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Wachtel H, Dickson P, Fisher SB, Kiernan CM, Solórzano CC. Adrenal Metastasectomy in the Era of Immuno- and Targeted Therapy. Ann Surg Oncol 2023:10.1245/s10434-023-13474-8. [PMID: 37079202 DOI: 10.1245/s10434-023-13474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/26/2023] [Indexed: 04/21/2023]
Abstract
Adrenal metastasectomy has an increasing role in multimodality oncologic care for diverse primary cancer types. In this review, we discuss the epidemiology, evaluation, and contemporary best practices in the management of adrenal metastases from various primaries. Initial evaluation of suspected adrenal metastases should include diagnostic imaging to assess the extent of tumor involvement and determine surgical resectability, as well as biochemical evaluation for hormone secretion. Biopsy has a minimal role and should only be performed in tumors that are established to be non-hormone secreting and when the biopsy results would change clinical management. Adrenal metastasectomy is associated with survival benefit in selected patients. We suggest that adrenal metastasectomy has the greatest benefit in four clinical scenarios: (1) disease limited to the adrenal gland in which adrenalectomy renders the patient disease-free; (2) isolated progression in the adrenal gland in the setting of otherwise controlled metastatic extra-adrenal disease; (3) need for palliation of symptoms related to adrenal metastases; or (4) in the context of tissue-based clinical trials. Both minimally invasive and open adrenalectomy techniques are safe and appear to have equivalent oncologic outcomes. Minimally invasive approaches are favored when technically feasible while maintaining oncologic principles. A multidisciplinary evaluation including clinicians with expertise in the primary cancer type is essential to the successful management of adrenal metastases.
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Affiliation(s)
- Heather Wachtel
- Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | - Paxton Dickson
- Division of Surgical Oncology, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sarah B Fisher
- Division of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Colleen M Kiernan
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Carmen C Solórzano
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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Haddad RI, Bischoff L, Ball D, Bernet V, Blomain E, Busaidy NL, Campbell M, Dickson P, Duh QY, Ehya H, Goldner WS, Guo T, Haymart M, Holt S, Hunt JP, Iagaru A, Kandeel F, Lamonica DM, Mandel S, Markovina S, McIver B, Raeburn CD, Rezaee R, Ridge JA, Roth MY, Scheri RP, Shah JP, Sipos JA, Sippel R, Sturgeon C, Wang TN, Wirth LJ, Wong RJ, Yeh M, Cassara CJ, Darlow S. Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022; 20:925-951. [PMID: 35948029 DOI: 10.6004/jnccn.2022.0040] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Differentiated thyroid carcinomas is associated with an excellent prognosis. The treatment of choice for differentiated thyroid carcinoma is surgery, followed by radioactive iodine ablation (iodine-131) in select patients and thyroxine therapy in most patients. Surgery is also the main treatment for medullary thyroid carcinoma, and kinase inhibitors may be appropriate for select patients with recurrent or persistent disease that is not resectable. Anaplastic thyroid carcinoma is almost uniformly lethal, and iodine-131 imaging and radioactive iodine cannot be used. When systemic therapy is indicated, targeted therapy options are preferred. This article describes NCCN recommendations regarding management of medullary thyroid carcinoma and anaplastic thyroid carcinoma, and surgical management of differentiated thyroid carcinoma (papillary, follicular, Hürthle cell carcinoma).
