1
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Mansfield AS, Wei Z, Mehra R, Shaw AT, Lieu CH, Forde PM, Drilon AE, Mitchell EP, Wright JJ, Takebe N, Sharon E, Hovelson D, Tomlins S, Zeng J, Poorman K, Malik N, Gray RJ, Li S, McShane LM, Rubinstein LV, Patton D, Williams PM, Hamilton SR, Conley BA, Arteaga CL, Harris LN, O’Dwyer PJ, Chen AP, Flaherty KT. Crizotinib in patients with tumors harboring ALK or ROS1 rearrangements in the NCI-MATCH trial. NPJ Precis Oncol 2022; 6:13. [PMID: 35233056 PMCID: PMC8888601 DOI: 10.1038/s41698-022-00256-w] [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: 06/24/2021] [Accepted: 12/16/2021] [Indexed: 01/14/2023] Open
Abstract
The NCI-MATCH was designed to characterize the efficacy of targeted therapies in histology-agnostic driver mutation-positive malignancies. Sub-protocols F and G were developed to evaluate the role of crizotinib in rare tumors that harbored either ALK or ROS1 rearrangements. Patients with malignancies that progressed following at least one prior systemic therapy were accrued to the NCI-MATCH for molecular profiling, and those with actionable ALK or ROS1 rearrangements were offered participation in sub-protocols F or G, respectively. There were five patients who enrolled on Arm F (ALK) and four patients on Arm G (ROS1). Few grade 3 or 4 toxicities were noted, including liver test abnormalities, and acute kidney injury. For sub-protocol F (ALK), the response rate was 50% (90% CI 9.8-90.2%) with one complete response among the 4 eligible patients. The median PFS was 3.8 months, and median OS was 4.3 months. For sub-protocol G (ROS1) the response rate was 25% (90% CI 1.3-75.1%). The median PFS was 4.3 months, and median OS 6.2 months. Data from 3 commercial vendors showed that the prevalence of ALK and ROS1 rearrangements in histologies other than non-small cell lung cancer and lymphoma was rare (0.1% and 0.4% respectively). We observed responses to crizotinib which met the primary endpoint for ALK fusions, albeit in a small number of patients. Despite the limited accrual, some of the patients with these oncogenic fusions can respond to crizotinib which may have a therapeutic role in this setting.
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Affiliation(s)
- A. S. Mansfield
- grid.66875.3a0000 0004 0459 167XDivision of Medical Oncology, Mayo Clinic, Rochester, MN USA
| | - Z. Wei
- grid.65499.370000 0001 2106 9910ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, MA USA
| | - R. Mehra
- grid.411024.20000 0001 2175 4264Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD USA
| | - A. T. Shaw
- grid.32224.350000 0004 0386 9924Massachusetts General Hospital, Boston, MA USA
| | - C. H. Lieu
- grid.499234.10000 0004 0433 9255University of Colorado Cancer Center, Aurora, CO USA
| | - P. M. Forde
- grid.280502.d0000 0000 8741 3625Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD USA
| | - A. E. Drilon
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY USA
| | - E. P. Mitchell
- grid.412726.40000 0004 0442 8581Thomas Jefferson University Hospital, Philadelphia, PA USA
| | - J. J. Wright
- grid.48336.3a0000 0004 1936 8075Investigational Drug Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | - N. Takebe
- grid.48336.3a0000 0004 1936 8075Investigational Drug Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | - E. Sharon
- grid.48336.3a0000 0004 1936 8075Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | | | | | - J. Zeng
- grid.492659.50000 0004 0492 4462Caris Life Sciences, Irving, TX USA
| | - K. Poorman
- grid.492659.50000 0004 0492 4462Caris Life Sciences, Irving, TX USA
| | - N. Malik
- grid.511425.60000 0004 9346 3636Tempus, Chicago, IL USA
| | - R. J. Gray
- grid.65499.370000 0001 2106 9910ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, MA USA
| | - S. Li
- grid.65499.370000 0001 2106 9910ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, MA USA
| | - L. M. McShane
- grid.48336.3a0000 0004 1936 8075Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | - L. V. Rubinstein
- grid.48336.3a0000 0004 1936 8075Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | - D. Patton
- grid.48336.3a0000 0004 1936 8075Center for Biomedical Informatics & Information Technology, National Cancer Institute, Bethesda, MD USA
| | - P. M. Williams
- grid.418021.e0000 0004 0535 8394Frederick National Laboratory for Cancer Research, Frederick, MD USA
| | - S. R. Hamilton
- grid.410425.60000 0004 0421 8357City of Hope, Duarte, CA USA
| | - B. A. Conley
- grid.48336.3a0000 0004 1936 8075Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | - C. L. Arteaga
- grid.267313.20000 0000 9482 7121Simmons Cancer Center, University of Texas Southwestern, Dallas, TX USA
| | - L. N. Harris
- grid.48336.3a0000 0004 1936 8075Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | - P. J. O’Dwyer
- grid.25879.310000 0004 1936 8972University of Pennsylvania, Philadelphia, PA USA
| | - A. P. Chen
- grid.48336.3a0000 0004 1936 8075Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD USA
| | - K. T. Flaherty
- grid.32224.350000 0004 0386 9924Massachusetts General Hospital, Boston, MA USA
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2
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Wilson R, King M, Butler NMH, Carroll DC, Frazer TP, Duff MJ, Higginson A, Dance RJ, Jarrett J, Davidson ZE, Armstrong CD, Liu H, Hawkes SJ, Clarke RJ, Neely D, Gray RJ, McKenna P. Influence of spatial-intensity contrast in ultraintense laser-plasma interactions. Sci Rep 2022; 12:1910. [PMID: 35115579 PMCID: PMC8814164 DOI: 10.1038/s41598-022-05655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/05/2022] [Indexed: 11/09/2022] Open
Abstract
Increasing the intensity to which high power laser pulses are focused has opened up new research possibilities, including promising new approaches to particle acceleration and phenomena such as high field quantum electrodynamics. Whilst the intensity achievable with a laser pulse of a given power can be increased via tighter focusing, the focal spot profile also plays an important role in the interaction physics. Here we show that the spatial-intensity distribution, and specifically the ratio of the intensity in the peak of the laser focal spot to the halo surrounding it, is important in the interaction of ultraintense laser pulses with solid targets. By comparing proton acceleration measurements from foil targets irradiated with by a near-diffraction-limited wavelength scale focal spot and larger F-number focusing, we find that this spatial-intensity contrast parameter strongly influences laser energy coupling to fast electrons. We find that for multi-petawatt pulses, spatial-intensity contrast is potentially as important as temporal-intensity contrast.
