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Suwajanakorn D, Lane AM, Go AK, Hartley CD, Oxenreiter M, Wu F, Gragoudas ES, Sullivan RJ, Montazeri K, Kim IK. Impact of gene expression profiling on diagnosis and survival after metastasis in patients with uveal melanoma. Melanoma Res 2024:00008390-990000000-00142. [PMID: 38578293 DOI: 10.1097/cmr.0000000000000971] [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: 04/06/2024]
Abstract
Surveillance frequency for metastasis is guided by gene expression profiling (GEP). This study evaluated the effect of GEP on time to diagnosis of metastasis, subsequent treatment and survival. A retrospective study was conducted of 110 uveal melanoma patients with GEP (DecisionDx-UM, Castle Biosciences, Friendswood, Texas, USA) and 110 American Joint Committee on Cancer-matched controls. Surveillance testing and treatment for metastasis were compared between the two groups and by GEP class. Rates of metastasis, overall survival and melanoma-related mortality were calculated using Kaplan-Meier estimates. Baseline characteristics and follow-up time were balanced in the two groups. Patients' GEP classification was 1A in 41%, 1B in 25.5% and 2 in 33.6%. Metastasis was diagnosed in 26.4% (n = 29) in the GEP group and 23.6% (n = 26) in the no GEP group (P = 0.75). Median time to metastasis was 30.5 and 22.3 months in the GEP and no GEP groups, respectively (P = 0.44). Median months to metastasis were 34.7, 75.8 and 26.1 in class 1A, 1B and 2 patients, respectively (P = 0.28). Disease-specific 5-year survival rates were 89.4% [95% confidence interval (CI): 81.0-94.2%] and 84.1% (95% CI: 74.9-90.1%) in the GEP and no GEP groups respectively (P = 0.49). Median time to death from metastasis was 10.1 months in the GEP group and 8.5 months in the no GEP group (P = 0.40). There were no significant differences in time to metastasis diagnosis and survival outcomes in patients with and without GEP. To realize the full benefit of GEP, more sensitive techniques for detection of metastasis and adjuvant therapies are required.
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Affiliation(s)
- D Suwajanakorn
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Department of Ophthalmology, Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - A M Lane
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - A K Go
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - C D Hartley
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska
| | - M Oxenreiter
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Close Concerns, San Francisco, California, USA
| | - F Wu
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - E S Gragoudas
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - R J Sullivan
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - K Montazeri
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - I K Kim
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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Sheth R, Kuban J, Weintraub J, Wehrenberg-Klee E, Novelli P, Gonsalves C, Adamo R, Kim A, Patel S, Javle M, Lee S, Carvajal R, Orloff M, Montazeri K, Davar D, Geller D, Nguyen Z, Hulstine A, Cox B, Katz S. Abstract No. 140 Hepatic Arterial Infusion of the Class C TLR9 Agonist SD-101 in Pressure Enabled Regional Immuno-Oncology (PERIO) Phase 1 Trials for Liver Tumors. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.192] [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: 02/27/2023] Open
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Panagides J, Ganguli S, Arellano R, Chen X, Montazeri K, Sullivan R, Wehrenberg-Klee E. Abstract No. 543 90Y Selective Internal Radiation Therapy for Ocular Melanoma Metastatic to the Liver: Dosimetry and Response Assessment. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.401] [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: 02/27/2023] Open
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Dimitriou F, Hassel J, Orloff M, Hughes I, Kapiteijn E, Mehmi I, Montazeri K, Johnson D, Grover P, Gerard C, Simeone E, Gaudy Marqueste C, Cheng P, Long G, Carvajal R, Dummer R. 832P Treatment sequence with tebentafusp (tebe) and anti-PD1/ipilimumab (PD1+IPI) in HLA-A2*02:01 patients (pts) with metastatic uveal melanoma (mUM). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Montazeri K, Dranitsaris G, Thomas JD, Curran C, Preston MA, Steele GS, Kilbridge KL, Mantia C, Ravi P, McGregor BA, Mossanen M, Sonpavde G. An economic analysis comparing health care resource use and cost of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin versus gemcitabine and cisplatin as neoadjuvant therapy for muscle invasive bladder cancer. Urol Oncol 2021; 39:834.e1-834.e7. [PMID: 34162500 DOI: 10.1016/j.urolonc.2021.04.032] [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: 01/23/2021] [Revised: 04/11/2021] [Accepted: 04/23/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE To compare healthcare resource utilization (HRU) and costs associated with dose-dense methotrexate, vinblastine, doxorubicin, cisplatin (ddMVAC) and gemcitabine, cisplatin (GC) as neoadjuvant chemotherapy for muscle-invasive bladder cancer (MIBC). METHODS Patient treated at Dana-Farber Cancer Institute from 2010 to 2019 were identified. HRU data on chemotherapy administered, supportive medications, patient monitoring, clinic, infusion, emergency department (ED) visits and hospitalization were collected retrospectively. Unit costs for HRU components were obtained from the Centers for Medicare and Medicaid Website and HRU was compared between groups using quantile regression analysis. RESULTS 137 patients were included; 51 received ddMVAC and 86 GC. Baseline characteristics were similar, except lower mean age (P < 0.001) and higher proportion of ECOG-PS = 0 (P < 0.001) for ddMVAC. ddMVAC required more granulocyte-colony stimulating factor support (P < 0.001), central line placement (P = 0.017), cardiac imaging (P < 0.001), and infusion visits (P < 0.001), whereas GC required more clinic visits. ED visits were higher for ddMVAC (P = 0.048), while chemotherapy cycle delays and hospitalization days were higher for GC (P = 0.008). After adjusting for ECOG-PS and age, the cost per patient was approximately 41% lower (95%CI: 28% to 52%; P < 0.001) for GC vs. ddMVAC, which translated to a median adjusted cost savings of $7,410 (95%CI: $5,474-$9,347) per patient. CONCLUSIONS Although excess HRU did not clearly favor one regimen, adjusting for PS and age indicated lower costs with GC vs. ddMVAC. Given the similar cumulative cisplatin delivery with both regimens, the associated values and costs supports the preferential selection of GC in the neoadjuvant setting of MIBC.
