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Sindhu KK, Dovey Z, Thompson M, Nehlsen AD, Skalina KA, Malachowska B, Hasan S, Guha C, Tang J, Salgado LR. The potential role of precision medicine to alleviate racial disparities in prostate, bladder and renal urological cancer care. BJUI Compass 2024; 5:405-425. [PMID: 38633827 PMCID: PMC11019243 DOI: 10.1002/bco2.323] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 04/19/2024] Open
Abstract
Background Racial disparities in oncological outcomes resulting from differences in social determinants of health (SDOH) and tumour biology are well described in prostate cancer (PCa) but similar inequities exist in bladder (BCa) and renal cancers (RCCs). Precision medicine (PM) aims to provide personalized treatment based on individual patient characteristics and has the potential to reduce these inequities in GU cancers. Objective This article aims to review the current evidence outlining racial disparities in GU cancers and explore studies demonstrating improved oncological outcomes when PM is applied to racially diverse patient populations. Evidence acquisition Evidence was obtained from Pubmed and Web of Science using keywords prostate, bladder and renal cancer, racial disparity and precision medicine. Because limited studies were found, preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were not applied but rather related articles were studied to explore existing debates, identify the current status and speculate on future applications. Results Evidence suggests addressing SDOH for PCa can reverse racial inequities in oncological outcomes but differences in incidence remain. Similar disparities in BCa and RCC are seen, and it would be reasonable to suggest achieving parity in SDOH for all races would do the same. Research applying a PM approach to different ethnicities is lacking although in African Americans (AAs) with metastatic castrate-resistant prostate cancer (mCRPCa) better outcomes have been shown with androgen receptor inhibitors, radium-223 and sipuleucel. Exploiting the abscopal effect with targeted radiation therapy (RT) and immunotherapy has promise but requires further study, as does defining actionable mutations in specific patient groups to tailor treatments as appropriate. Conclusion For all GU cancers, the historical underrepresentation of ethnic minorities in clinical trials still exists and there is an urgent need for recruitment strategies to address this. PM is a promising development with the potential to reduce inequities in GU cancers, however, both improved understanding of race-specific tumour biology, and enhanced recruitment of minority populations into clinical trials are required. Without this, the benefits of PM will be limited.
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Affiliation(s)
- Kunal K. Sindhu
- Department of Radiation OncologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Zachary Dovey
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Marcher Thompson
- Department of Radiation OncologyAIS Cancer Center/Adventist HealthBakersfieldCAUSA
| | - Anthony D. Nehlsen
- Department of Radiation OncologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Karin A. Skalina
- Department of Radiation OncologyMontefiore Medical Center/Albert Einstein College of MedicineBronxNYUSA
| | - Beata Malachowska
- Department of Radiation OncologyMontefiore Medical Center/Albert Einstein College of MedicineBronxNYUSA
| | - Shaakir Hasan
- Department of Radiation OncologyMontefiore Medical Center/Albert Einstein College of MedicineBronxNYUSA
| | - Chandan Guha
- Department of Radiation OncologyMontefiore Medical Center/Albert Einstein College of MedicineBronxNYUSA
| | - Justin Tang
- Department of Radiation OncologyMontefiore Medical Center/Albert Einstein College of MedicineBronxNYUSA
| | - Lucas Resende Salgado
- Department of Radiation OncologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
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Skalina KA, Jiang JM, Kaubisch A, Guha C, Ohri N, Tang J, Kabarriti R. Association of Radiation and Neutrophil to Lymphocyte Ratio with Survival in Hepatocellular Carcinoma Patients with Portal Vein Thrombus. Int J Radiat Oncol Biol Phys 2023; 117:e339-e340. [PMID: 37785186 DOI: 10.1016/j.ijrobp.2023.06.2399] [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) Hepatocellular carcinoma (HCC) is increasing in incidence worldwide with up to 60% of patients found to have a portal vein tumor thrombus at diagnosis. Recent studies demonstrated that high neutrophil-to-lymphocyte ratio (NLR) is associated with poorer survival in patients with hepatocellular carcinoma. Whether NLR