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Le B, Gonzalez B, Weaver F, Sinnott B, Ray C, Chu E, Premji S, Raiford M, Mayur O, Carbone L. Malunions following lower extremity fractures in veterans with a spinal cord injury/disorder. J Spinal Cord Med 2024; 47:293-299. [PMID: 36977321 PMCID: PMC10885743 DOI: 10.1080/10790268.2023.2188391] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Nearly 50% of all persons with a spinal cord injury/disorder (SCI/D) will sustain an osteoporotic fracture sometime in their life, with lower extremity fractures being the most common. There are a number of complications that can occur post fracture, including fracture malunion. To date, there have been no dedicated investigations of malunions among persons with SCI/D. OBJECTIVES The primary objective of this study was to identify risk factors associated with fracture malunion among fracture-related (type of fracture, fracture location, initial fracture treatment) and SCI/D-related factors. Secondary objectives were to describe treatment of fracture malunions and complications following these malunions. METHODS Veterans with SCI/D with an incident lower extremity fracture and subsequent malunion from Fiscal Year (FY) 2005-2015 were selected from the Veteran Health Administration (VHA) databases using International Classification of Diseases, 9th edition (ICD-9) codes for lower extremity fractures and malunion. These fracture malunion cases underwent electronic health record (EHR) review to abstract information on potential risk factors, treatments and complications for malunion. Twenty-nine cases were identified with a fracture malunion with 28 of them successfully matched with Veterans with a lower extremity fracture during FY2005-FY2014 without a malunion (matched 1:4) based on having an outpatient utilization date of care within 30 days of the fracture case. There was trend towards more nonsurgical treatment in the malunion group (n = 27, 96.43%) compared to the control group (n = 101, 90.18%) (P = 0.05), though fracture treatment proved not to be not associated with developing a malunion in univariate logistic regression analyses (OR = 0.30; 95% CI: 0.08-1.09). In multivariate analyses, Veterans with tetraplegia were significantly less likely (approximately 3-fold) to have a fracture malunion (OR = 0.38; 95% CI: 0.14-0.93) compared to those with paraplegia. Fracture malunion was significantly less likely to occur for fractures of the ankle (OR = 0.02; 95% CI: 0-0.13) or the hip (OR = 0.15; 95% CI: 0.03-0.56) compared to femur fractures. Fracture malunions were rarely treated. The most common complications following malunions were pressure injuries (56.3%) followed by osteomyelitis (25.0%). CONCLUSIONS Persons with tetraplegia as well as fractures of the ankle and hip (compared to the femur) were less likely to develop a fracture malunion. Attention to prevention of avoidable pressure injuries following a fracture malunion is important.
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Affiliation(s)
- Brian Le
- Division of Specialty Care, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, USA
| | - Beverly Gonzalez
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, Illinois, USA
| | - Frances Weaver
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, Illinois, USA
- Stritch School of Medicine, Loyola University, Maywood, Illinois, USA
| | - Bridget Sinnott
- Department of Medicine, Division of Endocrinology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Cara Ray
- Center of Innovation for Complex Chronic Healthcare, Edward J. Hines, Jr. VA Hospital, Hines, Illinois, USA
| | - Elizabeth Chu
- Division of Specialty Care, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, USA
| | - Sara Premji
- Division of Specialty Care, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, USA
| | - Mattie Raiford
- Division of Specialty Care, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, USA
| | - Omkar Mayur
- Department of Medicine, Division of Rheumatology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Laura Carbone
- Division of Specialty Care, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, USA
- Department of Medicine, Division of Rheumatology, J. Harold Harrison, MD, Distinguished University Chair in Rheumatology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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Lim YL, Mond H, Michael R, Liew TS, Chu E, Health P, Visagathilagar T, Basioni N, Chia J, Bharatula S. Seven-day holter monitoring detects more significant arrhythmias than 24-hour and 3-day monitoring. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
24-hour Holter monitors have been used widely to assess patients with suspected and known arrhythmias. Recent studies have shown increased yield of arrhythmia detection with longer durations of Holter monitoring.
Purpose
The aim of the study was to evaluate the incremental yield in significant arrhythmias detected using a 7-day continuous Holter monitor, as compared to what can be achieved within a 24-hour and 48 to 72 hours study.
Methods
A retrospective study of patients from 72 sites in two geographical locations, A and B, who completed a continuous 7-days patch monitor study was performed. 801 of these studies detected significant arrhythmias; pauses 3 seconds or more (PA), ventricular tachycardia of 6 beats or more (VT), and paroxysmal atrial fibrillation (PAF). The day of the first occurrence of a significant arrhythmia was noted and tallied to determine the incremental yield of a multiday Holter monitoring.
Results
Of 801 total cases detected with significant arrhythmia, only 278 (35%) were detected in the first 24hours, while 523 (65%) cases were detected after Day 1. 331 (41%) had first significant arrhythmia detected after the 3rd day of monitoring, with 68 (44%) being PA, 125 (40%) PAF, and 138 (41%) VT. Notably, in Group A, 31 (72%) of total VT detected and 35 (72%) of total PAF detected were first picked up after Day 1, 21 (49%) of total VT were first detected only after the 3rd day of monitoring.
Conclusions
1-day (24-hour) monitoring period fails to detect a significant number of potentially serious cardiac arrhythmias. Extended continuous Holter monitoring increases the yield of detection, with a substantial fraction (40-49%) detected after the 3rd day of monitoring. No difference in results obtained between two geographical locations demonstrates strong evidence that findings are consistent across different sites. Review of current practice and guidelines is necessary to further expand usage of multiday Holter monitoring, thus increasing benefits to patients.