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Affiliation(s)
| | | | - Douglas Ball
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | - Paxton Dickson
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Quan-Yang Duh
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | | | - Shelby Holt
- UT Southwestern Simmons Comprehensive Cancer Center
| | - Jason P Hunt
- Huntsman Cancer Institute at the University of Utah
| | | | | | | | - Susan Mandel
- Abramson Cancer Center at the University of Pennsylvania
| | - Stephanie Markovina
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Rod Rezaee
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Mara Y Roth
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | - Jennifer A Sipos
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Cord Sturgeon
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Michael Yeh
- UCLA Jonsson Comprehensive Cancer Center; and
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Haddad RI, Nasr C, Bischoff L, Busaidy NL, Byrd D, Callender G, Dickson P, Duh QY, Ehya H, Goldner W, Haymart M, Hoh C, Hunt JP, Iagaru A, Kandeel F, Kopp P, Lamonica DM, McIver B, Raeburn CD, Ridge JA, Ringel MD, Scheri RP, Shah JP, Sippel R, Smallridge RC, Sturgeon C, Wang TN, Wirth LJ, Wong RJ, Johnson-Chilla A, Hoffmann KG, Gurski LA. NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018. J Natl Compr Canc Netw 2019; 16:1429-1440. [PMID: 30545990 DOI: 10.6004/jnccn.2018.0089] [Citation(s) in RCA: 199] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The NCCN Guidelines for Thyroid Carcinoma provide recommendations for the management of different types of thyroid carcinoma, including papillary, follicular, Hürthle cell, medullary, and anaplastic carcinomas. These NCCN Guidelines Insights summarize the panel discussion behind recent updates to the guidelines, including the expanding role of molecular testing for differentiated thyroid carcinoma, implications of the new pathologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features, and the addition of a new targeted therapy option for BRAF V600E-mutated anaplastic thyroid carcinoma.
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Tran Mau-Them F, Guibaud L, Duplomb L, Keren B, Lindstrom K, Marey I, Mochel F, van den Boogaard MJ, Oegema R, Nava C, Masurel A, Jouan T, Jansen FE, Au M, Chen AH, Cho M, Duffourd Y, Lozier E, Konovalov F, Sharkov A, Korostelev S, Urteaga B, Dickson P, Vera M, Martínez-Agosto JA, Begemann A, Zweier M, Schmitt-Mechelke T, Rauch A, Philippe C, van Gassen K, Nelson S, Graham JM, Friedman J, Faivre L, Lin HJ, Thauvin-Robinet C, Vitobello A. De novo truncating variants in the intronless IRF2BPL are responsible for developmental epileptic encephalopathy. Genet Med 2018; 21:1008-1014. [DOI: 10.1038/s41436-018-0143-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/13/2018] [Indexed: 02/06/2023] Open
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Weatherall T, Denbo J, Sharpe J, Martin M, O'Brien T, Gupta R, Groshart K, Behrman S, Dickson P. Well-Differentiated, Non-Functional, Non-Ampullary Duodenal Neuroendocrine Tumors: Toward Defining Evaluation and Management. World J Surg 2017; 41:844-850. [PMID: 27743074 DOI: 10.1007/s00268-016-3770-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Nonfunctional, non-ampullary duodenal neuroendocrine tumors (dNETs) are rare neoplasms, and specific treatment recommendations are less clear than for other NETs. MATERIALS AND METHODS We performed a retrospective review of patients (pts) with a diagnosis of dNET, excluding hormonally functional, ampullary, and high-grade tumors. Clinical data were evaluated to identify factors that might impact clinical staging and predictors of metastases. RESULTS Thirty-six pts were identified. Surgical resection was performed in 28 and endoscopic resection in 8. LNs were included in specimens of 19/28 (68 %) pts who underwent surgical resection (median #LNs 5, range 1-12). Of these 19 pts, 5 (26 %) were found to be LN+. Of LN+ pts, all had tumors ≤2 cm. When compared to LN- pts, LN+ pts were more likely to have muscularis propria (MP) invasion (80 vs. 23 %, p = 0.04). Tumor size, tumor grade, lymphovascular invasion, and multifocality were similar between LN+ and LN- patients. No pt was found to have distant metastases. Heterogeneity in clinical staging modalities and small number of pts evaluated prohibited meaningful analysis of most appropriate preoperative imaging. At a median follow-up of 25 months (range 9-139), no patient developed recurrence or experienced disease-specific death. CONCLUSIONS Non-functional, non-ampullary dNETs, particularly those with MP invasion, have a propensity to metastasize to regional LNs. However, these neoplasms appear to have a favorable prognosis. Further evaluation of preoperative imaging is required to better determine most appropriate clinical staging. A suggested workup and management strategy for prospective evaluation is proposed.