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Affiliation(s)
- R Wilson
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - M King
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK.,The Cockcroft Institute, Sci-Tech Daresbury, Warrington, WA4 4AD, UK
| | - N M H Butler
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - D C Carroll
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - T P Frazer
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - M J Duff
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - A Higginson
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - R J Dance
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - J Jarrett
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - Z E Davidson
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - C D Armstrong
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK.,Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - H Liu
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK.,Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing, 100190, China
| | - S J Hawkes
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - R J Clarke
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - D Neely
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK.,Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - R J Gray
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - P McKenna
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK. .,The Cockcroft Institute, Sci-Tech Daresbury, Warrington, WA4 4AD, UK.
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3
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Armstrong CD, Neely D, Kumar D, McKenna P, Gray RJ, Pirozhkov AS. Deconvolution of multi-Boltzmann x-ray distribution from linear absorption spectrometer via analytical parameter reduction. Rev Sci Instrum 2021; 92:113102. [PMID: 34852528 DOI: 10.1063/5.0057486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
Accurate characterization of incident radiation is a fundamental challenge for diagnostic design. Herein, we present an efficient spectral analysis routine that is able to characterize multiple components within the spectral emission by analytically reducing the number of parameters. The technique is presented alongside the design of a hard x-ray linear absorption spectrometer using the example of multiple Boltzmann-like spectral distributions; however, it is generally applicable to all absorption based spectrometer designs and can be adapted to any incident spectral shape. This routine is demonstrated to be tolerable to experimental noise and suitable for real-time data processing at multi-Hz repetition rates.
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Affiliation(s)
- C D Armstrong
- Central Laser Facility, Rutherford Appleton Laboratory, Harwell OX110QX, United Kingdom
| | - D Neely
- Central Laser Facility, Rutherford Appleton Laboratory, Harwell OX110QX, United Kingdom
| | - D Kumar
- Department of Radiation and Chemical Physics, Institute of Physics of the Czech Academy of Sciences, Na Slovance 1999/2, 18221 Prague 8, Czechia
| | - P McKenna
- SUPA Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - R J Gray
- SUPA Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - A S Pirozhkov
- Kansai Photon Science Institute, National Institutes for Quantum and Radiological Science and Technology, 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
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4
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Jhaveri KL, Wang XV, Makker V, Luoh SW, Mitchell EP, Zwiebel JA, Sharon E, Gray RJ, Li S, McShane LM, Rubinstein LV, Patton D, Williams PM, Hamilton SR, Conley BA, Arteaga CL, Harris LN, O'Dwyer PJ, Chen AP, Flaherty KT. Corrigendum to 'Ado-trastuzumab emtansine (T-DM1) in patients with HER2-amplified tumors excluding breast and gastric/gastroesophageal junction (GEJ) adenocarcinomas: results from the NCI-MATCH trial (EAY131) subprotocol Q': [Annals of Oncology 30 (2019) 1821-1830]. Ann Oncol 2021; 32:1068. [PMID: 34099371 PMCID: PMC8929237 DOI: 10.1016/j.annonc.2021.05.797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- K L Jhaveri
- Department of Medicine, Memorial Sloan-Kettering Center, New York, USA.
| | - X V Wang
- Biostatistics, E-A Biostatistical Center, Boston, USA
| | - V Makker
- Gynecologic Medical Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - S-W Luoh
- Knight Cancer Institute, Oregon Health Science University, Portland, USA
| | - E P Mitchell
- Medical Oncology, Thomas Jefferson University, Philadelphia, USA
| | - J A Zwiebel
- Investigational Drug Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, USA
| | - E Sharon
- Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, USA
| | - R J Gray
- Department of Biostatistics, Dana Farber Cancer Institutes, Boston, USA
| | - S Li
- Department of Biostatistics, Dana Farber Cancer Institutes, Boston, USA
| | - L M McShane
- Biometric Research Branch, National Cancer Institute, Bethesda, USA
| | - L V Rubinstein
- Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institute of Health, Bethesda, USA
| | - D Patton
- Center for Biomedical, Informatics & Information Technology, National Cancer Institute, Bethesda, USA
| | - P M Williams
- Molecular Characterization Laboratory, Frederick National Laboratory for Cancer Research, Frederick, USA
| | - S R Hamilton
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - B A Conley
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, USA
| | - C L Arteaga
- Department of Internal Medicine, University of Texas Southwestern, Dallas, USA
| | - L N Harris
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, USA
| | - P J O'Dwyer
- University of Pennsylvania, Philadelphia, USA
| | - A P Chen
- CTEP, National Cancer Institute, Bethesda, USA
| | - K T Flaherty
- Cancer Center, Massachusetts General Hospital, Boston, USA
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5
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Duff MJ, Wilson R, King M, Gonzalez-Izquierdo B, Higginson A, Williamson SDR, Davidson ZE, Capdessus R, Booth N, Hawkes S, Neely D, Gray RJ, McKenna P. High order mode structure of intense light fields generated via a laser-driven relativistic plasma aperture. Sci Rep 2020; 10:105. [PMID: 31919383 PMCID: PMC6952361 DOI: 10.1038/s41598-019-57119-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/03/2019] [Indexed: 11/10/2022] Open
Abstract
The spatio-temporal and polarisation properties of intense light is important in wide-ranging topics at the forefront of extreme light-matter interactions, including ultrafast laser-driven particle acceleration, attosecond pulse generation, plasma photonics, high-field physics and laboratory astrophysics. Here, we experimentally demonstrate modifications to the polarisation and temporal properties of intense light measured at the rear of an ultrathin target foil irradiated by a relativistically intense laser pulse. The changes are shown to result from a superposition of coherent radiation, generated by a directly accelerated bipolar electron distribution, and the light transmitted due to the onset of relativistic self-induced transparency. Simulations show that the generated light has a high-order transverse electromagnetic mode structure in both the first and second laser harmonics that can evolve on intra-pulse time-scales. The mode structure and polarisation state vary with the interaction parameters, opening up the possibility of developing this approach to achieve dynamic control of structured light fields at ultrahigh intensities.
