1
|
Patel D, Jha A, Shah J. Technological Aspects of Nanoemulsions for Post-harvest Preservation of Fruits and Vegetables. Comb Chem High Throughput Screen 2024; 27:CCHTS-EPUB-139577. [PMID: 38584565 DOI: 10.2174/0113862073297299240325084138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
Recent times have witnessed a growing demand for sustainable technology for food preservation that can retain its freshness, promises lower contents of additives and preservatives, safe consumption, eco-friendly milder processing technologies and eco-friendlier packaging solutions. Application of Biopolymers has served as the most sustainable and viable option to its synthetic counterparts. These biopolymers have been incorporated to develop biodegradable packaging like edible films and coatings owing to their biological origin. Nanoemulsion technology offers a leap forward to upgrade the features of conventional biodegradable packaging items. The present review discusses various trends and perspectives of nanoemulsion technology in post-harvest preservation for enhancing the shelf life of fresh fruits and vegetables. It investigates the interconnectedness between food preservation techniques, biodegradable packaging materials made from biopolymers, and nanoemulsions. It further addresses the preservation challenges post-harvest and underscores the limitations of conventional preservation methods, advocating for eco-friendly alternatives with a specific focus on the potential of nanoemulsions in enhancing food safety and quality. This review elaborates on the composition, formulation techniques, nanoemulsion products and role of nanoemulsions in the management of foodborne pathogens. Furthermore, it examines the potential health hazards linked to the use of nanoemulsions and stresses the significance of a regulatory framework for food safety. In conclusion, this review offers insights into the promising prospects of using nanoemulsions in food preservation.
Collapse
Affiliation(s)
- D Patel
- Department of Biological Sciences, P D Patel Institute of Applied Sciences, Charotar University of Science and Technology, Changa, Anand-388421, Gujarat, India
| | - A Jha
- Department of Biological Sciences, P D Patel Institute of Applied Sciences, Charotar University of Science and Technology, Changa, Anand-388421, Gujarat, India
| | - J Shah
- Department of Biological Sciences, P D Patel Institute of Applied Sciences, Charotar University of Science and Technology, Changa, Anand-388421, Gujarat, India
| |
Collapse
|
2
|
Lopez J, Subramanian T, Durell J, Levyn H, Wong R, Shah J, LaQuaglia MP, Gerstle JT. Posttreatment complications in pediatric cervical neuroblastoma: A retrospective case series at a tertiary cancer center. J Surg Oncol 2024; 129:219-223. [PMID: 37850570 DOI: 10.1002/jso.27482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Neuroblastomas rarely occur as primary tumors in the cervical region. Therefore, very little has been reported regarding treatment strategies, complications, and outcomes of these cervical neuroblastomas. The goal of this study is to review the presentation, management, and outcomes of all primary cervical pediatric neuroblastoma cases at a single tertiary care center. METHODS A retrospective cohort review of all neuroblastoma patients treated at a single center were performed. All patients with primary cervical neuroblastoma were reviewed for demographic information, tumor characteristics, treatment, and outcomes. RESULTS Thirty (1.8%) patients were found to have undergone treatment for cervical neuroblastoma tumors diagnosed on average at 2.1 years old. Most presented with a swollen neck/palpable mass ± Horner's syndrome. Based on features including tumor staging, N-myc proto-oncogene protein (MYCN) amplification status, histology, most were deemed intermediate or high risk. Treatment strategies centered around chemotherapeutic regimens with surgery when possible as well as various adjuvant treatments including radiation therapy, immunotherapy, bone marrow transplant, and a neuroblastoma vaccine. Ten (33.3%) of patients experienced treatment-related complications and four (13.3%) died as a result of their disease progression. All four patients were high-risk patients, two of which had MYCN amplification. CONCLUSION Cervical neuroblastomas generally have favorable outcomes. These tumors can be treated effectively with chemotherapy and surgical intervention with various adjuvant therapies. MYCN amplification and higher stage disease presentation contribute to worse outcomes.
Collapse
Affiliation(s)
- Joseph Lopez
- Department of Pediatric Surgery, Division of Pediatric Head & Neck Surgery, AdventHealth for Children, Orlando, Florida, USA
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Tejas Subramanian
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Jonathan Durell
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Helena Levyn
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Richard Wong
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Jatin Shah
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Michael P LaQuaglia
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Justin Ted Gerstle
- Department of Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| |
Collapse
|
3
|
Ritter A, Levyn H, Shah J. Recent advances in head and neck surgical oncology. J Surg Oncol 2024; 129:32-39. [PMID: 37990842 PMCID: PMC10842243 DOI: 10.1002/jso.27529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/23/2023]
Abstract
In recent years, the field of head and neck oncology has witnessed a remarkable transformation with unprecedented advances that have revolutionized the management of complex tumors in this region. As an intricate subspecialty within oncology, head and neck surgical procedures demand detailed knowledge of the complex anatomy meticulous precision in surgical technique, and expertise to preserve vital functions while ensuring optimal oncological outcomes. With the relentless pursuit of improved patient outcomes, the integration of innovative technologies has significantly enhanced the surgical armamentarium. Robotics, endoscopic platforms, and image-guided navigation have revolutionized the surgical approach, enabling precise tumor resection and sparing healthy tissues. Furthermore, the application of advanced imaging modalities and molecular biomarker profiling has opened new avenues for personalized treatment strategies. From targeted therapies and immunotherapies to adaptive radiation techniques, clinicians are now equipped with an array of tailored options, ushering in a new era of personalized care for patients with head and neck malignancies. This article delves into the unfolding narratives of clinical triumphs, exploring the transformative potential of emerging therapies and the collaborative efforts propelling head and neck surgical oncology toward a future of hope and healing.
Collapse
|
4
|
Cao Y, Aryal M, Li P, Lee C, Schipper M, You D, Jaworski E, Gharzai L, Shah J, Eisbruch A, Mierzwa M. Diffusion MRI correlation with p16 status and prediction for tumor progression in locally advanced head and neck cancer. Front Oncol 2023; 13:998186. [PMID: 38188292 PMCID: PMC10771284 DOI: 10.3389/fonc.2023.998186] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/06/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose To investigate p16 effects on diffusion image metrics and associations with tumor progression in patients with locally advanced head and neck cancers. Methods Diffusion images pretreatment and after 20 Gy (2wk) of RT were analyzed in patients with cT4/N3 p16+ oropharynx cancer (OPSCC) (N=51) and locoregionally advanced head and neck squamous cell carcinoma (LAHNSCC) (N=28), enrolled onto a prospective adaptive RT trial. Mean ADC values, subvolumes with ADC <1.2 um2/ms (TVLADC), and peak values of low (µL) and high (µH) components of ADC histograms in primary and total nodal gross tumor volumes were analyzed for prediction of freedom from local, distant, or any progression (FFLP, FFDP or FFLRDP) using multivariate Cox proportional-hazards model with clinical factors. P value with false discovery control <0.05 was considered as significant. Results With a mean follow up of 36 months, 18 of LAHNSCC patients and 16 of p16+ OPSCC patients had progression. After adjusting for p16, small µL and ADC values, and large TVLADC of primary tumors pre-RT were significantly associated with superior FFLRDP, FFLP and FFDP in the LAHNSCC (p<0.05), but no diffusion metrics were significant in p16+ oropharynx cancers. Post ad hoc analysis of the p16+ OPSCC only showed that large TVLADC of the total nodal burden pre-RT was significantly associated with inferior FFDP (p=0.05). Conclusion ADC metrics were associated with different progression patterns in the LAHNSCC and p16+ OPSCC, possibly explained by differences in cancer biology and morphology. A deep understanding of ADC metrics is warranted to establish imaging biomarkers for adaptive RT in HNSCC.
Collapse
Affiliation(s)
- Yue Cao
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - M. Aryal
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - P. Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - C. Lee
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - M. Schipper
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - D. You
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - E. Jaworski
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - L. Gharzai
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - J. Shah
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Radiation Oncology, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - A. Eisbruch
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Michelle Mierzwa
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| |
Collapse
|
5
|
Lopez J, Subramanian T, Stambuk H, Schreyer M, Woods R, Scholfield D, Wong R, Cohen MA, Shah J, Ganly I. CAD/CAM-assisted ablative surgery and intraoperative brachytherapy for pediatric skull-base sarcomas. Head Neck 2023; 45:E61-E66. [PMID: 37814997 DOI: 10.1002/hed.27534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/26/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Head and neck (H&N) sarcomas in children can poise numerous challenges to the surgical oncologist and require multidisciplinary input and meticulous surgical planning. The application of computer-assisted design/computer-assisted manufacturing (CAD/CAM) has been extensively examined in H&N reconstruction in adults, but its utility in ablative oncologic surgery in children warrants further examination. We present preliminary results utilizing CAD/CAM techniques to assist in planning tumor resections and the application of intra-operative radiation in children with skull-base sarcomas. METHODS A retrospective cohort review of all pediatric patients who presented to a tertiary care cancer center for surgical resection of a skull-base malignancy was performed between 1980 and 2021. All children under 18 years of age with diagnosis of a skull-base sarcoma as confirmed with imaging and pathology were analyzed. RESULTS A total of 21 children were identified but only four children with skull-base sarcomas had diagnostic imaging available in whom computer-assisted volumetric analyses were generated. In these cases, CAD/CAM was used to plan surgical approaches and intraoperative radiotherapy, significantly aiding in treatment for these complicated pediatric cases. CONCLUSION CAD/CAM planning for oncologic resection has huge potential. Here we have shown its utility in pre-operative surgical planning and for administration of intraoperative radiation therapy. Future studies are needed to examine its value in facilitating intraoperative surgical management and patient outcomes, as well as cost effectiveness.
Collapse
Affiliation(s)
- Joseph Lopez
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
- Department of Surgery, Division of Pediatric Head & Neck Surgery, AdventHealth for Children, Orlando, Florida, USA
| | - Tejas Subramanian
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
- Weill Cornell Medical College New York, New York, New York, USA
| | - Hilda Stambuk
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mark Schreyer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Robbie Woods
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Daniel Scholfield
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Richard Wong
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Marc A Cohen
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Jatin Shah
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| | - Ian Ganly
- Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center New York, New York, New York, USA
| |
Collapse
|
6
|
Mclean T, Fitzgerald C, Eagan A, Long SM, Cracchiolo J, Shah J, Patel S, Ganly I, Dogan S, Cohen MA. Understanding frozen section histopathology in Sinonasal and anterior skull base malignancy and proposed reporting guidelines. J Surg Oncol 2023; 128:1243-1250. [PMID: 37650809 DOI: 10.1002/jso.27429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Intraoperative frozen section histopathology (IFSH) in sinonasal and skull base surgery although widely used is not well studied. METHODS We reviewed a database of sinonasal and anterior skull base tumors, between 1973 and 2019, and identified 312 suitable operative cases. Clinicopathologic data was collected and analyzed, in addition to descriptive data for histopathological reports classified as "ambiguous," or "limited/insufficient-quality/quantity." RESULTS Overall, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for IFSH were 90.2%, 97.5%, 94.2%, 95.6%, and 95.2%, respectively. IFSH for adenocarcinoma, salivary carcinoma, and SCC all demonstrated a better clinical utility with a sensitivity of 90% or greater, while it was less than 90% for esthesioneuroblastoma, melanoma, and sarcoma. Other factors such as unclear reporting, poor quality specimens, or limited quality specimens were shown to lower diagnostic performance. Based on limitations identified, we proposed a novel IFSH reporting algorithm to improve IFSH in sinonasal and skull base surgery. CONCLUSIONS IFSH is an accurate and clinically useful technique in sinonasal and skull base surgery patients; however, limitations exist.
Collapse
Affiliation(s)
- Tim Mclean
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Conall Fitzgerald
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Alana Eagan
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Sallie M Long
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Jennifer Cracchiolo
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Jatin Shah
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Snehal Patel
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Ian Ganly
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Snjezana Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Marc A Cohen
- Division of Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| |
Collapse
|
7
|
Sabouri P, Koroulakis A, Cusatis D, Lehman K, Wohlfahrt P, Shah J, Molitoris JK, Mossahebi S. Pelvis Treatment Plan Dose Comparison for Proton Therapy Using Single Energy and Dual Energy Computed Tomography Simulation Methods. Int J Radiat Oncol Biol Phys 2023; 117:e699. [PMID: 37786048 DOI: 10.1016/j.ijrobp.2023.06.2182] [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) In proton therapy, plan robustness is ameliorated by expanding the irradiation volume beyond the target, in order to mitigate setup and proton range uncertainties (RU). A byproduct of this expansion is elevated doses to surrounding organs at risk (OARs) which reduce some of the benefits associated with proton therapy. Dual-energy CT (DECT) has been shown in multiple phantom and animal tissue studies to reduce RU without compromising plan robustness. This study quantifies dosimetric differences between single-energy CT (SECT) and DECT for pelvis patients treated with intensity modulated proton therapy (IMPT). MATERIALS/METHODS Under IRB approval, SECT and DECT scans from 25 IMPT pelvis patients were acquired using a CT scanner. Clinical plans were generated on the SECT images using robust optimization settings of 3.5% RU and 5 mm setup uncertainty in a treatment planning system. Subsequently, the clinical plans were recomputed on the corresponding DECT generated SPR-map images. For each patient, target coverage, mean and maximum OAR doses were compared for both image sets. RESULTS Comparison of two plans showed systematic differences in target minimum dose (D99%) and V100%. Variations as high as 3.1% with DECT were observed in D99% indicating target under-dosage. On average, use of SECT overestimated V100% by 2.4% when compared to DECT. Since all clinical plans were optimized robustly to meet V95% coverage, higher agreement (<1%) was achieved for V95% (99.9±0.2%), and D95% (99.6±0.3%). DECT relative to SECT indicated slightly higher OAR maximum doses for femoral heads (2.3±2.78%), penile bulb/external genital (1.33±4.00%) and large bowel (0.5±1.25%). Similarly, higher mean dose was observed to rectum (2.08±4.88%), bladder (1.41±0.25%), femoral heads (1.18±6.61%) and penile bulb/external genital (1.78±5.74%) for DECT relative to SECT. CONCLUSION Our results show a disparity between evaluated SECT and DECT target and OAR dosimetric parameters. Given the higher accuracies in proton range estimation associated with the use of DECT, its use can imply a potential for more conformal proton plans as well as higher TPS computed target coverage and OAR dose accuracy, both of which enhance overall treatment quality.