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Affiliation(s)
- Y L Lim
- Cardioscan Asia , Singapore , Singapore
| | - H Mond
- Cardioscan Asia , Singapore , Singapore
| | - R Michael
- Cardioscan Asia , Singapore , Singapore
| | - T S Liew
- Cardioscan Asia , Singapore , Singapore
| | - E Chu
- Cardioscan Asia , Singapore , Singapore
| | - P Health
- Cardioscan Asia , Singapore , Singapore
| | | | - N Basioni
- Cardioscan Asia , Singapore , Singapore
| | - J Chia
- Cardioscan Asia , Singapore , Singapore
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Straker R, Sharon C, Chu E, Miura J, Karakousis G, Ming M. 213 Sentinel lymph node biopsy in patients with clinical stage IIB/C cutaneous melanoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.220] [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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Brown-Korsah J, Blebea C, Ming M, Chu E. 625 Association of race with thickness in cutaneous melanoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.636] [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: 11/16/2022]
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Sinnott B, Ray C, Weaver F, Gonzalez B, Chu E, Premji S, Raiford M, Elam R, Miskevics S, Parada S, Carbone L. Risk Factors and Consequences of Lower Extremity Fracture Nonunions in Veterans With Spinal Cord Injury. JBMR Plus 2022; 6:e10595. [PMID: 35309860 PMCID: PMC8914149 DOI: 10.1002/jbm4.10595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/16/2021] [Indexed: 12/11/2022] Open
Abstract
We used Veterans Health Administration (VHA) national administrative data files to identify a cohort (fiscal years 2005–2014) of veterans with spinal cord injuries and disorders (SCID) to determine risk factors for and consequences of lower extremity fracture nonunions. Odds ratios (OR) for fracture nonunion were computed using multivariable‐adjusted logistic regression models. We identified three risk factors for nonunion: (i) older age (OR = 2.29; 95% confidence interval [CI] 1.21–4.33), (ii) longer duration of SCID (OR = 1.02; 95% CI 1.00–1.04), and (iii) fracture site (distal femur), with OR (comparison distal femur) including distal tibia/fibula (OR = 0.14; 95% CI 0.09–0.24), proximal tibia/fibula (OR = 0.19; 95% CI 0.09–0.38), proximal femur (OR = 0.10; 95% CI 0.04–0.21), and hip (OR = 0.13; 95% CI 0.07–0.26). Nonunions resulted in multiple complications, with upwards of 1/3 developing a pressure injury, 13% osteomyelitis, and almost 25% requiring a subsequent amputation. Our data have identified a high‐risk population for fracture nonunion of older veterans with a long duration of SCID who sustain a distal femur fracture. In view of the serious complications of these nonunions, targeted interventions in these high‐risk individuals who have any signs of delayed union should be considered. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
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Affiliation(s)
- Bridget Sinnott
- Charlie Norwood Veterans Affairs Medical Center Augusta GA USA
| | - Cara Ray
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs Hines VA Hospital Hines IL USA
| | - Frances Weaver
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs Hines VA Hospital Hines IL USA
- Parkinson School of Health Sciences and Public Health Loyola University Maywood IL USA
| | - Beverly Gonzalez
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs Hines VA Hospital Hines IL USA
- Feinberg School of Medicine Northwestern University Chicago IL USA
- Department of Biostatistics University of Illinois Chicago IL USA
- Department of Mathematics Northeastern Illinois University Chicago IL USA
| | - Elizabeth Chu
- Division of Rheumatology, Medical College of Georgia Augusta University Augusta GA USA
| | - Sarah Premji
- Division of Rheumatology, Medical College of Georgia Augusta University Augusta GA USA
| | - Mattie Raiford
- Division of Rheumatology, Medical College of Georgia Augusta University Augusta GA USA
| | - Rachel Elam
- Charlie Norwood Veterans Affairs Medical Center Augusta GA USA
- Division of Rheumatology, Medical College of Georgia Augusta University Augusta GA USA
| | - Scott Miskevics
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs Hines VA Hospital Hines IL USA
| | - Stephen Parada
- Department of Orthopaedic Surgery, Medical College of Georgia Augusta University Augusta GA USA
| | - Laura Carbone
- Charlie Norwood Veterans Affairs Medical Center Augusta GA USA
- Division of Rheumatology, Medical College of Georgia Augusta University Augusta GA USA
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Straker R, Shannon A, Chu E, Karakousis G, Ming M. 315 Acral lentiginous melanoma: Presentation and outcomes in the era of effective melanoma therapy. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.337] [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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Cabanillas M, Drilon A, Farago A, Brose M, McDermott R, Sohal D, Oh DY, Almubarak M, Bauman J, Chu E, Kummar S, Leyvraz S, Park K, Reeves J, Dima L, Maeda P, Rodrigues L, Brega N, Hong D, Waguespack S. 1916P Larotrectinib treatment of advanced TRK fusion thyroid cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1404] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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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Nguyen L, Wang Z, Chowdhury AY, Chu E, Eerdeng J, Jiang D, Lu R. Functional compensation between hematopoietic stem cell clones in vivo. EMBO Rep 2018; 19:embr.201745702. [PMID: 29848511 DOI: 10.15252/embr.201745702] [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: 12/23/2017] [Revised: 05/10/2018] [Accepted: 05/13/2018] [Indexed: 02/05/2023] Open
Abstract
In most organ systems, regeneration is a coordinated effort that involves many stem cells, but little is known about whether and how individual stem cells compensate for the differentiation deficiencies of other stem cells. Functional compensation is critically important during disease progression and treatment. Here, we show how individual hematopoietic stem cell (HSC) clones heterogeneously compensate for the lymphopoietic deficiencies of other HSCs in a mouse. This compensation rescues the overall blood supply and influences blood cell types outside of the deficient lineages in distinct patterns. We find that highly differentiating HSC clones expand their cell numbers at specific differentiation stages to compensate for the deficiencies of other HSCs. Some of these clones continue to expand after transplantation into secondary recipients. In addition, lymphopoietic compensation involves gene expression changes in HSCs that are characterized by increased lymphoid priming, decreased myeloid priming, and HSC self-renewal. Our data illustrate how HSC clones coordinate to maintain the overall blood supply. Exploiting the innate compensation capacity of stem cell networks may improve the prognosis and treatment of many diseases.
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Affiliation(s)
- Lisa Nguyen
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zheng Wang
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Adnan Y Chowdhury
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth Chu
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jiya Eerdeng
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Du Jiang
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rong Lu
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Reddy N, Chung B, Chu E, Esmaeili A, Tu T, Lee P. The use of EGFR-CD3 bispecific antibody and antigen-specific high avidity T cells to target cancer associated fibroblasts and cancer cells within a melanoma organoid system. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.007] [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: 10/17/2022]
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Patnaik A, Appleman LJ, Tolcher AW, Papadopoulos KP, Beeram M, Rasco DW, Weiss GJ, Sachdev JC, Chadha M, Fulk M, Ejadi S, Mountz JM, Lotze MT, Toledo FGS, Chu E, Jeffers M, Peña C, Xia C, Reif S, Genvresse I, Ramanathan RK. First-in-human phase I study of copanlisib (BAY 80-6946), an intravenous pan-class I phosphatidylinositol 3-kinase inhibitor, in patients with advanced solid tumors and non-Hodgkin's lymphomas. Ann Oncol 2017; 27:1928-40. [PMID: 27672108 PMCID: PMC5035790 DOI: 10.1093/annonc/mdw282] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/06/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To evaluate the safety, tolerability, pharmacokinetics, and maximum tolerated dose (MTD) of copanlisib, a phosphatidylinositol 3-kinase inhibitor, in patients with advanced solid tumors or non-Hodgkin's lymphoma (NHL). PATIENTS AND METHODS Phase I dose-escalation study including patients with advanced solid tumors or NHL, and a cohort of patients with type 2 diabetes mellitus. Patients received three weekly intravenous infusions of copanlisib per 28-day cycle over the dose range 0.1-1.2 mg/kg. Plasma copanlisib levels were analyzed for pharmacokinetics. Biomarker analysis included PIK3CA, KRAS, BRAF, and PTEN mutational status and PTEN immunohistochemistry. Whole-body [(18)F]-fluorodeoxyglucose positron emission tomography ((18)FDG-PET) was carried out at baseline and following the first dose to assess early pharmacodynamic effects. Plasma glucose and insulin levels were evaluated serially. RESULTS Fifty-seven patients received treatment. The MTD was 0.8 mg/kg copanlisib. The most frequent treatment-related adverse events were nausea and transient hyperglycemia. Copanlisib exposure was dose-proportional with no accumulation; peak exposure positively correlated with transient hyperglycemia post-infusion. Sixteen of 20 patients treated at the MTD had reduced (18)FDG-PET uptake; 7 (33%) had a reduction >25%. One patient achieved a complete response (CR; endometrial carcinoma exhibiting both PIK3CA and PTEN mutations and complete PTEN loss) and two had a partial response (PR; both metastatic breast cancer). Among the nine NHL patients, all six with follicular lymphoma (FL) responded (one CR and five PRs) and one patient with diffuse large B-cell lymphoma had a PR by investigator assessment; two patients with FL who achieved CR (per post hoc independent radiologic review) were on treatment >3 years. CONCLUSION Copanlisib, dosed intermittently on days 1, 8, and 15 of a 28-day cycle, was well tolerated and the MTD was determined to be 0.8 mg/kg. Copanlisib exhibited dose-proportional pharmacokinetics and promising anti-tumor activity, particularly in patients with NHL. CLINICALTRIALSGOV NCT00962611; https://clinicaltrials.gov/ct2/show/NCT00962611.