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Affiliation(s)
- Timothy Weatherall
- Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA
| | - Jason Denbo
- Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA
| | - John Sharpe
- Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA
| | - Michael Martin
- Division of Hematology/Oncology, University of Tennessee Health Science Center, Memphis, TN, USA.,West Cancer Center, 7945 Wolf River Blvd, Germantown, TN, 38138, USA
| | - Thomas O'Brien
- Memphis Pathology Group, 1211 Union Avenue, Suite 300, Memphis, TN, 38104, USA
| | - Rajib Gupta
- Department of Pathology, University of Tennessee Health Science Center, 930 Madison Ave, 5th Floor, Memphis, TN, 38163, USA
| | - Kenneth Groshart
- Pathology Group of the Midsouth, 6019 Walnut Grove Rd, Memphis, TN, 38120, USA
| | - Stephen Behrman
- Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA
| | - Paxton Dickson
- Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA.
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Abstract
Improved oncological outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in highly selected patients have been well documented. The extensive nature of the procedure adversely affects quality of life (QoL). The aim of this study is to longitudinally evaluate QoL following CRS/HIPEC. This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC. Clinicopathological data, oncologic outcomes, and QoL were analyzed preoperatively and post-operatively at 2 weeks, and 1, 3, 6, and 12 months. The Functional Assessment of Cancer Therapy-Colorectal instrument was used to determine changes in QoL after CRS/HIPEC and the impact of early recurrence (<12 months) on QoL. Thirty-six patients underwent CRS/HIPEC over 36 months. The median peritoneal cancer index score was 18 and the completeness of cytoreduction-0/1 rate was 97.2 per cent. Postoperative major morbidity was 16.7 per cent with one perioperative death. Disease-free survival was 12.6 months in patients with high-grade tumors versus 31.0 months in those with low-grade tumors (P = 0.03). QoL decreased postoperatively and improved to baseline in six months. Patients with early recurrence had a decrease in global QoL compared with preoperative QoL at 6 (P < 0.03) and 12 months (P < 0.05). This correlation was not found in patients who had not recurred. Patients who undergo CRS/HIPEC have a decrease in QoL that plateaus in 3 to 6 months. Early recurrence adversely impacts QoL at 6 and 12 months. This study emphasizes the importance of patient selection for CRS/HIPEC. The expected QoL trajectory in patients at risk for early recurrence must be carefully weighed against the potential oncological benefit of CRS/HIPEC.
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Affiliation(s)
- Nathan M. Hinkle
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Vandana Botta
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; and
| | - John P. Sharpe
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Paxton Dickson
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Jeremiah Deneve
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Gitonga Munene
- Western Michigan University Homer Stryker School of Medicine/West Michigan Cancer Center, Kalamazoo, Michigan
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Hinkle NM, MacDonald J, Sharpe JP, Dickson P, Deneve J, Munene G. Cytoreduction with hyperthermic intraperitoneal chemotherapy: an appraisal of outcomes and cost at a newly established peritoneal malignancy program. Am J Surg 2016; 212:413-8. [DOI: 10.1016/j.amjsurg.2016.01.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 01/04/2016] [Accepted: 01/06/2016] [Indexed: 01/28/2023]
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Haddad RI, Lydiatt WM, Ball DW, Busaidy NL, Byrd D, Callender G, Dickson P, Duh QY, Ehya H, Haymart M, Hoh C, Hunt JP, Iagaru A, Kandeel F, Kopp P, Lamonica DM, McCaffrey JC, Moley JF, Parks L, Raeburn CD, Ridge JA, Ringel MD, Scheri RP, Shah JP, Smallridge RC, Sturgeon C, Wang TN, Wirth LJ, Hoffmann KG, Hughes M. Anaplastic Thyroid Carcinoma, Version 2.2015. J Natl Compr Canc Netw 2016; 13:1140-50. [PMID: 26358798 DOI: 10.6004/jnccn.2015.0139] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Thyroid Carcinoma focuses on anaplastic carcinoma because substantial changes were made to the systemic therapy recommendations for the 2015 update. Dosages and frequency of administration are now provided, docetaxel/doxorubicin regimens were added, and single-agent cisplatin was deleted because it is not recommended for patients with advanced or metastatic anaplastic thyroid cancer.