Collapse
Affiliation(s)
- P Sabouri
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - A Koroulakis
- Department of Radiation Oncology, Anne Arundel Medical Center, Annapolis, MD
| | - D Cusatis
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD
| | - K Lehman
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD
| | | | - J Shah
- Siemens Healthineers, Cary, NC
| | - J K Molitoris
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| | - S Mossahebi
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| |
Collapse
|
8
|
Russell MD, Shonka DC, Noel J, Karcioglu AS, Ahmed AH, Angelos P, Atkins K, Bischoff L, Buczek E, Caulley L, Freeman J, Kroeker T, Liddy W, McIver B, McMullen C, Nikiforov Y, Orloff L, Scharpf J, Shah J, Shaha A, Singer M, Tolley N, Tuttle RM, Witterick I, Randolph GW. Preoperative Evaluation of Thyroid Cancer: A Review of Current Best Practices. Endocr Pract 2023; 29:811-821. [PMID: 37236353 DOI: 10.1016/j.eprac.2023.05.009] [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] [Received: 02/28/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The incidence of thyroid cancer has significantly increased in recent decades. Although most thyroid cancers are small and carry an excellent prognosis, a subset of patients present with advanced thyroid cancer, which is associated with increased rates of morbidity and mortality. The management of thyroid cancer requires a thoughtful individualized approach to optimize oncologic outcomes and minimize morbidity associated with treatment. Because endocrinologists usually play a key role in the initial diagnosis and evaluation of thyroid cancers, a thorough understanding of the critical components of the preoperative evaluation facilitates the development of a timely and comprehensive management plan. The following review outlines considerations in the preoperative evaluation of patients with thyroid cancer. METHODS A clinical review based on current literature was generated by a multidisciplinary author panel. RESULTS A review of considerations in the preoperative evaluation of thyroid cancer is provided. The topic areas include initial clinical evaluation, imaging modalities, cytologic evaluation, and the evolving role of mutational testing. Special considerations in the management of advanced thyroid cancer are discussed. CONCLUSION Thorough and thoughtful preoperative evaluation is critical for formulating an appropriate treatment strategy in the management of thyroid cancer.
Collapse
Affiliation(s)
- Marika D Russell
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
| | - David C Shonka
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Julia Noel
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Amanda Silver Karcioglu
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, NorthShore University HealthSystem, Evanston, Illinois
| | - Amr H Ahmed
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Peter Angelos
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Kristen Atkins
- Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Lindsay Bischoff
- Division of Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Erin Buczek
- Department of Otolaryngology-Head and Neck Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - Lisa Caulley
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Jeremy Freeman
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Whitney Liddy
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bryan McIver
- Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Caitlin McMullen
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Yuri Nikiforov
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lisa Orloff
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Joseph Scharpf
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jatin Shah
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ashok Shaha
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael Singer
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan
| | - Neil Tolley
- Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, United Kingdom
| | - Robert Michael Tuttle
- Endocrine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ian Witterick
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Gregory W Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
9
|
Jacob S, Nair AB, Boddu SHS, Abuhijjleh RK, Selvaraju K, Babu T, Gorain B, Shah J, Morsy MA. The emerging role of lipid nanosystems and nanomicelles in liver diseases. Eur Rev Med Pharmacol Sci 2023; 27:8651-8680. [PMID: 37782180 DOI: 10.26355/eurrev_202309_33790] [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: 10/03/2023]
Abstract
Nanoparticles (NPs) exhibit remarkable potential in the diagnosis and treatment of various liver ailments, including primary liver cancer or hepatocellular carcinoma (HCC), liver cirrhosis, viral hepatitis, and alcoholic and non-alcoholic liver diseases. High surface area-to-volume ratio with distinct physicochemical and bio-pharmaceutical properties have contributed numerous benefits to NPs, such as high intracellular uptake and efficient drug delivery capabilities stemming from their ability to encapsulate a diverse range of drugs. Lipid-based nanosystems have demonstrated significant potential as reliable and efficient transport vehicles for a variety of actives, including small interfering RNA, targeting the liver, owing to their excellent in vivo compatibility, biodegradable nature, and non-toxic properties. Multiple aspects of various lipid-based materials, lipid nanosystems like solid lipid NPs, nanovesicles such as nanoemulsions, liposomes, and nanomicelles for liver-specific active targeting have been comprehensively reviewed. Ongoing and completed clinical trials of lipid nanosystems developed for HCC, hepatic fibrosis, and hepatitis are tabulated. Types of receptors and ligands typically used for active liver targeting in HCC are extensively discussed. The US FDA's recent approval for the use of Onpattro (Patisiran) injection to treat polyneuropathy in adult patients is indicative of the rapid development of lipid nanosystems employed for hepatic targeting. Nanoemulsions loaded with diagnostic imaging agents for multi-modal liver imaging were briefly discussed. Emerging technologies are being developed to integrate desirable properties of nanoparticles (NPs), including high stability, efficient drug loading, opsonization avoidance, active liver targeting, and facilitation of endosomal escape. Clinical translations of many lipid NPs for drug and gene therapy applications targeting different liver diseases are expected in the near future.
Collapse
Affiliation(s)
- S Jacob
- Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Cheema HA, Head MG, Bilal W, Shahid A, Corriero AC, Shah J. Reflections on vaccine-derived polio in London and the bigger picture globally: high public confidence in routine immunisations is vital. Public Health 2023; 222:e16-e17. [PMID: 36323599 DOI: 10.1016/j.puhe.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/05/2022]
Affiliation(s)
- H A Cheema
- Department of Medicine, King Edward Medical University, Lahore, Pakistan.
| | - M G Head
- Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - W Bilal
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - A Shahid
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - A C Corriero
- Anglia Ruskin University, Faculty of Health, Social Care, Education and Medicine, Chelmsford, Essex, United Kingdom
| | - J Shah
- New York State Department of Health, Albany, NY, United States
| |
Collapse
|
11
|
Mughal S, Salmon A, Churchill A, Tee K, Jaouich A, Shah J. Guiding Principles for Implementing Stepped Care in Mental Health: Alignment on the Bigger Picture. Community Ment Health J 2023; 59:1035-1042. [PMID: 37002486 DOI: 10.1007/s10597-023-01116-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
Stepped care models are a mental healthcare delivery framework in which a continuum of support allows selection of a range of interventions to match a client's evolving needs and preferences. Currently in use in multiple settings worldwide, stepped care has the potential to provide a needed advance for the development of comprehensive mental health systems. However, definitions of stepped care lack consistency, resulting in differing interpretations reflected in variable implementation, ultimately limiting its replicability, utility and potential for impact. To help foster greater alignment in research and practice, we propose a set of principles for stepped care which can provide guidance on how to bridge multiple mental health services together, reduce fragmentation, and respond to the full breadth of mental health needs along a continuum of care in diverse settings. We hope that articulating these principles will foster discussion and spur mental health stakeholders to translate them into actionable standards.
Collapse
Affiliation(s)
- S Mughal
- Department of Psychiatry, McGill University, Montréal, QC, Canada.
- Douglas Mental Health University Institute, Montréal, QC, Canada.
| | - A Salmon
- School of Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - A Churchill
- Stepped Care Solutions, St. Johns, NL, Canada
- Department of Psychology, Memorial University, St. Johns, NL, Canada
| | - K Tee
- Foundry, Vancouver, BC, Canada
| | - A Jaouich
- Stepped Care Solutions, St. Johns, NL, Canada
| | - J Shah
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Douglas Mental Health University Institute, Montréal, QC, Canada
| |
Collapse
|
12
|
Amer SA, AlAmri FA, AlRadini FA, Alenezi MA, Shah J, Fagehy AA, Shajeri GM, Abdullah DM, Zaitoun NA, Elsayed M. Caffeine addiction and determinants of caffeine consumption among health care providers: a descriptive national study. Eur Rev Med Pharmacol Sci 2023; 27:3230-3242. [PMID: 37140274 DOI: 10.26355/eurrev_202304_32093] [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: 05/05/2023]
Abstract
OBJECTIVE Caffeine is the most commonly used psychostimulant compound with a long history of worldwide consumption. Consuming low to moderate doses of caffeine is generally safe and quite beneficial; however, several clinical studies show that high doses could be toxic. Additionally, caffeine users can become dependent on the drug and find themselves unable to reduce consumption despite impending and recurrent health problems associated with continued use. This study was conducted to explore the prevalence, determinants, and positive and negative effects of caffeine consumption among governmental health care providers (HCPs) who were caffeine users. It aims to determine the frequency of caffeine dependence and addiction in the Kingdom of Saudi Arabia (KSA) in January 2020. SUBJECTS AND METHODS This cross-sectional study recruited 600 randomly selected HCPs from all regions of KSA, who fulfilled the selection criteria through a self-administrated, online-validated questionnaire composed of three main parts using the DSM-IV to diagnose dependence and probable addiction. RESULTS The majority of the studied HCPs were females (67.8%), nonsmokers (82.0%), and Saudis (80.5%), with a mean age of 35 years. According to the DSM-IV, the prevalence of caffeine consumption was 94.3%. Caffeine dependence was reported in 270 (47.7%), while 345 (60.9%) were diagnosed as addicts. The most commonly consumed caffeine-containing substances were coffee and its variants/types (70%), tea (59%), and chocolate (52%), with each person spending about 220 SR per week on them. The main reported adverse effects, in descending order, were sleep disturbances, stomach problems, and cardiac symptoms. The most positive effects reported of caffeine consumption were feeling active, alert, confident, and happy. These findings were significantly affected by sex, occupation, and general health. CONCLUSIONS Caffeine use, dependence, and addiction are common among government HCPs in KSA. Caffeine has both positive and negative effects on this population and further research is necessary to better understand the long-term consequences of caffeine consumption.
Collapse
Affiliation(s)
- S A Amer
- Department of Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Egypt.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Yu VJ, Sasson DC, Scholfield D, Woods R, Wong R, Shaha A, Shah J, Ganly I, Lopez J. Hospital Volume as a Predictor of Outcomes Following Pediatric Thyroidectomy. J Surg Oncol 2023. [PMID: 36959738 DOI: 10.1002/jso.27264] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/26/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Pediatric thyroidectomy (PT) is an uncommon procedure with a risk of significant morbidity. This study utilizes a national database to identify factors associated with short-term (30-day) post-thyroidectomy complications in children with thyroid cancer. METHODS The 2016 and 2012 Kids' Inpatient Databases (KID) were used in this study. All children with thyroid cancer undergoing thyroidectomy were included. Complications were categorized into endocrine, nervous, pulmonary, and other. Hospital volume was stratified into high-volume (performing the top 10% of total cases, HVC) or non-high-volume centers (NHVC). Risk factors were analyzed using univariable and multivariable statistical tests. RESULTS 663 patients with an average age of 15.93 years meeting inclusion criteria. Most patients were seen in a NHVC (90.0%) and 37.3% of thyroidectomies were performed with neck dissections. The incidence of any complication was 32.1%. Endocrine complications were the most frequent (32.7%). Independent predictors of any or only endocrine complications were age (odds ratio [OR]=0.927, p=0.002, any); (OR=0.926, p=0.003, endocrine), or concurrent neck dissection (OR=1.679, p=0.004, any); (OR=1.683, p=0.005, endocrine). There was no statistically significant change in odds with hospital volume. CONCLUSIONS Further investigation into the effect of single-surgeon versus hospital volume on the risk of complications in pediatric thyroid cancer surgery is warranted. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Victor J Yu
- Division of Plastic and Reconstructive Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Daniel Cyrus Sasson
- Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daniel Scholfield
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Robbie Woods
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ashok Shaha
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jatin Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ian Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Joseph Lopez
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Pediatric Head and Neck Surgery, AdventHealth for Children, Orlando, Florida, USA
| |
Collapse
|
14
|
Wadhwa S, Yoon A, Kister K, Bolin I, Chintalapudi N, Besmer A, Cantos A, Shah J, Gaitonde S, Granger S, Bryce C, Fischer R, Eisig S, Yin M. Detection of SARS-CoV-2 IgG antibodies and inflammatory cytokines in saliva-a pilot study. J Oral Biol Craniofac Res 2023; 13:267-271. [PMID: 36846089 PMCID: PMC9937664 DOI: 10.1016/j.jobcr.2023.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 12/30/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
Objective The pandemic caused by SARS-CoV-2 virus continues to have a profound effect worldwide. However, COVID-19 induced oral facial manifestations have not been fully described. We conducted a prospective study to demonstrate feasibility of anti-SARS-CoV-2 IgG and inflammatory cytokine detection in saliva. Our primary objective was to determine whether COVID-19 PCR positive patients with xerostomia or loss of taste had altered serum or saliva cytokine levels compared to COVID-19 PCR positive patients without those oral symptoms. Our secondary objective was to determine the correlation between serum and saliva COVID-19 antibody levels. Materials and methods For cytokine analysis, saliva and serum were obtained from 17 participants with PCR-confirmed COVID-19 infection at three sequential time points, yielding 48 saliva samples and 19 paired saliva-serum samples from 14 of the 17 patients. For COVID-19 antibody analyses, an additional 27 paired saliva-serum samples from 22 patients were purchased. Results The saliva antibody assay had 88.64% sensitivity [95% Confidence Interval (CI) 75.44%, 96.21%] to detect SARS-CoV-2 IgG antibodies compared to serum antibody. Among the inflammatory cytokines assessed - IL-6, TNF-α, IFN-γ, IL-10, IL-12p70, IL-1β, IL-8, IL-13, IL-2, IL-5, IL-7 and IL-17A, xerostomia correlated with lower levels of saliva IL-2 and TNF-α, and elevated levels of serum IL-12p70 and IL-10 (p < 0.05). Loss of taste was observed in patients with elevated serum IL-8 (p < 0.05). Conclusions Further studies are needed to construct a robust saliva-based COVID-19 assay to assess antibody and inflammatory cytokine response, which has potential utility as a non-invasive monitoring modality during COVID-19 convalescence.