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Affiliation(s)
- A Patnaik
- South Texas Accelerated Research Therapeutics (START) Center for Cancer Care, San Antonio
| | | | - A W Tolcher
- South Texas Accelerated Research Therapeutics (START) Center for Cancer Care, San Antonio
| | - K P Papadopoulos
- South Texas Accelerated Research Therapeutics (START) Center for Cancer Care, San Antonio
| | - M Beeram
- South Texas Accelerated Research Therapeutics (START) Center for Cancer Care, San Antonio
| | - D W Rasco
- South Texas Accelerated Research Therapeutics (START) Center for Cancer Care, San Antonio
| | - G J Weiss
- Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare/TGen, Scottsdale Cancer Treatment Centers of America, Goodyear
| | - J C Sachdev
- Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare/TGen, Scottsdale
| | - M Chadha
- Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare/TGen, Scottsdale
| | - M Fulk
- Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare/TGen, Scottsdale
| | - S Ejadi
- Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare/TGen, Scottsdale
| | | | - M T Lotze
- University of Pittsburgh, Pittsburgh
| | | | - E Chu
- University of Pittsburgh, Pittsburgh
| | - M Jeffers
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, USA
| | - C Peña
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, USA
| | - C Xia
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, USA
| | - S Reif
- Bayer Pharma AG, Berlin, Germany
| | | | - R K Ramanathan
- Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare/TGen, Scottsdale
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Dicecco S, Butcher C, Worswick M, Boettcher E, Chu E, Shi C. Determination of forming limit diagrams of AA6013-T6 aluminum alloy sheet using a time and position dependent localized necking criterion. ACTA ACUST UNITED AC 2016. [DOI: 10.1088/1757-899x/159/1/012009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Brewer C, Chu E, Chin M, Lu R. Transplantation Dose Alters the Differentiation Program of Hematopoietic Stem Cells. Cell Rep 2016; 15:1848-57. [PMID: 27184851 DOI: 10.1016/j.celrep.2016.04.061] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/07/2016] [Accepted: 04/15/2016] [Indexed: 01/14/2023] Open
Abstract
Hematopoietic stem cell (HSC) transplantation is the most prevalent stem cell therapy, but it remains a risky procedure. To improve this treatment, it is important to understand how transplanted stem cells rebuild the blood and immune systems and how this process is impacted by transplantation variables such as the HSC dose. Here, we find that, in the long term following transplantation, 70%-80% of donor-HSC-derived clones do not produce all measured blood cell types. High HSC doses lead to more clones that exhibit balanced lymphocyte production, whereas low doses produce more T-cell-specialized clones. High HSC doses also produce significantly higher proportions of early-differentiating clones compared to low doses. These complex differentiation behaviors uncover the clonal-level regeneration dynamics of hematopoietic regeneration and suggest that transplantation dose can be exploited to improve stem cell therapy.
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Affiliation(s)
- Casey Brewer
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Elizabeth Chu
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mike Chin
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Rong Lu
- Department of Stem Cell Biology and Regenerative Medicine, Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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Yau WY, Chu E, Lai N. Cannabis, serotonergic drug use and stroke in a 50-year-old woman. Intern Med J 2015; 45:1312-3. [DOI: 10.1111/imj.12933] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 04/25/2015] [Accepted: 04/26/2015] [Indexed: 11/29/2022]
Affiliation(s)
- W. Y. Yau
- Neurology Department; Perth Western Australia Australia
| | - E. Chu
- Sir Charles Gairdner Hospital; Perth Western Australia Australia
| | - N. Lai
- Neurology Department; Perth Western Australia Australia
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Karanjia R, Ganti A, Chu E, Wagschal T, Belfort R, Moraes-Filho M, Salomao S, Chicani F, Guy M, Sadun A. Treatment of Leber's hereditary optic neuropathy with EPI-743: the Brazilian experience. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Karanjia
- Doheny Eye Centers UCLA; Ophthalmology; Pasadena CA United States
| | - A. Ganti
- Ophthalmology; University of Southern California; Los Angeles CA United States
| | - E. Chu
- Ophthalmology; University of Southern California; Los Angeles CA United States
| | - T. Wagschal
- Visual Field Reading Center; University of Iowa; Coralville IA United States
| | - R. Belfort
- Ophthalmology; Universidade Federal de Sao Paulo; Sao Paolo Brazil
| | - M. Moraes-Filho
- Ophthalmology; Universidade Federal de Sao Paulo; Sao Paolo Brazil
| | - S. Salomao
- Ophthalmology; Universidade Federal de Sao Paulo; Sao Paolo Brazil
| | - F. Chicani
- Ophthalmology; Universidade Federal de Sao Paulo; Sao Paolo Brazil
| | - M. Guy
- Edison Pharmaceuticals, Research and Development; Mountain View CA United States
| | - A. Sadun
- Doheny Eye Centers UCLA; Ophthalmology; Pasadena CA United States
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Chu L, Chu E, Dogra G, Chakera A. Restless legs syndrome: an underappreciated and distressing problem for haemodialysis patients. Intern Med J 2014; 44:1030-3. [PMID: 25302722 DOI: 10.1111/imj.12559] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/30/2014] [Indexed: 11/30/2022]
Abstract
Restless legs syndrome is a distressing condition that is more common in patients with end-stage renal failure. Despite the significant impact it has on quality of life and the documented association between restless legs syndrome and increased mortality, limited data regarding the epidemiology of restless legs syndrome in Australian dialysis patients are available. We report a prospective study that assessed the prevalence and factors associated with restless legs syndrome in an in-centre haemodialysis population.
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Affiliation(s)
- L Chu
- Renal Unit, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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Chu E, Knight C, O'Neill M, Das Purkayastha D. H17 Huntington's Disease And Forensic Risk Factors In Females. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ashton MP, Tan I, Mackin L, Elso C, Chu E, Papenfuss A, Phipson B, Smyth G, O'Keeffe M, Summers S, Payne N, Bernard C, Brodnicki T. Innate immune responses and type 1 diabetes: A role for a long non-coding RNA? DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Maciasz RM, Arnold RM, Chu E, Park SY, White DB, Vater LB, Schenker Y. Does it matter what you call it? A randomized trial of language used to describe palliative care services. Support Care Cancer 2013; 21:3411-9. [PMID: 23942596 DOI: 10.1007/s00520-013-1919-z] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 07/22/2013] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Integration of palliative care into oncology practice remains suboptimal. Misperceptions about the meaning of palliative care may negatively impact utilization. PURPOSE We assessed whether the term and/or description of palliative care services affected patient views. METHODS 2x2 between-subject randomized factorial telephone survey of 169 patients with advanced cancer. Patients were randomized into one of four groups that differed by name (supportive care vs. palliative care) and description (patient-centered vs. traditional). Main outcomes (0-10 Likert scale) were patient understanding, impressions, perceived need, and intended use of services. RESULTS When compared to palliative care, the term supportive care was associated with better understanding (7.7 vs. 6.8; p = 0.021), more favorable impressions (8.4 vs. 7.3; p = 0.002), and higher future perceived need (8.6 vs. 7.7; p = 0.017). There was no difference in outcomes between traditional and patient-centered descriptions. In adjusted linear regression models, the term supportive care remained associated with more favorable impressions (p = 0.003) and higher future perceived need (p = 0.022) when compared to palliative care. CONCLUSIONS Patients with advanced cancer view the name supportive care more favorably than palliative care. Future efforts to integrate principles of palliative medicine into oncology may require changing impressions of palliative care or substituting the term supportive care.
