESULTS A total of 108 responses, including 13 trainees, were received. Most sites employ three or less ARPs in general radiography (n = 43/66; 65.2%), although 11 sites have five (range 1-15). The majority undertake imaging of both adults and children (n = 85/108; 78.7%), although limitations on age were described. Their scope of practice covers a broad anatomical range and included some non-ambulant patients. The level of supervision varied with some sites empowering ARPs to check the referral prior to examination (n = 25) or images post acquisition (n = 32) (both n = 20/66; χ2 = 16.003; 1df; p = 0.000). CONCLUSION ARPs are helping to maintain capacity in imaging departments but we suggest there is further scope for expansion. The practice described by the post holders suggests that many are working beyond the scope envisaged by the radiography professional body.
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Affiliation(s)
- D Palmer
- Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, WF1 4DG, UK
| | - B Snaith
- Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, WF1 4DG, UK; University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - M A Harris
- Mid Yorkshire Hospitals NHS Trust, Aberford Road, Wakefield, WF1 4DG, UK
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Westerman EL, Letchinger R, Tenger-Trolander A, Massardo D, Palmer D, Kronforst MR. Does male preference play a role in maintaining female limited polymorphism in a Batesian mimetic butterfly? Behav Processes 2018; 150:47-58. [PMID: 29471021 DOI: 10.1016/j.beproc.2018.02.014] [Citation(s) in RCA: 11] [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: 10/25/2017] [Revised: 01/16/2018] [Accepted: 02/13/2018] [Indexed: 11/28/2022]
Abstract
Female-limited polymorphism occurs in multiple butterfly species with Batesian mimicry. While frequency-dependent selection is often argued as the driving force behind polymorphism in Batesian mimicry systems, male preference and alternative female mating strategies may also influence the maintenance of multiple female forms. Through a series of behavioural assays with the female-limited Batesian mimetic butterfly Papilio polytes, we show that males prefer stationary mimetic females over stationary non-mimetic females, but weigh female activity levels more heavily than female wing pattern when choosing between active mimetic and active non-mimetic females. Male preference for mimetic vs. non-mimetic females is independent of male genotype at the locus responsible for the female wing pattern, the autosomal gene doublesex. However male genotype does influence their response to active females. Male emphasis on female behaviour instead of appearance may reduce sexual selection pressures on female morphology, thereby facilitating frequency-dependent natural selection due to predation risk and toxic model abundance.
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Affiliation(s)
- E L Westerman
- Department of Ecology & Evolution, University of Chicago, 1101 E. 57th St., Chicago, IL 60637, USA; Department of Biological Sciences, University of Arkansas, 850 W. Dickson St., Fayetteville, AR 72701, USA.
| | - R Letchinger
- Department of Ecology & Evolution, University of Chicago, 1101 E. 57th St., Chicago, IL 60637, USA.
| | - A Tenger-Trolander
- Department of Ecology & Evolution, University of Chicago, 1101 E. 57th St., Chicago, IL 60637, USA.
| | - D Massardo
- Department of Ecology & Evolution, University of Chicago, 1101 E. 57th St., Chicago, IL 60637, USA.
| | - D Palmer
- Department of Ecology & Evolution, University of Chicago, 1101 E. 57th St., Chicago, IL 60637, USA.
| | - M R Kronforst
- Department of Ecology & Evolution, University of Chicago, 1101 E. 57th St., Chicago, IL 60637, USA.
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Abstract
We present novel data on the role of attention in eliciting enhanced processing of stimuli associated with self. Participants were required to make pro- or anti-saccades according to whether learned shape–label pairings matched or mismatched. When stimuli matched participants were required to make an anti-saccade, and when the stimuli mismatched a pro-saccade was required. We found that anti-saccades were difficult to make to stimuli associated with self when compared to stimuli associated with a friend and a stranger. In contrast, anti-saccades to friend-stimuli were easier to make than anti-saccades to stranger-stimuli. In addition, a correct anti-saccade to a self-associated stimulus disrupted subsequent pro-saccade trials, relative to when the preceding anti-saccade was made to other stimuli. The data indicate that self-associated stimuli provide a strong cue for explicit shifts of attention to them, and that correct anti-saccades to such stimuli demand high levels of inhibition (which carries over to subsequent pro-saccade trials). The self exerts an automatic draw on attention.
