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Romesser PB, Miller ED, Shi Q, Dixon JG, Gholami S, White S, Wu C, Goulet CC, Jee KW, Wright CL, Yaeger R, Shergill A, Hong TS, George TJ, O'Reilly E, Meyerhardt J, Hitchcock KE. Alliance A022101: A Pragmatic Randomized Phase III Trial Evaluating Total Ablative Therapy for Patients with Limited Metastatic Colorectal Cancer - Evaluating Radiation, Ablation and Surgery (ERASur). Int J Radiat Oncol Biol Phys 2023; 117:e335. [PMID: 37785178 DOI: 10.1016/j.ijrobp.2023.06.2391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For patients with oligometastatic colorectal cancer (CRC), aggressive local therapy of isolated metastases, particularly in the liver, has been associated with long-term progression-free survival and overall survival (OS) primarily based on retrospective evidence. However, in patients with limited metastatic CRC that is deemed inoperable or those with additional disease outside of the liver or lungs, the role of local ablative therapies, including microwave ablation (MWA) and stereotactic body radiation therapy (SBRT), to render patients disease free is less clear. Further, despite the long history of treating oligometastatic CRC with local therapy, which is provider biased and not evidence based, questions remain regarding the benefit of extending the paradigm of metastatic directed therapy to patients with more extensive disease. This trial seeks to use a pragmatic multimodality approach that mirrors the current clinical dilemma. This study is designed to evaluate the safety and efficacy of adding total ablative therapy (TAT) of all sites of disease to standard of care systemic treatment in those with limited metastatic CRC. MATERIALS/METHODS A022101 is a National Clinical Trials Network randomized phase III study planned to enroll 364 patients with newly diagnosed metastatic CRC (BRAF wild-type, microsatellite stable) with 4 or fewer sites of metastatic disease on baseline imaging. Liver-only metastatic disease is not permitted, and lesions must be amenable to any combination of surgical resection, MWA, and/or SBRT with SBRT required for at least one lesion. Patients receive first-line systemic therapy for 4-6 months and are then randomized 1:1, stratified by number of metastatic organ sites (1-2 vs. 3-4), timing of metastatic disease diagnosis (de novo vs. secondary), and presence of metastatic disease outside the liver and lungs in at least one site. Patients in Arm 1 will receive TAT which consists of treatment of all metastatic sites with SBRT ± MWA ± surgical resection followed by standard of care systemic therapy. Patients in Arm 2 will continue with standard of care systemic therapy alone. The primary endpoint is OS. Secondary endpoints include event-free survival, treatment-related toxicities, and local recurrence with exploratory biomarker analyses. The study needs 346 evaluable patients combined in the 2 arms to demonstrate an improvement in OS with a hazard ratio of 0.7 to provide 80% power with a one-sided alpha of 5%. The trial utilizes a group sequential design with two interim analyses (25% and 50% of events) for futility. RESULTS The trial activated in January 2023. CONCLUSION Recruitment is ongoing.
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Affiliation(s)
- P B Romesser
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - E D Miller
- Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Q Shi
- Mayo Clinic, Rochester, MN
| | | | - S Gholami
- University of California, Davis, Davis, CA
| | - S White
- Medical College of Wisconsin, Milwaukee, WI
| | - C Wu
- Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - K W Jee
- Massachusetts General Hospital, Boston, MA
| | | | - R Yaeger
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Shergill
- The University of Chicago, Chicago, IL, United States
| | - T S Hong
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - T J George
- Division of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, FL
| | - E O'Reilly
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - K E Hitchcock
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
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Reyngold M, O'Reilly E, Zinovoy M, Hajj C, Wu AJ, Cuaron J, Romesser PB, Varghese AM, Park W, Yu K, Khalil DN, Lu W, Tyagi N, Diaz LA, Crane CH. Favorable Survival after Definitive Ablative RT in Surgically Resectable Pancreatic Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e335. [PMID: 37785177 DOI: 10.1016/j.ijrobp.2023.06.2390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Surgical resection has been considered the only curative option for patients with pancreatic adenocarcinoma (PDAC). Ablative RT ≥100Gy BED10 (A-RT) is associated with favorable survival in patients with locally advanced unresectable disease. We sought to evaluate A-RT outcomes in patients with technically resectable disease who did not undergo surgery. MATERIALS/METHODS Our prospectively maintained database of patients treated with A-RT was queried for consecutive patients with radiographic T1/T2 resectable PDAC. Patients were treated with a standardized technique within a large academic cancer center regional network. Ablative RT using several hypofractionated regimens was delivered on either standard Linacs with respiratory motion management, CBCT image guidance and selective adaptive replanning or MR-Linac with compression belt and daily on-line adaptive replanning. Freedom from local progression (FFLP), distant metastasis-free and overall survival (DMFS and OS, respectively) were analyzed using the Kaplan Meier estimates. RESULTS Between 2016 and 2022, 28 patients (54% male) with radiographically resectable PDAC received definitive A-RT. Median age was 80 (interquartile range, 77-84) years and 23 (82.1%) had KPS of 80 or below. Eighteen patients (64.3%) had T2 cancer, 5 (17.9%) were node positive, and 23 (82.1%) had head location. Median size was 2.6 (range, 1.6-4.0) cm with a median carbohydrate antigen 19-9 (CA19-9) of 160.5 (0-1823) U/mL. Twenty patients (71.4%) received induction chemotherapy for a median of 2.4 (0-6.2) months. RT regimens delivered on conventional Linacs unless otherwise indicated included 75Gy in 25 fractions (n = 15), 67.5Gy in 15 fractions (n = 10), 50Gy in 5 (N = 2, MR Linac), 60Gy in 10 (n = 1). 24-month FFLP and DMFS were 78.8% (52.3-91.7%) and 17.7% (95% CI, 5.8%-34.8%), respectively. 24-month and 48-month rate of OS from A-RT were 49.1% (95% CI, 27.53-67.5%) and 36.3 (95%16.0-57.1%). Grade 3 acute and late GI toxicity was noted in 3 and 1 patients, respectively, including 2 bleeding events treated with transfusions. There were no ≥ grade 4 events. CONCLUSION In patients with surgically resectable PDAC we found that definitive A-RT following multiagent induction therapy was associated with oncologic outcomes similar to resection with minimal toxicity.