can predict survival after local therapy, such as radiation (RT), is currently unknown. We, therefore, reviewed the patient outcomes with special focus on the type of therapies received. MATERIALS/METHODS This study is a retrospective review of HCC patients with portal vein thrombus from a single institution diagnosed between 2010 and 2022. Follow up time was defined as time from diagnosis to death or last follow up visit. Cox regression models were used to analyze overall survival (OS) rates. RESULTS One-hundred and forty-five patients met inclusion criteria. Median follow-up time was 4 months [interquartile range (IQR): 1.7 - 13 months]. Median NLR at diagnosis was 3.5 (IQR: 2.2-4.9). Forty patients received RT as part of their therapy. Higher NLR was associated with shorter survival (HR 1.10, 95% CI 1.04 - 1.17, p = 0.002). Treatment with RT improved OS (HR 0.55, 95% CI 0.35 - 0.86, p = 0.009). After controlling for NLR at diagnosis, the addition of radiation still provides survival benefit (HR 0.55, 95% CI 0.35 - 0.86, p = 0.01). In patients who received immunotherapy as the first systemic agent, RT improved OS (HR 0.47, 95% CI 0.22 - 1.01, p = 0.05). This improvement held even when controlling for NLR. In patients who received tyrosine kinase inhibitor (TKI) as first systemic agent, RT did not improve OS. However, when controlling for NLR in patients receiving TKI, RT did improve OS (HR 0.45, 95% CI 0.2 - 1.0, p = 0.05). CONCLUSION This retrospective, hypothesis-generating analysis suggests that NLR at diagnosis could predict OS benefit of RT addition in certain patients. These results could be due to the effect of radiation on the immune system; however, further studies are needed.
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Affiliation(s)
- K A Skalina
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - J M Jiang
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - A Kaubisch
- Department of Medical Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - C Guha
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - N Ohri
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - J Tang
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - R Kabarriti
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
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Andraos TY, Skalina KA, Feldman S, Mehta K, Tome WA, McEvoy MP, Gupta AM, Fox JL. Experience with intraoperative radiation therapy in an urban cancer center. Radiat Oncol 2023; 18:123. [PMID: 37491260 PMCID: PMC10367245 DOI: 10.1186/s13014-023-02299-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/15/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND/OBJECTIVE Intra-operative radiation therapy (IORT) is a newer partial breast irradiation technique that has been well studied in 2 large randomized trials, the TARGIT-A and ELIOT trials. We initiated our IORT program in 2018 in the context of a registry trial, and aim to report our early results thus far. METHODS We instituted an IORT practice using Intrabeam® low energy 50kVp x-rays for selected breast cancer cases in 2018. Patients were enrolled on our institutional registry protocol which allowed for IORT in ER + patients with grade 1-2 DCIS ≤ 2.5 cm or invasive disease ≤ 3.5 cm in patients of at least 45 years of age. RESULTS Between January 2018 and December 2021, 181 patients with clinical stage 0-IIA ER + breast cancer were evaluated. One hundred sixty-seven patients ultimately received IORT to 172 sites. The majority of patients received IORT at the time of initial diagnosis and surgery (160/167; 95.8%). Re-excision post IORT occurred in 16/167 patients (9.6%) due to positive margins. Adjuvant RT to the whole breast +/- LN was ultimately given to 23/167 (13.8%) patients mainly due to positive sentinel LN found on final pathology (12/23; 52%); other reasons were close margins for DCIS (3/23; 13%), tumor size (3/23; 4.3%), and multifactorial (5/23; 17.4%). Five patients (3%) had post-operative complications of wound dehiscence. There were 3 local recurrences (1.6%) at a median follow-up of 27.9 months (range: 0.7- 54.8 months). CONCLUSIONS IORT has been proven to be a safe and patient-centered form of local adjuvant RT for our population, in whom compliance with a longer course of external beam radiation can be an issue. Long term efficacy remains to be evaluated through continued follow up. In the era of COVID-19 and beyond, IORT has been an increasingly attractive option, as it greatly minimizes toxicities and patient visits to the clinic. TRIAL REGISTRATION All patients were prospectively enrolled on an institutional review board-approved registry trial (IRB number: 2018-9409).