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Calton M, Dickson P, Harper RM, Goldowitz D, Mittleman G. Impaired hypercarbic and hypoxic responses from developmental loss of cerebellar Purkinje neurons: implications for sudden infant death syndrome. Cerebellum 2015; 13:739-50. [PMID: 25132500 DOI: 10.1007/s12311-014-0592-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Impaired responsivity to hypercapnia or hypoxia is commonly considered a mechanism of failure in sudden infant death syndrome (SIDS). The search for deficient brain structures mediating flawed chemosensitivity typically focuses on medullary regions; however, a network that includes Purkinje cells of the cerebellar cortex and its associated cerebellar nuclei also helps mediate responses to carbon dioxide (CO2) and oxygen (O2) challenges and assists integration of cardiovascular and respiratory interactions. Although cerebellar nuclei contributions to chemoreceptor challenges in adult models are well described, Purkinje cell roles in developing models are unclear. We used a model of developmental cerebellar Purkinje cell loss to determine if such loss influenced compensatory ventilatory responses to hypercapnic and hypoxic challenges. Twenty-four Lurcher mutant mice and wild-type controls were sequentially exposed to 2% increases in CO2 (0-8%) or 2% reductions in O2 (21-13%) over 4 min, with return to room air (21% O2/79% N2/0% CO2) between each exposure. Whole body plethysmography was used to continuously monitor tidal volume (TV) and breath frequency (f). Increased f to hypercapnia was significantly lower in mutants, slower to initiate, and markedly lower in compensatory periods, except for very high (8%) CO2 levels. The magnitude of TV changes to increasing CO2 appeared smaller in mutants but only approached significance. Smaller but significant differences emerged in response to hypoxia, with mutants showing smaller TV when initially exposed to reduced O2 and lower f following exposure to 17% O2. Since cerebellar neuropathology appears in SIDS victims, developmental cerebellar neuropathology may contribute to SIDS vulnerability.
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Affiliation(s)
- M Calton
- Department of Psychology, The University of Memphis, 400 Innovation Drive, Memphis, TN, 38152, USA
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Tuttle RM, Haddad RI, Ball DW, Byrd D, Dickson P, Duh QY, Ehya H, Haymart M, Hoh C, Hunt JP, Iagaru A, Kandeel F, Kopp P, Lamonica DM, Lydiatt WM, McCaffrey J, Moley JF, Parks L, Raeburn CD, Ridge JA, Ringel MD, Scheri RP, Shah JP, Sherman SI, Sturgeon C, Waguespack SG, Wang TN, Wirth LJ, Hoffmann KG, Hughes M. Thyroid carcinoma, version 2.2014. J Natl Compr Canc Netw 2014; 12:1671-80; quiz 1680. [PMID: 25505208 DOI: 10.6004/jnccn.2014.0169] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
These NCCN Guidelines Insights focus on some of the major updates to the 2014 NCCN Guidelines for Thyroid Carcinoma. Kinase inhibitor therapy may be used to treat thyroid carcinoma that is symptomatic and/or progressive and not amenable to treatment with radioactive iodine. Sorafenib may be considered for select patients with metastatic differentiated thyroid carcinoma, whereas vandetanib or cabozantinib may be recommended for select patients with metastatic medullary thyroid carcinoma. Other kinase inhibitors may be considered for select patients with either type of thyroid carcinoma. A new section on "Principles of Kinase Inhibitor Therapy in Advanced Thyroid Cancer" was added to the NCCN Guidelines to assist with using these novel targeted agents.