Collapse
Affiliation(s)
- S. Wadhwa
- Division of Orthodontics, Columbia University Irving Medical Center, New York, NY, USA
| | - A.J. Yoon
- Division of Oral & Maxillofacial Pathology and Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York, NY, USA
| | - K. Kister
- Division of Orthodontics, Columbia University Irving Medical Center, New York, NY, USA
| | - I. Bolin
- Division of Orthodontics, Columbia University Irving Medical Center, New York, NY, USA
| | - N. Chintalapudi
- Division of Orthodontics, Columbia University Irving Medical Center, New York, NY, USA
| | - A. Besmer
- Division of Orthodontics, Columbia University Irving Medical Center, New York, NY, USA
| | - A. Cantos
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - J. Shah
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - C. Bryce
- Salimetrics, LLC, Carlsbad, CA, USA
| | | | - S.B. Eisig
- Division of Oral & Maxillofacial Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - M.T. Yin
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
15
|
Shkolyar E, Bhambhvani H, Tiu E, Krishna V, Krishna V, Nimgaonkar V, Krishnan R, O’Donoghue O, Vrabac D, Kao CS, Joshi A, Shah J. Corrigendum to “1773P Prediction of chemotherapy response in muscle-invasive bladder cancer: A machine learning approach”. Ann Oncol 2023. [DOI: 10.1016/j.annonc.2023.02.014] [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: 03/09/2023] Open
|
16
|
Westin SN, Fu S, Tsimberidou A, Piha-Paul S, Akhmedzhanov F, Yilmaz B, McQuinn L, Brink AL, Gong J, Leung CH, Lin H, Hong DS, Pant S, Carter B, Jazaeri A, Gershenson D, Sood AK, Coleman RL, Shah J, Meric-Bernstam F, Naing A. Selinexor in combination with weekly paclitaxel in patients with metastatic solid tumors: Results of an open label, single-center, multi-arm phase 1b study with expansion phase in ovarian cancer. Gynecol Oncol 2023; 168:76-82. [PMID: 36423446 PMCID: PMC9797438 DOI: 10.1016/j.ygyno.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Selinexor is a first-in-class, oral selective inhibitor of nuclear export (SINE) compound which blocks Exportin-1 (XPO1). Our objective was to determine maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of selinexor and weekly paclitaxel. METHODS This was an open label, single-center, multi-arm phase 1b study utilizing a "3 + 3" design and a "basket-type" expansion in recurrent solid tumors. Selinexor (60 mg or 80 mg twice weekly orally) and weekly paclitaxel (80 mg IV 2 week on, 1 week off) were one of 13 parallel arms. Efficacy was evaluated using RECIST version 1.1. RESULTS All 35 patients treated were evaluable for toxicity and 31 (88%) were evaluable for response. Patient diagnoses included platinum-resistant/refractory ovarian (n = 28), breast (n = 4), prostate (n = 2), and cervical (n = 1) cancer. Patients had a median of four prior therapies (range 1-10), and 47% had a prior taxane in the recurrent setting. There were no DLTs and 60 mg was chosen as the RP2D due to long-term tolerability. Ninety-seven percent of patients had at least one treatment-emergent adverse event (TEAE), and the most common grade ≥ 3 TEAE were neutropenia (46%), anemia (31%), and nausea (21%). Among 24 evaluable patients with ovarian cancer, response rate was 17%, CBR was 58%, and median PFS was 6.8 months (95% CI 3.7, not reached (NR)). CONCLUSIONS Oral selinexor in combination with weekly paclitaxel demonstrated promising clinical activity with manageable toxicity. This combination should be considered for further exploration in a randomized study, especially in ovarian malignancies.
Collapse
Affiliation(s)
- Shannon N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Siqing Fu
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Apostolia Tsimberidou
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarina Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fechukwu Akhmedzhanov
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bulent Yilmaz
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lacey McQuinn
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amanda L Brink
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jing Gong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cheuk Hong Leung
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Heather Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David S Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shubham Pant
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brett Carter
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amir Jazaeri
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Gershenson
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anil K Sood
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jatin Shah
- Karyopharm Therapeutics, Inc, Newton, MA, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
17
|
Lopez J, Chen YH, Eagan A, Fitzgerald C, Woods R, Wong R, Shah J, Ganly I. Surgical management of pediatric salivary malignant tumors-A single-center cohort study. J Surg Oncol 2022; 126:1389-1395. [PMID: 35969241 PMCID: PMC10251410 DOI: 10.1002/jso.27063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/30/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to report incidence, clinicopathologic behavior, management, and outcome of pediatric patients treated surgically for salivary gland (SG) malignancies. METHODS Patients who underwent surgery for SG malignancies from 1985 to 2015 were identified. Clinical, pathological, treatment and outcomes data were collected. Disease-specific survival (DSS), recurrence-free survival (RFS), and overall survival (OS) were calculated using Kaplan-Meier method. RESULTS Twenty-eight pediatric patients were included. The most common histopathological types were mucoepidermoid (n = 18, 64.3%), acinic cell (n = 7, 25.0%), adenoid cystic (n = 2, 7.1%), and adenocarcinoma (n = 1, 3.6%). Surgical approach varied and ranged from superficial parotidectomy (n = 11, 39.3%) to partial maxillectomy (n = 6, 21.4%). Nine patients (32%) required postoperative radiotherapy. DSS, OS, and RFS probability at 5 years were 96.4%, 96.4%, and 89.3%, respectively. CONCLUSION Pediatric SG malignancies are rare and have favorable outcome at 5 years. Larger, multi-institutional studies are required to better understand the natural history of these rare tumors.
Collapse
Affiliation(s)
- Joseph Lopez
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Division of Pediatric Head & Neck Surgery, AdventHealth For Children, Orlando, Florida, USA
| | - Yu Han Chen
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alana Eagan
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Conall Fitzgerald
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Robbie Woods
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard Wong
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jatin Shah
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ian Ganly
- Department of Surgery, Head & Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
18
|
Wadhwa S, Dave S, Daily M, Nardone A, Li R, Rosario J, Cantos A, Shah J, Lu H, McMahon D, Yin M. The Role of Oral Health in the Acquisition and Severity of SARS-CoV-2: A Retrospective Chart Review. Saudi Dent J 2022; 34:596-603. [PMID: 35974970 PMCID: PMC9371763 DOI: 10.1016/j.sdentj.2022.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/29/2022] [Accepted: 08/07/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Studies have shown that gingival crevices may be a significant route for SARS-CoV-2 entry. However, the role of oral health in the acquisition and severity of COVID-19 is not known. Design A retrospective analysis was performed using electronic health record data from a large urban academic medical center between 12/1/2019 and 8/24/2020. A total of 387 COVID-19 positive cases were identified and matched 1:1 by age, sex, and race to 387 controls without COVID-19 diagnoses. Demographics, number of missing teeth and alveolar crestal height were determined from radiographs and medical/dental charts. In a subgroup of 107 cases and controls, we also examined the rate of change in alveolar crestal height. A conditional logistic regression model was utilized to assess association between alveolar crestal height and missing teeth with COVID-19 status and with hospitalization status among COVID-19 cases. Results Increased alveolar bone loss, OR = 4.302 (2.510 - 7.376), fewer missing teeth, OR = 0.897 (0.835-0.965) and lack of smoking history distinguished COVID-19 cases from controls. After adjusting for time between examinations, cases with COVID-19 had greater alveolar bone loss compared to controls (0.641 ± 0.613 mm vs 0.260 ± 0.631 mm, p < 0.01.) Among cases with COVID-19, increased number of missing teeth OR = 2.1871 (1.146- 4.174) was significantly associated with hospitalization. Conclusions Alveolar bone loss and missing teeth are positively associated with the acquisition and severity of COVID-19 disease, respectively.
Collapse
Affiliation(s)
- S. Wadhwa
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - S. Dave
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - M.L. Daily
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - A. Nardone
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - R. Li
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - J. Rosario
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - A. Cantos
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - J. Shah
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - H.H. Lu
- Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA
| | - D.J. McMahon
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| | - M.T. Yin
- Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
19
|
Teo P, Randall J, Bajaj A, Lou B, Shah J, Gopalakrishnan M, Kamen A, Das I, Abazeed M. Lung Tumor Motion and its Impact on Deep Learning Prediction of Local Recurrence. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.950] [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]
|
20
|
Tuttle RM, Fagin J, Minkowitz G, Wong R, Roman B, Patel S, Untch B, Ganly I, Shaha A, Shah J, Li D, Bach A, Girshman J, Lin O, Cohen M, Cohen JM, Cracchiolo J, Ghossein R, Sabra M, Boucai L, Fish S, Morris L. Active Surveillance of Papillary Thyroid Cancer: Frequency and Time Course of the Six Most Common Tumor Volume Kinetic Patterns. Thyroid 2022; 32:1337-1345. [PMID: 36178355 PMCID: PMC9700377 DOI: 10.1089/thy.2022.0325] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: The change in size of the papillary thyroid cancer (PTC) nodule during active surveillance has traditionally been characterized as either stable, increasing, or decreasing based on changes in maximal tumor diameter or tumor volume. More recently, it has been observed that the changes in tumor size observed during observation are more complex with tumor volume kinetic patterns that can be characterized either as stable (Pattern I), early increase in volume (Pattern II), later increase in volume (Pattern III), early increase in volume followed by stability (Pattern IV), stability followed by an increase in volume (Pattern V), or a decrease in tumor volume (Pattern VI). Methods: The frequency, time course, and clinical correlates of these six tumor volume kinetic patterns were analyzed in a cohort of 483 patients with low-risk PTC up to 1.5 cm in maximal diameter followed with active surveillance at our center for a median of 3.7 years. Results: The cumulative incidence of an increase in tumor volume for the entire cohort was 15.9% [confidence interval (CI) 11.8-20.0] at 5 years. At 5 years, most tumors demonstrated stability (78.8%, Pattern I) with 10.0% showing early growth (Pattern II), 4.1% late growth (Pattern III), 1.9% growth then stability (Pattern IV), 0.6% stability then growth (Pattern V), and 5.6% with a decrease in tumor volume (Pattern VI). Tumor volume doubling time during exponential growth significantly differed across the kinetic patterns, with median values of 2.4, 7.1, and 3.3 years for Patterns II, III, and IV, respectively (p < 0.01). Similarly, the time to a change in tumor volume was significantly different across the kinetic patterns, with median values of 1.5, 3, 1.6, 4.7, and 4.1 years for Patterns II, III, IV, V, and VI, respectively (analysis of variance, p < 0.01). Clinical correlates at baseline were not associated with tumor volume kinetic pattern. Conclusions: These six kinetic tumor volume patterns provide a comprehensive description of the changes in PTC tumor volume observed during the first 5 years of active surveillance.