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Affiliation(s)
- R M Maciasz
- Doris Duke Clinical Research Fellow, University of Pittsburgh, Pittsburgh, PA, USA
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Cui J, Zhong R, Chu E, Zhang XF, Zhang WG, Fang CF, Dong Q, Li FL, Li H. Correlation between oxidative stress and L-type calcium channel expression in the ventricular myocardia of selenium-deficient mice. J Int Med Res 2013. [PMID: 23206450 DOI: 10.1177/030006051204000507] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Expression of the Cacna1c (calcium channel, voltage-dependent, L-type, α1C subunit) gene was studied to investigate the relationship between oxidative stress and L-type calcium channels in the myocardium of selenium-deficient mice. METHODS Selenium levels in liver and heart tissue samples from mice fed normal or selenium-deficient diets were evaluated by fluorometry. In the same mice, glutathione peroxidase (GPx) and Cacna1c gene expression were analysed, malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were measured, oxidoreductase gene expression profiles were analysed (by DNA microarray), and myocardial structural changes were studied. RESULTS In selenium-deficient versus control mice, GPx expression and SOD activity were decreased, and Cacna1c expression and MDA concentration were increased. Selenoprotein oxidoreductase and nonselenoprotein oxidoreductase gene expression differed significantly between selenium-deficient and control mice. In selenium-deficient mice, myocardial fibres were separated by loose collagenous tissue; electron microscopy showed shortened sarcomeres, dilated sarcoplasmic reticulum, scattered myofibril lysis and increased mitochondria with amorphous matrix densities. CONCLUSION L-type calcium channels were involved in selenium deficiency-induced cardiomyocyte injury, which was positively related to oxidative stress.
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Affiliation(s)
- J Cui
- Harbin Medical University, Harbin, Hei Longjiang Province, China
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Wang Q, Wu PC, Dong DZ, Ivanova I, Chu E, Zeliadt S, Vesselle H, Wu DY. Polyploidy road to therapy-induced cellular senescence and escape. Int J Cancer 2012; 132:1505-15. [PMID: 22945332 DOI: 10.1002/ijc.27810] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 07/31/2012] [Indexed: 12/21/2022]
Abstract
Therapy-induced cellular senescence (TCS), characterized by prolonged cell cycle arrest, is an in vivo response of human cancers to chemotherapy and radiation. Unfortunately, TCS is reversible for a subset of senescent cells, leading to cellular reproliferation and ultimately tumor progression. This invariable consequence of TCS recapitulates the clinical treatment experience of patients with advanced cancer. We report the findings of a clinicopathological study in patients with locally advanced non-small cell lung cancer demonstrating that marker of in vivo TCS following neoadjuvant therapy prognosticate adverse clinical outcome. In our efforts to elucidate key molecular pathways underlying TCS and cell cycle escape, we have previously shown that the deregulation of mitotic kinase Cdk1 and its downstream effectors are important mediators of survival and cell cycle reentry. We now report that aberrant expression of Cdk1 interferes with apoptosis and promotes the formation of polyploid senescent cells during TCS. These polyploid senescent cells represent important transition states through which escape preferentially occurs. The Cdk1 pathway is in part modulated differentially by p21 and p27 two members of the KIP cyclin-dependent kinase inhibitor family during TCS. Altogether, these studies underscore the importance of TCS in cancer therapeutics.
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Affiliation(s)
- Qin Wang
- Seattle Institute for Biomedical and Clinical Research, VA Puget Sound Health Care System, Seattle, WA 98108, USA.
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Affiliation(s)
- J B Samarasena
- Division of Gastroenterology, University of California - Irvine, Orange, California, USA.
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Wu PC, Wang Q, Grobman L, Chu E, Wu DY. Accelerated cellular senescence in solid tumor therapy. Exp Oncol 2012; 34:298-305. [PMID: 23070015] [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: 06/01/2023]
Abstract
Accelerated cellular senescence (ACS) is an emerging concept that implicates sustained, telomere-independent cell cycle arrest of neoplastic cells in response to chemotherapeutic agents, ionizing radiation, oxidative stress, or the presence of selective oncogenic stimuli. Recent evidence suggests that a subset of tumor cells induced in a state of reversible ACS can escape cell cycle arrest and resume proliferation accounting for cancer progression. The purpose of this review is to describe our current understanding of ACS including signaling pathways of senescence escape, role of senescence biomarkers, and rationale for senescence-based therapy. This article is part of a Special Issue entitled "Apoptosis: Four Decades Later".
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Affiliation(s)
- P C Wu
- Department of Surgery, VA Puget Sound Health Care System, Seattle, WA 98108, USA.