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Affiliation(s)
- A. Yankouskaya
- Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - D. Palmer
- Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - M. Stolte
- Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - J. Sui
- Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - G. W. Humphreys
- Cognitive Neuropsychology Centre, Department of Experimental Psychology, University of Oxford, Oxford, UK
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Wang H, Richter M, Psatha N, Li C, Kim J, Liu J, Ehrhardt A, Nilsson SK, Cao B, Palmer D, Ng P, Izsvák Z, Haworth KG, Kiem HP, Papayannopoulou T, Lieber A. A Combined In Vivo HSC Transduction/Selection Approach Results in Efficient and Stable Gene Expression in Peripheral Blood Cells in Mice. Mol Ther Methods Clin Dev 2017; 8:52-64. [PMID: 29255741 PMCID: PMC5722719 DOI: 10.1016/j.omtm.2017.11.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 12/21/2022]
Abstract
We recently reported on an in vivo hematopoietic stem cell (HSC) gene therapy approach. It involves the subcutaneous injections of G-CSF/AMD3100 to mobilize HSCs from the bone marrow into the peripheral blood stream and the intravenous injection of an integrating helper-dependent adenovirus vector system. HSCs transduced in the periphery homed back to the bone marrow, where they persisted long-term. However, high transgene marking rates found in primitive bone marrow HSCs were not reflected in peripheral blood cells. Here, we tested small-molecule drugs to achieve selective mobilization and transduction of HSCs. We found more efficient GFP marking in bone marrow HSCs but no increased marking in the peripheral blood cells. We then used an in vivo HSC chemo-selection based on a mutant of the O6-methylguanine-DNA methyltransferase (mgmtP140K) gene that confers resistance to O6-BG/BCNU and should give stably transduced HSCs a proliferation stimulus and allow for the selective survival and expansion of progeny cells. Short-term exposure of G-CSF/AMD3100-mobilized, in vivo-transduced mice to relatively low selection drug doses resulted in stable GFP expression in up to 80% of peripheral blood cells. Overall, the further improvement of our in vivo HSC transduction approach creates the basis for a simpler HSC gene therapy.
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Affiliation(s)
- Hongjie Wang
- University of Washington, Department of Medicine, Division of Medical Genetics, Box 357720, Seattle, WA 98195, USA
| | - Maximilian Richter
- University of Washington, Department of Medicine, Division of Medical Genetics, Box 357720, Seattle, WA 98195, USA
| | - Nikoletta Psatha
- Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA
| | - Chang Li
- University of Washington, Department of Medicine, Division of Medical Genetics, Box 357720, Seattle, WA 98195, USA
| | - Jiho Kim
- University of Washington, Department of Medicine, Division of Medical Genetics, Box 357720, Seattle, WA 98195, USA
| | - Jing Liu
- Witten/Herdecke University, Witten, 58448, Germany
| | | | - Susan K Nilsson
- Biomedical Manufacturing, CSIRO, Clayton, VIC 3800, Australia.,Australian Regenerative Medicine Institute, Monash University, Clayton, VIC 3800, Australia
| | - Benjamin Cao
- Biomedical Manufacturing, CSIRO, Clayton, VIC 3800, Australia.,Australian Regenerative Medicine Institute, Monash University, Clayton, VIC 3800, Australia
| | - Donna Palmer
- Baylor College of Medicine, Houston, TX 77046, USA
| | - Philip Ng
- Baylor College of Medicine, Houston, TX 77046, USA
| | - Zsuzsanna Izsvák
- Max-Delbrück-Center for Molecular Medicine, Berlin 13092, Germany
| | - Kevin G Haworth
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Hans-Peter Kiem
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Thalia Papayannopoulou
- Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA
| | - André Lieber
- University of Washington, Department of Medicine, Division of Medical Genetics, Box 357720, Seattle, WA 98195, USA.,Department of Pathology, University of Washington, Seattle, WA, USA
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El Miedany Y, El Gaafary M, El Aroussy N, Bahlas S, Hegazi M, Palmer D, Youssef S. Toward electronic health recording: evaluation of electronic patient reported outcome measures (e-PROMs) system for remote monitoring of early systemic lupus patients. Clin Rheumatol 2017; 36:2461-2469. [PMID: 28567555 DOI: 10.1007/s10067-017-3675-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 04/27/2017] [Accepted: 05/08/2017] [Indexed: 01/06/2023]
Abstract
The study aimed to assess the value of evaluation of electronic patient reported outcome measures (e-PROMs) in the assessment and management of SLE disease activity flares, its association with adherence to therapy as well as organ damage. A randomized, controlled crossover study was carried out over a 24-month duration. One hundred forty-seven SLE patients meeting the revised American College of Rheumatology (ACR) criteria were enrolled. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was used to assess disease activity, whereas organ damage was scored using the Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index. In the first 12 months, the patients were assessed every 3 months. At 12 months, the patients were randomized into a cohort of 73 patients who continued their care in the same style and 74 patients who completed an online e-PROMs questionnaire on monthly basis for another 12-month period. The data captured were then retrospectively analyzed at the end of the 24-month study period. At the end of the first year of the study, the mean SLEDAI and SDI scores were 8.72 (6.1) and 1.9 (2.2). At the end of the second year, the mean SLEDAI and SDI scores in the e-PROMs cohort were 3.1 (2.6) and 1.2 (1.3), whereas in the control group, the scores were 7.63 (6.7) and 1.8 (2.3), respectively (p < 0.01). Adjusting for possible confounding variables, the number of flares, regardless of their severity, was associated with damage accrual (OR 2.03, 95% CI 1.34 to 2.83, p < 0.001). Adherence to therapy was significantly (p < 0.1) higher in the e-PROMs group. e-PROMs was equivalent to PROMs paper format and has a potential disease-modifying effect as it facilitated close monitoring of disease activity with an option of management escalation whenever indicated.