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Affiliation(s)
- Therese Youssef Andraos
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karin A Skalina
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sheldon Feldman
- Department of Breast Surgical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Keyur Mehta
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Wolfgang A Tome
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Maureen P McEvoy
- Department of Breast Surgical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anjuli M Gupta
- Department of Breast Surgical Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jana L Fox
- Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
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Fels JM, Khan S, Forster R, Skalina KA, Sirichand S, Fox AS, Bergman A, Mitchell WB, Wolgast LR, Szymczak WA, Bortz RH, Dieterle ME, Florez C, Haslwanter D, Jangra RK, Laudermilch E, Wirchnianski AS, Barnhill J, Goldman DL, Khine H, Goldstein DY, Daily JP, Chandran K, Kelly L. Genomic surveillance of SARS-CoV-2 during the first year of the pandemic in the Bronx enabled clinical and epidemiological inference. Cold Spring Harb Mol Case Stud 2022; 8:mcs.a006211. [PMID: 35831070 PMCID: PMC9528964 DOI: 10.1101/mcs.a006211] [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: 03/18/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
The Bronx was an early epicenter of the COVID-19 pandemic in the USA. We conducted temporal genomic surveillance of 104 SARS-CoV-2 genomes across the Bronx from March October 2020. Although the local structure of SARS-CoV-2 lineages mirrored those of New York City and New York State, temporal sampling revealed a dynamic and changing landscape of SARS-CoV-2 genomic diversity. Mapping the trajectories of mutations, we found that while some became 'endemic' to the Bronx, other, novel mutations rose in prevalence in the late summer/early fall. Geographically resolved genomes enabled us to distinguish between cases of reinfection and persistent infection in two pediatric patients. We propose that limited, targeted, temporal genomic surveillance has clinical and epidemiological utility in managing the ongoing COVID pandemic.
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Affiliation(s)
| | | | | | - Karin A Skalina
- Montefiore Medical Center/Albert Einstein College of Medicine
| | | | - Amy S Fox
- Montefiore Medical Center/Albert Einstein College of Medicine
| | | | | | - Lucia R Wolgast
- Montefiore Medical Center/Albert Einstein College of Medicine
| | | | | | | | - Catalina Florez
- Albert Einstein College of Medicine and United States Military Academy at West Point
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Movahed-Ezazi M, Skalina KA, Parashar K, Manjila S, Vdovenko A, Iannuzzi C, Cartun RW. A Rare Presentation of Low-Grade Prostate Adenocarcinoma as Delayed Pineal Region Metastasis: A Case Report and Review of Multicenter Clinical Experience in Prostate Carcinoma Brain Metastases. J Neuropathol Exp Neurol 2021; 80:1128-1133. [PMID: 34388234 DOI: 10.1093/jnen/nlab081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Misha Movahed-Ezazi
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut, USA
| | - Karin A Skalina
- Department of Internal Medicine, St. Vincent's Medical Center, Bridgeport, Connecticut, USA
| | - Kalind Parashar
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, Connecticut, USA
| | - Sunil Manjila
- Department of Neurosurgery, Hospital of Central Connecticut, New Britain, Connecticut, USA
| | - Alexandre Vdovenko
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut, USA
| | - Christopher Iannuzzi
- Department of Radiation Oncology, St. Vincent's Medical Center, Bridgeport, Connecticut, USA
| | - Richard W Cartun
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut, USA
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Fels JM, Khan S, Forster R, Skalina KA, Sirichand S, Fox AS, Bergman A, Mitchell WB, Wolgast LR, Szymczak WA, Bortz RH, Dieterle ME, Florez C, Haslwanter D, Jangra RK, Laudermilch E, Wirchnianski AS, Barnhill J, Goldman DL, Khine H, Goldstein DY, Daily JP, Chandran K, Kelly L. Genomic surveillance of SARS-CoV-2 in the Bronx enables clinical and epidemiological inference. medRxiv 2021. [PMID: 33594384 PMCID: PMC7885943 DOI: 10.1101/2021.02.08.21250641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Bronx was an early epicenter of the COVID-19 pandemic in the USA. We conducted temporal genomic surveillance of SARS-CoV-2 genomes across the Bronx from March-October 2020. Although the local structure of SARS-CoV-2 lineages mirrored those of New York City and New York State, temporal sampling revealed a dynamic and changing landscape of SARS-CoV-2 genomic diversity. Mapping the trajectories of variants, we found that while some became ‘endemic’ to the Bronx, other, novel variants rose in prevalence in the late summer/early fall. Geographically resolved genomes enabled us to distinguish between cases of reinfection and persistent infection in two pediatric patients. We propose that limited, targeted, temporal genomic surveillance has clinical and epidemiological utility in managing the ongoing COVID pandemic. Temporally and geographically resolved sequencing of SARS-CoV-2 genotypes enabled surveillance of novel genotypes, identification of endemic viral variants, and clinical inferences, in the first wave of the COVID-19 pandemic in the Bronx.