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Elion-Mboussa A, Gong L, Roy L, Zhu B, DeCory H, Chu E. Loteprednol Etabonate Ophthalmic Suspension, 0.2% Is As Safe as Olopatadine Hydrochloride Ophthalmic Solution, 0.1% With Superior Relief of Signs and Symptoms In The Treatment of Seasonal Allergic Conjunctivitis. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.279] [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]
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Chu E, Haller DG, Cartwright TH, Twelves C, McKenna E, Scotto N, Gilberg F, Cassidy J, Sun W, Saif MW, Schmoll H. Epidemiology and natural history of central venous access device (CVAD) use and infusion pump performance among patients (pts) treated for metastatic colorectal cancer (mCRC): Analysis from the NO16966 trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14010] [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: 11/20/2022] Open
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Wang Q, Wu P, Ivanova I, Chu E, Wu DY. Abstract 1242: Induction and targeting of polyploid senescent cells in cancer therapeutics. Cancer Res 2011. [DOI: 10.1158/1538-7445.am2011-1242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Therapy-induced cellular senescence (TCS), an emerging concept in cancer therapeutics, describes an in vivo response of human tumors to chemotherapy and radiation. These treatments elicit a coordinated response that results in prolonged cell cycle arrest, characteristic senescence morphology and expression of senescence-specific markers. In the past decade, a growing body of evidence has supported the hypothesis that “senescence response occurs in treated human cancers and the response is reversible.” We now present evidence that TCS may be adverse to cancer therapeutics based on a clinicopatholgical study conducted in patients with advanced non-small cell lung cancer following induction therapy prior to surgery. To further define how a subpopulation of senescent cells could escape terminal arrest, our work now implicates a polyploid state through which senescent cells can survive and eventually resume proliferation. In H1299 lung cancer cells, we show that mitotic kinase Cdk1 facilitates endoreplication and formation of polyplid senescent cells (PSCs) following chemotherapy as the genetic modulation of Cdk1 activity profoundly affect the prevalence of these polyploid cells. Importantly, senescence escape occurs from the PSCs at 2.5 times the frequency of escape observed from diploid (2/4n) cells through novel non-canonical cell division mechanisms. Furthermore, we also demonstrate distinct functions of p21 and p27, two members of KIP family in TCS. While both interact with endogenous cyclin B1-Cdk1 complex in senescent cells, only p27 directly inhibits Cdk1 kinase activity and modulates PSC formation, whereas the knockdown of p21 leads to massive apoptosis. Finally, we show that statins, HMG-CoA inhibitors, currently approved for treatment of dyslipidemia down-regulate several key targets of the Cdk1 pathway, including Cdk1 itself, cyclin B1, and survivin, while up-regulating p27. Statins both decrease polyploid cells and abrogate escape of several cancer cell lines from TCS. Altogether, our work here challenges the current cancer treatment paradigm and supports the incorporation of novel strategies to enforce irreversible cell cycle exit in senescent tumor cells following treatment.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1242. doi:10.1158/1538-7445.AM2011-1242
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Kuet KP, Goepel J, Mudhar H, Bourne JT, Sykes MP, Riaz I, Borg FA, Everett C, Dasgupta B, Byng-Maddick R, Wincup C, Penn H, Jani M, Bukhari M, Halsey J, Chander S, Marsh J, Hughes R, Chu E, Little J, Bruce I, Soh C, Lee L, Ho P, Ntatsaki E, Vassiliou V, Youngstein T, Mohamed M, Lanham J, Haskard D, Lutalo PM, Scott IC, Sangle S, D'Cruz DP, Scott IC, Garrood T, Mackie SL, Backhouse O, Melsom R, Pease CT, Marzo-Ortega H, Al-Mossawi MH, Wathen CJ, Al-Balushi F, Mahto A, Humby F, Kelly C, Jawad A, Lee M, Haigh RC, Derrett-Smith EC, Nihtyanova S, Parker J, Bunn C, Burns A, Little M, Denton C, Tosounidou S, Harris S, Steventon D, Sheeran T, Baxter D, Field M, Lutalo PM, Sangle S, Davies R, Khamashta MA, D'Cruz D, Wajed J, Kiely P, Srikanth A, Lanyon P. Case reports: 1. IGG4 Related Fibrosis: A Treatable Disease. Four Cases in a District General Hospital. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker025] [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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Strumwasser A, Chu E, Miraflor E, Yeung L, Sadjadi J, Victorino G. Thoracic Computed Tomography Is An Effective Screening Modality In Patients With Penetrating Injuries To The Chest. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.498] [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: 11/16/2022]
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Cassidy J, Schmoll H, Chu E, Hawkins N, Tatt I, Saini JP, Urspruch A. Comparative clinical efficacy of adjuvant chemotherapy regimens in randomized controlled trials (RCTs) of early-stage colon cancer: Systematic review and meta-analysis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
498 Background: A systematic review was conducted to identify RCTs of adjuvant chemotherapy regimens for early-stage colon cancer and a network meta-analysis performed to compare efficacy of oxaliplatin/fluoropyrimidine regimens. Methods: A systematic review identified RCTs recruiting adult patients with early-stage (adjuvant) stage II/III colon cancer. Outcome measures included hazard ratios for DFS and OS. Only publications in English were considered. Study quality was assessed using the Cochrane Collaboration “risk of bias” assessment tool. A single reviewer screened abstracts/titles using predefined selection criteria, with critical appraisal and data extraction conducted independently by two reviewers. A Bayesian network meta-analysis was used to estimate comparative efficacy of adjuvant chemotherapy across RCTs. Results: 56 articles describing 40 trials were selected, of which six reported data on regimens accepted as current standard of care (capecitabine/X-ACT, XELOX/NO16968, FOLFOX/MOSAIC, FLOX/C-07) or common comparators: bolus 5FU/LV and LV5FU2 (C-96-1, PETACC-2). Statistical assessment of heterogeneity was not possible due to the limited study network. Baseline characteristics were similar across trials with the exception of three trials recruiting only stage III patients; sub-group analysis on these trials was not possible due to lack of common comparators. There was no significant difference in DFS at a median follow-up of 3-years (or closest reported analysis) for XELOX vs. FLOX (HR=0.99, 95% CI 0.80–1.22) or FOLFOX (HR=1.00, 95% CI 0.72–1.41). There was also no significant difference in OS at a median follow-up of at least 5 years. Taken as a class, oxaliplatin-containing regimens (XELOX, FOLFOX, FLOX) improved DFS vs. non-oxaliplatin-containing regimens (HR=0.80, 95% CI 0.73–0.87). This result was confirmed for OS. Conclusions: Despite the limited number of available trials, the results of these analyses demonstrate a clear benefit of incorporating oxaliplatin into combination regimens for early-stage colon cancer. XELOX, FOLFOX and FLOX appear to be equivalent in terms of efficacy in this setting. [Table: see text]
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Affiliation(s)
- J. Cassidy
- University of Glasgow/Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University Clinic Halle (Saale), Halle, Germany; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Oxford Outcomes, Oxford, United Kingdom; F. Hoffmann-La Roche, Basel, Switzerland
| | - H. Schmoll
- University of Glasgow/Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University Clinic Halle (Saale), Halle, Germany; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Oxford Outcomes, Oxford, United Kingdom; F. Hoffmann-La Roche, Basel, Switzerland
| | - E. Chu
- University of Glasgow/Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University Clinic Halle (Saale), Halle, Germany; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Oxford Outcomes, Oxford, United Kingdom; F. Hoffmann-La Roche, Basel, Switzerland
| | - N. Hawkins
- University of Glasgow/Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University Clinic Halle (Saale), Halle, Germany; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Oxford Outcomes, Oxford, United Kingdom; F. Hoffmann-La Roche, Basel, Switzerland
| | - I. Tatt
- University of Glasgow/Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University Clinic Halle (Saale), Halle, Germany; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Oxford Outcomes, Oxford, United Kingdom; F. Hoffmann-La Roche, Basel, Switzerland
| | - J. P. Saini
- University of Glasgow/Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University Clinic Halle (Saale), Halle, Germany; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Oxford Outcomes, Oxford, United Kingdom; F. Hoffmann-La Roche, Basel, Switzerland
| | - A. Urspruch
- University of Glasgow/Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; University Clinic Halle (Saale), Halle, Germany; University of Pittsburgh Cancer Institute, Pittsburgh, PA; Oxford Outcomes, Oxford, United Kingdom; F. Hoffmann-La Roche, Basel, Switzerland
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Brooks SA, Makvandi-Nejad S, Chu E, Allen JJ, Streeter C, Gu E, McCleery B, Murphy BA, Bellone R, Sutter NB. Morphological variation in the horse: defining complex traits of body size and shape. Anim Genet 2010; 41 Suppl 2:159-65. [DOI: 10.1111/j.1365-2052.2010.02127.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wang Q, Wu PC, Roberson RS, Luk BV, Ivanova I, Chu E, Wu DY. Survivin and escaping in therapy-induced cellular senescence. Int J Cancer 2010; 128:1546-58. [PMID: 20503268 DOI: 10.1002/ijc.25482] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 05/14/2010] [Indexed: 01/21/2023]
Abstract
Therapy-induced accelerated cellular senescence (ACS) is a reversible tumor response to chemotherapy that is likely detrimental to the overall therapeutic efficacy of cancer treatment. To further understand the mechanism by which cancer cells can escape the sustained cell cycle arrest in ACS, we established a tissue culture model, in which the p53-null NCI-H1299 cells can be induced into senescence by an abbreviated exposure to a chemotherapeutic agent. Previously, we have reported that senescent cells overexpress Cdc2/Cdk1 when they bypassed the prolonged arrest and their viability is dependent on Cdc2/Cdk1 kinase activity. In our study, we show that human survivin is the immediate downstream effector of the Cdc2/Cdk1 mediated survival signal. Survivin cooperates with Cdc2/Cdk1 to inhibit apoptosis following chemotherapy and promote senescence escape. Using HIV-1 TAT peptides to disrupt survivin phosphorylation by Cdc2/Cdk1, we also found that phosphorylated survivin is necessary both for the escape of senescent cells and for maintenance of subsequent viability after bypassing senescence. These results further propose survivin as an important determinant of senescence reversibility and as a putative molecular target to enforce cell death in ACS.