Collapse
Affiliation(s)
- Robert Michael Tuttle
- Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - James Fagin
- Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gerald Minkowitz
- Department of Surgery Education, Columbia University Irving Medical Center, New York, New York, USA
| | - Richard Wong
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Benjamin Roman
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Snehal Patel
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Brian Untch
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ian Ganly
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ashok Shaha
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jatin Shah
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Duan Li
- Radiology and Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ariadne Bach
- Radiology and Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jeffrey Girshman
- Radiology and Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Oscar Lin
- Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Marc Cohen
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jean-Marc Cohen
- Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jennifer Cracchiolo
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ronald Ghossein
- Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mona Sabra
- Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Laura Boucai
- Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephanie Fish
- Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Luc Morris
- Head and Neck Service, Department of Surgery, Department of Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
21
|
Centorame A, Dumut C, Youssef M, Ondra M, Kianicka I, Shah J, Paun R, Ozdian T, Hanrahan J, Gusev E, Petrof B, Hajduch M, Pislariu R, De Sanctis J, Radzioch D. 657 Combinatory treatment of LAU-7b with triple therapy results in improved lung physiology and restored fatty acid and lipid levels. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
22
|
Lee S, Mohan S, Knupp J, Chamoun K, de Jonge A, Yang F, Baloglu E, Shah J, Kauffman MG, Shacham S, Bhatnagar B. Oral eltanexor treatment of patients with higher-risk myelodysplastic syndrome refractory to hypomethylating agents. J Hematol Oncol 2022; 15:103. [PMID: 35922861 PMCID: PMC9351096 DOI: 10.1186/s13045-022-01319-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/07/2022] [Indexed: 12/04/2022] Open
Abstract
Patients with higher-risk myelodysplastic syndromes (MDS) refractory to hypomethylating agents (HMAs) have limited therapeutic options and an expected overall survival (OS) of 3–5 months. Eltanexor is an investigational oral selective inhibitor of nuclear export with low central nervous system penetrance and an acceptable tolerability profile. Preclinical studies suggest that myeloid malignancies are sensitive to nuclear export inhibition. Eltanexor exhibited efficacy in hematologic models, supporting exploration in a clinical trial. This phase 1/2 study (NCT02649790) assessed single-agent activity of eltanexor in patients with higher-risk MDS and 5–19% myeloblasts. Two starting doses of eltanexor were evaluated: 20 mg (n = 15), 10 mg (n = 5), both administered on days 1–5 each week of a 28-day cycle. Twenty patients with primary HMA-refractory MDS, with a median age of 77 years (range 62–89), and a median of two prior treatment regimens (range 1–4) were enrolled. Of these, 15 were evaluated for efficacy and 20 for safety. The overall response rate (ORR) was 53.3%, with seven patients (46.7%) achieving marrow complete remission (mCR) and one additional patient achieving hematologic improvement (HI). In the 10 mg group, three patients (60%) reached mCR and two (40%) stable disease (SD), while for 20 mg, four patients (40%) had mCR and two (20%) SD. A total of three patients (20%) had HI and became transfusion independent ≥ 8 weeks. Median OS for the efficacy-evaluable patients (n = 15) was 9.86 months (7.98, NE). Overall, the most frequently reported treatment-related adverse events were nausea (45%), diarrhea (35%), decreased appetite (35%), fatigue and neutropenia (both 30%). Single-agent oral eltanexor was active, safe, and well tolerated in patients with higher-risk, primary HMA-refractory MDS.
Collapse
Affiliation(s)
- Sangmin Lee
- Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, 520 East 70thStreet, Starr 341, New York, NY, 10021, USA. .,Janssen Research and Development, Spring House, PA, USA.
| | - Sanjay Mohan
- Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Fan Yang
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | - Erkan Baloglu
- West Virginia University Cancer Institute, Wheeling Hospital, Wheeling, WV, USA
| | - Jatin Shah
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | | | | | - Bhavana Bhatnagar
- West Virginia University Cancer Institute, Wheeling Hospital, Wheeling, WV, USA
| |
Collapse
|
23
|
Schuster M, Zijlstra J, Casasnovas RO, Vermaat JSP, Kalakonda N, Goy A, Choquet S, Neste EVD, Hill B, Thieblemont C, Cavallo F, De la Cruz F, Kuruvilla J, Hamad N, Jaeger U, Caimi P, Gurion R, Warzocha K, Bakhshi S, Sancho JM, Follows G, Egyed M, Offner F, Vassilakopoulos T, Samal P, Ku M, Ma X, Corona K, Chamoun K, Shah J, Shacham S, Kauffman MG, Canales M, Maerevoet M. Effect of Prior Therapy and Disease Refractoriness on the Efficacy and Safety of Oral Selinexor in Patients with Diffuse Large B-cell Lymphoma (DLBCL): A Post-hoc Analysis of the SADAL Study. Clin Lymphoma Myeloma Leuk 2022; 22:483-494. [PMID: 35078739 DOI: 10.1016/j.clml.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/07/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Despite a number of treatment options, patients with diffuse large B-cell lymphoma (DLBCL) whose disease has become refractory to treatment have a poor prognosis. Selinexor is a novel, oral drug that is approved to treat patients with relapsed/refractory DLBCL. In this post hoc analysis of the SADAL study, a multinational, open-label study, we evaluated subpopulations to determine if response to single agent selinexor is impacted by number of lines of prior treatment, autologous stem cell transplant (ASCT), response to first and most recent therapies, and time to progressive disease. PATIENTS Patients (n = 134) with DLBCL after 2-5 prior therapies were enrolled in SADAL and received 60mg selinexor twice weekly. RESULTS The median overall survival was 9.0 months and median progression free survival was 2.6 months. Patients who had the best overall response rate (ORR) and disease control rate were those who had prior ASCT (42.5% and 50.0%) or responded to last line of therapy (35.9% and 43.5%). Patients with primary refractory DLBCL also showed responses (ORR 21.8%). Adverse events between subgroups were similar to the overall study population, the most common being thrombocytopenia (29.1%), fatigue (7.5%), and nausea (6.0%). CONCLUSION Regardless of prior therapy and disease refractory status, selinexor treatment demonstrated results consistent with its novel mechanism of action and lack of cross-resistance. Thus, single agent oral selinexor can induce deep, durable, and tolerable responses in patients with DLBCL who have recurrent disease after several chemoimmunotherapy combination regimens.
Collapse
Affiliation(s)
| | - Josée Zijlstra
- Amsterdam UMC, Vrije Universiteit, Cancer Center, Amsterdam, Netherlands
| | | | | | | | - Andre Goy
- Hackensack University Medical Center, Hackensack, NJ, United States
| | | | | | - Brian Hill
- Cleveland Clinic, Cleveland, OH, United States
| | - Catherine Thieblemont
- APHP, Saint-Louis Hospital, Hemato-oncology, Paris, France & Diderot University, Paris, France
| | | | | | | | - Nada Hamad
- St. Vincent's Hospital Sydney, Darlinghurst, Australia
| | | | - Paolo Caimi
- UH Seidman Cancer Center, Cleveland, OH, United States
| | | | | | - Sameer Bakhshi
- Dr. B. R. A. Institute Rotary Cancer Hospital, New Delhi, India
| | | | | | | | | | | | - Priyanka Samal
- Institute of Medical Sciences & SUM Hospital, Odisha, India
| | - Matthew Ku
- St.Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Xiwen Ma
- Karyopharm Therapeutics, Newton, MA, United States
| | - Kelly Corona
- Karyopharm Therapeutics, Newton, MA, United States
| | | | - Jatin Shah
- Karyopharm Therapeutics, Newton, MA, United States
| | | | | | | | | |
Collapse
|
24
|
Shah J, Shah A, El-Sakka AA, Kandil OA, Shehata MA, Shoib S. Family structure and substance use in 6,178 American Indian youth: a cross-sectional study. Eur Rev Med Pharmacol Sci 2022; 26:4979-4982. [PMID: 35916793 DOI: 10.26355/eurrev_202207_29283] [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: 06/15/2023]
Abstract
OBJECTIVE Adolescents from single-parent families are at significantly higher risk of substance use compared to those from mother-father families. More than half of American Indian (AI) children live in single-parent families, the second highest percentage among all groups. Given the paucity of research pertaining to the role of family structure and substance use in the AI population, we sought to examine this relationship. MATERIALS AND METHODS Data from this study were obtained from the Substance Use Among American Indian Youth: Epidemiology and Etiology, [US], 2015-2020 study. Response variables of interest included age at first substance use, number of substances used, ever-use of substance, and substance use type (i.e., alcohol, cigarette, marijuana, etc.). RESULTS Living in a father-only or mother-only setting showed a similar pattern of drug use. There was a significant increase in the risk of cigarette, alcohol and marijuana use. For cigarettes, the odds ratio was (OR = 2.60, 95% CI 1.80-3.75) in father-only setting compared to (OR = 1.42, 95% CI 1.13-1.78) for mother only setting. Alcohol use showed (OR = 1.72, 95% CI 1.19-2.50 and OR = 1.40, 95% CI 1.12-1.74) for father-only and mother-only respectively and marijuana use showed (OR = 1.59, 95% CI 1.10-2.30 and OR = 1.54, 95% CI -1.24-1.92) for father-only and mother-only respectively. CONCLUSIONS Disturbed family structure is associated with increased risk of substance use among AI youth. This indicates the importance and need for policy and community level interventions to reduce youth substance exposure.
Collapse
Affiliation(s)
- J Shah
- New York State Department of Health, New York, NY, USA.
| | | | | | | | | | | |
Collapse
|
25
|
Shah J, Childress K, Smith A, Swerdlin R, Variyam D, Hawkins C, Gill A. Abstract No. 576 Image-guided sclerotherapy for genital low-flow vascular malformations: safety and efficacy for children and adolescents. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
26
|
Ho J, Heong V, Peng Yong W, Soo R, Ean Chee C, Wong A, Sundar R, Liang Thian Y, Gopinathan A, Yan Pang M, Koe P, Nathan Jeraj S, Pyar Soe P, Yar Soe M, Tang T, Ng MC, Tai DW, Tan TJ, Xu H, Chang H, Landesman Y, Shah J, Shacham S, Chin Lee S, Tan DS, Cher Goh B, Tan DS. A phase 1 study of the safety, pharmacokinetics and pharmacodynamics of escalating doses followed by dose expansion of the selective inhibitor of nuclear export (SINE) selinexor in Asian patients with advanced or metastatic malignancies. Ther Adv Med Oncol 2022; 14:17588359221087555. [PMID: 35432603 PMCID: PMC9008867 DOI: 10.1177/17588359221087555] [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] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Purpose: This phase 1 study aims to evaluate the tolerability and the recommended
phase 2 dose of selinexor in Asian patients with advanced or metastatic
malignancies. Experimental Design: A total of 105 patients with advanced malignancies were enrolled from two
sites in Singapore (National University Hospital and the National Cancer
Centre, Singapore) from 24 February 2014 to 14 January 2019. We investigated
four dosing schedules of selinexor in a 3 + 3 dose escalation design with an
additional Phase 1b expansion cohort. Adverse events were graded with the
NCI Common Terminology Criteria for Adverse Events v 4.03. Pharmacodynamic
assessments included nuclear cytoplasmic localization of p27, XPO1 cargo
proteins pre and post selinexor dosing and pharmacokinetic assessments were
conducted at doses between 40 and 60 mg/m2. Results: In our Asian patient cohort, dosing at 40 mg/m2 given 2 out of
3 weeks, was the most tolerable for our patients. At this dose level, grade
3 adverse events included fatigue (8%), hyponatremia (23%), vomiting (5%),
thrombocytopenia (5%), and anaemia (2%). Selinexor had a rapid oral
absorption with median Tmax of 2 h and no PK accumulation after
multiple doses of tested regimens. Complete responses were seen in two
lymphoma patients. Partial responses were noted in three diffuse large B
cell lymphomas, one Hodgkin’s lymphoma and thymic carcinoma patient,
respectively. Conclusion: Selinexor is tolerated by Asian patients at 40 mg/m2 twice a week
given 2 out of 3 weeks. A 1-week drug holiday was needed as our patients
could not tolerate the current approved continuous dosing regimens because
of persistent grade 3 fatigue, anorexia and hyponatremia.