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7
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Willcockson MA, Healton SE, Weiss CN, Bartholdy BA, Botbol Y, Mishra LN, Sidhwani DS, Wilson TJ, Pinto HB, Maron MI, Skalina KA, Toro LN, Zhao J, Lee CH, Hou H, Yusufova N, Meydan C, Osunsade A, David Y, Cesarman E, Melnick AM, Sidoli S, Garcia BA, Edelmann W, Macian F, Skoultchi AI. H1 histones control the epigenetic landscape by local chromatin compaction. Nature 2021; 589:293-298. [PMID: 33299182 PMCID: PMC8110206 DOI: 10.1038/s41586-020-3032-z] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 10/06/2020] [Indexed: 01/29/2023]
Abstract
H1 linker histones are the most abundant chromatin-binding proteins1. In vitro studies indicate that their association with chromatin determines nucleosome spacing and enables arrays of nucleosomes to fold into more compact chromatin structures. However, the in vivo roles of H1 are poorly understood2. Here we show that the local density of H1 controls the balance of repressive and active chromatin domains by promoting genomic compaction. We generated a conditional triple-H1-knockout mouse strain and depleted H1 in haematopoietic cells. H1 depletion in T cells leads to de-repression of T cell activation genes, a process that mimics normal T cell activation. Comparison of chromatin structure in normal and H1-depleted CD8+ T cells reveals that H1-mediated chromatin compaction occurs primarily in regions of the genome containing higher than average levels of H1: the chromosome conformation capture (Hi-C) B compartment and regions of the Hi-C A compartment marked by PRC2. Reduction of H1 stoichiometry leads to decreased H3K27 methylation, increased H3K36 methylation, B-to-A-compartment shifting and an increase in interaction frequency between compartments. In vitro, H1 promotes PRC2-mediated H3K27 methylation and inhibits NSD2-mediated H3K36 methylation. Mechanistically, H1 mediates these opposite effects by promoting physical compaction of the chromatin substrate. Our results establish H1 as a critical regulator of gene silencing through localized control of chromatin compaction, 3D genome organization and the epigenetic landscape.
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Affiliation(s)
| | - Sean E Healton
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Cary N Weiss
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Boris A Bartholdy
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Yair Botbol
- Department of Pathology, Albert Einstein College of Medicine, New York, NY, USA
| | - Laxmi N Mishra
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Dhruv S Sidhwani
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Tommy J Wilson
- Department of Neurology, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Hugo B Pinto
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Maxim I Maron
- Department of Biochemistry, Albert Einstein College of Medicine, New York, NY, USA
| | - Karin A Skalina
- Department of Pathology, Albert Einstein College of Medicine, New York, NY, USA
| | - Laura Norwood Toro
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jie Zhao
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Chul-Hwan Lee
- Department of Biochemistry and Molecular Pharmacology, NYU School of Medicine, New York, NY, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
- Department of Pharmacology, Seoul National University College of Medicine, Seoul, Korea
| | - Harry Hou
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Nevin Yusufova
- Cell & Molecular Biology Graduate Program, Weill Cornell Medicine, New York, NY, USA
- Division of Hematology/Oncology, Department of Medicine, Biochemistry, Weill Cornell Medicine, New York, NY, USA
| | - Cem Meydan
- Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Adewola Osunsade
- Chemical Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Tri-Institutional PhD Program in Chemical Biology, New York, NY, USA
| | - Yael David
- Chemical Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Tri-Institutional PhD Program in Chemical Biology, New York, NY, USA
| | - Ethel Cesarman
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Ari M Melnick
- Division of Hematology/Oncology, Department of Medicine, Biochemistry, Weill Cornell Medicine, New York, NY, USA
| | - Simone Sidoli
- Department of Biochemistry and Molecular Biophysics, Perelman School of Medicine, University of Pennsylvania, Smilow Center for Translational Research, Philadelphia, PA, USA
- Department of Biochemistry, Albert Einstein College of Medicine, New York, NY, USA
| | - Benjamin A Garcia
- Department of Biochemistry and Molecular Biophysics, Perelman School of Medicine, University of Pennsylvania, Smilow Center for Translational Research, Philadelphia, PA, USA
| | - Winfried Edelmann
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
| | - Fernando Macian
- Department of Pathology, Albert Einstein College of Medicine, New York, NY, USA
| | - Arthur I Skoultchi
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA.