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Affiliation(s)
- Qin Wang
- Seattle Institute for Biomedical and Clinical Research, VA Puget Sound Health Care System, Seattle, Washington.
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Alsamarai S, Ravage-Mass L, Kaley K, Dutschman G, Zhang W, Jiang Z, Liu S, Cheng YC, Chu E, Saif M. A phase I study of PHY906 as a modulator of irinotecan (CPT-11) in patients with advanced solid tumors. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e13571] [Citation(s) in RCA: 5] [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: 11/20/2022] Open
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Saif MW, Li J, Lamb L, Rosenberg A, Elligers K, Ruta S, Mezes M, Grant N, Liu SH, Chu E, Cheng Y. A phase II study of capecitabine (CAP) plus PHY906 in patients (pts) with advanced pancreatic cancer (APC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
e15508 Background: Gemcitabine (G) is regarded as the standard treatment for pts with APC. However, a standard second-line chemotherapy regimen has yet to be defined after G. PHY906, a 4-herb traditional Chinese medicine has a history of > 1,800 yrs of human use to treat GI symptoms including diarrhea. Preclinical studies showed that PHY906 may potentiate antitumor activity of CAP in human PANC-1 xenograft (ASCO 2007). A phase I study showed that CAP can be escalated up to 1750 mg/m2 PO BID on d1- 7 and PHY906 800mg PO BID on d1–4 q 2 wks with no DLTs (ASCO, 2008). Delivered dose-intensity of CAP was similar at 1750mg/m2 dose level as 1500mg/m2. Therefore, 1500mg/m2 of CAP and PHY906 was further tested in a phase II study as second-line treatment in pts with APC. Methods: Pts with G-refractory APC with ECOG PS <2 were treated with CAP 1500mg/m2 d1–7 with PHY906 800mg d1–4 q 2 wks. Response was assessed by CT scan according to RECIST q 6 wks and toxicity according to NCI-CTC v3.0. Primary objective is overall survival. Secondary objectives include overall RR, PFS and measurement of cytokines to assess inhibition of NF-kappa B, a possible mechanism responsible for PHY906's pharmacological activity. Results: As of January 5, 2009, 25 pts have been enrolled. Baseline characteristics include median age, 65 (range, 40–85); male/female,15/10; ECOG PS 0/1, 4/19; median cycles: 3 (r: 0.5–15). At this point 5 pts are still in active treatment. 4 pts have confirmed OS > 6 ms (1 still on study) with 2 further pts approaching 6 ms. Among evaluable pts, 1 had PR (5.3%), 11 SD (57.9%) and 7 PD (36.8%) after initial restaging scan. 36 % pts had >30% reduction in CA19–9 as biochemical response. There were 7 deaths on/within 30 days of study treatment, 6 related to PD and 1 had acute MI. G3/4 toxicities diarrhea 3/25 (12%), fatigue, 1/25 (4%), HFS 1/25 (4%) and mucositis 1/25 (4%). 1 pt was removed from study due to G3 HFS. Biomarker studies (IL4, GM-CSF, TNF-alpha, IL10, MCP-1, IL2, IL6) are ongoing. Conclusions: This is the first clinical study to evaluate a botanical formulation PHY906 with CAP in G-refractory APC pts. CAP + PHY906 regimen appears a safe and feasible salvage therapy in APC and warrants further investigation. In addition, PHY906 may have a cytoprotective antidiarrheal and anti-HFS effect, making treatment with CAP more tolerable. [Table: see text]
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Affiliation(s)
- M. W. Saif
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - J. Li
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - L. Lamb
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - A. Rosenberg
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - K. Elligers
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - S. Ruta
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - M. Mezes
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - N. Grant
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - S. H. Liu
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - E. Chu
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
| | - Y. Cheng
- Yale University School of Medicine, New Haven, CT; Phyotceutica Inc., New Haven, CT
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Yen Y, So S, Rose M, Saif MW, Chu E, Chen L, Liu S, Foo A, Tilton R, Cheng Y. Phase I/II study of capecitabine and PHY906 in hepatocellular carcinoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
15152 Traditional botanical formulations in combination with conventional antitumor chemotherapeutics may prove a powerful approach in reducing toxicity and improving clinical outcomes. In vivo studies show that PHY906, a traditional Chinese formulation, can reduce chemo-induced gastrointestinal toxicity while enhancing the therapeutic efficacy of a broad-spectrum of common anticancer agents in various cancer models, including capecitabine, CPT-11, thalidomide, adriamycin, and sorafenib in liver cancer; gemcitabine, capecitabine, oxaliplatin, gem/ox in pancreatic cancer; and CPT-11, 5-FU, sorafenib, VP-16, L-OddC, CPT-11/5-FU/LV, and oxaliplatin/5-FU/LV in colorectal cancer. Co- administration of PHY906 with a host of chemotherapeutic agents appears to neither alter the pharmacokinetic profiles of the chemotherapeutic agents nor their respective metabolites. PHY906 is currently being studied in a phase I/II, multicenter, open-label, dose-modification, safety and efficacy study in combination with capecitabine in patients with non-resectable HCC in the U.S. and Taiwan. Phase I patients (n=18) were enrolled at COH, Yale, VA and Stanford beginning November 2003. The primary objective of phase I was the determination of a safe dose regimen by varying the dose levels of PHY906 and/or capecitabine. Three dose levels of PHY906 + capecitabine were evaluated: PHY906 1000 mg BID + Capecitabine 1000 mg/m2 BID; PHY906 600 mg BID + Capecitabine 750 mg/m2 BID; and PHY906 800 mg BID + Capecitabine 750 mg/m2 BID. The final dosing level was chosen for the phase II portion of the study. Preliminary results suggest that the quality of life of patients on PHY906 + capecitabine was improved when compared to historical controls studying capecitabine alone. There is also no evidence of drug-induced toxicity caused by PHY906; nor does PHY906 reduce capecitabine antitumor activity. For patients receiving capecitabine at 750 mg/m2 BID and PHY906 at either 600 mg BID (N=4) or 800 mg BID (N=24), 10.7% (N=3) achieved minor response (MR), 50% (N=14) had stable disease (SD) and 39.3% (N=11) had progressive disease (PD). These findings support the further investigation of PHY906 as an adjuvant therapy of capecitabine in a larger HCC population. No significant financial relationships to disclose.