Collapse
Affiliation(s)
- Jingshan Ho
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Valerie Heong
- Department of Medical Oncology, Tan Tock Seng Hospital, Singapore
| | - Wei Peng Yong
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Ross Soo
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Cheng Ean Chee
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Andrea Wong
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Raghav Sundar
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Yee Liang Thian
- Department of Radiology, National University Hospital, Singapore
| | - Anil Gopinathan
- Department of Radiology, National University Hospital, Singapore
| | - Mei Yan Pang
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Priscillia Koe
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Santhiay Nathan Jeraj
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Phyu Pyar Soe
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Mu Yar Soe
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore
| | - Tiffany Tang
- Department of Haematology-Oncology, National Cancer Centre, Singapore
| | - Matthew C.H. Ng
- Department of Haematology-Oncology, National Cancer Centre, Singapore
| | - David W.M. Tai
- Department of Haematology-Oncology, National Cancer Centre, Singapore
| | - Tira J.Y. Tan
- Department of Haematology-Oncology, National Cancer Centre, Singapore
| | - Hongmei Xu
- Karyopharm Therapeutics, Newton, MA, USA
| | - Hua Chang
- Karyopharm Therapeutics, Newton, MA, USA
| | | | - Jatin Shah
- Karyopharm Therapeutics, Newton, MA, USA
| | | | - Soo Chin Lee
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Daniel S.W. Tan
- Department of Haematology-Oncology, National Cancer Centre, Singapore
| | - Boon Cher Goh
- Department of Haematology and Oncology, National University Cancer Institute Singapore, Singapore Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - David S.P. Tan
- Department of Haematology and Oncology, National University Cancer Institute, NUHS Tower Block, Level 7, 1E Kent Ridge Road, Singapore 119228
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Cancer Science Institute of Singapore, National University of Singapore, Singapore
| |
Collapse
|
27
|
Valero C, Yuan A, Matsuura D, Adilbay D, McGill M, Harries V, Shaha A, Shah J, Tuttle R, Patel S, Ganly I. Nomogram Using Host and Tumor Factors to Predict Survival in Individual Patients with Well Differentiated Thyroid Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.113] [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: 11/27/2022]
|
28
|
Mohamed Hussein AAR, Galal I, Amin MT, Moshnib AA, Makhlouf NA, Makhlouf HA, Abd-Elaal HK, Kholief KMS, Abdel Tawab DA, Kamal Eldin KA, Attia AM, Othman AEA, Shah J, Aiash H. Prevalence of vitamin D deficiency among patients attending Post COVID-19 follow-up clinic: a cross-sectional study. Eur Rev Med Pharmacol Sci 2022; 26:3038-3045. [PMID: 35503606 DOI: 10.26355/eurrev_202204_28635] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Post-COVID-19 syndrome appears to be a multi-organ illness with a broad spectrum of manifestations, occurring after even mild acute illness. Limited data currently available has suggested that vitamin D deficiency may play a role in COVID-19 cases. However, to our knowledge, no study has examined the frequency of vitamin D deficiency in post-COVID-19 cases and its effect on the symptom severity. The aim of this study is to both screen the frequency of vitamin D deficiency in post-COVID-19 syndrome patients and to study its relation to persistent symptoms. PATIENTS AND METHODS A cross-sectional, single-center study was conducted involving all cases attending post-COVID-19 follow-up clinic from November 2020 to May 2021. Complete history, clinical examination, and laboratory analysis [kidney functions, serum calcium, C-reactive protein, serum ferritin, Serum 25-(OH) vitamin D] was done as well as HRCT chest. RESULTS The study included 219 post-COVID-19 cases, 84% had deficient vitamin D levels (< 20 ng/dL); 11.4% had insufficient level (20-30 ng/dL) and only 4.9 % reported normal level. There was no link between levels of vitamin D with either the acute or post-COVID-19 symptoms in the studied groups. CONCLUSIONS Despite the prevalence of vitamin D deficiency among the study population, no association was observed between the levels of vitamin D and post-COVID-19 symptoms. It appears that post-COVID-19 syndrome pathophysiology involves a more complex interaction with the immune system. Dedicated clinical trials are advised to better study vitamin D levels and the related disease severity in COVID-19 patients.
Collapse
|
29
|
Dykes J, Zafar F, Almond C, Sofilos M, Lytrivi I, Szugye N, Plasencia J, Edelson J, Ghosh R, Shah J, Shugh S, Bansal N, Choueiter N, Romanowicz J, Zhang Y, Moore R, Rosenthal D, Zangwill S. Inter-Rater Reliability of Total Cardiac Volume Measurement for Heart Transplantation: An ACTION Collaborative Study. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
30
|
Jirge PR, Patil MM, Gutgutia R, Shah J, Govindarajan M, Roy VS, Kaul-Mahajan N, Sharara FI. Ovarian Stimulation in Assisted Reproductive Technology Cycles for Varied Patient Profiles: An Indian Perspective. J Hum Reprod Sci 2022; 15:112-125. [PMID: 35928474 PMCID: PMC9345274 DOI: 10.4103/jhrs.jhrs_59_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
Controlled ovarian stimulation has been an integral part of in vitro fertilisation (IVF) treatment cycles. Availability of different gonadotropins for ovarian stimulation and gonadotropin releasing hormone (GnRH) analogues for prevention of premature rise of leutinising hormone during follicular phase offer an opportunity to utilise them for a successful outcome in women with different subsets of ovarian response. Further, use of GnRH agonist as an alternative for human chorionic gonadotropin improves safety of ovarian stimulation in hyper-responders. Mild ovarian stimulation protocols have emerged as an alternative to conventional protocols in the recent years. Individualisation plays an important role in improving safety of IVF in hyper-responders while efforts continue to improve efficacy in poor responders. Some of the follicular and peri-ovulatory phase interventions may be associated with negative impact on the luteal phase and segmentalisation of the treatment with frozen embryo transfer may be an effective strategy in such a clinical scenario. This narrative review looks at the available evidence on various aspects of ovarian stimulation strategies and their consequences. In addition, it provides a concise summary of the evidence that has emerged from India on various aspects of ovarian stimulation.
Collapse
Affiliation(s)
- Padma Rekha Jirge
- Shreyas Hospital and Sushrut Assisted Conception Clinic, Kohlhapur, India
| | | | | | - Jatin Shah
- Mumbai Fertility Clinic & IVF Centre, Mumbai, India
| | | | | | | | - Faddy I Sharara
- Virginia Center for Reproductive Medicine, Reston; Department of O&G, George Washington University, Washington, DC, USA
| |
Collapse
|
31
|
Delimpasi S, Mateos MV, Auner HW, Gavriatopoulou M, Dimopoulos MA, Quach H, Pylypenko H, Hájek R, Leleu X, Dolai TK, Sinha DK, Venner CP, Benjamin R, Garg MK, Doronin V, Levy Y, Moreau P, Chai Y, Arazy M, Shah J, Shacham S, Kauffman MG, Richardson PG, Grosicki S. Efficacy and tolerability of once-weekly selinexor, bortezomib, and dexamethasone in comparison with standard twice-weekly bortezomib and dexamethasone in previously treated multiple myeloma with renal impairment: Subgroup analysis from the BOSTON study. Am J Hematol 2022; 97:E83-E86. [PMID: 34882831 DOI: 10.1002/ajh.26434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 01/03/2023]
Affiliation(s)
| | | | - Holger W. Auner
- The Hugh and Josseline Langmuir Centre for Myeloma Research Imperial College London London UK
| | - Maria Gavriatopoulou
- Alexandra Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece
| | | | - Hang Quach
- St. Vincent's Hospital University of Melbourne Fitzroy Victoria Australia
| | - Halyna Pylypenko
- Department of Hematology Cherkassy Regional Oncological Center Cherkassy Ukraine
| | - Roman Hájek
- Department of Hemato‐oncology, University Hospital Ostrava University of Ostrava Ostrava Czech Republic
| | - Xavier Leleu
- Department of Hematology CHU la Miletrie and Inserm CIC 1402 Poitiers France
| | | | - Dinesh Kumar Sinha
- State Cancer Institute Indira Gandhi Institute of Medical Sciences Patna India
| | | | | | | | - Vadim Doronin
- City Clinical Hospital #40 Moscow Russian Federation
| | - Yair Levy
- Baylor University Medical Center Dallas Texas USA
| | | | - Yi Chai
- Karyopharm Therapeutics Newton Massachusetts USA
| | - Melina Arazy
- Karyopharm Therapeutics Newton Massachusetts USA
| | - Jatin Shah
- Karyopharm Therapeutics Newton Massachusetts USA
| | | | | | | | | |
Collapse
|
32
|
Thein KZ, Fu S, Janku F, Tsimberidou AM, Piha-Paul SA, Karp DD, Shah J, Milton DR, Gong J, Sulovic S, McQuinn L, Stephen BA, Colen RR, Carter BW, Meric-Bernstam F, Naing A. Selinexor in Combination with Carboplatin and Pemetrexed in Patients with Advanced or Metastatic Solid Tumors: Results of an Open-Label, Single-Center, Multi-Arm Phase 1b Study. J Immunother Precis Oncol 2022; 5:10-12. [PMID: 35663832 PMCID: PMC9138422 DOI: 10.36401/jipo-21-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Kyaw Z Thein
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Hematology and Medical Oncology, Oregon Health and Science University/Knight Cancer Institute, Portland, OR, USA
| | - Siqing Fu
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Filip Janku
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Apostolia M Tsimberidou
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Daniel D Karp
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jatin Shah
- Karyopharm Therapeutics, Newton, MA, USA
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jing Gong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Selma Sulovic
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lacey McQuinn
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bettzy A Stephen
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rivka R Colen
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brett W Carter
- Department of Thoracic Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
33
|
Cornell RF, Baz R, Richter JR, Rossi A, Vogl DT, Chen C, Shustik C, Alvarez MJ, Shen Y, Unger TJ, Ben-Shahar O, Wang H, Baloglu E, Senapedis W, Ma X, Landesman Y, Bai X, Bader J, Xu H, Marshall T, Chang H, Walker CJ, Shah J, Shacham S, Kauffman MG, Hofmeister CC. A phase 1 clinical trial of oral eltanexor in patients with relapsed or refractory multiple myeloma. Am J Hematol 2022; 97:E54-E58. [PMID: 34817872 DOI: 10.1002/ajh.26420] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/29/2021] [Accepted: 11/16/2021] [Indexed: 11/11/2022]
Affiliation(s)
| | - Rachid Baz
- Moffitt Cancer Center, Tampa, Florida, USA
| | - Joshua R Richter
- Hackensack University John Theurer Cancer Center, Hackensack, New Jersey, USA
| | - Adriana Rossi
- Weill Cornell Medical College Myeloma Center, New York, New York, USA
| | - Dan T Vogl
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christine Chen
- UHN Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Chaim Shustik
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Yao Shen
- DarwinHealth Inc., New York, New York, USA
| | - T J Unger
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | | | - Hongwei Wang
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | - Erkan Baloglu
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | | | - Xiwen Ma
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | | | - Xiang Bai
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | - Justin Bader
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | - Hongmei Xu
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | | | - Hua Chang
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | | | - Jatin Shah
- Karyopharm Therapeutics Inc, Newton, Massachusetts, USA
| | | | | | | |
Collapse
|
34
|
Thein KZ, Piha-Paul SA, Tsimberidou A, Karp DD, Janku F, Fu S, Subbiah V, Hong DS, Yap TA, Shah J, Milton DR, McQuinn L, Gong J, Tran Y, Carter BW, Colen R, Meric-Bernstam F, Naing A. Selinexor in combination with standard chemotherapy in patients with advanced or metastatic solid tumors. Exp Hematol Oncol 2021; 10:59. [PMID: 34965890 PMCID: PMC8715578 DOI: 10.1186/s40164-021-00251-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022] Open
Abstract
Selinexor, an oral selective inhibitor of nuclear export (SINE), was demonstrated to hinder the DNA damage repair (DDR) system by reducing DDR proteins while enhancing the killing of cancer cells by DDR-based therapeutics in vivo studies. In this single-center, multi-arm phase 1b study, selinexor with carboplatin, doxorubicin and cyclophosphamide (DC), irinotecan with fluorouracil and folinic acid (FOLFIRI), irinotecan, and capecitabine and oxaliplatin (XELOX), were employed as separate parallel arms. Eligible patients have relapsed/ metastatic refractory solid tumors following standard therapy or addition of selinexor to systemic therapy was appropriate. Nineteen patients were treated in the 5 arms. Tumor types included were colorectal (n = 3), breast (n = 3), neuroendocrine (n = 2), ovarian (n = 2), and pancreas cancers (n = 2). All patients developed one treatment-related adverse events (TRAE). The most prevalent TRAE were thrombocytopenia (84%), nausea (68%), leukopenia (68%), neutropenia (63%), and fatigue (58%). The common grade 3/4 TRAE were neutropenia (42%), leukopenia (26%), and hyponatremia (21%). Three patients had dose-limiting toxicities (DLT) in 3 separate arms. Fourteen patients were evaluable for response. Although no patients achieved complete or partial response (CR or PR), seven patients attained stable disease (SD). Disease control rate (DCR) was 14%. The combination of oral selinexor with different standard chemotherapies showed limited clinical activity despite toxicity and DLT prevented further dose escalation. Optimizing supportive care, the utility of growth factors, and aggressive measures on antiemetics strategies remain tangible. Trial registration ClinicalTrials.gov Identifier: NCT02419495. Registered 14 April 2015, https://clinicaltrials.gov/ct2/show/NCT02419495). Sponsor(s): Karyopharm Therapeutics
Collapse
Affiliation(s)
- Kyaw Z Thein
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Division of Hematology and Medical Oncology, Oregon Health and Science University/Knight Cancer Institute, 3181 SW Sam Jackson Park Rd, Mail Code: OC14HO, Portland, OR, 97239, USA.