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Affiliation(s)
- M Reyngold
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - E O'Reilly
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Zinovoy
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Hajj
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A J Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Cuaron
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - P B Romesser
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A M Varghese
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - W Park
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - K Yu
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - D N Khalil
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - W Lu
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - N Tyagi
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - L A Diaz
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C H Crane
- Memorial Sloan Kettering Cancer Center, New York, NY
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Reyngold M, O'Reilly E, Herrera R, Kaiser A, Zinovoy M, Romesser P, Wu A, Hajj C, Cuaron J, Ucar A, de Zarraga F, Aparo S, Lu W, Mittauer K, McCulloch J, Romaguera T, Alvarez D, Gutierrez A, Crane C, Chuong M. Multi-Institutional Comparison of Ablative Radiation Therapy in 5 Versus 15-25 Fractions for Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.534] [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: 10/31/2022]
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Hammel P, Golan T, Reni M, Van Cutsem E, Macarulla Mercade T, Hall M, Park J, Hochhauser D, Arnold D, Oh DY, Reinacher-Schick A, Tortora G, Algül H, O'Reilly E, Sharan K, Ou X, Cui K, Locker G, Kindler H. 1298P Extended overall survival results from the POLO study of active maintenance olaparib in patients with metastatic pancreatic cancer and a germline BRCA mutation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Keane F, Park W, Varghese A, Balogun F, Yu K, El Dika I, Khalil D, Kelsen D, Reidy-Lagunes D, Ku G, Raj N, Chou J, Capanu M, Schultz N, Yaeger R, O'Reilly E. 1304P Characterizing the clinico-genomic landscape and outcomes of KRAS G12C mutated pancreas cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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O'Reilly E, Golan T, Ikeda M, Milella M, Taieb J, Wainberg Z, Wang L, Gyambibi N, López E, Xu K, Macarulla T. P-22 Phase III study (daNIS-2) of the anti–TGF-β monoclonal antibody NIS793 with nab-paclitaxel/gemcitabine vs nab-paclitaxel/gemcitabine alone in patients with first-line metastatic pancreatic ductal adenocarcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.113] [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: 12/01/2022] Open
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Tempero M, O'Reilly E, Van Cutsem E, Berlin J, Philip P, Goldstein D, Tabernero J, Borad M, Bachet J, Parner V, Tebbutt N, Chua Y, Corrie P, Harris M, Taieb J, Burge M, Kunzmann V, Zhang G, McGovern D, Marks H, Biankin A, Reni M. LBA-1 Phase 3 APACT trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P + Gem) vs gemcitabine (Gem) alone in patients with resected pancreatic cancer (PC): Updated 5-year overall survival. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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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McCabe JJ, O'Reilly E, Coveney S, Collins R, Healy L, McManus J, Mulcahy R, Moynihan B, Cassidy T, Hsu F, Worrall B, Murphy S, O'Donnell M, Kelly PJ. Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis. Eur Stroke J 2021; 6:62-71. [PMID: 33817336 PMCID: PMC7995315 DOI: 10.1177/2396987320984003] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/06/2020] [Indexed: 01/02/2023] Open
Abstract
Background Recent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification. Methods We performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures. Results Of 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in loge-CRP (1.14, 95% CI 1.06-1.22, p < 0.01)] and MVEs (pooled HR 1.21, CI 1.10-1.34, p < 0.01). Fibrinogen was also associated with recurrent stroke (HR 1.26, CI 1.07-1.47, p < 0.01) and MVEs (HR 1.31, 95% CI 1.15-1.49, p < 0.01). Trends were identified for IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97-1.41, p = 0.10) and MVEs (HR 1.22, CI 0.96-1.55, p = 0.10). Conclusion Despite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.
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Affiliation(s)
- J J McCabe
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland.,Medicine for the Elderly Department/Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - E O'Reilly
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland
| | - S Coveney
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland.,Department of Geriatric Medicine, Tallaght University Hospital, Dublin, Ireland
| | - R Collins
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Department of Geriatric Medicine, Tallaght University Hospital, Dublin, Ireland
| | - L Healy
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
| | - J McManus
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Department of Geriatric Medicine, University Hospital Limerick, Ireland
| | - R Mulcahy
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Department of Geriatric Medicine, Waterford University Hospital, Waterford, Ireland
| | - B Moynihan
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - T Cassidy
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Geriatric and Stroke Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - F Hsu
- The Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - S Murphy
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland.,Medicine for the Elderly Department/Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M O'Donnell
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Department of Geriatric Medicine, University Hospital Galway, Galway, Ireland.,Department of Translational Medicine, National University of Ireland Galway, Ireland
| | - P J Kelly
- Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.,Neurovascular Unit for Applied Translational and Therapeutics Research, Catherine McAuley Centre, Dublin, Ireland.,Department of Neurology/Stroke Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
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Johnstone Z, Stewart R, Butcher R, O'Reilly E. P193 Audit of cough swab sampling techniques in children with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01218-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Reyngold M, O'Reilly E, Zinovoy M, Romesser P, Wu A, Hajj C, Cuaron J, Yorke E, Varghese A, Crane C. Ablative RT Results in Excellent Local Control and Survival in Localized Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Foran A, Lundon D, Kelly B, Hegarty N, O'Reilly E, Connolly S, O'Malley K. Correlation between neutrophil count and positive prostate biopsy. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.477] [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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O'Connell L, Prichard RS, O'Reilly E, Skehan S, Gibbons D, McDermott EW. Running in the family: A rare diagnosis of familial papillary thyroid cancer. Int J Surg Case Rep 2015; 16:64-6. [PMID: 26432498 PMCID: PMC4643435 DOI: 10.1016/j.ijscr.2015.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 09/10/2015] [Accepted: 09/15/2015] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Whilst inherited medullary thyroid cancer has been extensively reported, familial non-medullary thyroid cancer is a rare and less well described clinical entity. Familial forms of the disease demonstrate more aggressive features than sporadic non-medullary thyroid cancer. PRESENTATION OF CASE A 54 year old lady was referred with globus on a background of a longstanding goitre. Three first degree relatives had a history of non-medullary thyroid carcinoma. Investigations revealed a papillary thyroid carcinoma and the patient proceeded to total thyroidectomy and ipsilateral Level VI neck dissection, followed by adjuvant radioiodine ablation. DISCUSSION Familial papillary thyroid carcinoma syndrome is defined as three or more first degree relatives diagnosed with the disease in the absence of other known associated syndromes. It is often associated with the presence of benign thyroid disorders, and is characterised by the early onset of multi-focal bilateral locally advanced tumours. CONCLUSION Familial papillary thyroid cancer is a rare clinical entity but should be considered where ≥3 first degree relatives are diagnosed with non-medullary thyroid cancer. It is necessary to exclude other familial tumour syndromes to make the diagnosis. It demonstrates more aggressive features with higher rates of local recurrence than its sporadic counterpart, and therefore mandates more aggressive management than might otherwise be indicated. Screening of first degree relatives should be considered. SUMMARY The case of a 54 year old female diagnosed with familial non-medullary thyroid carcinoma is reported.