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Affiliation(s)
- Y El Miedany
- Rheumatology, Darent Valley Hospital, Darenth Wood Road, Dartford, England, DA2 8DA, UK.
- Rheumatology & Rehab, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt.
| | - M El Gaafary
- Community and Public Health, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt
| | - Nadia El Aroussy
- Rheumatology & Rehab, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt
| | - S Bahlas
- Rheumatology Department, King Abdulaziz University, Jeddah, 21441, Saudi Arabia
| | - M Hegazi
- Medicine Department, Al Adan Hospital, KW52853, Hadeya, Kuwait
| | - D Palmer
- Rheumatology, North Middlesex University Hospitals, Sterling Way, London, N18 1QX, UK
| | - S Youssef
- Rheumatology & Rehab, School of Medicine St. Abbassia, Ain Shams University, Cairo, 11381, Egypt
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Corrie P, Qian W, Gopinathan A, Williams M, Brais R, Valle J, Basu B, Falk S, Iwuji C, Wasan H, Palmer D, Scott-Brown M, Wadsley J, Arif S, Bax L, Bundi P, Skells R, Neesse A, Tuveson D, Jodrell D. Strong tumour cytidine deaminase (CDA) staining predicts for improved survival associated with sequential nab-Paclitaxel (nabP) and gemcitabine (GEM) chemotherapy as first line treatment of patients (pts) with metastatic pancreatic adenocarcinoma (mPDAC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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38
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Palmer D, Ross P, Shah T, Yu D, Shergill S, Patterson K, Brereton N, Lee D. Cost effectiveness of selective internal radiation therapy (SIRT) with Y-90 resin microspheres versus sorafenib in Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma patients in the UK. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dueland S, Valle J, Bell K, Faluyi O, Staiger H, Gjertsen T, Møller AS, Aksnes AK, Palmer D. TG01/GM-CSF and adjuvant gemcitabine in patients with resected RAS-mutant adenocarcinoma of the pancreas. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Bird NTE, Elmasry M, Jones R, Psarelli E, Dodd J, Malik H, Greenhalf W, Kitteringham N, Ghaneh P, Neoptolemos JP, Palmer D. Immunohistochemical hENT1 expression as a prognostic biomarker in patients with resected pancreatic ductal adenocarcinoma undergoing adjuvant gemcitabine-based chemotherapy. Br J Surg 2017; 104:328-336. [PMID: 28199010 DOI: 10.1002/bjs.10482] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/12/2016] [Accepted: 12/08/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Human equilibrative nucleoside transporters (hENTs) are transmembranous proteins that facilitate the uptake of nucleosides and nucleoside analogues, such as gemcitabine, into the cell. The abundance of hENT1 transporters in resected pancreatic ductal adenocarcinoma (PDAC) might make hENT1 a potential biomarker of response to adjuvant chemotherapy. The aim of this study was to see whether hENT1 expression, as determined by immunohistochemistry, was a suitable predictive marker for subsequent treatment with gemcitabine-based adjuvant chemotherapy. METHODS A systematic review was performed, searching databases from January 1997 to January 2016. Articles pertaining to hENT1 immunohistochemical analysis in resected PDAC specimens from patients who subsequently underwent adjuvant gemcitabine-based chemotherapy were identified. Eligible studies were required to contain survival data, reporting specifically overall survival (OS) and disease-free survival (DFS) with associated hazard ratios (HRs) stratified by hENT1 status. RESULTS Of 42 articles reviewed, eight were suitable for review, with seven selected for quantitative meta-analysis. The total number of patients included in the meta-analysis was 770 (405 hENT1-negative, 365 hENT1-positive). Immunohistochemically detected hENT1 expression was significantly associated with both prolonged DFS (HR 0·58, 95 per cent c.i. 0·42 to 0·79) and OS (HR 0·52, 0·38 to 0·72) in patients receiving adjuvant gemcitabine but not those having fluoropyrimidine-based adjuvant therapy. CONCLUSION Expression of hENT1 is a suitable prognostic biomarker in patients undergoing adjuvant gemcitabine-based chemotherapy.