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Apostolia Tsimberidou
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Daniel D Karp
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Filip Janku
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Siqing Fu
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David S Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Timothy A Yap
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jatin Shah
- Karyopharm Therapeutics, Newton, MA, USA
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lacey McQuinn
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jing Gong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yanyan Tran
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brett W Carter
- Department of Thoracic Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rivka Colen
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
35
|
Gasparetto C, Schiller GJ, Tuchman SA, Callander NS, Baljevic M, Lentzsch S, Rossi AC, Kotb R, White D, Bahlis NJ, Chen CI, Sutherland HJ, Madan S, LeBlanc R, Sebag M, Venner CP, Bensinger WI, Biran N, Ammu S, Ben-Shahar O, DeCastro A, Van Domelen D, Zhou T, Zhang C, Bentur OS, Shah J, Shacham S, Kauffman M, Lipe B. Once weekly selinexor, carfilzomib and dexamethasone in carfilzomib non-refractory multiple myeloma patients. Br J Cancer 2021; 126:718-725. [PMID: 34802051 PMCID: PMC8605887 DOI: 10.1038/s41416-021-01608-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/20/2021] [Indexed: 01/07/2023] Open
Abstract
Background Proteasome inhibitors (PIs), including carfilzomib, potentiate the activity of selinexor, a novel, first-in-class, oral selective inhibitor of nuclear export (SINE) compound, in preclinical models of multiple myeloma (MM). Methods The safety, efficacy, maximum-tolerated dose (MTD) and recommended phase 2 dose (RP2D) of selinexor (80 or 100 mg) + carfilzomib (56 or 70 mg/m2) + dexamethasone (40 mg) (XKd) once weekly (QW) was evaluated in patients with relapsed refractory MM (RRMM) not refractory to carfilzomib. Results Thirty-two patients, median prior therapies 4 (range, 1–8), were enrolled. MM was triple-class refractory in 38% of patients and 53% of patients had high-risk cytogenetics del(17p), t(4;14), t(14;16) and/or gain 1q. Common treatment-related adverse events (all/Grade 3) were thrombocytopenia 72%/47% (G3 and G4), nausea 72%/6%, anaemia 53%/19% and fatigue 53%/9%, all expected and manageable with supportive care and dose modifications. MTD and RP2D were identified as selinexor 80 mg, carfilzomib 56 mg/m2, and dexamethasone 40 mg, all QW. The overall response rate was 78% including 14 (44%) ≥ very good partial responses. Median progression-free survival was 15 months. Conclusions Weekly XKd is highly effective and well-tolerated. These data support further investigation of XKd in patients with MM.
Collapse
Affiliation(s)
| | - Gary J Schiller
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | | | | | | | | | - Rami Kotb
- Cancer Care Manitoba, Winnipeg, MB, Canada
| | - Darrell White
- Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | - Nizar J Bahlis
- Charbonneau Cancer Research Institute, Calgary, AB, Canada
| | - Christine I Chen
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | | | - Sumit Madan
- Banner MD Anderson Cancer Center, Gilbert, AZ, USA
| | - Richard LeBlanc
- Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC, Canada
| | | | | | | | - Noa Biran
- Hackensack Meridian Health, Hackensack University Medical Center, Teaneck, USA
| | - Sonia Ammu
- Karyopharm Therapeutics Inc., Newton, MA, USA
| | | | | | | | | | - Chris Zhang
- Karyopharm Therapeutics Inc., Newton, MA, USA
| | | | - Jatin Shah
- Karyopharm Therapeutics Inc., Newton, MA, USA
| | | | | | - Brea Lipe
- University of Rochester Medical College, Rochester, NY, USA
| |
Collapse
|
36
|
Odia Y, Wen P, Mehta M, Colman H, Dunbar E, Butowski N, Harrison R, Schulder M, Boockvar J, Chow F, Kumthekar P, Mason W, Venur V, Plotkin S, Lassman A, Duic P, Tamir S, Li K, Liu Y, Mundy G, Damestani Y, Sbar E, Shah J, Shacham S, Goldlust S. CTNI-17. A PHASE 1 WITH DOSE EXPANSION/PHASE 2 STUDY OF SELINEXOR IN COMBINATION WITH STANDARD OF CARE THERAPY FOR NEWLY DIAGNOSED OR RECURRENT GLIOBLASTOMA. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.242] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastoma (GBM) is the most common and aggressive primary brain tumor with median overall survival of 15 months and 5-7 months for patients with newly diagnosed or recurrent disease (nGBM or rGBM), respectively. Selinexor is a first-in-class, oral, selective inhibitor of nuclear export which blocks exportin 1 (XPO1), forcing the nuclear retention and reactivation of tumor suppressor proteins, ultimately causing cancer cell death. Increased XPO1 expression in gliomas is associated with higher pathological grade and poorer prognosis. Consistent with these data, selinexor inhibited tumor growth and prolonged survival in an animal model of GBM. Importantly, selinexor showed encouraging intra-tumoral penetration and single-agent efficacy in rGBM (KING study). The current trial tests the hypothesis that adding selinexor to standard therapy will improve clinical outcomes for patients with nGBM or rGBM.
METHODS
To facilitate the successful development of new therapies, consensus recommendations are to use biomarker enrichment and flexible design that allows expansion of promising cohorts. Accordingly, this phase 1a dose finding study is followed by a phase 1b dose expansion (and ultimately by a 1:1 randomized phase 2 efficacy exploration trial) to independently evaluate: radiation + selinexor in nGBM with unmethylated MGMT promoter (Arm A), radiation + temozolomide + selinexor for nGBM with methylated MGMT promoter (Arm B), and lomustine + selinexor in rGBM (Arm C). Bevacizumab or TTField + selinexor in rGBM (Arms D & E, respectively) are being considered. The Phase 1a primary endpoint is maximum tolerated dose/recommended phase 2 dose. The phase 1b primary endpoint is PFS at 3 months against historic controls. The phase 1b dose expansion is included to evaluate preliminary efficacy before launching into a randomized phase 2 trial. Patient quality of life during the trial will be objectively measured using digital devices (e.g. smartwatch/customized smartphone app). We are currently enrolling patients nationwide. Clinical Trial Registration number: NCT04421378.
Collapse
Affiliation(s)
- Yazmin Odia
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Patrick Wen
- Center For Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Minesh Mehta
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Howard Colman
- University of Utah - Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Erin Dunbar
- Piedmont Brain Tumor Center, Atlanta, GA, USA
| | | | - Rebecca Harrison
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Schulder
- Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - John Boockvar
- Lenox Hill Hospital-Northwell Health, New York, NY, USA
| | - Frances Chow
- University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Priya Kumthekar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Vyshak Venur
- University of Washington - Alvord Brain Tumor Center, Seattle, WA, USA
| | | | - Andrew Lassman
- Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Paul Duic
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | | | - Kai Li
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | - Yang Liu
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | | | | | - Eric Sbar
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | - Jatin Shah
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | | | - Samuel Goldlust
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| |
Collapse
|
37
|
Migowa A, Odhiambo R, Orwa J, Shah J. P010 Clinico-epidemiological characteristics and outcomes of Juvenile Idiopathic Arthritis (JIA) patients in Kenya: data from the KAPRI registry. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab722.002] [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: 11/12/2022] Open
Abstract
Abstract
Background
Pediatric rheumatic diseases pose a significant disease burden upon children and their families (1–3). They lead to physical disability and diminished quality of life (1–3). Determination of the burden and clinical characteristics of these diseases is a critical first step to improving access to care and optimizing use of existing health systems for the well-being of these patients (4). This is in line with the goal of the Bone and Joint decade (2000–2010) aimed at increasing recognition and understanding of the impact of musculoskeletal diseases (5,6). The Kenya Pediatric Rheumatology Registry (KAPRI) offers a unique opportunity to pioneer and spearhead a systematic and organized format to inform policy and better healthcare provision. Our objective was to determine the patient characteristics, clinical features and outcomes of Juvenile Idiopathic Arthritis (JIA) patients assessed at the Aga Khan University Medical College East Africa from March 2019 to December 2020.
Methods
Data of JIA patients on age, gender, laboratory and clinical features at diagnosis and treatment options offered were extracted from the database. A further detailed chart review was undertaken to determine the proportion of patients who achieved remission or minimally active diseases.
Results
Among the 207 patients enrolled thus far, 16 (7.7%) were diagnosed to have JIA. Majority of the patients were females (75%; n = 12) with a mean age of 7 years and 3 months (Range : 1 year—13 years 7 months).
All patients had joint pain and swelling as the initial presenting complaints. Majority of the patients had polyarticular JIA (75%, n = 12). The other 4 patients were oligoarticular (n = 2) and systemic JIA (n = 2). Among the polyarticular JIA patients (n = 12), only 3 (25%) were rheumatoid factor (RF) positive and 1 was antinuclear antibody (ANA) positive. The oligoarticular and systemic JIA patients were all negative for antinuclear antibody, rheumatoid factor and cyclic citrullinated peptide antibodies (anti-ccp). Seven patients (43.8%) required biological therapies; tocilizumab (n = 2: systemic JIA), adalimumab (n = 2: polyarticular JIA), etanercept (n = 2: polyarticular JIA) andtofacitnib (n = 1: polyarticular JIA). One patient with systemic JIA on tocilizumab developed herpes simplex which was successfully managed with oral acyclovir. All the other patients did not develop any infections, allergic reactions or any other untoward events as adverse outcomes following the use of biological therapies. Five patients have attained remission as illustrated in the table below. Two patients have been lost to follow up.
Conclusion
Seronegative polyarticular JIA was the predominant form of JIA observed with a predilection to affect more girls and boys. Over a period of 2 years, remission has been attained among 31.25% of the patients (5 of 16) with use of synthetic disease modifying anti-rheumatic drugs and biological therapies.
Collapse
Affiliation(s)
- A Migowa
- Aga Khan University Medical College East Africa
| | - R Odhiambo
- Aga Khan University Medical College East Africa
| | - J Orwa
- Aga Khan University Medical College East Africa
| | - J Shah
- Aga Khan University Medical College East Africa
| |
Collapse
|
38
|
Hajibandeh S, Shah J, Hajibandeh S, Asim U, Purchase D, Maw A, Mansour M. Erect chest x-ray is inadequately diagnostic and falsely reassuring in assessment of abdominal visceral perforation. Radiography (Lond) 2021; 28:249-250. [PMID: 34764008 DOI: 10.1016/j.radi.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/16/2021] [Indexed: 11/26/2022]
Affiliation(s)
- S Hajibandeh
- General Surgery, Wales Deanery, Health Education and Improvement Wales, United Kingdom; Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, United Kingdom.
| | - J Shah
- Department of General Surgery, North Manchester General Hospital, North Manchester Care Organisation, Manchester, United Kingdom
| | - S Hajibandeh
- Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - U Asim
- Department of General Surgery, Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham, United Kingdom
| | - D Purchase
- Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, United Kingdom
| | - A Maw
- Department of General Surgery, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Rhyl, United Kingdom
| | - M Mansour
- Department of General Surgery, North Manchester General Hospital, North Manchester Care Organisation, Manchester, United Kingdom
| |
Collapse
|
39
|
Thein KZ, Karp DD, Tsimberidou A, Gong J, Sulovic S, Shah J, Milton DR, Hong DS, Janku F, McQuinn L, Stephen BA, Colen R, Carter BW, Yap TA, Piha-Paul SA, Fu S, Meric-Bernstam F, Naing A. Correction to: Selinexor in combination with carboplatin and paclitaxel in patients with advanced solid tumors: results of a single‑center, multi‑arm phase Ib study. Invest New Drugs 2021; 40:463. [PMID: 34731355 PMCID: PMC8993707 DOI: 10.1007/s10637-021-01194-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kyaw Z Thein
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Division of Hematology and Medical Oncology, Oregon Health and Science University/ Knight Cancer Institute, Portland, OR, USA.
| | - Daniel D Karp
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Apostolia Tsimberidou
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jing Gong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Selma Sulovic
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jatin Shah
- , Karyopharm Therapeutics, Newton, MA, USA
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David S Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Filip Janku
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lacey McQuinn
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bettzy A Stephen
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rivka Colen
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brett W Carter
- Department of Thoracic Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Timothy A Yap
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Siqing Fu
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Thoracic Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
40
|
Centorame A, Ondra M, Dumut D, Shah J, Liao J, Hanrahan J, Sanctis JD, Hajduch M, Radzioch D. 627: Investigation of pharmacological correction of F508del-CFTR protein during chronic infections. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02050-6] [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: 11/29/2022]
|
41
|
Noid G, Tai A, Zhong H, Shah J, Gore E, Li A. Lung Perfused Blood Volume Calculated From Dynamic Contrast Enhanced DECT for Radiation Treatment Planning of Lung Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
42
|
Shah J. 1511 A Review of Non-Surgical Management of Hand Osteoarthritis. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.732] [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: 11/13/2022]
Abstract
Abstract
Introduction
Hand osteoarthritis (OA) is a common musculoskeletal condition leading to pain and loss of function. Current treatment aims to target the symptoms of hand OA involving a combination of non-surgical and surgical interventions. During the COVID-19 pandemic, there has been a renewed interest in conservative management. The purpose of this article is to review non-surgical therapies in hand OA, their mechanism of action and efficacy.
Method
An online search of PubMed for articles between 1st January 2004- 1st February 2020 was performed according to specific terms and agreed inclusion criteria.
Results
The search produced 289 results of which 28 met the inclusion criteria comprising 13 RCTs, 8 systematic reviews, 5 clinical trials and 2 international guidelines.
Conclusions
Topical NSAIDs remain first-line pharmacological agents in the management of hand OA. Increasingly, oral NSAIDs have been recommended however their use must be balanced against their potential adverse effects. Supplementation with chondroitin sulfate may help to delay the structural damage in hand OA, which may reduce the need for oral NSAIDs. Intra-articular injections of hyaluronic acid and corticosteroids are effective treatments and provide longer symptomatic relief, additionally hyaluronic acid may improve function over a longer period of time. Targeted hand exercises are widely recommended however may only provide short-term improvements and vary according to the different subtypes of hand OA. In summary, there are multiple conservative management options for hand OA which should be considered prior to operative intervention given the current restrictions on surgical practice.