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Affiliation(s)
- M J Duff
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - R Wilson
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - M King
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | | | - A Higginson
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - S D R Williamson
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - Z E Davidson
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - R Capdessus
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - N Booth
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - S Hawkes
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - D Neely
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK.,Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire, OX11 0QX, UK
| | - R J Gray
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK
| | - P McKenna
- SUPA Department of Physics, University of Strathclyde, Glasgow, G4 0NG, UK.
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6
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Jhaveri KL, Wang XV, Makker V, Luoh SW, Mitchell EP, Zwiebel JA, Sharon E, Gray RJ, Li S, McShane LM, Rubinstein LV, Patton D, Williams PM, Hamilton SR, Conley BA, Arteaga CL, Harris LN, O'Dwyer PJ, Chen AP, Flaherty KT. Ado-trastuzumab emtansine (T-DM1) in patients with HER2-amplified tumors excluding breast and gastric/gastroesophageal junction (GEJ) adenocarcinomas: results from the NCI-MATCH trial (EAY131) subprotocol Q. Ann Oncol 2019; 30:1821-1830. [PMID: 31504139 PMCID: PMC6927318 DOI: 10.1093/annonc/mdz291] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The National Cancer Institute-Molecular Analysis for Therapy Choice (NCI-MATCH) is a national precision medicine study incorporating centralized genomic testing to direct refractory cancer patients to molecularly targeted treatment subprotocols. This treatment subprotocol was designed to screen for potential signals of efficacy of ado-trastuzumab emtansine (T-DM1) in HER2-amplified histologies other than breast and gastroesophageal tumors. METHODS Eligible patients had HER2 amplification at a copy number (CN) >7 based on targeted next-generation sequencing (NGS) with a custom Oncomine AmpliSeq™ (ThermoFisher Scientific) panel. Patients with prior trastuzumab, pertuzumab or T-DM1 treatment were excluded. Patients received T-DM1 at 3.6 mg/kg i.v. every 3 weeks until toxicity or disease progression. Tumor assessments occurred every three cycles. The primary end point was centrally assessed objective response rate (ORR). Exploratory end points included correlating response with HER2 CN by NGS. The impact of co-occurring genomic alterations and PTEN loss by immunohistochemistry were also assessed. RESULTS Thirty-eight patients were enrolled and 36 included in efficacy analysis. Median prior therapies in the metastatic setting was 3 (range 0-9; unknown in one patient). Median HER2 CN was 17 (range 7-139). Partial responses were observed in two (5.6%) patients: one mucoepidermoid carcinoma of parotid gland and one parotid gland squamous cell cancer. Seventeen patients (47%) had stable disease including 8/10 (80%) with ovarian and uterine carcinomas, with median duration of 4.6 months. The 6-month progression-free survival rate was 23.6% [90% confidence interval 14.2% to 39.2%]. Common toxicities included fatigue, anemia, fever and thrombocytopenia with no new safety signals. There was a trend for tumor shrinkage with higher levels of gene CN as determined by the NGS assay. CONCLUSION T-DM1 was well tolerated. While this subprotocol did not meet the primary end point for ORR in this heavily pre-treated diverse patient population, clinical activity was seen in salivary gland tumors warranting further study in this tumor type in dedicated trials.
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Affiliation(s)
- K L Jhaveri
- Department of Medicine, Memorial Sloan-Kettering Center, New York.
| | - X V Wang
- Biostatistics, E-A Biostatistical Center, Boston
| | - V Makker
- Gynecologic Medical Oncology Service, Memorial Sloan-Kettering Cancer Center, New York
| | - S-W Luoh
- Knight Cancer Institute, Oregon Health Science University, Portland
| | - E P Mitchell
- Medical Oncology, Thomas Jefferson University, Philadelphia
| | - J A Zwiebel
- Investigational Drug Branch, Division of Cancer Treatment and Diagnosis
| | - E Sharon
- Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda
| | - R J Gray
- Department of Biostatistics, Dana Farber Cancer Institutes, Boston
| | - S Li
- Department of Biostatistics, Dana Farber Cancer Institutes, Boston
| | - L M McShane
- Biometric Research Branch, National Cancer Institute, Bethesda
| | - L V Rubinstein
- Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institute of Health, Bethesda
| | - D Patton
- Center for Biomedical, Informatics & Information Technology, National Cancer Institute, Bethesda
| | - P M Williams
- Molecular Characterization Laboratory, Frederick National Laboratory for Cancer Research, Frederick
| | - S R Hamilton
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston
| | - B A Conley
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda
| | - C L Arteaga
- Department of Internal Medicine, University of Texas Southwestern, Dallas
| | - L N Harris
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda
| | | | - A P Chen
- CTEP, National Cancer Institute, Bethesda
| | - K T Flaherty
- Cancer Center, Massachusetts General Hospital, Boston, USA
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7
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Sheaffer WW, Gray RJ, Wasif N, Stucky CC, Cronin PA, Kosiorek HE, Basu A, Pizzitola VJ, Patel B, Giurescu ME, Lorans R, McCullough AE, Ocal IT, Pockaj BA. Predictive factors of upstaging DCIS to invasive carcinoma in BCT vs mastectomy. Am J Surg 2019; 217:1025-1029. [PMID: 30879795 DOI: 10.1016/j.amjsurg.2018.12.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 11/02/2018] [Accepted: 12/29/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Upstaging from DCIS to invasive ductal carcinoma varies widely from 0 to 59%. We aim to identify risk factors associated with upstaging in all DCIS patients and based on specific surgical intervention. METHODS Patients with a pre-operative diagnosis of DCIS undergoing BCT or mastectomy were reviewed. Multivariable analysis was performed to identify risk factors for upstaging. RESULTS In total, 623 patients had a preoperative diagnosis of DCIS. Upstaging occurred in 74 patients (12%) overall. There was no difference in upstaging rates between mastectomy and BCT (11% v 14% p = 0.27). Sentinel lymph node biopsy was positive in 4/212 patients (1%). Multivariable analysis revealed suspicion of microinvasion (OR 5.7 95%CI2.2-14.9), surgeon suspicion of invasive disease (OR 2.7, 95% CI 1.2-6.4) and larger size/multicentric/extensive tumor (OR 1.9 95% CI 1.1-3.4) increase risk of upstaging. CONCLUSIONS Suspicion of microinvasion, surgeon suspicion, and tumor size can be used to help guide the use of sentinel lymph node biopsy. For patients without these high risk characteristics, it is hard to justify the use of concurrent SLN biopsy for patients who undergo BCT.