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Affiliation(s)
- R Michael Tuttle
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Robert I Haddad
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Douglas W Ball
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - David Byrd
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Paxton Dickson
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Quan-Yang Duh
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Hormoz Ehya
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Megan Haymart
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Carl Hoh
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Jason P Hunt
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Andrei Iagaru
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Fouad Kandeel
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Peter Kopp
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Dominick M Lamonica
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - William M Lydiatt
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Judith McCaffrey
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Jeffrey F Moley
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Lee Parks
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Christopher D Raeburn
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - John A Ridge
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Matthew D Ringel
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Randall P Scheri
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Jatin P Shah
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Steven I Sherman
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Cord Sturgeon
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Steven G Waguespack
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Thomas N Wang
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Lori J Wirth
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Karin G Hoffmann
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
| | - Miranda Hughes
- From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network
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Nelson J, Deneve J, Dickson P, Sylvestre P, Munene G. Management of a ruptured mucinous mesenteric cyst with hyperthermic intraperitoneal chemotherapy. Tumori 2014. [PMID: 24852878 DOI: 10.1700/1491.16439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Mesenteric cysts are rare intra-abdominal cysts that are generally regarded as benign, and the incidence of malignancy is often cited to be 3%. The typical recommendation for treatment is complete excision to minimize recurrence. Excision can be performed laparoscopically, but this can lead to intra-abdominal dissemination of the cyst contents. There has been one case report describing the development of pseudomyxoma peritonei following rupture of a mesenteric cyst. We describe the treatment and outcome of a patient who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for the treatment of an incompletely resected mucinous cystadenocarcinoma originating from the colonic mesentery.
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Pandey M, Sutton GR, Portnoy DC, Tauer KW, Schwartzberg LS, Dickson P, Martin MG. Relationship of grade to prognosis in localized primary angiosarcoma of the breast (PAOB). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.10559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Manjari Pandey
- The University of Tennessee Health Science Center/The West Clinic, Memphis, TN
| | | | - David Craig Portnoy
- The University of Tennessee Health Science Center/The West Clinic, Memphis, TN
| | | | | | - Paxton Dickson
- The University of Tennessee Health Science Center, Memphis, TN
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Wiedower E, Chandler JC, Pallera AM, Johnson RA, Munene G, Dickson P, Deneve JL, Fleming MD, Tauer KW, Schwartzberg LS, Martin MG. Effect of rituximab on outcomes in gastric B-cell lymphomas and on early mortality in gastric DLBCL. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e19501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Eric Wiedower
- University of Tennessee/The West Clinic, Memphis, TN
| | | | | | | | | | - Paxton Dickson
- The University of Tennessee Health Science Center, Memphis, TN
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14
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Nelson J, Deneve J, Dickson P, Sylvestre P, Munene G. Management of a Ruptured Mucinous Mesenteric Cyst with Hyperthermic Intraperitoneal Chemotherapy. Tumori 2014; 100:e55-8. [DOI: 10.1177/030089161410000226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mesenteric cysts are rare intra-abdominal cysts that are generally regarded as benign, and the incidence of malignancy is often cited to be 3%. The typical recommendation for treatment is complete excision to minimize recurrence. Excision can be performed laparoscopically, but this can lead to intra-abdominal dissemination of the cyst contents. There has been one case report describing the development of pseudomyxoma peritonei following rupture of a mesenteric cyst. We describe the treatment and outcome of a patient who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for the treatment of an incompletely resected mucinous cystadenocarcinoma originating from the colonic mesentery.