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Affiliation(s)
- L O'Connell
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - R S Prichard
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - E O'Reilly
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - S Skehan
- Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - D Gibbons
- Department of Pathology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - E W McDermott
- Department of Endocrine Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Tempero M, Cardin D, Biankin A, Goldstein D, Moore M, O'Reilly E, Philip P, Riess H, Macarulla T, Yung L, Li M, Lu B. P-185 Randomized phase III trial of nab-paclitaxel (nab-P) plus gemcitabine (Gem) vs Gem alone as adjuvant therapy for patients with resected pancreatic cancer: APACT. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kapoun A, O'Reilly E, Cohn A, Bendell J, Smith L, Strickler J, Gluck W, Liu Y, Wallace B, Tam R, Cancilla B, Brunner A, Hill D, Zhou L, Dupont J, Zhang C, Wang M. 465 Biomarker analysis in Phase 1b study of anti-cancer stem cell antibody Tarextumab (TAR) in combination with nab-paclitaxel and gemcitabine (Nab-P+Gem) demonstrates pharmacodynamic (PD) modulation of the Notch pathway in patients (pts) with untreated metastatic pancreatic cancer (mPC). Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70591-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hajj C, Huguet F, Wu A, Shi W, Zhang Z, O'Reilly E, Winston C, Reidy D, Ho A, Allen P, Goodman K. Chemotherapy and Intensity Modulated Radiation Therapy for Locally Advanced Pancreatic Cancer Achieves Prolonged Survival. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Moriarty RD, Martin A, Adamson K, O'Reilly E, Mollard P, Forster RJ, Keyes TE. The application of water soluble, mega-Stokes-shifted BODIPY fluorophores to cell and tissue imaging. J Microsc 2014; 253:204-18. [PMID: 24467513 DOI: 10.1111/jmi.12111] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 12/20/2013] [Indexed: 01/30/2023]
Abstract
BODIPY (4,4-difluoro-4-bora-3a,4a-diaza-s-indacene) fluorophores are widely used in bioimaging to label proteins, lipids and nucleotides, but in spite of their attractive optical properties they tend to be prone to self-quenching because of their notably small Stokes shift. Herein, we compare two BODIPY compounds from a recently developed family of naphthyridine substituted BODIPY derivatives, one a visible emitting derivative (BODIPY-VIS) and one a near-infrared emitting fluorophore with a Stokes shift of approximately 165 nm as contrast reagents for live mammalian cells and murine brain tissue. The compounds were rendered water soluble by their conjugation to polyethylene glycol (PEG). Both PEGylated compounds exhibited good cell uptake compared with their parent compounds and confocal fluorescence microscopy revealed all dyes explored to be nuclear excluding, localizing predominantly within the lipophilic organelles; the endoplasmic reticulum and mitochondria. Cytotoxicity studies revealed that these BODIPY derivatives are modestly cytotoxic at concentrations exceeding 10 μM where they induce apoptosis and necrosis. Although the quantum yield of emission of the visible emitting fluorophore was over an order of magnitude greater than the Mega-Stokes shifted probe, the latter showed considerably reduced tendency to self quench and less interference from autofluorescence. The near-infrared probe also showed good penetrability and staining in live tissue samples. In the latter case similar tendency to exclude the nucleus and to localize in the mitochondria and endoplasmic reticulum was observed as in live cells. This to our knowledge is the first demonstration of such a Mega-Stokes BODIPY probe applied to cell and tissue imaging.
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Affiliation(s)
- R D Moriarty
- National Centre for Sensor Research, Dublin City University, Dublin 9, Ireland
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O'Reilly E, Vormoor B, Kyle S, Newell H. 289 Assessment of a DNA-PK Inhibitor as a Chemo-potentiating Agent in Osteosarcoma. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72087-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Weiner-Gorzel K, O'Reilly E, McGoldrick A, Fitzpatrick P, O'Toole S, Maguire A, Kay E, O'Leary J, McCann A, Furlong F. 886 Mitotic Arrest Deficiency Protein 2 (MAD2) and Histone Deacetylase 6 (HDAC6) Present a Complex Relationship in Their Regulation and Expression and Subsequent Impact on Chemoresponsiveness. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ruane EM, Murphy PNC, Clifford E, O'Reilly E, French P, Rodgers M. Performance of a woodchip filter to treat dairy soiled water. J Environ Manage 2012; 95:49-55. [PMID: 22115510 DOI: 10.1016/j.jenvman.2011.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 04/25/2011] [Accepted: 09/11/2011] [Indexed: 05/31/2023]
Abstract
The milking process on dairy farms produces wastewaters, known as dairy soiled waters (DSW), which contain variable concentrations of nutrients. The most common method of disposal is by application to land. However, this practise can result in the pollution of nearby receiving water bodies. A laboratory study, comprising two sets of 0.5 m, 1 m and 1.5 m-deep filters loaded at two loading rates, examined the performance of woodchip filters in treating DSW. The filters comprised de-barked Sitka spruce (Picea sitchensis) woodchips. Dried DSW was reconstituted to 1% and 3% suspended solids (SS) concentrations and was applied at 28 L/m(2).d to the surface of the filters at loading rates of 280 g SS/m(2).d and 840 g SS/m(2).d, respectively. Filters were loaded for a maximum of 277 days. The filters achieved substantial decreases in SS (>99%), chemical oxygen demand (COD) (>97%) and total nitrogen (TN) (>89%). The dominant treatment mechanism appears to be physical filtration, but sorption and biological uptake likely also play a role. As the filters are aerobic, mineralisation and nitrification occur, but gaseous N losses are probably not significant. Woodchip shows potential as a filter medium for treating DSW, significantly decreasing the concentrations of SS, COD and TN.
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Affiliation(s)
- Eimear M Ruane
- Civil Engineering, National University of Ireland, Galway, Ireland.
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O'Reilly E, Rodgers M, Clifford E. Operation of a full-scale pumped flow biofilm reactor (PFBR) under two aeration regimes. Water Sci Technol 2011; 64:1218-1225. [PMID: 22214073 DOI: 10.2166/wst.2011.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A novel technology suitable for centralised and decentralised wastewater treatment has been developed, extensively tested at laboratory-scale, and trialled at a number of sites for populations ranging from 15 to 400 population equivalents (PE). The two-reactor-tank pumped flow biofilm reactor (PFBR) is characterised by: (i) its simple construction; (ii) its ease of operation and maintenance; (iii) low operating costs; (iv) low sludge production; and (v) comprising no moving parts or compressors, other than hydraulic pumps. By operating the system in a sequencing batch biofilm reactor (SBBR) mode, the following treatment can be achieved: 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD) and total suspended solids (TSS) reduction; nitrification and denitrification. During a 100-day full-scale plant study treating municipal wastewater and operating at 165 PE and 200 PE (Experiments 1 and 2, respectively), maximum average removals of 94% BOD5, 86% TSS and 80% ammonium-nitrogen (NH4-N) were achieved. During the latter part of Experiment 2, effluent concentrations averaged: 14 mg BOD5/l; 32 mg COD(filtered)/l; 14 mg TSS/l; 4.4 mg NH4-N/l; and 4.0 mg NO3-N/l (nitrate-nitrogen). The average energy consumption was 0.46-0.63 kWh/m3(treated) or 1.25-1.76 kWh/kg BOD5 removed. No maintenance was required during these experiments. The PFBR technology offers a low energy, minimal maintenance technology for the treatment of municipal wastewater.