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Affiliation(s)
- M. G. Rose
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - Y. Yen
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - S. So
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - M. W. Saif
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - E. Chu
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - S. Liu
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - Z. Jiang
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - A. Foo
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - R. Tilton
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
| | - Y. Cheng
- VA CT Healthcare System, West Haven, CT; City of Hope National Medical Center, Duarte, CA; Stanford University School of Medicine, Stanford, CA; Yale Cancer Center, New Haven, CT; PhytoCeutica Inc., New Haven, CT; Yale University School of Medicine, New Haven, CT
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Yoo P, Mulkeen A, Schmitz J, Uchio E, Chu E, Cha C. P60. J Surg Res 2007. [DOI: 10.1016/j.jss.2006.12.289] [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]
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Yoo P, Mulkeen A, Schmitz J, Uchio E, Chu E, Longo W, Cha C. 173. J Surg Res 2007. [DOI: 10.1016/j.jss.2006.12.188] [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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37
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Chu E. Storytelling in person-centred care. Perspectives 2006; 30:5-9. [PMID: 17256397] [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] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Storytelling is a powerful tool that can be used successfully to pass on knowledge, wisdom and expertise from educators to students. A story is more easily remembered and new concepts in nursing taught in story form are understood more readily. By the same token, the story of a resident's history allows caregivers to really understand who that person is and was, and in turn provide the care that will suit the unique needs of that resident. The person-centered care concept revolves around this uniqueness of person and the process of storytelling serves the understanding of the resident, the crafting of the care package itself, and communicating that knowledge to other caregivers.
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Xi Y, Nakajima G, Chu E, Ju J. Systematic analysis of both steady state and actively translated mRNA transcripts regulated by thymidylate synthase and 5-FU treatment in human colon cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Y. Xi
- Univ of S Alabama Cancer Rsrch Inst, Mobile, AL; Yale Univ, New Haven, CT
| | - G. Nakajima
- Univ of S Alabama Cancer Rsrch Inst, Mobile, AL; Yale Univ, New Haven, CT
| | - E. Chu
- Univ of S Alabama Cancer Rsrch Inst, Mobile, AL; Yale Univ, New Haven, CT
| | - J. Ju
- Univ of S Alabama Cancer Rsrch Inst, Mobile, AL; Yale Univ, New Haven, CT
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Morris MJ, Beekman KW, Kelly WK, Slovin SF, Shaffer D, Eicher C, Chu E, Curley T, Delacruz A, Scher HI. Phase II study of bortezomib for castrate metastatic prostate cancer (PC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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)
- M. J. Morris
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | | | - W. K. Kelly
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | - S. F. Slovin
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | - D. Shaffer
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | - C. Eicher
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | - E. Chu
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | - T. Curley
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | - A. Delacruz
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
| | - H. I. Scher
- Memorial Sloan-Kettering Cancer Ctr, New York, NY
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Haffty BG, Psyrri A, Joe JK, Slater D, Zaheer W, Wilson LD, Son Y, Sasaki C, Chu E. Capecitabine (XEL) and Mitomycin-C (MMC) used concurrently with accelerated concomitant boost radiation therapy (CB-RT) in head and neck cancer (SCCHN): Preliminary results of a phase I clinical trial. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - A. Psyrri
- Yale Univ Sch of Medicine, New Haven, CT
| | - J. K. Joe
- Yale Univ Sch of Medicine, New Haven, CT
| | - D. Slater
- Yale Univ Sch of Medicine, New Haven, CT
| | - W. Zaheer
- Yale Univ Sch of Medicine, New Haven, CT
| | | | - Y. Son
- Yale Univ Sch of Medicine, New Haven, CT
| | - C. Sasaki
- Yale Univ Sch of Medicine, New Haven, CT
| | - E. Chu
- Yale Univ Sch of Medicine, New Haven, CT
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Murren J, Gerson S, Kummar S, Davies M, Remick S, Chu E, Karsten V, Sznol M. A Phase I trial of the sulfonylhydrazine alkylator, VNP40101M (101M), administered weekly in patients (pts) with metastatic cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Murren
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
| | - S. Gerson
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
| | - S. Kummar
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
| | - M. Davies
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
| | - S. Remick
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
| | - E. Chu
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
| | - V. Karsten
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
| | - M. Sznol
- Yale Cancer Center, New Haven, CT; Case Comprehensive Cancer Center, CWRU, Cleveland, OH; West Haven VA Medical Center, West Haven, CT; Vion Pharmaceuticals, New Haven, CT
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Chu E. A pluralistic approach to resident centred care. Perspectives 2004; 27:14-6. [PMID: 15085616] [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: 04/29/2023]
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Schmitz JC, Liu J, Lin X, Chen TM, Yan W, Tai N, Gollerkeri A, Chu E. Translational regulation as a novel mechanism for the development of cellular drug resistance. Cancer Metastasis Rev 2002; 20:33-41. [PMID: 11831645 DOI: 10.1023/a:1013100306315] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cellular drug resistance is one of the principal obstacles to the clinical efficacy of cancer chemotherapy. In this review, we describe the potential role for translational regulation as a novel mechanism for modulating chemosensitivity. The evidence for the translational control of thymidylate synthase, dihydrofolate reductase, and p53 will be presented, as will experimental data showing how disruptions in this important regulatory process can lead to the rapid emergence of cellular drug resistance.
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Affiliation(s)
- J C Schmitz
- Department of Medicine and Pharmacology, Yale Cancer Center, Yale University School of Medicine and VA CT Cancer Center, VA CT Healthcare System, New Haven 06516, USA
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Chu E. Clinical colorectal cancer: thymidylate synthase as a molecular biomarker. Clin Colorectal Cancer 2001; 1:136-7. [PMID: 12450424 DOI: 10.3816/ccc.2001.n.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Copur MS, Ledakis P, Bolton M, Morse AK, Werner T, Norvell M, Muhvic J, Chu E. An adverse interaction between warfarin and capecitabine: a case report and review of the literature. Clin Colorectal Cancer 2001; 1:182-4. [PMID: 12450435 DOI: 10.3816/ccc.2001.n.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [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: 11/20/2022]
Abstract
Warfarin is one of the most commonly used oral anticoagulants in the clinic. It is well established that a wide range of antineoplastic drugs interact with warfarin, resulting in altered coagulation parameters and/or bleeding sequelae. While altered coagulation parameters have been observed in patients taking the oral 5-fluorouracil prodrug, capecitabine, in combination with warfarin, no report to date has described clinically overt evidence of bleeding. Herein, we report 2 cancer patients who presented with bleeding episodes that most likely resulted from an adverse interaction between capecitabine and warfarin after 6 weeks of concomitant therapy. In each case, there was a marked elevation in both the prothrombin time and international normalized ratio (> 10), with subsequent gastrointestinal bleeding. The exact mechanism of this interaction is yet unknown, but it is possible that capecitabine might, in some manner, reduce the hepatic metabolism of warfarin. Close monitoring of coagulation parameters is recommended for all patients receiving concomitant warfarin and capecitabine, with appropriate adjustment of warfarin dosage. The nature and extent of this interaction requires further investigation.