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Affiliation(s)
- N T E Bird
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - M Elmasry
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - R Jones
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - E Psarelli
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - J Dodd
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - H Malik
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - W Greenhalf
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - N Kitteringham
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - P Ghaneh
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - J P Neoptolemos
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
| | - D Palmer
- Liverpool University Pharmacology Unit, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L69 3BX, UK
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Bird N, Elmasry M, Jones R, Elniel M, Kelly M, Palmer D, Fenwick S, Poston G, Malik H. Role of staging laparoscopy in the stratification of patients with perihilar cholangiocarcinoma. Br J Surg 2016; 104:418-425. [PMID: 27861766 DOI: 10.1002/bjs.10399] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/09/2016] [Accepted: 09/06/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cholangiocarcinoma is a rare cancer with a poor prognosis. Radical surgical resection is the only option for curative treatment. Optimal determination of resectability is required so that patients can be stratified into operative or chemotherapeutic treatment cohorts in an accurate and time-efficient manner. Staging laparoscopy is utilized to determine the presence of radiologically occult disease that would preclude further surgical treatment. The aim of this study was to analyse the utility of staging laparoscopy in a contemporary cohort of patients with perihilar cholangiocarcinoma. METHODS Patients diagnosed with potentially resectable perihilar cholangiocarcinoma between January 2010 and April 2015 were analysed retrospectively from a prospective database linked to UK Hospital Episode Statistics data. Patients with distal cholangiocarcinoma and gallbladder cancer were excluded from analysis. RESULTS A total of 431 patients with perihilar cholangiocarcinoma were referred for assessment of potential resection at a supraregional referral centre. Some 116 patients with potentially resectable disease subsequently underwent surgical assessment. The cohort demonstrated an all-cause yield of staging laparoscopy for unresectable disease of 27·2 per cent (31 of 114). The sensitivity for detection of peritoneal disease was 71 per cent (15 of 21; P < 0·001). The accuracy for all-cause non-resection for staging laparoscopy was 66 per cent (31 of 47) with a positive predictive value of progress to resection of 81 per cent (69 of 85). Neither the Bismuth-Corlette nor the Memorial Sloan Kettering Cancer Center preoperative scoring system was contingent with cause of unresectability at staging laparoscopy (P = 0·462 and P = 0·280 respectively). CONCLUSION In the present cohort, staging laparoscopy proved useful in determining the presence of radiologically occult metastatic disease in perihilar cholangiocarcinoma.