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Affiliation(s)
- W W Sheaffer
- Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - R J Gray
- Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - N Wasif
- Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - C C Stucky
- Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - P A Cronin
- Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - H E Kosiorek
- Department of Biostatistics, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - A Basu
- Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - V J Pizzitola
- Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - B Patel
- Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - M E Giurescu
- Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - R Lorans
- Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - A E McCullough
- Department of Pathology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - I T Ocal
- Department of Pathology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - B A Pockaj
- Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
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8
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Davidson ZE, Gonzalez-Izquierdo B, Higginson A, Lancaster KL, Williamson SDR, King M, Farley D, Neely D, McKenna P, Gray RJ. An optically multiplexed single-shot time-resolved probe of laser-plasma dynamics. Opt Express 2019; 27:4416-4423. [PMID: 30876060 DOI: 10.1364/oe.27.004416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/01/2019] [Indexed: 06/09/2023]
Abstract
We introduce a new approach to temporally resolve ultrafast micron-scale processes via the use of a multi-channel optical probe. We demonstrate that this technique enables highly precise time-resolved, two-dimensional spatial imaging of intense laser pulse propagation dynamics, plasma formation and laser beam filamentation within a single pulse over four distinct time frames. The design, development and optimization of the optical probe system is presented, as are representative experimental results from the first implementation of the multi-channel probe with a high-power laser pulse interaction with a helium gas jet target.
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9
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Wagner LI, Gray RJ, Garcia S, Whelan TJ, Tevarweerk A, Yanez B, Carlos R, Gareen I, McCaskill-Stevens W, Cella D, Sparano JA, Sledge GW. Abstract GS6-03: Symptoms and health-related quality of life on endocrine therapy alone (E) versus chemoendocrine therapy (C+E): TAILORx patient-reported outcomes results. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs6-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: TAILORx patient-reported outcomes (PRO) quantify symptoms and health-related quality of life (HRQL) from C+E beyond E alone from the patient's perspective, thus can inform decision-making for women in the intermediate risk group for whom chemotherapy may still be considered.
Methods: TAILORx participants with OncoType DX Recurrence Scores 11-25 were randomly assigned to E or C+E. All TAILORx participants enrolled 1/2010-10/2010 (N=612) completed PROs measuring fatigue, endocrine symptoms, cognitive impairments (PCI), and fear of recurrence at baseline, 3, 6, 12, 24 and 36 months. HRQL was assessed at baseline, 12, and 36 months. Linear regression (LR) examined PRO scores among the per-protocol sample.
Results: Overall, participants reported significantly more fatigue, endocrine symptoms and PCI at 3, 6, 12, 24 and 36 months compared to baseline and those randomized to C+E reported a greater magnitude of change baseline-3 months compared to those randomized to E alone (Table 1). Overall, by 12 months symptoms were comparable between groups. Pre-menopausal women had comparable symptoms at 24 and 36 months. Post-menopausal women randomized to C+E had greater endocrine symptoms at 24 and 36 months and greater fatigue at 6 and 24 months. Fear of recurrence was comparable between arms during treatment and follow-up. Multiple linear regression identified increased fatigue (LR slope β=0.67), endocrine symptoms (β =0.14), and PCI (β=0.11) as significant predictors of decreased HRQL across arms (p< 0.001). HRQL was comparable between E and C+E at 12- and 36-months.
Mean PRO change scores from baseline by treatment arm and menopausal status in per protocol population Months 36122436N=Overall454469458384343n=Pre-menopausal153151150118103n=Post-menopausal301318308266240FACIT-Fatigue Overall sample C+E-8.77-4.37-4.01-4.27-3.67E-2.48-1.97-2.14-1.49-1.83LMED-5.32***-1.55-1.01-1.76-0.90Pre-M C+E-8.01-3.26-2.99-2.45-1.60E-3.87-1.66-1.32-2.52-2.11LMED-3.11-0.82-1.121.021.46Post-M C+E-9.22-4.97-4.55-5.14-4.67E-1.87-2.10-2.52-1.09-1.71LMED-6.42***-1.99*-1.16-3.02*-2.01FACT-Endocrine Symptoms Overall sample C+E-5.56-5.63-6.96-6.81-7.14E-3.61-4.24-5.62-5.31-5.17LMED-1.62*-0.97-1.08-1.05-1.69Pre-M C+E-7.62-8.34-7.94-8.29-8.96E-5.96-6.19-8.95-10.39-10.84LMED-1.44-1.631.062.272.18Post-M C+E-4.39-4.19-6.45-6.10-6.28E-2.55-3.41-4.10-3.23-2.87LMED-1.49-0.45-2.04-2.39*-3.17**Significance between mean change scores *p<0.05;**p<0.01;***p<0.001. LMED=estimated tx difference using linear model regressing score on baseline value and tx
Conclusions: TAILORx is the first trial to examine patient-reported fatigue, endocrine symptoms, PCI and HRQL among breast cancer patients randomized to endocrine therapy alone vs chemoendocrine therapy, thus allowing us to quantify acute and long-term symptoms uniquely attributable to chemotherapy. As expected, chemotherapy is associated with greater fatigue, endocrine symptoms and PCI acutely during treatment, and for post-menopausal women with greater long-term endocrine symptoms. Increased symptoms were associated with poorer HRQL. Long-term HRQL was comparable between groups.
Citation Format: Wagner LI, Gray RJ, Garcia S, Whelan TJ, Tevarweerk A, Yanez B, Carlos R, Gareen I, McCaskill-Stevens W, Cella D, Sparano JA, Sledge, Jr. GW, On behalf of the TAILORx Study Team. Symptoms and health-related quality of life on endocrine therapy alone (E) versus chemoendocrine therapy (C+E): TAILORx patient-reported outcomes results [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS6-03.