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Affiliation(s)
- E O'Reilly
- College of Engineering and Informatics, National University of Ireland, Galway (NUI Galway), University Road, Galway, Ireland.
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O'Reilly E, Rodgers M, Zhan XM. Pumped flow biofilm reactors (PFBR) for treating municipal wastewater. Water Sci Technol 2008; 57:1857-1865. [PMID: 18587171 DOI: 10.2166/wst.2008.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A novel laboratory bench-scale sequencing batch biofilm reactor (SBBR) system was developed for the treatment of synthetic domestic strength wastewater, comprising two side-by-side 18 l reactor tanks, each containing a plastic biofilm media module. Aerobic and anoxic conditions in the biofilms were effected by intermittent alternate pumping of wastewater between the two reactors. With a media surface area loading rate of 4.2 g chemical oxygen demand (COD)/m2.d, the average influent COD, total nitrogen (TN) and ammonium-nitrogen (NH4-N) concentrations of 1021 mg/l, 97 mg/l and 54 mg/l, respectively, reduced to average effluent concentrations of 72 mg COD/l, 17.8 mg TN/l, and 5.5 mg NH4-N /l. Using a similar alternating biofilm exposure arrangement, a 16 person equivalent pilot (PE) plant was constructed at a local village treatment works to remove organic carbon from highly variable settled municipal wastewater and comprised two reactors, one positioned above the other, each containing a module of cross-flow plastic media with a surface area of 100 m2. Two different pumping sequences (PS) in the aerobic phase were examined where the average influent COD concentrations were 220 and 237 mg/l for PS1 and PS2, respectively, and the final average effluent COD was consistently less than 125 mg/l--the European Urban Wastewater Treatment Directive limit--with the best performance occurring in PS1. Nitrification was evident during both PS1 and PS2 studies. A 300 PE package treatment plant was designed based on the bench-scale and pilot-scale studies, located at a local wastewater treatment works and treated municipal influent with average COD, suspended solids (SS) and TN concentrations of 295, 183 and 15 mg/l, respectively resulting in average effluent concentrations of 67 mg COD/l, 17 mg SS/l and 9 mg TN/l. The SBBR systems performed well, and were simple to construct and operate.
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Affiliation(s)
- E O'Reilly
- Department of Civil Engineering, National University of Ireland, Galway, Ireland.
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Weisskopf MG, O'Reilly E, Chen H, Schwarzschild MA, Ascherio A. THE AUTHORS REPLY. Am J Epidemiol 2007. [DOI: 10.1093/aje/kwn009] [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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Fornier MN, Rathkopf D, Shah M, Patil S, O'Reilly E, Tse AN, Hudis C, Lefkowitz R, Kelsen DP, Schwartz GK. Phase I dose-finding study of weekly docetaxel followed by flavopiridol for patients with advanced solid tumors. Clin Cancer Res 2007; 13:5841-6. [PMID: 17908977 DOI: 10.1158/1078-0432.ccr-07-1218] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Flavopiridol is a cyclin-dependent kinase inhibitor that enhances docetaxel-induced apoptosis in a sequence-specific manner. In vivo, docetaxel must precede flavopiridol by at least 4 h to induce this effect. We conducted a phase I trial of weekly, sequential docetaxel followed 4 h later by flavopiridol in patients with advanced solid tumors. EXPERIMENTAL DESIGN Docetaxel at a fixed dose of 35 mg/m2 was administered over 30 min, followed 4 h later by escalating doses of flavopiridol, ranging from 20 to 80 mg/m2 in successive cohorts, administered weekly over 1 h. This schedule was repeated for 3 weeks of each 4-week cycle. RESULTS Twenty-seven evaluable patients were enrolled. The combination was well tolerated, with one dose-limiting toxicity occurring at flavopiridol 70 mg/m2 (grade 3 mucositis) and one dose-limiting toxicity at 80 mg/m2 (grade 4 neutropenia). We observed 1 complete response in a patient with pancreatic carcinoma and 4 partial responses in pancreatic (1), breast (2), and ovarian (1) cancer patients. Stable disease was seen in 10 patients. Pharmacokinetic studies showed Cmax ranging from 1.49 +/- 0.69 micromol/L (flavopiridol 20 mg/m2) to 4.54 +/- 0.08 micromol/L (flavopiridol 60 mg/m2) in cycle 1. CONCLUSIONS Treatment with weekly, sequential docetaxel followed by flavopiridol is an effective and safe regimen at all flavopiridol dose levels. The pharmacokinetic data indicate that concentrations of flavopiridol that enhance the effects of docetaxel both in vitro and in vivo can be achieved. Clinical activity is encouraging, even in patients who have received a prior taxane and in patients with gemcitabine-refractory metastatic pancreatic cancer.
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Affiliation(s)
- M N Fornier
- Breast Cancer Medicine Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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Abstract
Oxidative stress contributes to dopaminergic neuron degeneration in Parkinson's disease. Urate, a potent antioxidant, could be neuroprotective. To determine whether higher plasma concentrations of urate predict a reduced risk of Parkinson's disease, the authors conducted a nested case-control study among participants in the Health Professionals Follow-up Study, a cohort comprising over 18,000 men who provided blood samples in 1993-1995. Eighty-four incident cases of Parkinson's disease were diagnosed through 2000, and each was randomly matched to two controls by year of birth, race, and time of blood collection. Rate ratios of Parkinson's disease according to quartile of uricemia were estimated by use of conditional logistic regression. The mean urate concentration was 5.7 mg/dl among cases and 6.1 mg/dl among controls (p = 0.01). After adjustment for age, smoking, and caffeine, the rate ratio of Parkinson's disease for the highest quartile of uricemia compared with the lowest was 0.43 (95% confidence interval: 0.18, 1.02; p(trend) = 0.017). This association was stronger in analyses excluding cases diagnosed within 4 years (median) from blood collection (rate ratio = 0.17, 95% confidence interval: 0.04, 0.69; p(trend) = 0.010). These results suggest that high plasma urate concentrations may decrease the risk of Parkinson's disease, and they raise the possibility that interventions to increase plasma urate may reduce the risk and delay the progression of Parkinson's disease.
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Affiliation(s)
- M G Weisskopf
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA.