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Affiliation(s)
- N Bird
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
| | - M Elmasry
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
| | - R Jones
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
| | - M Elniel
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
| | - M Kelly
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
| | - D Palmer
- Oncology Department, Clatterbridge Hospital, Bebington, UK
| | - S Fenwick
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
| | - G Poston
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
| | - H Malik
- Department of Hepato-Biliary Surgery, University Hospital Aintree, Liverpool, UK
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Chen A, Felix C, Wang J, Basehart V, Wong D, Rosove M, Beron P, Rao S, Melanson H, Palmer D, Kelly K, Steinberg M, Kupelian P, Daly M. Phase 2 Trial of Induction Chemotherapy Followed by Attenuated Chemoradiation Therapy for Human Papillomavirus–Positive Locally Advanced Squamous Cell Carcinoma of the Oropharynx. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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43
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Krug S, Beyer G, Javed M, Le N, Vinci A, Morgan R, Hubner R, Valle J, Wong H, Chowdhury S, Ma YT, Palmer D, Maisonneuve P, Neesse A, Sund M, Schober M. Intensified chemotherapy for metastatic pancreatic cancer: interim analysis of a large retrospective pan-European database and real life evaluation. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.68] [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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44
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Faluyi O, Connor J, Chatterjee B, Ikin C, Wong H, Palmer D. Advanced pancreatic adenocarcinoma outcomes with transition from devolved to centralised care in a UK regional cancer centre. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.78] [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: 11/14/2022] Open
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45
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El Miedany Y, Maha El Gaafary M, Youssef S, Palmer D. FRI0114 Development of The Patient Motivation Questionnaire: Conceptualizing and Measuring Motivation in Patients with Inflammatory Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2425] [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: 11/03/2022]
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46
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Rastall DPW, Seregin SS, Aldhamen YA, Kaiser LM, Mullins C, Liou A, Ing F, Pereria-Hicks C, Godbehere-Roosa S, Palmer D, Ng P, Amalfitano A. Long-term, high-level hepatic secretion of acid α-glucosidase for Pompe disease achieved in non-human primates using helper-dependent adenovirus. Gene Ther 2016; 23:743-752. [PMID: 27367841 DOI: 10.1038/gt.2016.53] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/09/2016] [Accepted: 05/31/2016] [Indexed: 02/07/2023]
Abstract
Pompe disease (glycogen storage disease type II (GSD-II)) is a myopathy caused by a genetic deficiency of acid α-glucosidase (GAA) leading to lysosomal glycogen accumulation causing muscle weakness, respiratory insufficiency and death. We previously demonstrated in GSD-II mice that a single injection of a helper-dependent adenovirus (HD-Ad) expressing GAA resulted in at least 300 days of liver secretion of GAA, correction of the glycogen storage in cardiac and skeletal muscles and improved muscle strength. Recent reports suggest that gene therapy modeling for lysososomal storage diseases in mice fails to predict outcomes in larger animal models. We therefore evaluated an HD-Ad expressing GAA in non-human primates. The baboons not only tolerated the procedure well, but the results also confirmed that a single dose of the HD-Ad allowed the livers of the treated animals to express and secrete large amounts of GAA for at least 6 months, at levels similar to those achieved in mice. Moreover, we detected liver-derived GAA in the heart, diaphragm and skeletal muscles of the treated animals for the duration of the study at levels that corrected glycogen accumulation in mice. This work validates our proof-of-concept studies in mice, and justifies future efforts using Ad-based vectors in Pompe disease patients.
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Affiliation(s)
- D P W Rastall
- Department of Microbiology and Molecular Genetics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - S S Seregin
- Department of Microbiology and Molecular Genetics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Y A Aldhamen
- Department of Microbiology and Molecular Genetics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - L M Kaiser
- Department of Microbiology and Molecular Genetics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - C Mullins
- Baylor College of Medicine, Houston, TX, USA
| | - A Liou
- Baylor College of Medicine, Houston, TX, USA
| | - F Ing
- Keck School of Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - C Pereria-Hicks
- Department of Microbiology and Molecular Genetics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - S Godbehere-Roosa
- Department of Microbiology and Molecular Genetics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - D Palmer
- Baylor College of Medicine, Houston, TX, USA
| | - P Ng
- Baylor College of Medicine, Houston, TX, USA
| | - A Amalfitano
- Department of Microbiology and Molecular Genetics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.,Department of Pediatrics, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
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Mason NWH, Mudge PL, Palmer D, McLeod M, Ausseil AG, Dymond J. Catchment-scale contribution of invasive nitrogen fixing shrubs to nitrate leaching: a scoping study. J R Soc N Z 2016. [DOI: 10.1080/03036758.2015.1127261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- NWH Mason