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Affiliation(s)
- LI Wagner
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - RJ Gray
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - S Garcia
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - TJ Whelan
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - A Tevarweerk
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - B Yanez
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - R Carlos
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - I Gareen
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - W McCaskill-Stevens
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - D Cella
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - JA Sparano
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
| | - GW Sledge
- Wake Forest School of Medicine, Winston Salem, NC; Dana-Farber Cancer Institute, Boston, MA; Northwestern University School of Medicine, Chicago, IL; McMaster University, Hamilton, ON, Canada; University of Wisconsin, Madison, WI; University of Michigan, Ann Arbor, MI; Brown University, Providence, RI; National Institutes of Health, National Cancer Institute, Bethesda, MD; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Stanford University Medical Center, Stanford, CA
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Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer CE, Dees EC, Goetz MP, Olson JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW. Abstract GS4-07: Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs4-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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
Abstract
Background: Black race is associated with worse outcomes in localized hormone receptor (HR)-positive breast cancer in population-based and in clinical trial cohorts, whether using self-identified race (Albain et al. JNCI 2009 [PMID: 19584328; Sparano et al. JNCI 2012 [PMID: 22250182) or genetically-identified race (Schneider et al. J Precision Oncol 2017 [PMID: 29333527]). This disparity persists after adjustment for treatment delivery parameters (Hershman et al. JCO 2009 [PMID:19307504]). We evaluated clinicopathologic characteristics, treatment delivered and clinical outcomes in the Trial Assigning Individualized Options for Treatment (TAILORx) by race and ethnicity (Sparano et al. NEJM 2018 [PMID: 29860917]).
Methods: The analysis included 9719 evaluable TAILORx participants. The association between clinical outcomes and race (white, black, Asian, other/unknown) and ethnicity (Hispanic vs. non-Hispanic) was examined, including invasive disease-free survival (iDFS), distant relapse-free interval (DRFI), relapse-free interval (RFI), and overall survival (OS). Proportional hazards models were fit including age (5 categories), tumor size (>2 cm vs. <=2 cm), histologic grade (high vs. medium vs. low vs. unknown), continuous recurrence score (RS), race, and ethnicity in the overall population and randomized treatment arms in the RS 11-25 cohort.
Results: The study population included 8189 (84%) whites, 693 (7%) blacks, 405 (4%) Asians, and 432 (4%) with other/unknown race. Regarding ethnicity, 7635 (79%) were non-Hispanic, 889 (9%) Hispanic, and 1195 (12%) unknown. There was no significant difference in RS distribution (p=0.22) in blacks compared with whites, or in median (17 vs. 17) or mean RS (19.1 vs. 18.2). There was likewise no difference in Hispanic vs. non-Hispanic ethnicity for RS distribution (p=0.72) or median (17 vs. 17) or mean RS (18.5 vs. 18.0). Black race (39% vs. 30%) and Hispanic ethnicity (39% vs. 30%) were both associated with younger age (</=50 years) at diagnosis. The use and type of adjuvant chemotherapy and endocrine therapy, and duration of endocrine therapy, were similar in black (vs. white) and Hispanic (vs. non-Hispanic) populations. In proportional hazards models, black race (compared with white race) was associated with worse clinical outcomes in the entire population and in those with a RS 11-25 (see table). Hispanic ethnicity was generally associated with better outcomes (compared with non-Hispanic ethnicity). For the cohort with a RS of 11-25, there was no evidence for chemotherapy benefit for any racial or ethnic group.
Race (black vs.white) and clinical outcomes in proportional hazards modelsClinical endpointEntire Population (N=693 black) Hazard ratio for eventRS 11-25 (N=471 black) Hazard ratio for eveniDFS1.33 (p=0.005)1.49 (p=0.001)DRFI1.21 (p=0.28)1.60 (p=0.02)RFI1.39 (p=0.02)1.80 (p<0.001)OS1.52 (p=0.005)1.67 (p=0.003
Conclusions: In patients eligible and selected for participation in TAILORx, black women had worse clinical outcomes despite similar 21-gene assay RS results and comparable systemic therapy. This adds to an emerging body of evidence suggesting a biologic basis or other factors contributing to racial disparities in HR-positive breast cancer that requires further evaluation.
Citation Format: Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer, Jr. CE, Dees EC, Goetz MP, Olson, Jr. JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge, Jr. GW. Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS4-07.
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Affiliation(s)
- K Albain
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - RJ Gray
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Sparano
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Makower
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - KI Pritchard
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Hayes
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - CE Geyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - EC Dees
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MP Goetz
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Olson
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - T Lively
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - SS Badve
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Saphner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - LI Wagner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Whelan
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MJ Ellis
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - S Paik
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - WC Wood
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PM Ravdin
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MM Keane
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - HL Gomez
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PS Reddy
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TF Goggins
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - IA Mayer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - AM Brufsky
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DL Toppmeyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - VG Kaklamani
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JL Berenberg
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - J Abrams
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - GW Sledge
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
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11
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Green JS, Booth N, Dance RJ, Gray RJ, MacLellan DA, Marshall A, McKenna P, Murphy CD, Ridgers CP, Robinson APL, Rusby D, Scott RHH, Wilson L. Time-resolved measurements of fast electron recirculation for relativistically intense femtosecond scale laser-plasma interactions. Sci Rep 2018. [PMID: 29540743 PMCID: PMC5852165 DOI: 10.1038/s41598-018-22422-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A key issue in realising the development of a number of applications of high-intensity lasers is the dynamics of the fast electrons produced and how to diagnose them. We report on measurements of fast electron transport in aluminium targets in the ultra-intense, short-pulse (<50 fs) regime using a high resolution temporally and spatially resolved optical probe. The measurements show a rapidly (≈0.5c) expanding region of Ohmic heating at the rear of the target, driven by lateral transport of the fast electron population inside the target. Simulations demonstrate that a broad angular distribution of fast electrons on the order of 60° is required, in conjunction with extensive recirculation of the electron population, in order to drive such lateral transport. These results provide fundamental new insight into fast electron dynamics driven by ultra-short laser pulses, which is an important regime for the development of laser-based radiation and particle sources.
