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Bakouny Z, Labaki C, Bhalla S, Schmidt AL, Steinharter JA, Cocco J, Tremblay DA, Awad MM, Kessler A, Haddad RI, Evans M, Busser F, Wotman M, Curran CR, Zimmerman BS, Bouchard G, Jun T, Nuzzo PV, Qin Q, Hirsch L, Feld J, Kelleher KM, Seidman D, Huang H, Anderson-Keightly HM, El Zarif T, Alaiwi SA, Champagne C, Rosenbloom TD, Stewart PS, Johnson BE, Trinh Q, Tolaney SM, Galsky MD, Choueiri TK, Doroshow DB. Oncology clinical trial disruption during the COVID-19 pandemic: a COVID-19 and cancer outcomes study. Ann Oncol 2022; 33:836-844. [PMID: 35715285 PMCID: PMC9197329 DOI: 10.1016/j.annonc.2022.04.071] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 03/14/2022] [Accepted: 04/18/2022] [Indexed: 12/01/2022] Open
Abstract
Background COVID-19 disproportionately impacted patients with cancer as a result of direct infection, and delays in diagnosis and therapy. Oncological clinical trials are resource-intensive endeavors that could be particularly susceptible to disruption by the pandemic, but few studies have evaluated the impact of the pandemic on clinical trial conduct. Patients and methods This prospective, multicenter study assesses the impact of the pandemic on therapeutic clinical trials at two large academic centers in the Northeastern United States between December 2019 and June 2021. The primary objective was to assess the enrollment on, accrual to, and activation of oncology therapeutic clinical trials during the pandemic using an institution-wide cohort of (i) new patient accruals to oncological trials, (ii) a manually curated cohort of patients with cancer, and (ii) a dataset of new trial activations. Results The institution-wide cohort included 4756 new patients enrolled to clinical trials from December 2019 to June 2021. A major decrease in the numbers of new patient accruals (−46%) was seen early in the pandemic, followed by a progressive recovery and return to higher-than-normal levels (+2.6%). A similar pattern (from −23.6% to +30.4%) was observed among 467 newly activated trials from June 2019 to June 2021. A more pronounced decline in new accruals was seen among academically sponsored trials (versus industry sponsored trials) (P < 0.05). In the manually curated cohort, which included 2361 patients with cancer, non-white patients tended to be more likely taken off trial in the early pandemic period (adjusted odds ratio: 2.60; 95% confidence interval 1.00-6.63), and substantial pandemic-related deviations were recorded. Conclusions Substantial disruptions in clinical trial activities were observed early during the pandemic, with a gradual recovery during ensuing time periods, both from an enrollment and an activation standpoint. The observed decline was more prominent among academically sponsored trials, and racial disparities were seen among people taken off trial.
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Affiliation(s)
- Z Bakouny
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - C Labaki
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - S Bhalla
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - A L Schmidt
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - J A Steinharter
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - J Cocco
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - D A Tremblay
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - M M Awad
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - A Kessler
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - R I Haddad
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - M Evans
- Department of Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - F Busser
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - M Wotman
- Department of Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - C R Curran
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - B S Zimmerman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - G Bouchard
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - T Jun
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - P V Nuzzo
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - Q Qin
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - L Hirsch
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - J Feld
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - K M Kelleher
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - D Seidman
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - H Huang
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | | | - T El Zarif
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - S Abou Alaiwi
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - C Champagne
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - T D Rosenbloom
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - P S Stewart
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - B E Johnson
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - Q Trinh
- Division of Urological Surgery, Brigham and Women's Hospital, Boston, USA
| | - S M Tolaney
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - M D Galsky
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - T K Choueiri
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA.
| | - D B Doroshow
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, USA.
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Nguyen D, Herzog P, Cone E, Labban M, Zorn K, Chughtai B, Basaria S, Elterman D, Trinh Q, Bhojani N. Pharmacovigilance analysis of reports of sexual dysfunction associated with finasteride use: Implications for the post-finasteride syndrome. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Haeuser L, Marchese M, Noldus J, Kibel A, Carvalho F, Preston M, Cooper Z, Trinh Q, Mossanen M. Examining the association between operative time and radical cystectomy complications. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01185-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Haeuser L, Herzog P, Ayub A, Nguyen D, Noldus J, Cone E, Mossanen M, Trinh Q. Comparison of comorbidity indices for prediction of morbidity and mortality after major surgical procedures. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00585-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Paciotti M, Nguyen D, Modonutti D, Casale P, Hurle R, Lughezzani G, Buffi N, Chang S, Mossanen M, Trinh Q. Conversion to open surgery remains minimal despite growing use of laparoscopic or robotic nephrectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35493-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Reese S, Tully K, Nabi J, Paciotti M, Cone E, Modonutti D, Lipsitz S, Trinh Q. Temporal trends in the incidence of testicular cancer in the United States over the past four decades. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32832-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Jamil M, Keeley J, Sood A, Dalela D, Arora S, Peabody J, Trinh Q, Menon M, Rogers C, Abdollah F. Long-term risk of recurrence in surgically treated renal cell carcinoma: A post-hoc analysis of the Eastern Cooperative Oncology Group - American College of Radiology Imaging Network E2805 Trial cohort. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Cone E, Haeuser L, Reese S, Marchese M, Nabi J, Abdollah F, Kilbridge K, Trinh Q. Checkpoint inhibitor monotherapy is associated with less cardiac toxicity than combination therapy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33319-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Haeuser L, Cone E, Reese S, Marchese M, Paciotti M, Trinh Q. Evaluating the relationship between time-normalized relative value unit assignment and complication rates across specialties: Is urology undercompensated? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33930-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Friedlander D, Modonutti D, Cone E, Wang Y, Chang S, Trinh Q. Trends in ambulatory prescribing of fluoroquinolones following United States Food and Drug Administration adverse effect warnings in 2008 and 2013. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33960-4] [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: 11/24/2022] Open
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Raup V, Berger A, Szymaniak J, Trinh Q, Eswara J. 266 Perioperative Outcomes of Female Urethroplasty. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.272] [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: 11/26/2022]
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Seisen T, Sun M, Lipsitz S, Abdollah F, Leow J, Menon M, Preston M, Harshman L, Kibel A, Nguyen P, Bellmunt J, Choueiri T, Trinh Q. Efficacité de la thérapie trimodale versus cystectomie radicale pour le traitement des tumeurs de vessie infiltrant le muscle localisées. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mahal B, Aizer A, Ziehr D, Hyatt A, Sammon J, Schmid M, Choueiri T, Hoffman K, Hu J, Sweeney C, Beard C, D'Amico A, Martin N, Kim S, Trinh Q, Nguyen P. Racial Disparities in the Management of African American Men With Intermediate- to High-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rogers C, Sukumar S, Jeong W, Petros F, Sammon J, Trinh Q, Menon M. MP-14.12 Intraoperative Finding of Gross Lymph Node Metastasis During Robotic Radical Prostatectomy. Urology 2011. [DOI: 10.1016/j.urology.2011.07.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Pantuck AJ, Trinh Q, Karakiewicz PI, Fergelot P, Rioux-Leclercq N, Figlin R, Said J, Belldegrun A, Patard J. Use of carbonic anhydrase IX (CAIX) expression and Von Hippel Lindau (VHL) gene mutation status to predict survival in renal cell carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5042 Background: VHL gene mutations induce the expression of CAIX, and previous studies have shown that low CAIX results in worse prognosis for RCC. We attempt to further describe the relationship between CAIX expression, VHL gene mutations and tumor characteristics. Methods: Radical nephrectomy was performed in 100 patients at 2 centers. Genomic DNA was extracted from frozen tumor samples using the QIAmp DNA mini kit. Four amplimers covering the whole coding sequence of the VHL gene were synthesized by PCR and sequenced by Big Dye. Mutation bearing sequences were confirmed by a second round of sequencing. The monoclonal antibody M75 was used to score the expression of the CAIX protein. Life table, Kaplan-Meier and Cox regression analyses addressed RCC-specific mortality (RCC-SM). Results: VHL mutations were identified in 58 patients (58%) and CAIX tumor expression ranged from 0% to 100%. Low CAIX expression (<85%) was associated with absence of VHL mutation (p=0.02), larger tumors (p=0.002), higher T stage (p=0.007), nodal metastases (p=0.001) and higher Fuhrman grade (p=0.006). Absence of VHL mutation was associated with worse ECOG (p=0.005), higher T stage (p=0.01) and presence of nodal (p=0.03) and distant metastases (p=0.02). Categorically-coded, CAIX was a statistically significant predictor of RCC-SM (p=0.002), while VHL mutation approached statistical significance (p=0.08) and a trend was observed for worse survival when VHL was not mutated. Patients with both high CAIX and VHL mutation had better survival (95.9% 1 year and 6 year median survival) than their counterparts with low CAIX expression and absence of VHL mutation (62.9% 1 year and 1.5 year median survival) (p<0.001). In Cox regression analyses, neither CAIX (p=0.06) nor VHL (p=0.4) achieved independent predictor status, when adjusted for age, gender, TNM stage, tumor size, Fuhrman and ECOG. Conclusions: Low CAIX expression is associated with the absence of VHL mutation and aggressive tumor characteristics, and is a statistically significant predictor of poor prognosis in patients with clear cell RCC. No significant financial relationships to disclose.
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Affiliation(s)
- A. J. Pantuck
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - Q. Trinh
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - P. I. Karakiewicz
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - P. Fergelot
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - N. Rioux-Leclercq
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - R. Figlin
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - J. Said
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - A. Belldegrun
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
| | - J. Patard
- David Geffen School of Medicine at UCLA, Los Angeles, CA; University of Montreal Health Center, Montreal, PQ, Canada; University of Rennes, Rennes, France
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Cashion LM, Bare LA, Harvey S, Trinh Q, Zhu Y, Devlin JJ. Use of enhanced green fluorescent protein to optimize and quantitate infection of target cells with recombinant retroviruses. Biotechniques 1999; 26:924-6, 928-30. [PMID: 10337486 DOI: 10.2144/99265rr02] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recombinant retroviral vectors are useful tools for gene transfer in both gene therapy and research applications. An enhanced form of green fluorescent protein has been incorporated into recombinant retroviruses as a marker to follow infected cells. In this paper, we extended the use of the fluorescent reporter to quantify protein expression using such analytical tools as fluorescent microscopy, flow cytometry and fluorescent plate reader analysis. These tools enabled us to rapidly assess the titer of recombinant retrovirus harvested from packaging cells and to optimize parameters for infection of different cell lines.
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Affiliation(s)
- L M Cashion
- Department of Biological Research, Berlex Biosciences, Richmond, CA 94804-0099, USA
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