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Affiliation(s)
- John Nelson
- Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jeremiah Deneve
- Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Paxton Dickson
- Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Pamela Sylvestre
- Department of Pathology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Gitonga Munene
- Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA
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15
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Dickson P, Bell D, Scholfield N, Johnson C. P5.4 Contribution of NPY Y1 and NPY Y2 receptors to sympathetic vasoconstriction in the diabetic streptozotocin-treated rat tail artery at two time points. Auton Neurosci 2009. [DOI: 10.1016/j.autneu.2009.05.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tolar J, Dickson P, Orchard P. Intravenous and Intrathecal Enzyme Replacement Before and After Hematopoietic Cell Transplantation for Hurler Syndrome. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hamner JB, Dickson P, Gaber MW, Ng C, Zhou J, Davidoff A. Continuous delivery of IFN-beta sensitizes human gliomas to ionizing radiation. J Am Coll Surg 2006. [DOI: 10.1016/j.jamcollsurg.2006.05.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tiranti V, Briem E, Lamantea E, Mineri R, Papaleo E, De Gioia L, Forlani F, Rinaldo P, Dickson P, Abu-Libdeh B, Cindro-Heberle L, Owaidha M, Jack RM, Christensen E, Burlina A, Zeviani M. ETHE1 mutations are specific to ethylmalonic encephalopathy. J Med Genet 2005; 43:340-6. [PMID: 16183799 PMCID: PMC2563233 DOI: 10.1136/jmg.2005.036210] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Mutations in ETHE1, a gene located at chromosome 19q13, have recently been identified in patients affected by ethylmalonic encephalopathy (EE). EE is a devastating infantile metabolic disorder, characterised by widespread lesions in the brain, hyperlactic acidaemia, petechiae, orthostatic acrocyanosis, and high levels of ethylmalonic acid in body fluids. To investigate to what extent ETHE1 is responsible for EE, we analysed this gene in 29 patients with typical EE and in 11 patients presenting with early onset progressive encephalopathy with ethylmalonic aciduria (non-EE EMA). Frameshift, stop, splice site, and missense mutations of ETHE1 were detected in all the typical EE patients analysed. Western blot analysis of the ETHE1 protein indicated that some of the missense mutations are associated with the presence of the protein, suggesting that the corresponding wild type amino acid residues have a catalytic function. No ETHE1 mutations were identified in non-EE EMA patients. Experiments based on two dimensional blue native electrophoresis indicated that ETHE1 protein works as a supramolecular, presumably homodimeric, complex, and a three dimensional model of the protein suggests that it is likely to be a mitochondrial matrix thioesterase acting on a still unknown substrate. Finally, the 625G-->A single nucleotide polymorphism in the gene encoding the short chain acyl-coenzyme A dehydrogenase (SCAD) was previously proposed as a co-factor in the aetiology of EE and other EMA syndromes. SNP analysis in our patients ruled out a pathogenic role of SCAD variants in EE, but did show a highly significant prevalence of the 625A alleles in non-EE EMA patients.
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Affiliation(s)
- V Tiranti
- Unit of Molecular Neurogenetics, Pierfranco and Luisa Mariani Center for the Study ofChildren's Mitochondrial Disorders, National Neurological Institute C. Besta, Via Temolo 4, 20126 Milan, Italy
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Kakkis E, McEntee M, Vogler C, Le S, Levy B, Belichenko P, Mobley W, Dickson P, Hanson S, Passage M. Intrathecal enzyme replacement therapy reduces lysosomal storage in the brain and meninges of the canine model of MPS I. Mol Genet Metab 2004; 83:163-74. [PMID: 15464431 DOI: 10.1016/j.ymgme.2004.07.003] [Citation(s) in RCA: 135] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2004] [Revised: 07/05/2004] [Accepted: 07/07/2004] [Indexed: 11/19/2022]
Abstract
Enzyme replacement therapy (ERT) has been developed for several lysosomal storage disorders, including mucopolysaccharidosis I (MPS I), and is effective at reducing lysosomal storage in many tissues and in ameliorating clinical disease. However, intravenous ERT does not adequately treat storage disease in the central nervous system (CNS), presumably due to effects of the blood-brain barrier on enzyme distribution. To circumvent this barrier, we studied whether intrathecal (IT) recombinant human alpha-L-iduronidase (rhIDU) could penetrate and treat the brain and meninges. An initial dose-response study showed that doses of 0.46-4.14 mg of IT rhIDU successfully penetrated the brain of normal dogs and reached tissue levels 5.6 to 18.9-fold normal overall and 2.7 to 5.9-fold normal in deep brain sections lacking CSF contact. To assess the efficacy and safety in treating lysosomal storage disease, four weekly doses of approximately 1 mg of IT rhIDU were administered to MPS I-affected dogs resulting in a mean 23- and 300-fold normal levels of iduronidase in total brain and meninges, respectively. Quantitative glycosaminoglycan (GAG) analysis showed that the IT treatment reduced mean total brain GAG to normal levels and achieved a 57% reduction in meningeal GAG levels accompanied by histologic improvement in lysosomal storage in all cell types. The dogs did develop a dose-dependent immune response against the recombinant human protein and a meningeal lymphocytic/plasmacytic infiltrate. The IT route of ERT administration may be an effective way to treat the CNS disease in MPS I and could be applicable to other lysosomal storage disorders.