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Affiliation(s)
- J S Green
- Central Laser Facility, STFC, Rutherford Appleton Laboratory, Chilton, Oxon, OX11 0QX, UK.
| | - N Booth
- Central Laser Facility, STFC, Rutherford Appleton Laboratory, Chilton, Oxon, OX11 0QX, UK
| | - R J Dance
- York Plasma Institute, Department of Physics, University of York, York, YO10 5DD, UK
| | - R J Gray
- Department of Physics, SUPA, University of Strathclyde, Glasgow, G4 0NG, UK
| | - D A MacLellan
- Department of Physics, SUPA, University of Strathclyde, Glasgow, G4 0NG, UK
| | - A Marshall
- York Plasma Institute, Department of Physics, University of York, York, YO10 5DD, UK
| | - P McKenna
- Department of Physics, SUPA, University of Strathclyde, Glasgow, G4 0NG, UK
| | - C D Murphy
- York Plasma Institute, Department of Physics, University of York, York, YO10 5DD, UK
| | - C P Ridgers
- York Plasma Institute, Department of Physics, University of York, York, YO10 5DD, UK
| | - A P L Robinson
- Central Laser Facility, STFC, Rutherford Appleton Laboratory, Chilton, Oxon, OX11 0QX, UK
| | - D Rusby
- Central Laser Facility, STFC, Rutherford Appleton Laboratory, Chilton, Oxon, OX11 0QX, UK.,Department of Physics, SUPA, University of Strathclyde, Glasgow, G4 0NG, UK
| | - R H H Scott
- Central Laser Facility, STFC, Rutherford Appleton Laboratory, Chilton, Oxon, OX11 0QX, UK
| | - L Wilson
- Central Laser Facility, STFC, Rutherford Appleton Laboratory, Chilton, Oxon, OX11 0QX, UK
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12
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Gray RJ, Worsley PR, Voegeli D, Bader DL. Monitoring contractile dermal lymphatic activity following uniaxial mechanical loading. Med Eng Phys 2016; 38:895-903. [DOI: 10.1016/j.medengphy.2016.04.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/18/2016] [Accepted: 04/23/2016] [Indexed: 11/25/2022]
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13
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Culfa O, Tallents GJ, Rossall AK, Wagenaars E, Ridgers CP, Murphy CD, Dance RJ, Gray RJ, McKenna P, Brown CDR, James SF, Hoarty DJ, Booth N, Robinson APL, Lancaster KL, Pikuz SA, Faenov AY, Kampfer T, Schulze KS, Uschmann I, Woolsey NC. Plasma scale-length effects on electron energy spectra in high-irradiance laser plasmas. Phys Rev E 2016; 93:043201. [PMID: 27176413 DOI: 10.1103/physreve.93.043201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Indexed: 06/05/2023]
Abstract
An analysis of an electron spectrometer used to characterize fast electrons generated by ultraintense (10^{20}Wcm^{-2}) laser interaction with a preformed plasma of scale length measured by shadowgraphy is presented. The effects of fringing magnetic fields on the electron spectral measurements and the accuracy of density scale-length measurements are evaluated. 2D EPOCH PIC code simulations are found to be in agreement with measurements of the electron energy spectra showing that laser filamentation in plasma preformed by a prepulse is important with longer plasma scale lengths (>8 μm).
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Affiliation(s)
- O Culfa
- Department of Physics, Karamanoglu MehmetBey University, Karaman, Turkey
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
| | - G J Tallents
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
| | - A K Rossall
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
| | - E Wagenaars
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
| | - C P Ridgers
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
| | - C D Murphy
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
| | - R J Dance
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
| | - R J Gray
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - P McKenna
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - C D R Brown
- AWE, Aldermaston, Reading, Berkshire RG7 4PR, United Kingdom
| | - S F James
- AWE, Aldermaston, Reading, Berkshire RG7 4PR, United Kingdom
| | - D J Hoarty
- AWE, Aldermaston, Reading, Berkshire RG7 4PR, United Kingdom
| | - N Booth
- CLF, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - A P L Robinson
- CLF, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - K L Lancaster
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
- CLF, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - S A Pikuz
- Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow 125412, Russia
| | - A Ya Faenov
- Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow 125412, Russia
- Osaka University, Suita, Osaka 656-0871, Japan
| | - T Kampfer
- Friedrich Schiller University of Jena, D-07743 Jena, Germany
| | - K S Schulze
- Friedrich Schiller University of Jena, D-07743 Jena, Germany
| | - I Uschmann
- Friedrich Schiller University of Jena, D-07743 Jena, Germany
| | - N C Woolsey
- York Plasma Institute, The Department of Physics, The University of York, York YO10 5DD, United Kingdom
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14
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Moyer AM, Boughey JC, Kalari KR, Suman VJ, McLaughlin SA, Moreno-Aspitia A, Northfelt DW, Gray RJ, Sinnwell JP, Carlson EE, Dockter TJ, Jones KN, Felten SJ, Conners AL, Wieben ED, Ingle JN, Wang L, Weinshilboum RM, Visscher DW, Goetz MP. Abstract P4-04-05: Differential mRNA expression patterns in breast tumors with high vs. low quantity of stromal tumor–Infiltrating lymphocytes. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-04-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Tumor-infiltrating lymphocytes (TIL) have prognostic and potentially predictive significance in the (neo)adjuvant treatment of high-risk breast cancer. However, quantitative TIL measurement is not routinely performed. It is unclear why some tumors attract large quantities of TIL while others do not. We sought to confirm the association between TIL and pathologic complete response rate (pCR) and to further use next generation sequencing (NGS) to identify genes and gene pathways associated with the presence/absence of TIL.
Methods: We studied 140 women with high risk stage I-III breast cancer, enrolled in the Breast Cancer Genome Guided Therapy Study (BEAUTY), obtaining serial biopsies for DNA/RNA sequencing and MRI imaging to assess response to neoadjuvant chemotherapy (NAC) with taxane (+/- trastuzumab+/-pertuzumab for HER2+ disease) followed by AC or (F)EC. Diagnostic pre-NAC core needle biopsies and surgical resection specimens post-NAC were available from 110 patients. Stromal TIL were semi-quantitated on a scale of 1-4 (with 1: ≤10/hpf, 2: subtle infiltrate >10/hpf, 3: moderate infiltrate readily visible at low power magnification, 4: dense infiltrate with innumerable lymphocytes). For this analysis, low TIL was defined as scores of 1-2 vs. high defined as 3-4. Using pre-NAC biopsies, RNAseq was performed using the Illumina HiSeq2000 and the Mayo Analysis Pipeline for RNAseq (MAP-Rseq) for quality control, sequence alignment, and gene counts. The quantity of TIL was associated with transcripts across the transcriptome after conditional quantile normalization. Differentially expressed genes were obtained using EdgeR analysis, using a false discovery rate of 0.05, and pathways were evaluated using GAGE methods.