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Philip PA, Benedetti J, Fenoglio-Preiser C, Zalupski M, Lenz H, O'Reilly E, Wong R, Atkins J, Abruzzese J, Blanke C. Phase III study of gemcitabine [G] plus cetuximab [C] versus gemcitabine in patients [pts] with locally advanced or metastatic pancreatic adenocarcinoma [PC]: SWOG S0205 study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.lba4509] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA4509 Background: Epidermal growth factor receptor [EGFR] pathway is a rational target for therapeutic intervention. This study tested the efficacy of an anti-EGFR monoclonal antibody and gemcitabine [G] combination in the Phase III setting in patients with advanced PC. Methods: Eligibility included locally advanced unresectable or metastatic PC; adequacy of organ function; performance status (PS) 0- 2; no prior EGFR therapy; no prior systemic chemotherapy except for adjuvant chemotherapy; and submission of tumor for EGFR immunostaining. The primary endpoint was overall survival. Secondary endpoints included objective response, time to progression, pain control, and quality of life. Assuming 6 months median survival, the study was designed to detect a median improvement to 8 months (1.33 hazard ratio) with 90% power, based on a one-sided 0.0125 test, and 704 eligible patients. Primary analyses used a Cox regression model, stratified for factors used in the randomization. Patients were stratified by PS, stageand prior pancreatectomy, and randomized to either G alone or G plus C. G was given at a dose of 1,000 mg/m2/wk for seven weeks out of 8, then 3 weeks on and one week off. C was given as a loading dose of 400 mg/m2 on week 1 and then 250 mg/m2 weekly. Results: 766 pts (735 eligible) with a median age of 64 (30–91) were enrolled by SWOG and CTSU between January 2004 and April 2006. Of those, 51% were males, 21.5% had locally advanced disease, and 13% had PS of 2. The study closed with full accrual. The median survival was 6 months in the G arm and 6.5 months in the G plus C arm for an overall HR of 1.09 (95% CI 0.93–1.27, p= 0.14) . The corresponding PFS was 3 months and 3.5 months, for G and G+C arms, respectively (HR =1.13, 95%CI .97–1.3, p=.058). The confirmed response probabilities were 7 % in each arm, and inclusion of unconfirmed responses yielded 14% in the G arm and 12% in the G + C arm.702 pts were evaluable for toxicity. 90 pts experienced at least one grade 4 toxicity; 14% on the G plus C, 11% on G alone. Conclusions: This study failed to demonstrate a clinically significant advantage of the addition of cetuximab to gemcitabine for overall survival, PFS and response in advanced PC. No significant financial relationships to disclose.
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Affiliation(s)
- P. A. Philip
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - J. Benedetti
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - C. Fenoglio-Preiser
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - M. Zalupski
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - H. Lenz
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - E. O'Reilly
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - R. Wong
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - J. Atkins
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - J. Abruzzese
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
| | - C. Blanke
- Karmanos Cancer Inst, Detroit, MI; Fred Hutchinson Cancer Research Center, Seattle, WA; University of Cincinnati, Cincinnati, OH; University of Michigan, Ann Arbor, MI; USC Norris Cancer Center, Los Angeles, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; CancerCare Manitoba, Winnipeg, MB, Canada; Southeastern Med/Onc Center, Goldsboro, NC; OHSU Hem/Med Onc, Portland, OR
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Weisskopf M, O'Reilly E, McCullough M, Calle E, Thun M, Schwarzschild M, Ascherio A. Prospective Study Of Education, Occupation, and Risk of Parkinson's Disease. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s178-c] [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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Kortmansky JS, Sauter N, O'Reilly E, Shah M, Abou-Alfa GK, Winkelmann J, Yi S, Gonen M, Kelsen DP, Schwartz GK. Management of hyperglycemia in patients with metastatic pancreatic cancer receiving UCN-01 and fluorouracil. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - N. Sauter
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - E. O'Reilly
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. Shah
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | - J. Winkelmann
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - S. Yi
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. Gonen
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | - D. P. Kelsen
- Memorial Sloan-Kettering Cancer Center, New York, NY
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Rathkopf D, Fornier M, Shah M, Kortmansky J, O'Reilly E, King A, Winkelmann J, Kelsen DP, Olsen S, Schwartz GK. A phase I dose finding study of weekly, sequential docetaxel (Doc) followed by flavopiridol (F) in patients with advanced solid tumors. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D. Rathkopf
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - M. Fornier
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - M. Shah
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - J. Kortmansky
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - E. O'Reilly
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - A. King
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - J. Winkelmann
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - D. P. Kelsen
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - S. Olsen
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
| | - G. K. Schwartz
- Memorial Sloan-Kettering, New York, NY; Aventis Pharmaceuticals, Bridgewater, NJ
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Abstract
BACKGROUND A protective effect of vitamin D on risk of multiple sclerosis (MS) has been proposed, but no prospective studies have addressed this hypothesis. METHODS Dietary vitamin D intake was examined directly in relation to risk of MS in two large cohorts of women: the Nurses' Health Study (NHS; 92,253 women followed from 1980 to 2000) and Nurses' Health Study II (NHS II; 95,310 women followed from 1991 to 2001). Diet was assessed at baseline and updated every 4 years thereafter. During the follow-up, 173 cases of MS with onset of symptoms after baseline were confirmed. RESULTS The pooled age-adjusted relative risk (RR) comparing women in the highest quintile of total vitamin D intake at baseline with those in the lowest was 0.67 (95% CI = 0.40 to 1.12; p for trend = 0.03). Intake of vitamin D from supplements was also inversely associated with risk of MS; the RR comparing women with intake of >or=400 IU/day with women with no supplemental vitamin D intake was 0.59 (95% CI = 0.38 to 0.91; p for trend = 0.006). No association was found between vitamin D from food and MS incidence. CONCLUSION These results support a protective effect of vitamin D intake on risk of developing MS.
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Affiliation(s)
- K L Munger
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115, USA.