Collapse
Affiliation(s)
- J Shah
- Chelsea and Westminster Hospital, London, United Kingdom
| |
Collapse
|
43
|
Sanchez L, Leleu X, Beaumont JL, Yu H, Hudgens S, Simonova M, Auner HW, Quach H, Delimpasi S, Špička I, Pour L, Kriachok I, Dimopoulos MA, Usenko G, Hájek R, Benjamin R, Sinha DK, Venner C, Illmer T, Garg MK, Stevens DA, Jagannath S, Levy M, Anderson LD, Bahlis NJ, Facon T, Cavo M, Chai Y, Ma X, Tang S, Leong H, Shah J, Shacham S, Kauffman M, Richardson P, Grosicki S. Peripheral neuropathy symptoms, pain, and functioning in previously treated multiple myeloma patients treated with selinexor, bortezomib, and dexamethasone. Am J Hematol 2021; 96:E383-E386. [PMID: 34161627 DOI: 10.1002/ajh.26282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Larysa Sanchez
- Icahn School of Medicine at Mount Sinai New York New York USA
| | - Xavier Leleu
- CHU de Poitiers ‐ Hôpital La Milétrie Service d'Hématologie et Thérapie Cellulaire, Pôle Régional de Cancérologie Poitiers France
| | | | - Hailin Yu
- Clinical Outcomes Solutions Tucson Arizona USA
| | | | - Maryana Simonova
- Institute of Blood Pathology & Transfusion Medicine of National Academy of Medical Sciences of Ukraine Lviv Ukraine
| | - Holger W. Auner
- Hugh and Josseline Langmuir Centre for Myeloma Research Imperial College London London UK
| | - Hang Quach
- St Vincent's Hospital University of Melbourne Melbourne Victoria Australia
| | - Sosana Delimpasi
- Evangelismos Hospital Hematology/Lymphomas and BMT Unit Athens Greece
| | - Ivan Špička
- 1st Internal Clinic ‐ Clinic of Hematology General University Hospital in Prague Prague Czechia
| | - Ludĕk Pour
- University Hospital Brno Clinic of Internal Medicine ‐ Hematology and Oncology Brno Czechia
| | - Iryna Kriachok
- Scientific Research Department of Chemotherapy of Hemoblastoses and Adjuvant Treatment Methods National Cancer Institute Rockville Maryland USA
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Ganna Usenko
- City Clinical Hospital No.4 of Dnipro City Council City Hematology Center Dnipro Ukraine
| | - Roman Hájek
- Department of Hemato‐oncology University Hospital Ostrava Ostrava Czechia
| | | | - Dinesh Kumar Sinha
- State Cancer Institute Indira Gandhi Institute of Medical Sciences, Patna India
| | | | - Thomas Illmer
- Group Practice for Hematology and Oncology Dresden Germany
| | | | | | | | - Moshe Levy
- Baylor University Medical Center Dallas Texas USA
| | - Larry D. Anderson
- Simmons Comprehensive Cancer Center UT Southwestern Medical Center Dallas Texas USA
| | - Nizar Jacques Bahlis
- University of Calgary Charbonneau Cancer Research Institute Calgary Alberta Canada
| | | | | | - Yi Chai
- Karyopharm Therapeutics Newton Massachusetts USA
| | - Xiwen Ma
- Karyopharm Therapeutics Newton Massachusetts USA
| | - Shijie Tang
- Karyopharm Therapeutics Newton Massachusetts USA
| | - Hoyee Leong
- Karyopharm Therapeutics Newton Massachusetts USA
| | - Jatin Shah
- Karyopharm Therapeutics Newton Massachusetts USA
| | | | | | | | | |
Collapse
|
44
|
Thein KZ, Piha-Paul SA, Tsimberidou A, Karp DD, Janku F, Zarifa A, Shah J, Milton DR, Bean S, McQuinn L, Gong J, Colen R, Carter BW, Subbiah V, Ogbonna DC, Pant S, Meric-Bernstam F, Naing A. Selinexor in combination with topotecan in patients with advanced or metastatic solid tumors: Results of an open-label, single-center, multi-arm phase Ib study. Invest New Drugs 2021; 39:1357-1365. [PMID: 33909232 PMCID: PMC8542012 DOI: 10.1007/s10637-021-01119-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022]
Abstract
Background Selinexor, a first-in-class, oral selective inhibitor of nuclear export (SINE) compound inhibits Exportin-1(XPO1), had demonstrated synergistic activity with many chemotherapies and conferred in vivo antitumor efficacy in hematologic as well as solid tumors. Methods This open-label, single-center, multi-arm phase 1b study used a standard 3 + 3 design and a "basket type" expansion. Selinexor with intravenous topotecan was given in one of the 13 parallel arms. Patients with advanced or metastatic relapsed/refractory solid tumors following prior systemic therapy, or in whom the addition of selinexor to standard chemotherapy deemed appropriate, were eligible. Results Fourteen patients with the median age of 61 years (range, 22-68years) were treated, and the most common cancer types were gynecological cancers; ovarian (n = 5), endometrial (n = 2), and 1 each with fallopian tube and vaginal cancers. Of the 14 patients treated, 12 (86 %) had at least one treatment-related adverse event (TRAE). The most common TRAEs were anemia (71 %), thrombocytopenia (57 %), hyponatremia (57 %), vomiting (57 %), fatigue (50 %), nausea (50 %), and neutropenia (36 %). Two patients had dose limiting toxicities. One patient dosed at selinexor 80 mg had grade 3 nausea and vomiting and one patient dosed at selinexor 60 mg experienced grade 4 neutropenia and thrombocytopenia. Of the 13 efficacy evaluable patients, one (8 %) with endometrial cancer achieved unconfirmed partial response (uPR) and the time-to-treatment failure (TTF) was 48 weeks, whereas 6 of the 13 (46 %) patients had stable disease (SD) contributing to the clinical benefit rate of 46 %. The median TTF for all patients was 9 weeks (range, 2-48weeks). Conclusions Once weekly selinexor in combination with topotecan was viable and showed some preliminary tumor efficacy. The recommend phase 2 dose of selinexor was 60 mg once weekly in combination with IV topotecan.Trial registration: NCT02419495. Registered 14 April 2015, https://clinicaltrials.gov/ct2/show/NCT02419495.
Collapse
Affiliation(s)
- Kyaw Zin Thein
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
- Division of Hematology and Medical Oncology, Oregon Health and Science University/ Knight Cancer Institute, Portland, OR, USA.
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Apostolia Tsimberidou
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Daniel D Karp
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Filip Janku
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Abdulrazzak Zarifa
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Jatin Shah
- Karyopharm Therapeutics, Newton, MA, USA
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stacie Bean
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Lacey McQuinn
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Jing Gong
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Rivka Colen
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brett W Carter
- Department of Thoracic Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Deby C Ogbonna
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Shubham Pant
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| |
Collapse
|
45
|
Thein KZ, Karp DD, Tsimberidou A, Gong J, Sulovic S, Shah J, Milton DR, Hong DS, Janku F, McQuinn L, Stephen BA, Colen R, Carter BW, Yap TA, Piha-Paul SA, Fu S, Meric-Bernstam F, Naing A. Selinexor in combination with carboplatin and paclitaxel in patients with advanced solid tumors: Results of a single-center, multi-arm phase Ib study. Invest New Drugs 2021; 40:290-299. [PMID: 34562230 PMCID: PMC8993773 DOI: 10.1007/s10637-021-01188-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022]
Abstract
Background. Carboplatin and paclitaxel (CT) is one of the standard chemotherapy regimens used in various tumor types. Preclinical models have suggested that selinexor, a first-in-class oral potent selective inhibitor of nuclear export Exportin-1, and CT exerts antitumor activity in multiple malignancies. Methods. This was a single-center, multi-arm phase Ib study utilizing a “basket type” expansion. CT and selinexor was employed as one of the 13 parallel arms. Advanced relapsed/refractory solid tumors following standard therapy or where the addition of selinexor to standard regimens deemed appropriate, were eligible. Results. Of 13 patients treated, 12 patients were evaluable for response. The most common cancers were breast (n = 4), esophageal (n = 2), ovarian (n = 2) and non-small cell lung cancers (n = 2). All 13 patients had at least one treatment-related adverse events (TRAEs) and the most common were neutropenia (85%), leukopenia (85%), thrombocytopenia (85%), anemia (69%), nausea (54%), vomiting (46%), and fatigue (46%). One patient at 60 mg QW experienced DLT with grade 3 nausea and vomiting lasting 3 days. Unconfirmed partial response (uPR) was observed in 3 patients; one patient each with esophageal, breast, and ovarian cancer. One patient with esophageal adenocarcinoma had confirmed PR, however, was discontinued from the study due to clinical progression. Five patients achieved stable disease (SD). Disease control rate was 8%. Majority of patients (77%), including two patients who had uPR, had prior exposure to carboplatin and/or paclitaxel. Time-to-treatment failure (TTF) ranged from 1 to 153 weeks. Conclusion. The RP2D of selinexor was 60 mg QW in combination with CT. The combination conferred viable clinical activity with durable objective responses which should further be explored in tumor types for which CT is used as standard of care. Trial information. ClinicalTrials.gov Identifier: NCT02419495. Sponsor(s): Karyopharm Therapeutics. (Trial registration: NCT02419495. Registered 14 April 2015, https://clinicaltrials.gov/ct2/show/NCT02419495).
Collapse
Affiliation(s)
- Kyaw Z Thein
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Division of Hematology and Medical Oncology, Oregon Health and Science University/ Knight Cancer Institute, Portland, OR, USA.
| | - Daniel D Karp
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Apostolia Tsimberidou
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jing Gong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Selma Sulovic
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jatin Shah
- , Karyopharm Therapeutics, Newton, MA, USA
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David S Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Filip Janku
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lacey McQuinn
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bettzy A Stephen
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rivka Colen
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brett W Carter
- Department of Thoracic Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Timothy A Yap
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Siqing Fu
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
46
|
Tremblay G, Daniele P, Breeze J, Li L, Shah J, Shacham S, Kauffman M, Engelhardt M, Chari A, Nooka A, Vogl D, Gavriatopoulou M, Dimopoulos MA, Richardson P, Biran N, Siegel D, Vlummens P, Doyen C, Facon T, Mohty M, Meuleman N, Levy M, Costa L, Hoffman JE, Delforge M, Kaminetzky D, Weisel K, Raab M, Dingli D, Tuchman S, Laurent F, Vij R, Schiller G, Moreau P, Richter J, Schreder M, Podar K, Parker T, Cornell RF, Lionel K, Choquet S, Sundar J. Quality of life analyses in patients with multiple myeloma: results from the Selinexor (KPT-330) Treatment of Refractory Myeloma (STORM) phase 2b study. BMC Cancer 2021; 21:993. [PMID: 34488662 PMCID: PMC8419947 DOI: 10.1186/s12885-021-08453-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/07/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Selinexor is an oral, selective nuclear export inhibitor. STORM was a phase 2b, single-arm, open-label, multicenter trial of selinexor with low dose dexamethasone in patients with penta-exposed relapsed/refractory multiple myeloma (RRMM) that met its primary endpoint, with overall response of 26% (95% confidence interval [CI], 19 to 35%). Health-related quality of life (HRQoL) was a secondary endpoint measured using the Functional Assessment of Cancer Therapy - Multiple Myeloma (FACT-MM). This study examines impact of selinexor treatment on HRQoL of patients treated in STORM and reports two approaches to calculate minimal clinically important differences for the FACT-MM. METHODS FACT-MM data were collected at baseline, on day 1 of each 4-week treatment cycle, and at end of treatment (EOT). Changes from baseline were analyzed for the FACT-MM total score, FACT-trial outcome index (TOI), FACT-General (FACT-G), and the MM-specific domain using mixed-effects regression models. Two approaches for evaluating minimal clinically important differences were explored: the first defined as 10% of the instrument range, and the second based on estimated mean baseline differences between Eastern Cooperative Oncology Group performance status (ECOG PS) scores. Post-hoc difference analysis compared change in scores from baseline to EOT for treatment responders and non-responders. RESULTS Eighty patients were included in the analysis; the mean number of prior therapies was 7.9 (standard deviation [SD] 3.1), and mean duration of myeloma was 7.6 years (SD 3.4). Each exploratory minimal clinically important difference threshold yielded consistent results whereby most patients did not experience HRQoL decline during the first six cycles of treatment (range: 53.9 to 75.7% for the first approach; range: 52.6 to 72.9% for the second). Treatment responders experienced less decline in HRQoL from baseline to EOT than non-responders, which was significant for the FACT-G, but not for other scores. CONCLUSION The majority of patients did not experience decline in HRQoL based on minimal clinically important differences during early cycles of treatment with selinexor and dexamethasone in the STORM trial. An anchor-based approach utilizing patient-level data (ECOG PS score) to define minimal clinically important differences for the FACT-MM gave consistent results with a distribution-based approach. TRIAL REGISTRATION This trial was registered on ClinicalTrials.gov under the trial-ID NCT02336815 on January 8, 2015.