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Affiliation(s)
- E Kakkis
- Division of Medical Genetics, Department of Pediatrics, Harbor-UCLA Research and Education Institute, Torrance CA, USA.
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Dickson P, Greasley P, Small N. The Bradford salaried non-principal scheme: addressing the problems of GP recruitment and retention in the inner city – it's not just the money but the support. Prim Health Care Res Dev 2002. [DOI: 10.1191/1463423602pc096oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Dickson P. Passage of the lines. Army Q Def J 2001; 112:199-204. [PMID: 11614229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Tsaroucha A, Webb M, Karatzas T, Dickson P, Demirbas A, Fragulidis G, Nery J, Khan F, Tzakis A. Management of allograft-replaced right hepatic arteries in liver transplantation: a review of the University of Miami experience and a preferred method of reconstruction. Transplant Proc 1997; 29:2856-8. [PMID: 9365591 DOI: 10.1016/s0041-1345(97)00707-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- A Tsaroucha
- University of Miami School of Medicine, Department of Surgery, FL, USA
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23
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Kamitani A, Wong ZY, Dickson P, van Herwerden L, Raven J, Forbes AB, Abramson MJ, Walters EH, Harrap SB. Absence of genetic linkage of chromosome 5q31 with asthma and atopy in the general population. Thorax 1997; 52:816-7. [PMID: 9371215 PMCID: PMC1758647 DOI: 10.1136/thx.52.9.816] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Clinical asthma is associated with increased serum total immunoglobulin E (IgE), atopy (skin prick test positivity to common aeroallergens), and bronchial hyperreactivity (BHR) to non-specific stimuli (positive methacholine challenge test). A region on chromosome 5q31-33 has been linked with increased total serum IgE and BHR. A study of the genetic linkage of this region with clinical asthma and atopy was therefore undertaken. METHODS A polymorphic microsatellite marker in chromosome 5q31 (D5S399) was studied in 119 sibling pairs recruited from the general population who shared asthma, atopy, and/or BHR. Based on our population distribution of 13 different alleles, it was expected that by chance alone sibling pairs would share on average 1.24 alleles and that a significant excess would indicate genetic linkage. RESULTS No evidence of linkage was found in 45 siblings concordant for asthma (shared alleles = 1.09, p = 0.95), in 103 sibling pairs with atopy (shared alleles = 1.18, p = 0.82), in 51 sibling pairs with BHR (shared alleles = 1.22, p = 0.62), or in 68 sibling pairs who shared atopy in the absence of BHR (shared alleles = 1.22, p = 0.61). A slight non-significant excess of shared alleles (1.44, p = 0.11) was observed in siblings who shared BHR without atopy. CONCLUSIONS No evidence of genetic linkage of chromosome 5q31 with either clinical asthma or atopy was therefore detected in the population studied. Linkage between chromosome 5q and BHR needs further investigation.
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Affiliation(s)
- A Kamitani
- Department of Physiology, University of Melbourne, Parkville, Victoria, Australia
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Abstract
Duodenal administration of casein and oleate increased plasma levels from oral administration of a poorly water-soluble antiepileptic drug as compared to duodenal glucose and saline in a canine model. Pre-treatment with intravenous MK-329, benzodiazepine CCK A-receptor antagonist, blocked the duodenal oleate effect on drug plasma levels in a single dog preliminary study. In a follow-up study, oral drug co-administration with Intralipid increased drug plasma levels as compared to drug co-administration with a noncaloric equivalent-volume load in seven dogs. Pre-treatment with MK-329 reduced drug plasma levels from co-administration with Intralipid toward fasted-state values. While increased drug solubility in the lipid vehicle might have been projected to account for the fed-state effect in the oral studies, the gut peptide inhibitor studies suggest that biliary secretion plays a major role in promoting the dissolution and subsequent absorption of this lipophilic drug. The data also support the hypothesis that meal-enhanced pancreatic secretion provides a greater fluid volume for drug dissolution in the small intestine. An increase in the extent of drug dissolution in the stomach, as a result of meal prolongation of gastric residence time, does not appear to contribute substantially to fed-state increases in drug plasma levels from oral drug co-administration with a lipid meal.