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Sharma S, Kemeny N, Kelsen DP, Ilson D, O'Reilly E, Zaknoen S, Baum C, Statkevich P, Hollywood E, Zhu Y, Saltz LB. A phase II trial of farnesyl protein transferase inhibitor SCH 66336, given by twice-daily oral administration, in patients with metastatic colorectal cancer refractory to 5-fluorouracil and irinotecan. Ann Oncol 2002; 13:1067-71. [PMID: 12176785 DOI: 10.1093/annonc/mdf173] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND ras genes encode Ras proteins that are important for signal transduction in cancer cells. Farnesyl protein transferase (FPTase) is an enzyme that is responsible for a critical post-translational modification of Ras. PATIENTS AND METHODS We report the results of a phase II trial of SCH 66336, an FPTase inhibitor, in patients with metastatic colorectal cancer. This is the first reported experience of an FPTase inhibitor in this disease. All patients were considered refractory to first- and second-line therapy. A total of 21 evaluable patients were treated with a starting dose of 200 mg b.i.d. given continuously. RESULTS The major side-effects were fatigue (grade 1 in 42%, grade 2 in 42% and grade 3 in 14%), diarrhea (grade 1 in 23% and grade 3 in 42%) and nausea (grade 2 in 16%). Elevations in serum creatinine (grade 2 or 3) were observed in 19% of patients and appeared to be related to dehydration induced by diarrhea. Significant hematological toxicity was not observed (only grade 1 thrombocytopenia in 19% and grade 2 or 3 anemia in 28%). Pharmacological studies revealed adequate mean pre-dose plasma concentrations in this group of patients on day 15 of therapy. No objective responses were observed, although stable disease was seen in three patients for several months. Administration of SCH 66336 was accompanied by gastrointestinal toxicity. CONCLUSIONS Future development of this compound cannot be recommended as monotherapy in this disease.
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Affiliation(s)
- S Sharma
- Gastrointestinal Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 11201, USA.
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Sharma S, Kemeny N, Schwartz GK, Kelsen D, O'Reilly E, Ilson D, Coyle J, De Jager RL, Ducharme MP, Kleban S, Hollywood E, Saltz LB. Phase I study of topoisomerase I inhibitor exatecan mesylate (DX-8951f) given as weekly 24-hour infusions three of every four weeks. Clin Cancer Res 2001; 7:3963-70. [PMID: 11751488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Exatecan mesylate (DX-8951f) is a topoisomerase I inhibitor that has increased solubility and antitumor activity compared with other topoisomerase I inhibitors. The purpose of this study was to establish a safe dose of DX-8951f given as a weekly 24-h infusion 3 of every 4 weeks. DX-8951f was administered as a 24-h continuous infusion in escalating doses. Twenty-seven patients were treated with 81 courses of the drug. Dose-limiting toxicities included neutropenia, thrombocytopenia, and inability to administer all three doses in the first cycle. In minimally pretreated patients, a dose of 0.8 mg/m(2) was tolerable. In patients who were heavily pretreated, a slightly lower dose, 0.53 mg/m(2), was tolerated without any severe toxicities. Nonhematological toxicities were mild and consisted of mild diarrhea, asthenia, mild nausea, and constipation. Pharmacokinetic parameters could be well described with a one-compartment model in most patients, although the application of the one-compartment model probably resulted in an underestimated elimination half-life. In conclusion, the recommended Phase II dose for DX-8951f administered as a weekly 24-h infusion on a 3-of-4 week schedule is 0.8 mg/m(2) in minimally pretreated patients and 0.53 mg/m(2) in patients who are heavily pretreated.
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Affiliation(s)
- S Sharma
- Division of Gastrointestinal Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Sanz-Altamira PM, O'Reilly E, Stuart KE, Raeburn L, Steger C, Kemeny NE, Saltz LB. A phase II trial of irinotecan (CPT-11) for unresectable biliary tree carcinoma. Ann Oncol 2001; 12:501-4. [PMID: 11398883 DOI: 10.1023/a:1011135014895] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Unresectable adenocarcinomas of the biliary tree have a very poor prognosis. No good chemotherapeutic regimen is available. Irinotecan has not yet been fully tested in this disease. We evaluated its activity in unresectable bile duct cancers. PATIENTS AND METHODS Twenty-five consecutive eligible patients at our two institutions were treated with irinotecan at a starting dose of 125 mg/m2. A cycle consisted of once-a-week treatments for four consecutive weeks, followed by two weeks of rest. All patients were required to have histologically confirmed diagnosis, clinically documented metastatic or unresectable carcinoma and measurable disease. Patients were evaluated for response, toxicity, and survival. RESULTS A total of 83 cycles of therapy were delivered. Two patients had a partial response (8%; 95% confidence interval (CI): 0%-18%) and ten additional patients had stable disease for at least two months (40%; 95% CI: 20.8%-59.2%). The therapy was well tolerated, with moderate myelosuppression and diarrhea as the main toxicities. The overall median survival was 10 months. CONCLUSIONS Irinotecan has minimal activity in biliary tree carcinomas, but is well tolerated with appropriate supportive care, and produces occasional objective responses.
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Affiliation(s)
- P M Sanz-Altamira
- Division of Hematology/Oncology, Boston Center for Liver Cancer, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA
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Schwartz GK, Ilson D, Saltz L, O'Reilly E, Tong W, Maslak P, Werner J, Perkins P, Stoltz M, Kelsen D. Phase II study of the cyclin-dependent kinase inhibitor flavopiridol administered to patients with advanced gastric carcinoma. J Clin Oncol 2001; 19:1985-92. [PMID: 11283131 DOI: 10.1200/jco.2001.19.7.1985] [Citation(s) in RCA: 153] [Impact Index Per Article: 6.7] [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] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Flavopiridol is the first cyclin-dependent kinase inhibitor to enter clinical trials. Activity in gastric cancer xenografts and in a patient with gastric cancer on the phase I trial led to this phase II study of flavopiridol in patients with metastatic gastric cancer. PATIENTS AND METHODS Sixteen patients were entered onto the study, and 14 were assessable for response. Flavopiridol was administered initially at a dose of 50 mg/m(2)/d by continuous infusion for 72 hours every 2 weeks. Assessment of plasma pharmacokinetics was performed in all patients. Peripheral mononuclear cells were collected throughout the 72-hour infusion for determinants of apoptosis. RESULTS There were no major objective responses (exact confidence interval 0% to 23%). One patient achieved a minor response in his liver metastases, though the primary progressed. Other patients exhibited histologic and radiographic evidence of tumor necrosis. Common toxicities included fatigue in 93% of patients (grade 3 or 4 in 27%) and diarrhea in 73% of patients (grade 3 or 4 in 20%). Five patients (33%) developed venous thromboses at the central catheter tip. The studies performed on peripheral mononuclear cells indicated no induction of apoptosis. CONCLUSION Flavopiridol administered as a single agent for 72 hours every 14 days is inactive in the treatment of gastric cancer. The drug also induced an unexpected higher incidence of vascular thrombosis and fatigue than was anticipated from the phase I trials. Future development of flavopiridol will depend on other doses and schedules in combination with chemotherapy.