Results: The pCR and residual cancer burden (RCB)-0/I rates by stromal TIL status within each molecular subtype are presented in the table. A diverse spectrum of 1344 genes with differential expression between tumors with high vs. low stromal TIL was identified. The genes with >2.0-fold change (FC) and p<1e-09 included S100A7 (4.49 FC), LCN2 (2.48 FC), and ART3 (2.82 FC) (genes known to be involved in immune regulation), as well as TDRD1 (2.71 FC) (a gene related to ERG [ETS-related gene] expression). In addition, the "regulation of actin cytoskeleton" pathway was upregulated in tumors with high TIL, while the "Hedgehog signaling" and "Wnt signaling" pathways were downregulated.
Molecular SubtypeStromal TILspCR rate n (%)RCB-0/I rateLuminal AHigh------Luminal ALow0/9 (0%)0/9 (0%)Luminal BHigh1/9 (11.1%)1/8 (12.5%)Luminal BLow3/24 (12.5%)6/23 (26.1%)ER+/HER2+High3/9 (33.3%)4/9 (44.4%)ER+/HER2+Low1/6 (16.7%)1/6 (16.7%)ER-/HER2+High8/9 (88.9%)7/7 (100%)ER-/HER2+Low4/8 (50.0%)6/8 (75.0%)Triple NegativeHigh10/19 (52.6%)13/19 (68.4%)Triple NegativeLow7/14 (50.0%)9/13 (69.2%)
Conclusions: We identified genes and gene pathways associated with high TIL expression in breast tumors prior to NAC that provide insight into the interactions between TIL and tumors. TIL can be easily semi-quantitated on H&E and along with these novel biomarkers, may contribute to the personalization of breast cancer therapy.
Citation Format: Moyer AM, Boughey JC, Kalari KR, Suman VJ, McLaughlin SA, Moreno-Aspitia A, Northfelt DW, Gray RJ, Sinnwell JP, Carlson EE, Dockter TJ, Jones KN, Felten SJ, Conners AL, Wieben ED, Ingle JN, Wang L, Weinshilboum RM, Visscher DW, Goetz MP. Differential mRNA expression patterns in breast tumors with high vs. low quantity of stromal tumor–Infiltrating lymphocytes. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-04-05.
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Affiliation(s)
- AM Moyer
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JC Boughey
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - KR Kalari
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - VJ Suman
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - SA McLaughlin
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - A Moreno-Aspitia
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - DW Northfelt
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - RJ Gray
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JP Sinnwell
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - EE Carlson
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - TJ Dockter
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - KN Jones
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - SJ Felten
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - AL Conners
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - ED Wieben
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JN Ingle
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - L Wang
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - RM Weinshilboum
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - DW Visscher
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - MP Goetz
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
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15
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Boughey JC, Kalari KR, Suman VJ, McLaughlin SA, Moreno Aspitia A, Moyer AM, Northfelt DW, Gray RJ, Vedell PT, Tang X, Dockter TJ, Jones KN, Felten SJ, Conners AL, Hart SN, Visscher DW, Wieben ED, Ingle JN, Hartman AR, Timms K, Elkin E, Jones J, Wang L, Weinshilboum RW, Goetz MP. Abstract P3-07-29: Role of germline BRCA status and tumor homologous recombination (HR) deficiency in response to neoadjuvant weekly paclitaxel followed by anthracycline-based chemotherapy. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Both HR deficiency and BRCA mutation status predict response to platinum-based therapy and BRCA mutation status predicts docetaxel resistance. However, the association of either biomarker with response to the individual elements of either AC or taxanes (T) is unknown since T is commonly given concomitantly with or after anthracyclines (A). We evaluated the association of HRD and BRCA mutation status with response to neoadjuvant weekly T followed by AC or (F)EC in high-risk breast cancer.
Methods: We studied 140 high risk Stage I-III breast cancer patients (pts), enrolled in the breast cancer genome guided therapy study (BEAUTY), obtaining biopsies for DNA/RNA sequencing and MRI imaging to assess response to neoadjuvant weekly T (+trastuzumab+/-pertuzumab for HER2+ disease) followed by AC or (F)EC. Germline BRCA status and HR status of tumor samples (Myriad laboratories) were obtained. HR deficient tumor was defined as HRD score ≥42 or BRCA mutation. MRI response by changes in tumor size after 12 weeks of T was classified by WHO criteria. pCR was defined as ypT0/Tis ypN0. Both MRI response after T and pCR (after T and AC) were examined in terms of germline BRCA mutation (gBRCAmut vs. gBRCAwt) and tumor HR deficiency.
Results: Of 140 pts enrolled, 8 withdrew consent and 2 carboplatin treated pts were excluded. Germline data were available for 124/130 pts. 12 patients had BRCA deleterious germline mutations (4 BRCA1, 8 BRCA2). MRI partial (PR)/complete response (CR) rate to T was 47.3% (95% CI: 37.8-57.0%) in the BRCAwt group and 66.7% (95% CI: 34.9-90.1%) in the BRCAmut group. No MRI CR's were observed in BRCA1 mut pts. In contrast, pCR rate was 50% in the 12 gBRCAmut pts (95% CI: 21.1-78.9%) and 31.3% in the 112 gBRCAwt pts (95% CI: 22.8-40.7%). HR deficiency status has thus far been determined for 74 pts: 26 pts have HD deficient tumors: 18 TNBC, 5 Luminal B, 2 ER-/HER2+; and 1 ER+/HER2+. Determination of HR deficiency is ongoing and will be reported for the full cohort in terms of 12 week MRI response to T and pCR to T+AC.