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Affiliation(s)
- K Montazeri
- Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | | | - J D Thomas
- Beth Israel Deaconess Medical Center, Boston, MA
| | - C Curran
- Beth Israel Deaconess Medical Center, Boston, MA
| | - M A Preston
- Department of Urology, Brigham and Women's Hospital, Boston, MA
| | - G S Steele
- Department of Urology, Brigham and Women's Hospital, Boston, MA
| | - K L Kilbridge
- Department of Urology, Brigham and Women's Hospital, Boston, MA
| | - C Mantia
- Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Boston, MA
| | - P Ravi
- Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Boston, MA
| | - B A McGregor
- Beth Israel Deaconess Medical Center, Boston, MA
| | - M Mossanen
- Department of Urology, Brigham and Women's Hospital, Boston, MA
| | - G Sonpavde
- Beth Israel Deaconess Medical Center, Boston, MA.
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Eizadi-Mood N, Sabzghabaee AM, Yaraghi A, Montazeri K, Golabi M, Sharifian A, Badri S. Effect of Antioxidants on the Outcome of Therapy in Paraquat-intoxicated Patients. TROP J PHARM RES 2011. [DOI: 10.4314/tjpr.v10i1.66537] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sabzghabaee AM, Eizadi-Mood N, Montazeri K, Yaraghi A, Golabi M. Fatality in paraquat poisoning. Singapore Med J 2010; 51:496-500. [PMID: 20658110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Acute paraquat (PQ) poisoning continues to be a major public health concern in many developing countries. This study was designed to evaluate the data on cases of acute PQ poisoning and compare the different variables between survivors and non-survivors. METHODS All patients of PQ poisoning who were admitted to the poisoning emergency department during the past five years were retrospectively evaluated. The different variables that were compared between survivors and non-survivors included age and gender, the time from ingestion of PQ to hospital admission, the amount of PQ ingested, occurrence of vomiting after ingestion, the time from hospital admission to initiation of haemodialysis, the length of hospital stay and the outcomes. RESULTS A total of 29 patients were evaluated. The in-hospital fatality rate was 55.2 percent. No significant differences were observed between survivors and non-survivors with regard to the patient characteristics. Most of the patients who died had ingested more than 40 mg/kg of 20 percent PQ (62.5 percent). There was a correlation between the outcome of patients and vomiting (p-value is 0.05; correlation coefficient is 0.45) and age (p-value is 0.013; correlation coefficient is 0.56). CONCLUSION A large amount of ingested PQ, vomiting and age may be important variables to consider in association with the high fatality rate of PQ poisoning.
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Affiliation(s)
- A M Sabzghabaee
- Isfahan Clinical Toxicology Research Centre, Noor and Ali-Asghar General Teaching Hospital, Isfahan, Iran
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Kashefi P, Montazeri K, Honarmand A, Masoomi G. 626. Adding Magnesium Sulfate to Lidocaine for Intravenous Regional Anesthesia. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00185] [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: 11/03/2022]
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Kashefi P, Montazeri K, Mirzaei H. 597. Addition of Midazolam to Lidocaine for Intravenous Regional Anesthesia. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00183] [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: 11/03/2022]
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Montazeri K, Kashefi P, Honarmand A. Pre-emptive gabapentin significantly reduces postoperative pain and morphine demand following lower extremity orthopaedic surgery. Singapore Med J 2007; 48:748-51. [PMID: 17657384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Gabapentin has demonstrated analgesic effects in clinical trials as a preemptive analgesic and in acute postoperative pain management. This study was conducted to evaluate whether the pre-emptive use of gabapentin could reduce postoperative pain and morphine consumption in patients after lower extremity orthopaedic surgery. METHODS 70 ASA I and II patients were randomly assigned to receive 300 mg gabapentin or placebo in a double-blind manner two hours before surgery under general anaesthesia. Postoperatively, the pain was assessed on a visual analogue scale (VAS) at 2, 4, 12, and 24 hours at rest. Morphine 0.05 mg/kg intravenously was used to treat postoperative pain on patients' demand. Total morphine consumption in the first 24 hours after surgery was also recorded. RESULTS Patients in the gabapentin group had significantly lower VAS scores at all time intervals of 2, 4, 12, and 24 hours, than those in the placebo group (respectively, 55.50 [mean] +/- 15.80 [standard deviation], 57.30 +/- 19.30, 45.74 +/- 16.00, 44.60 +/- 17.64, versus 72.30 +/- 14.00, 70.50 +/- 18.13, 62.00 +/- 23.32, 66.50 +/- 25.70; p-value is less than 0.05). The total morphine consumed after surgery in the first 24 hours in the gabapentin group (15.43 +/- 2.54) was significantly less than in the placebo group (17.94 +/- 3.00; p-value is less than 0.05). CONCLUSION Pre-emptive use of gabapentin 300 mg orally significantly decreases postoperative pain and rescue analgesic requirements in patients who undergo lower extremity orthopaedic surgery.
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Affiliation(s)
- K Montazeri
- Department of Anaesthesiology and Intensive Care Medicine, School of Medical Sciences, Isfahan University, Isfahan, Iran
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