- Landcare Research, Hamilton, New Zealand
| | - PL Mudge
- Landcare Research, Palmerston North, New Zealand
| | - D Palmer
- Landcare Research, Hamilton, New Zealand
| | - M McLeod
- Landcare Research, Hamilton, New Zealand
| | - A-G Ausseil
- Landcare Research, Palmerston North, New Zealand
| | - J Dymond
- Landcare Research, Palmerston North, New Zealand
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VanderVeen N, Raja N, Yi E, Appelman H, Ng P, Palmer D, Zamler D, Dzaman M, Lowenstein PR, Castro MG. Preclinical Efficacy and Safety Profile of Allometrically Scaled Doses of Doxycycline Used to Turn "On" Therapeutic Transgene Expression from High-Capacity Adenoviral Vectors in a Glioma Model. Hum Gene Ther Methods 2016; 27:98-111. [PMID: 27056322 PMCID: PMC4926229 DOI: 10.1089/hgtb.2015.168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/29/2016] [Indexed: 01/05/2023] Open
Abstract
Glioblastoma multiforme (GBM) is the most commonly occurring primary brain cancer in adults, in whom its highly infiltrative cells prevent total surgical resection, often leading to tumor recurrence and patient death. Our group has discovered a gene therapy approach for GBM that utilizes high-capacity "gutless" adenoviral vectors encoding regulatable therapeutic transgenes. The herpes simplex type 1-thymidine kinase (TK) actively kills dividing tumor cells in the brain when in the presence of the prodrug, ganciclovir (GCV), whereas the FMS-like tyrosine kinase 3 ligand (Flt3L) is an immune-stimulatory molecule under tight regulation by a tetracycline-inducible "Tet-On" activation system that induces anti-GBM immunity. As a prelude to a phase I clinical trial, we evaluated the safety and efficacy of Food and Drug Administration (FDA)-approved doses of the tetracycline doxycycline (DOX) allometrically scaled for rats. DOX initiates the expression of Flt3L, which has been shown to recruit dendritic cells to the brain tumor microenvironment-an integral first step in the development of antitumor immunity. The data revealed a highly safe profile surrounding these human-equivalent doses of DOX under an identical therapeutic window as proposed in the clinical trial. This was confirmed through a neuropathological analysis, liver and kidney histopathology, detection of neutralizing antibodies, and systemic toxicities in the blood. Interestingly, we observed a significant survival advantage in rats with GBM receiving the 300 mg/day equivalent dosage of DOX versus the 200 mg/day equivalent. Additionally, rats rejected "recurrent" brain tumor threats implanted 90 days after their primary brain tumors. We also show that DOX detection within the plasma can be an indicator of optimal dosing of DOX to attain therapeutic levels. This work has significant clinical relevance for an ongoing phase I clinical trial in humans with primary GBM and for other therapeutic approaches using Tet-On transactivation system in humans.
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Affiliation(s)
- Nathan VanderVeen
- Department of Neurosurgery, The University of Michigan Medical School, Ann Arbor, Michigan
- Department of Cell and Developmental Biology, The University of Michigan Medical School, Ann Arbor, Michigan
| | - Nicholas Raja
- Department of Neurosurgery, The University of Michigan Medical School, Ann Arbor, Michigan
- Department of Cell and Developmental Biology, The University of Michigan Medical School, Ann Arbor, Michigan
| | - Elizabeth Yi
- Department of Neurosurgery, The University of Michigan Medical School, Ann Arbor, Michigan
- Department of Cell and Developmental Biology, The University of Michigan Medical School, Ann Arbor, Michigan
| | - Henry Appelman
- Department of Pathology, The University of Michigan Medical School, Ann Arbor, Michigan
| | - Philip Ng
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Donna Palmer
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Daniel Zamler
- Department of Neurosurgery, The University of Michigan Medical School, Ann Arbor, Michigan
- Department of Cell and Developmental Biology, The University of Michigan Medical School, Ann Arbor, Michigan
| | - Marta Dzaman
- Department of Neurosurgery, The University of Michigan Medical School, Ann Arbor, Michigan
- Department of Cell and Developmental Biology, The University of Michigan Medical School, Ann Arbor, Michigan
| | - Pedro R. Lowenstein
- Department of Neurosurgery, The University of Michigan Medical School, Ann Arbor, Michigan
- Department of Cell and Developmental Biology, The University of Michigan Medical School, Ann Arbor, Michigan
| | - Maria G. Castro
- Department of Neurosurgery, The University of Michigan Medical School, Ann Arbor, Michigan
- Department of Cell and Developmental Biology, The University of Michigan Medical School, Ann Arbor, Michigan
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El Miedany Y, Maha El Gaafary M, Youssef S, Palmer D, Nasr A. OP0258 Optimizing Therapy in Inflammatory Arthritis: Prediction of Relapse after Tapering or Stopping Dmards/ Biologic Agents by Ultrasonographic Assessment in Rheumatoid Arthritis Patients Who Achieved Clinical Remission. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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50
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Hillson J, Mant T, Ganguly T, Rosano M, Huntenburg C, Alai-Safar M, Darne S, Palmer D, Pavlova B, Doralt J, Reeve R, Goel N, Weilert D, Rhyne P, Caminis J, Roach J. FRI0182 A Single Dose Study Comparing Pharmacokinetics, Safety, and Immunogenicity of M923 (A Proposed Biosimilar To Adalimumab), US-Sourced Adalimumab, and EU-Sourced Adalimumab in Healthy Subjects. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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