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Affiliation(s)
- G K Schwartz
- Department of Medicine, Division of Solid Tumor Oncology, Gastrointestinal Oncology Section, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Farid A, O'Reilly E, Dollard C, Kelsey Jr. C. Genetic analysis of ten sheep breeds using microsatellite markers. Can J Anim Sci 2000. [DOI: 10.4141/a99-086] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The genetic variability of 257 sheep from 10 breeds; North Country Cheviot (NCC), Cheviot (CHE), Dorset (DOR), Suffolk (SUF), Scottish Blackface (SBF), Texel (TEX), Romanov (ROM), Finnish Landrace (FIN), Icelandic (ICE) and Red Masai (MAS) was assessed using 10 microsatellite loci. The average number of alleles per locus was 4.3 in ROM, 5.0 in MAS, and spanned a narrow range (5.4 to 6.0) in the other breeds. Estimates of expected heterozygosity (HE) of the breeds varied within 0.05 point of each other (0.62 in FIN to 0.67 in CHE), except for ROM (0.53) which was lower (P < 0.05) than those of the other breeds, and in MAS (0.57), which was lower (P < 0.05) than those of NCC, CHE and SBF. Estimates of observed heterozygosity (HO) of the breeds were the lowest in MAS, ROM and SUF (0.50 to 0.53) and the highest in NCC and CHE (0.64 and 0.67). The HE was greater (P < 0.01) than HO only in SUF. The results suggest that there have not been drastic losses of genetic variability in the intensely selected breeds. The low genetic variability of ROM was probably due to a small number of animals imported to North America. The British breeds (NCC, CHE, SUF, DOR, SBF) were genetically close to each other, as were the North European breeds (ROM, ICE, FIN). MAS was remotely related to the British breeds, but it was surprisingly close to the North European breeds. TEX was more closely related to the British breeds than to the North European breeds. More than 90% of 1000 simulated individuals from each breed were assigned to the correct breed, indicating that this panel of markers is useful for the identification of breed membership of individual animals, and could be used to protect the integrity of registered breeds. Key words: Sheep, genetic variability, genetic distance, microsatellites
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Fata F, O'Reilly E, Ilson D, Pfister D, Leffel D, Kelsen DP, Schwartz GK, Casper ES. Paclitaxel in the treatment of patients with angiosarcoma of the scalp or face. Cancer 1999; 86:2034-7. [PMID: 10570428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Angiosarcomas are rare tumors. Based on a complete response observed in a patient with angiosarcoma of the scalp treated with paclitaxel in a Phase II trial, the authors treated a cohort of patients with angiosarcoma of the scalp or face with paclitaxel as single agent. METHODS The authors identified nine patients with angiosarcoma of the scalp or face treated at Memorial Sloan-Kettering Cancer Center with paclitaxel between January 1992 and December 1998. Various paclitaxel schedules were used over 1, 3, and 24 hours. RESULTS Of the 9 patients, 8 had major responses (4 partial responses and 4 clinical complete responses) and 1 had a minor response, for a major response rate of 89%. The median duration of response was 5 months (range, 2-13 months). Neutropenia and peripheral neuropathy were the most frequent dose-limiting toxicities. No deaths were attributed to therapy. CONCLUSIONS Paclitaxel as a single agent has substantial activity against angiosarcoma of the scalp or face, even in patients previously treated with chemotherapy or radiation therapy. Further investigation is warranted to define the optimal treatment dose and schedule.
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Affiliation(s)
- F Fata
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, New York, USA
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Abstract
BACKGROUND Diarrhea and oral mucositis are the most frequently reported gastrointestinal side effects caused by 5-fluorouracil (5-FU). Diarrhea may be severe in 10-30% of patients and is schedule-dependent. 5-FU-induced gastrointestinal toxicity predominantly affects the upper and the lower gastrointestinal tract. The current study describes 5-FU-induced small bowel toxicity as an entity that to the authors' knowledge has not been reported previously in patients with colon carcinoma receiving 5-FU-based therapy. METHODS The authors report a series of six patients with colorectal carcinoma who developed acute small bowel toxicity after treatment with 5-FU and leucovorin. RESULTS Six patients developed a clinical picture of acute abdominal pain and diarrhea. Small bowel damage was documented by laparotomy in two patients, by colonoscopy in one patient, and by abdominal computed tomography scan in three patients. The course was complicated by recurrence of symptoms in one patient who was rechallenged with 5-FU and leucovorin, but the remaining four patients were rechallenged safely with lower doses of 5-FU and leucovorin after the acute toxicity episode. A possible explanation for this toxicity is 5-FU-induced vasospasm and/or decrease in fibrinolytic activity that results in decreased mucosal blood flow. CONCLUSIONS 5-FU-induced small bowel toxicity is a potentially severe toxicity that may occur in patients with colon carcinoma or other malignancies who are receiving 5-FU-based therapy. [See editorial on pages 1099-100, this issue.]
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Affiliation(s)
- F Fata
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and the Cornell University Medical College, New York, New York 10021, USA
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Ilson DH, Saltz L, Enzinger P, Huang Y, Kornblith A, Gollub M, O'Reilly E, Schwartz G, DeGroff J, Gonzalez G, Kelsen DP. Phase II trial of weekly irinotecan plus cisplatin in advanced esophageal cancer. J Clin Oncol 1999; 17:3270-5. [PMID: 10506629 DOI: 10.1200/jco.1999.17.10.3270] [Citation(s) in RCA: 208] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate the response, toxicity, survival, and quality of life in patients with unresectable or metastatic esophageal cancer treated with weekly irinotecan and cisplatin. PATIENTS AND METHODS Thirty-five patients with metastatic or unresectable esophageal adenocarcinoma (23 patients) or squamous cell carcinoma (12 patients) were treated. No prior chemotherapy was allowed. The majority of patients had metastatic and bidimensionally measurable disease (34 patients each [97%]). Patients were treated with cisplatin 30 mg/m(2) and irinotecan 65 mg/m(2), repeated weekly for 4 weeks, followed by a 2-week rest period. Treatment was recycled every 6 weeks. Degree of dysphagia relief was monitored, and quality of life was measured prospectively using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 and Functional Assessment of Cancer Therapy-General instruments. RESULTS Thirty-five patients were assessable for response and toxicity. Major objective responses were observed in 20 patients (57%; 95% confidence interval, 41% to 73%), including two complete responses (6%). Similar response rates were observed for adenocarcinoma (12 of 23 patients; 52%) and squamous carcinoma (eight of 12 patients; 66%). The median duration of response was 4.2 months (range, 1 to 8.8+ months). Median actuarial survival was 14.6 months (range, 1 to 15.2+ months). In 20 patients with dysphagia assessable at baseline, 18 (90%) noted either improvement or resolution of dysphagia on chemotherapy. Global quality of life improved in responding patients, primarily because of improvements in pain, emotional state, and relationships with family and friends. Toxicity was relatively mild and included only three patients (9%) with grade 4 neutropenia and four (11%) with grade 3 diarrhea. There were no treatment-related deaths. CONCLUSION The combination of weekly cisplatin plus irinotecan had significant activity in metastatic esophageal carcinoma and resulted in significant relief of dysphagia. The regimen was well tolerated, with acceptable myelosuppression and rare treatment-related diarrhea. Further evaluation of the combination of weekly irinotecan and cisplatin, including the addition of other agents to this regimen, is indicated.