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8
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Skalina KA, Goldstein DY, Sulail J, Hahm E, Narlieva M, Szymczak W, Fox AS. Extended storage of SARS-CoV-2 nasopharyngeal swabs does not negatively impact results of molecular-based testing across three clinical platforms. J Clin Pathol 2020; 75:61-64. [PMID: 33144357 PMCID: PMC8685649 DOI: 10.1136/jclinpath-2020-206738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 01/19/2023]
Abstract
With the global outbreak of COVID-19, the demand for testing rapidly increased and quickly exceeded the testing capacities of many laboratories. Clinical tests which receive CE (Conformité Européenne) and Food and Drug Administration (FDA) authorisations cannot always be tested thoroughly in a real-world environment. Here we demonstrate the long-term stability of nasopharyngeal swab specimens for SARS-CoV-2 molecular testing across three assays recently approved by the US FDA under Emergency Use Authorization. This study demonstrates that nasopharyngeal swab specimens can be stored under refrigeration or even ambient conditions for 21 days without clinically impacting the results of the real-time reverse transcriptase-PCR testing.
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Affiliation(s)
- Karin A Skalina
- Pathology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - D Y Goldstein
- Pathology, Montefiore Medical Center, Bronx, New York, USA
| | - Jaffar Sulail
- Pathology, Montefiore Medical Center, Bronx, New York, USA
| | - Eunkyu Hahm
- Pathology, Montefiore Medical Center, Bronx, New York, USA
| | - Momka Narlieva
- Pathology, Montefiore Medical Center, Bronx, New York, USA
| | - Wendy Szymczak
- Pathology, Montefiore Medical Center, Bronx, New York, USA
| | - Amy S Fox
- Pathology, Montefiore Medical Center, Bronx, New York, USA
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9
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Skalina KA, Singh S, Chavez CG, Macian F, Guha C. Low Intensity Focused Ultrasound (LOFU)-mediated Acoustic Immune Priming and Ablative Radiation Therapy for in situ Tumor Vaccines. Sci Rep 2019; 9:15516. [PMID: 31664044 PMCID: PMC6820551 DOI: 10.1038/s41598-019-51332-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 09/03/2018] [Accepted: 09/17/2019] [Indexed: 12/31/2022] Open
Abstract
Focal ablative therapies have been primarily used for local tumor ablation. However, they often fail to impact systemic disease. Here we propose the use of low intensity focused ultrasound (LOFU), a noninvasive, nontoxic, conformal therapy, to deliver acoustic stress to the tumor for immune priming. We demonstrate that LOFU significantly induces expression and cell surface localization of heat shock proteins in murine breast (4T1) and prostate adenocarcinoma (TPSA23) cancer cell lines. In vivo LOFU followed by ablative radiation therapy (RT) results in primary tumor cure, upregulation of a cytotoxic immune response and induction of immunological memory by inhibiting secondary tumor growth upon re-challenge with tumor cells. We, therefore, describe a regimen of a combination therapy with noninvasive, acoustic immune priming and ablative radiation therapy to generate an in situ tumor vaccine, induce CD8+ T cells against tumor-associated antigens and provide a viable oncologic treatment option for solid tumors.
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Affiliation(s)
- Karin A Skalina
- Departments of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Saurabh Singh
- Radiation Oncology, Albert Einstein College of Medicine & Montefiore Medical Center, Bronx, NY, USA.,Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Claudia Gutierrez Chavez
- Radiation Oncology, Albert Einstein College of Medicine & Montefiore Medical Center, Bronx, NY, USA.,Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Fernando Macian
- Departments of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Chandan Guha
- Departments of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA. .,Urology, Albert Einstein College of Medicine & Montefiore Medical Center, Bronx, NY, USA. .,Radiation Oncology, Albert Einstein College of Medicine & Montefiore Medical Center, Bronx, NY, USA. .,Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA.
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10
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Skalina KA, Ramesh M. A case of allergic contact dermatitis caused by Disperse Blue dye in ultrasound gel. Contact Dermatitis 2018; 79:175-176. [DOI: 10.1111/cod.13014] [Citation(s) in RCA: 3] [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: 03/18/2018] [Accepted: 03/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - Manish Ramesh
- Division of Allergy and Immunology, Department of Medicine; Montefiore Medical Center; Bronx New York
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