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Affiliation(s)
- C Miles
- College of Pharmacy, University of Michigan, Ann Arbor 48109-1065, USA
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Abstract
Constant light exposure (LL) can result in "splitting" of circadian rhythms into two components coupled about 12 hr apart. Splitting has been interpreted as evidence for the presence of two main oscillators or groups of oscillators underlying circadian rhythms. Abolition of splitting after unilateral suprachiasmatic nucleus ablation suggested that each suprachiasmatic nucleus could correspond to one of these component oscillators. We examined whether lesions outside the suprachiasmatic nuclei (SCN) would abolish split activity rhythms of hamsters in LL. Wheel-running activity was recorded for 3 months after surgery. Tissue damage was assessed by Klüver-Barrera staining. Damage to areas dorso-caudal to the SCN was able to abolish the split condition. Bilateral damage to the anterior SCN, partial unilateral SCN ablation or unilateral periventricular damage also abolished the split pattern. These results indicate that destruction of one SCN is not essential for the elimination of split rhythms since lesions dorsal to the SCN or partial bilateral SCN damage are also effective. Indirect lesion effects on SCN function or damage to extra-SCN oscillators may account for the loss of the split condition.
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Affiliation(s)
- M E Harrington
- Department of Psychology, Dalhousie University, Halifax, Canada
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Blouin RA, Dickson P, McNamara PJ, Cibull M, McClain C. Phenobarbital induction and acetaminophen hepatotoxicity: resistance in the obese Zucker rodent. J Pharmacol Exp Ther 1987; 243:565-70. [PMID: 3681696] [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: 01/06/2023] Open
Abstract
The obese Zucker rodent appears to lack a significant induction response after phenobarbital pretreatment. Induction of the hepatic cytochrome P-450 system with phenobarbital is known to enhance acetaminophen hepatotoxicity. The purpose of this study was to evaluate the influence of phenobarbital enzyme induction on acetaminophen hepatotoxicity in the obese and lean Zucker rodent. A preliminary study was performed evaluating the pharmacokinetics of acetaminophen in both the obese and lean Zucker rats. Data were utilized to calculate appropriate loading doses of acetaminophen during the subsequent hepatotoxicity study. Phenobarbital enzyme-inducing regimens were administered p.o. to achieve similar steady-state phenobarbital plasma concentrations. Control rats received appropriate placebo solutions. Serum hepatic transaminase enzymes and histologic evidence of hepatocellular necrosis were utilized to evaluate hepatic damage after p.o. administration of 1300 mg of acetaminophen to both obese and lean Zucker rats. Obese Zucker control animals had approximately 2.5 times the total hepatic glutathione content compared to their lean control (164.9 +/- 43.2 vs. 65.3 +/- 18.4 mumol/whole liver). Obese Zucker animals receiving only acetaminophen showed a trend toward a reduced incidence of hepatocellular necrosis compared to similarly treated lean littermates. Obese Zucker rodents pretreated with phenobarbital had an even more pronounced resistance to acetaminophen-induced hepatocellular necrosis (P less than .01) when compared to similarly treated lean littermates. Thus, acetaminophen hepatotoxicity is reduced in the obese Zucker rat and pretreatment with phenobarbital offers further protection against hepatocellular damage. We suggest that the previously unrecognized increase in hepatic glutathione plays a major role in the resistance of the obese Zucker rat to acetaminophen hepatotoxicity.
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Affiliation(s)
- R A Blouin
- College of Pharmacy, University of Kentucky, Lexington
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DiPiro JT, Michael KA, Clark BA, Dickson P, Vallner JJ, Bowden TA, Tedesco FJ. Absorption of polyethylene glycol after administration of a PEG-electrolyte lavage solution. Clin Pharm 1986; 5:153-5. [PMID: 3956124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Dickson P. Su Clinica Familiar, Harlingen, Texas. Public Health Rep 1979; 94:56-63. [PMID: 472105 PMCID: PMC1426246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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