Collapse
Affiliation(s)
- Gabriel Tremblay
- Purple Squirrel Economics, 1600 Notre Dame W, Suite 201, Montreal, QC, H3J 1M1, Canada.
| | - Patrick Daniele
- Purple Squirrel Economics, 1600 Notre Dame W, Suite 201, Montreal, QC, H3J 1M1, Canada
| | - Janis Breeze
- Purple Squirrel Economics, 1600 Notre Dame W, Suite 201, Montreal, QC, H3J 1M1, Canada
| | | | - Jatin Shah
- Karyopharm Therapeutics Inc., Newton, USA
| | | | | | | | - Ajaj Chari
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ajay Nooka
- Winship Cancer Institute, Emory University, Atlanta, USA
| | - Dan Vogl
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | | | | | | | - Noa Biran
- Hackensack Meridian Health Hackensack University Medical Center, Hackensack, USA
| | - David Siegel
- Hackensack Meridian Health Hackensack University Medical Center, Hackensack, USA
| | | | - Chantal Doyen
- Université catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | | | | | | | - Moshe Levy
- Baylor University Medical Center, Dallas, USA
| | - Luciano Costa
- University of Alabama at Birmingham, Birmingham, USA
| | | | | | | | - Katja Weisel
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Raab
- University of Heidelberg, Heidelberg, Germany
| | | | - Sascha Tuchman
- Lineberger Comprehensive Cancer Center at University of North Carolina-Chapel Hill, Chapel Hill, USA
| | | | - Ravi Vij
- Washington University School of Medicine, St. Louis, USA
| | - Gary Schiller
- David Geffen School of Medicine at University of California, Los Angeles, USA
| | | | - Joshua Richter
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Klaus Podar
- University Hospital Krems, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | | | | | - Karlin Lionel
- Centre Hospitalier Lyon Sud, Saint-Genis-Laval, France
| | | | - Jagannath Sundar
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|
47
|
Dhawan V, Joshi G, Sutariya B, Shah J, Ashtikar M, Nagarsekar K, Steiniger F, Lokras A, Fahr A, Krishnapriya M, Warawdekar U, Saraf M, Nagarsenker M. Polysaccharide conjugates surpass monosaccharide ligands in hepatospecific targeting - Synthesis and comparative in silico and in vitro assessment. Carbohydr Res 2021; 509:108417. [PMID: 34481155 DOI: 10.1016/j.carres.2021.108417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/22/2021] [Accepted: 07/31/2021] [Indexed: 12/18/2022]
Abstract
Ligands with the polysaccharide headgroups have been recently reported by our group to possess enhanced interaction with asialoglycoprotein receptor (ASGPR) in silico as compared to ligands having galactose moieties. This enhanced interaction is a result of the polymer's backbone support in anchoring the ligand in a specific orientation within the bilayer. In this paper, we have attempted to provide an in vitro proof of concept by performing a comparative evaluation of polysaccharide and monosaccharide-based ligands. Docking was performed to understand interaction with ASGPR in silico. Agarose and galactose conjugates with behenic acid were synthesized, purified, and characterized to yield biocompatible hepatospecific ligands which were incorporated into nanoliposomes. Cellular internalization of these targeted liposomes was studied using confocal microscopy and flow cytometry. The toxicity potential was assessed in vivo. Results indicated that the polysaccharide-based ligand increased cellular uptake due to better interaction with the receptor as compared to ligand bearing a single galactose group. In addition to developing novel liver targeting ligands, the study also established proof of concept that has been suggested by earlier in silico investigations. The approach can be used to design targeting ligands and develop formulations with improved targeting efficacy.
Collapse
Affiliation(s)
- V Dhawan
- Bombay College of Pharmacy, Kalina, Santacruz East, Mumbai, 400098, India
| | - G Joshi
- CRI Lab 1, Advanced Centre for Treatment, Research & Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
| | - B Sutariya
- Bombay College of Pharmacy, Kalina, Santacruz East, Mumbai, 400098, India
| | - J Shah
- Bombay College of Pharmacy, Kalina, Santacruz East, Mumbai, 400098, India
| | - M Ashtikar
- Department of Pharmaceutical Technology, Friedrich Schiller University of Jena, Lessingstraße 8, D-07743, Jena, Germany
| | - K Nagarsekar
- Department of Pharmaceutical Technology, Friedrich Schiller University of Jena, Lessingstraße 8, D-07743, Jena, Germany
| | - F Steiniger
- Centre for Electron Microscopy of the Medical Faculty, Friedrich Schiller University of Jena, Ziegelmühlenweg 1, 07743, Jena, Germany
| | - A Lokras
- Bombay College of Pharmacy, Kalina, Santacruz East, Mumbai, 400098, India; Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2100, Denmark
| | - A Fahr
- Department of Pharmaceutical Technology, Friedrich Schiller University of Jena, Lessingstraße 8, D-07743, Jena, Germany
| | - M Krishnapriya
- Bombay College of Pharmacy, Kalina, Santacruz East, Mumbai, 400098, India
| | - U Warawdekar
- CRI Lab 1, Advanced Centre for Treatment, Research & Education in Cancer, Tata Memorial Centre, Navi Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400085, India
| | - M Saraf
- Bombay College of Pharmacy, Kalina, Santacruz East, Mumbai, 400098, India
| | - M Nagarsenker
- Bombay College of Pharmacy, Kalina, Santacruz East, Mumbai, 400098, India.
| |
Collapse
|
48
|
Richard S, Chari A, Delimpasi S, Simonova M, Spicka I, Pour L, Kriachok I, Dimopoulos MA, Pylypenko H, Auner HW, Leleu X, Usenko G, Hajek R, Benjamin R, Dolai TK, Sinha DK, Venner CP, Garg M, Stevens DA, Quach H, Jagannath S, Moreau P, Levy M, Badros A, Anderson LD, Bahlis NJ, Facon T, Mateos MV, Cavo M, Chang H, Landesman Y, Chai Y, Arazy M, Shah J, Shacham S, Kauffman MG, Grosicki S, Richardson PG. Selinexor, bortezomib, and dexamethasone versus bortezomib and dexamethasone in previously treated multiple myeloma: Outcomes by cytogenetic risk. Am J Hematol 2021; 96:1120-1130. [PMID: 34062004 PMCID: PMC8457116 DOI: 10.1002/ajh.26261] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/20/2021] [Accepted: 05/27/2021] [Indexed: 11/06/2022]
Abstract
In the phase 3 BOSTON study, patients with multiple myeloma (MM) after 1-3 prior regimens were randomized to once-weekly selinexor (an oral inhibitor of exportin 1 [XPO1]) plus bortezomib-dexamethasone (XVd) or twice-weekly bortezomib-dexamethasone (Vd). Compared with Vd, XVd was associated with significant improvements in median progression-free survival (PFS), overall response rate (ORR), and lower rates of peripheral neuropathy, with trends in overall survival (OS) favoring XVd. In BOSTON, 141 (35.1%) patients had MM with high-risk (presence of del[17p], t[4;14], t[14;16], or ≥4 copies of amp1q21) cytogenetics (XVd, n = 70; Vd, n = 71), and 261 (64.9%) exhibited standard-risk cytogenetics (XVd, n = 125; Vd, n = 136). Among patients with high-risk MM, median PFS was 12.91 months for XVd and 8.61 months for Vd (HR, 0.73 [95% CI, (0.4673, 1.1406)], p = 0.082), and ORRs were 78.6% and 57.7%, respectively (OR 2.68; p = 0.004). In the standard-risk subgroup, median PFS was 16.62 months for XVd and 9.46 months for Vd (HR 0.61; p = 0.004), and ORRs were 75.2% and 64.7%, respectively (OR 1.65; p = 0.033). The safety profiles of XVd and Vd in both subgroups were consistent with the overall population. These data suggest that selinexor can confer benefits to patients with MM regardless of cytogenetic risk. ClinicalTrials.gov identifier: NCT03110562.
Collapse
Affiliation(s)
- Shambavi Richard
- Icahn School of Medicine at Mount Sinai Tisch Cancer Institute New York New York USA
| | - Ajai Chari
- Icahn School of Medicine at Mount Sinai Tisch Cancer Institute New York New York USA
| | | | - Maryana Simonova
- Institute of Blood Pathology & Transfusion Medicine of National Academy of Medical Sciences of Ukraine Lviv Ukraine
| | - Ivan Spicka
- Charles University and General Hospital Prague Czech Republic
| | - Ludek Pour
- Clinic of Internal Medicine —Hematology and Oncology University Hospital Brno Brno Czech Republic
| | | | - Meletios A. Dimopoulos
- School of Medicine National and Kapodistrian University of Athens School of Medicine Athens Greece
| | - Halyna Pylypenko
- Department of Hematology Cherkassy Regional Oncological Center Cherkassy Ukraine
| | | | - Xavier Leleu
- Department of Hematology CHU la Miletrie and Inserm CIC 1402 Poitiers France
| | - Ganna Usenko
- City Clinical Hospital No. 4 of Dnipro City Council Dnipro Ukraine
| | - Roman Hajek
- Department of Hemato‐oncology, University Hospital Ostrava University of Ostrava Ostrava Czech Republic
| | | | | | - Dinesh Kumar Sinha
- State Cancer Institute Indira Gandhi Institute of Medical Sciences Patna India
| | | | - Mamta Garg
- University Hospitals of Leicester NHS Trust Leicester UK
| | | | - Hang Quach
- University of Melbourne, St. Vincent's Hospital Melbourne Victoria Australia
| | - Sundar Jagannath
- Icahn School of Medicine at Mount Sinai Tisch Cancer Institute New York New York USA
| | | | - Moshe Levy
- Baylor University Medical Center Dallas Texas USA
| | - Ashraf Badros
- University of Maryland, Greenebaum Comprehensive Cancer Center Baltimore Maryland USA
| | - Larry D. Anderson
- Simmons Comprehensive Cancer Center UT Southwestern Medical Center Dallas Texas USA
| | - Nizar J. Bahlis
- University of Calgary Charbonneau Cancer Research Institute Calgary Alberta Canada
| | - Thierry Facon
- CHU Lille Service des Maladies du Sang F‐59000 Lille France
| | | | - Michele Cavo
- Seràgnoli Institute of Hematology Bologna University School of Medicine Bologna Italy
| | - Hua Chang
- Karyopharm Therapeutics Inc. Newton Massachusetts USA
| | | | - Yi Chai
- Karyopharm Therapeutics Inc. Newton Massachusetts USA
| | - Melina Arazy
- Karyopharm Therapeutics Inc. Newton Massachusetts USA
| | - Jatin Shah
- Karyopharm Therapeutics Inc. Newton Massachusetts USA
| | | | | | | | | |
Collapse
|
49
|
Zer A, Dudnik J, Shamai S, Gottfried M, Zick A, Shai A, Kutiel TS, Netiv E, Yang F, Sharoni S, Meng C, Duic P, Michel D, Sbar E, Shah J, Kauffman M, Shacham S, Golan T. 1331P Open-label phase I/II study evaluating the tolerability and anti-tumor activity of selinexor (SEL) and docetaxel (DTX) in non-small cell lung cancer (NSCLC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
50
|
Sweet K, Bhatnagar B, Döhner H, Donnellan W, Frankfurt O, Heuser M, Kota V, Liu H, Raffoux E, Roboz GJ, Röllig C, Showel MM, Strickland SA, Vives S, Tang S, Unger TJ, Joshi A, Shen Y, Alvarez MJ, Califano A, Crochiere M, Landesman Y, Kauffman M, Shah J, Shacham S, Savona MR, Montesinos P. A 2:1 randomized, open-label, phase II study of selinexor vs. physician's choice in older patients with relapsed or refractory acute myeloid leukemia. Leuk Lymphoma 2021; 62:3192-3203. [PMID: 34323164 DOI: 10.1080/10428194.2021.1950706] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Selinexor, a selective inhibitor of nuclear export, has demonstrated promising activity in patients with acute myeloid leukemia (AML). This randomized, phase II study evaluated selinexor 60 mg twice weekly (n = 118) vs. physician's choice (PC) treatment (n = 57) in patients aged ≥60 years with relapsed/refractory (R/R) AML. The primary outcome was overall survival (OS). Median OS did not differ significantly for selinexor vs. PC (3.2 vs. 5.6 months; HR = 1.18 [95% CI: 0.79-1.75]; p = 0.422). Complete remission (CR) plus CR with incomplete hematologic recovery trending in favor of selinexor occurred in a minority of patients. Selinexor treated patients had an increased incidence of adverse events. The most common grade ≥3 adverse events were thrombocytopenia, febrile neutropenia, anemia, hyponatremia. Despite well-balanced baseline characteristics, there were numerically higher rates of TP53 mutations, prior myelodysplastic syndrome, and lower absolute neutrophil counts in the selinexor group; warranting further investigation of selinexor in more carefully stratified R/R AML patients.Registered trial: NCT02088541.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Susana Vives
- ICO Badalona-Hospital Germans Trias i Pujol, Badalona, Spain
| | | | | | | | - Yao Shen
- DarwinHealth Inc, New York, NY, USA
| | - Mariano J Alvarez
- DarwinHealth Inc, New York, NY, USA.,Columbia University, New York, NY, USA
| | | | | | | | | | - Jatin Shah
- Karyopharm Therapeutics, Newton, MA, USA
| | | | | | - Pau Montesinos
- Departamento de Hematologia, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|