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Affiliation(s)
- M S Copur
- Saint Francis Cancer Center, Medical and Radiation Oncology Department, 2116 W. Faidley Avenue, Grand Island, Nebraska, USA.
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Klonoff-Cohen H, Chu E, Natarajan L, Sieber W. A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertil Steril 2001; 76:675-87. [PMID: 11591398 DOI: 10.1016/s0015-0282(01)02008-8] [Citation(s) in RCA: 195] [Impact Index Per Article: 8.5] [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: 11/28/2022]
Abstract
OBJECTIVE To evaluate whether baseline or procedural stress during in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT) affects pregnancy or live birth delivery rates. DESIGN Prospective study. SETTING Seven clinics in Southern California between 1993 and 1998. PATIENT(S) One hundred and fifty-one women completed two questionnaires. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The number of oocytes aspirated and fertilized, the number of embryos transferred, the achievement of a pregnancy, live birth delivery, and infant outcomes. RESULT(S) Positive-affect negative-affect score at baseline negatively influenced the number of oocytes retrieved and embryos transferred. A higher expectation of pregnancy was associated with greater numbers of oocytes fertilized and embryos transferred. At baseline, the risk of no live birth was 93% lower for women who had the highest positive-affect score compared to those with the lowest score. Furthermore, the score on the Infertility Reaction Scale was related to negative outcomes in live birth delivery, infant birth weight, and multiple births. During the time of the procedure, the PANAS and Bipolar Profile of Moods States results were related to the number of oocytes fertilized and embryos transferred; stress did not affect pregnancy or delivery. CONCLUSION(S) Baseline (acute and chronic) stress affected biologic end points (i.e., number of oocytes retrieved and fertilized), as well as pregnancy, live birth delivery, birth weight, and multiple gestations, whereas (procedural) stress only influenced biologic end points.
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Affiliation(s)
- H Klonoff-Cohen
- Department of Family and Preventive Medicine, Division of Epidemiology, University of California-San Diego, La Jolla, California 92093-0607, USA.
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Ngan RK, Lau WH, Yip TT, Cho WC, Cheng WW, Lim CK, Wan KK, Chu E, Joab I, Grunewald V, Poon YF, Ho JH. Remarkable application of serum EBV EBER-1 in monitoring response of nasopharyngeal cancer patients to salvage chemotherapy. Ann N Y Acad Sci 2001; 945:73-9. [PMID: 11708497 DOI: 10.1111/j.1749-6632.2001.tb03866.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [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: 11/27/2022]
Abstract
Nineteen consecutive patients with metastatic or recurrent nasopharyngeal cancer (NPC) receiving combination chemotherapy were monitored for EBV DNA in their serum. EBV DNA (EBER-1) concentration in serum was measured before, during, and after chemotherapy. Thirteen patients had additional multiple prechemotherapy readings. There was a significant lead time from first detection of serum EBER-1 to clinical recurrence in 62% of patients by a mean of 17.4 weeks (range: 8-74.5 weeks; mean = 28.2 weeks if confined to the 8 patients with significant lead time). The median EBER-1 concentration was significantly higher in those with distant metastasis as compared to those with loco-regional recurrence only (17,468 vs. 684 pg/mL serum; p = 0.046, Mann-Whitney U test). Among the 13 patients who responded to chemotherapy, 4 exhibited clinical complete remission (CR) who were only found in the group with EBER-1 DNA drop to background level, while the magnitude of EBER-1 drop did not discriminate partial remission (PR) and stable disease (SD) patients clearly. Subsequent profile of EBER-1 DNA showed concordance with clinical course of either continuous remission or later progression. EBER-1 DNA in serum can become a useful adjunctive surrogate marker to monitor chemotherapeutic response in NPC patients with distant metastasis or advanced local recurrence.
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Affiliation(s)
- R K Ngan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China.
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Abstract
The tumor suppressor p53 and primary response gene Egr-1 are nuclear transcription factors with regulatory roles in signal transduction pathways mediating cellular proliferation and growth arrest as well as the complex genetic programs controlling differentiation and programmed cell death. We identified a physical association between these regulatory proteins in vitro and in vivo. Recombinant p53 and Egr-1 fusion proteins complexed with in vitro translates of Egr-1 or p53, respectively, or with these respective proteins in cell lysates. This protein-protein interaction was detected in vivo by immunoprecipitation and Western blot analysis of serum-activated cellular lysates with high levels of induced Egr-1 and of human lung cancer cell lines with constitutive overexpression of Egr-1 and mutant p53. A p53 mutant at codon 154 did not bind Egr-1, while p53 proteins with point mutations at residues 156, 246, 247, and 273 associated with this zinc finger transcription factor. p53 bound full-length Egr-1 and an Egr-1 mutant with a deletion of the 5' transactivation region but did not associate with Egr-1 protein lacking an internal segment that included the first two zinc finger domains, suggesting that binding may require the presence of intact zinc finger motifs. A variant-sized Egr-1 protein expressed by lung fibroblast cell line MRC-9 was also bound by p53. The interaction of these regulatory proteins may alter multiple features of their biological activity especially with regard to the specificity of transcriptional control.
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Affiliation(s)
- J Liu
- VA CT Healthcare System, Cancer Center-111D, 950 Campbell Avenue, West Haven, CT 06516, USA.
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Schmitz JC, Yu D, Agrawal S, Chu E. Effect of 2'-O-methyl antisense ORNs on expression of thymidylate synthase in human colon cancer RKO cells. Nucleic Acids Res 2001; 29:415-22. [PMID: 11139611 PMCID: PMC29681 DOI: 10.1093/nar/29.2.415] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 11/13/2022] Open
Abstract
Translation of thymidylate synthase (TS) mRNA is controlled by its own protein end-product TS in a negative autoregulatory manner. Disruption of this regulation results in increased synthesis of TS and may lead to the development of cellular drug resistance to TS-directed anticancer agents. As a strategy to inhibit TS expression, antisense 2'-O-methyl RNA oligoribonucleotides (ORNs) were designed to directly target the 5' upstream cis-acting regulatory element (nucleotides 80-109) of TS mRNA. A 30 nt ORN, HYB0432, inhibited TS expression in human colon cancer RKO cells in a dose-dependent manner but had no effect on the expression of beta-actin, alpha-tubulin or topoisomerase I. TS expression was unaffected by treatment with control sense or mismatched ORNs. HYB0504, an 18 nt ORN targeting the same core sequence, also repressed expression of TS protein. However, further reduction in oligo size resulted in loss of antisense activity. Following HYB0432 treatment, TS protein levels were reduced by 60% within 6 h and were maximally reduced by 24 h. Expression of p53 protein was inversely related to that of TS, suggesting that p53 expression may be directly linked to intracellular levels of TS. Northern blot analysis demonstrated that TS mRNA was unaffected by HYB0432 treatment. The half-life of TS protein was unchanged after antisense treatment suggesting that the mechanism of action of antisense ORNs is mediated through a process of translational arrest. These findings demonstrate that an antisense ORN targeted at a critical cis-acting element on TS mRNA can specifically inhibit expression of TS protein in RKO cells.
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Affiliation(s)
- J C Schmitz
- Department of Medicine and Pharmacology, Yale Cancer Center, Yale University School of Medicine and VA Connecticut Healthcare System, New Haven, CT 06520, USA
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