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Affiliation(s)
- D H Ilson
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Abstract
BACKGROUND Diarrhea and oral mucositis are the most frequently reported gastrointestinal side effects caused by 5-fluorouracil (5-FU). Diarrhea may be severe in 10-30% of patients and is schedule-dependent. 5-FU-induced gastrointestinal toxicity predominantly affects the upper and the lower gastrointestinal tract. The current study describes 5-FU-induced small bowel toxicity as an entity that to the authors' knowledge has not been reported previously in patients with colon carcinoma receiving 5-FU-based therapy. METHODS The authors report a series of six patients with colorectal carcinoma who developed acute small bowel toxicity after treatment with 5-FU and leucovorin. RESULTS Six patients developed a clinical picture of acute abdominal pain and diarrhea. Small bowel damage was documented by laparotomy in two patients, by colonoscopy in one patient, and by abdominal computed tomography scan in three patients. The course was complicated by recurrence of symptoms in one patient who was rechallenged with 5-FU and leucovorin, but the remaining four patients were rechallenged safely with lower doses of 5-FU and leucovorin after the acute toxicity episode. A possible explanation for this toxicity is 5-FU-induced vasospasm and/or decrease in fibrinolytic activity that results in decreased mucosal blood flow. CONCLUSIONS 5-FU-induced small bowel toxicity is a potentially severe toxicity that may occur in patients with colon carcinoma or other malignancies who are receiving 5-FU-based therapy. [See editorial on pages 1099-100, this issue.]
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Affiliation(s)
- F Fata
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and the Cornell University Medical College, New York, New York 10021, USA
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Charmley E, O'Reilly E. Evaluation of seal meal as a protein supplement for growing steers. Can J Anim Sci 1997. [DOI: 10.4141/a97-037] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This experiment evaluated the suitability of dried seal meal (SM) as a protein supplement for growing steers. Protein in the SM had an effective degradability of 65% and a slow degradation rate in the rumen. There was a positive quadratic growth response to replacing soybean meal (SBM) with SM (P < 0.05). We attribute this response to optimized concentrations of fat and metabolizable protein supplied by the SM/SBM mixtures. We conclude that SM is a beneficial protein source for growing steers when combined with SBM. Key words: Growing steer, seal, protein supplement, silage
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Nelson BW, O'Reilly E, Miller M, Hogan M, Wegner JA, Kelly C. The clinical effects of intensive, specific exercise on chronic low back pain: a controlled study of 895 consecutive patients with 1-year follow up. Orthopedics 1995; 18:971-81. [PMID: 8584467 DOI: 10.3928/0147-7447-19951001-05] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Eight hundred ninety-five consecutive chronic low back pain patients were evaluated. Six hundred twenty-seven completed the program. One hundred sixty-one began, but dropped out, and 107 were recommended for treatment but did not undergo treatment for various reasons. Average duration of symptoms prior to evaluation was 26 months. Forty-seven percent of patients were workers' compensation patients. The primary treatment was intensive, specific exercise using firm pelvic stabilization to isolate and rehabilitate the lumbar spine musculature. Patients were encouraged to work hard to achieve specific goals. Seventy-six percent of patients completing the program had excellent or good results. At 1-year follow up 94% of patients with good or excellent results reported maintaining their improvement. Results in the control group were significantly poorer in all areas surveyed except employment.
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Affiliation(s)
- B W Nelson
- Physicians Neck & Back Clinic, Minneapolis, Minn., USA
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O'Reilly E, Crown J. The medical treatment of advanced prostate cancer. Ir Med J 1994; 87:130, 132. [PMID: 7960647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
In today's complex society where dissolution of the nuclear family has become commonplace, grandparents are playing an increasingly significant role in the nurturing of their young grandchildren. The authors studied twelve randomly selected grandparent-headed families from the case files of a suburban child guidance clinic. Comparisons were made among the cases in terms of a number of factors, most significantly, elements of treatment including therapeutic issues, modalities and outcomes. The authors stress a multi-modal and intergenerational approach to the treatment of these families.
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Affiliation(s)
- E O'Reilly
- Community Child Guidance Clinic, Inc., Manchester, Connecticut 06040
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Gillan JE, Curran C, O'Reilly E, Cahalane SF, Unwin AR. Abnormal patterns of pulmonary neuroendocrine cells in victims of sudden infant death syndrome. Pediatrics 1989; 84:828-34. [PMID: 2571973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Ventilatory dysfunction has become the main focus of current research in sudden infant death syndrome (SIDS). This has been correlated with structural abnormalities in the carotid body and respiratory nuclei of the brainstem. In recent studies, the denervating effect of asphyxial brainstem dysfunction on the pulmonary neuroendocrine cells, which probably function as chemoreceptors, was demonstrated and prompted the following study. The pulmonary neuroendocrine system was evaluated in 25 victims of SIDS and 20 control infants, ranging in age from 3 weeks to 7 months and 1 to 12 months, respectively. The pulmonary neuroendocrine cells were stained by the Churukian-Schenk method and the neuroendocrine cell-positive airway values expressed as a percentage of the total number of airways. The range of positive airway values for victims of SIDS was 2% to 97% with a median of 73%. In contrast, the range for the control infants was 1% to 44% with a median of 25.5%. The SIDS victims' percentage was significantly greater than the control infants' percentage (P less than .0001). The number of pulmonary neuroendocrine cells in positive airway was also increased among SIDS victims compared with control infants. The altered pulmonary neuroendocrine cell pattern could be attributable to either brainstem dysfunction or chronic hypoxia. These explanations are not, however, mutually exclusive of one another; in fact, it is possible that both mechanisms may be operative.
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Affiliation(s)
- J E Gillan
- Department of Pathology, Trinity College, Rotunda Hospital, Dublin, Ireland
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Abstract
The first part of this study explored relationships of 41 individual-difference measures to an earlier self-report measure of habitual alcohol use. Five measures of individual differences relating to anxiety exhibited negative correlations with habitual alcohol use. Also, obesity was not correlated significantly with alcohol use. The second part showed that a bored temperament was associated with the highest level, and a docile temperament was associated with the lowest level of habitual alcohol use. The second lowest level of habitual alcohol use was associated with an anxious temperament.
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O'Reilly E. Diabetics and Christmas. Queens Nurs J 1974; 17:195. [PMID: 4498739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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O'Reilly E. A comprehensive record. Nurs Times 1972; 68:612-4. [PMID: 5027866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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O'Reilly E, Steger JA. Children's use of context in judgment of weight. Child Dev 1970; 41:1095-101. [PMID: 5496257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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