HR deficientMolecular Subtypeyes (%)no (%)TBD (%)Luminal A0/112/11 (18.2)9/11 (81.8)Luminal B5/37 (13.5)13/37 (35.1)19/37 (51.3)Luminal NOS0/21/2 (50)1/2 (50)ER+/Her2+1/17 (5.8)14/17 (82.4)2/17 (11.8)ER-/Her2+2/20 (10)11/20 (55)7/20 (35)Triple Negative18/43 (41.9)6/43 (18.6)17/43 (39.5)germline BRCA statusMRI partial response after T (%)MRI complete response after T (%)pCR after T&AC (%)BRCA11/4 (25)0/42/4 (50)BRCA25/8 (62.5)2/8 (25)4/8 (50)BRCAwt35/112 (31.3)18/112 (16.1)35/112 (31.3)
Conclusion: In the setting of neoadjuvant weekly T followed by AC, pCR rates were non-significantly higher in pts with BRCA1 mutations. While we observed no overall association between BRCA mutation status and response rates to taxanes; nearly all MRI responses to taxanes (partial and complete) were observed in the BRCA2 group. Prospective studies are needed to validate these findings and to determine whether BRCA status can be used to select therapy. HR deficiency is uncommon in luminal A and HER2+, frequent in TNBC, and the association of HRD with both MRI response to taxanes and pCR will be reported at the meeting.
Citation Format: Boughey JC, Kalari KR, Suman VJ, McLaughlin SA, Moreno Aspitia A, Moyer AM, Northfelt DW, Gray RJ, Vedell PT, Tang X, Dockter TJ, Jones KN, Felten SJ, Conners AL, Hart SN, Visscher DW, Wieben ED, Ingle JN, Hartman A-R, Timms K, Elkin E, Jones J, Wang L, Weinshilboum RW, Goetz MP. Role of germline BRCA status and tumor homologous recombination (HR) deficiency in response to neoadjuvant weekly paclitaxel followed by anthracycline-based chemotherapy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-29.
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Affiliation(s)
- JC Boughey
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - KR Kalari
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - VJ Suman
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - SA McLaughlin
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - A Moreno Aspitia
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - AM Moyer
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - DW Northfelt
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - RJ Gray
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - PT Vedell
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - X Tang
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - TJ Dockter
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - KN Jones
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - SJ Felten
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - AL Conners
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - SN Hart
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - DW Visscher
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - ED Wieben
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - JN Ingle
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - A-R Hartman
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - K Timms
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - E Elkin
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - J Jones
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - L Wang
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - RW Weinshilboum
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
| | - MP Goetz
- Mayo Clinic, Rochester, MN; Mayo Clinic, Scottsdale, AR; Mayo Clinic, Jacksonville, FL; Myriad Genetic Laboratories, Salt Lake City, UT
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16
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Yu J, Qin B, Boughey JC, Moyer AM, Visscher DW, Sinnwell JP, Yin P, Thompson KJ, Docter TJ, Kalari KR, Suman VJ, Wieben ED, Felten SJ, Conners AL, Jones KN, McLaughlin SA, Copland JA III, Moreno Aspitia A, Northfelt DW, Gray RJ, Ingle JN, Lou Z, Weinshilboum R, Goetz MP, Wang L. Abstract P3-07-51: Regulation of DNA methyltransferases via TRAF6 determines breast cancer response to decitabine. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-51] [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
Abstract
Background: Tumorigenesis involves both genetic and epigenetic changes. Epigenetic alterations are reversible and are promising cancer therapeutic targets. Decitabine (5-aza-2'-deoxycytidine), a DNA methyltransferase inhibitor, is FDA approved for hematological malignancies. However, the effect of decitabine in breast cancer is not completely understood. Previous reports indicated that one decitabine mechanism involves regulation of protein levels for DNMT1, the major DNA methyltransferase that methylates hemimethylated CpG di-nucleotides in DNA. However, the E3 ligase involved in this process has not been identified. Whether decitabine also regulates DNMT3A and 3B in a similar fashion remains unclear. Therefore, our goals were to 1) understand mechanisms underlying decitabine action, 2) test the antitumor activity of decitabine in breast cancer models and 3) identify biomarkers associated with response to decitabine.
Methods and Results: Western blots of breast cancer cell lines showed that DNMT1, DNMT3A, and DNMT3B protein levels decreased following decitabine treatment without a reduction in mRNA levels. Bioinformatic analysis of DNA methyltransferase sequences revealed a potential TRAF6 binding motif, and the interaction with TRAF6 (TNF receptor-associated factor 6) was confirmed by IP. TRAF6 functions as an E3 ligase. To determine whether TRAF6 might be the E3 ligase responsible for the degradation of DNMTs after decitabine treatment, we knocked down TRAF6 by RNA interference or knocked out the TRAF6 gene by CRISPR/Cas9. Down regulation of TRAF6 attenuated DNMT ubiquitination and increased DNMT protein levels, suggesting that TRAF6 might mediate proteasome-dependent degradation of all three DNMTs. This was further confirmed by reconstituting the knockout cells with WT and a TRAF6-C70A mutant, followed by assessing DNMT protein levels. Global DNA methylation was also increased after TRAF6 depletion and was confirmed in TRAF6 knock out cells in which DNMT levels were unaffected by decitabine. Cell cytotoxicity and colony forming assays showed that TRAF6 knockout cells were resistant to decitabine, suggesting that a major decitabine mechanism of action is through the regulation of TRAF6 which, in turn, degrades DNMTs, leading to decreased global methylation. Finally, decitabine significantly induced TRAF6 at both mRNA and protein levels, a process that might create positive feedback leading to increased degradation of DNMT proteins upon decitabine treatment. Based on these results, we further hypothesized that levels of the three DNMTs might influence decitabine response. Using 18 breast cancer patient derived xenograft (PDX) models, we found a wide range of DNMT protein levels regardless of ER/HER2 status. DNMT levels in the PDX models were directly associated with sensitivity to decitabine treatment, confirming our hypothesis.
Conclusion: Our data showed that decitabine might be an effective agent for treating breast cancer and revealed a novel mechanism underlying decitabine treatment. Baseline DNMT protein levels may serve as a biomarker for predicting decitabine drug response.
Citation Format: Yu J, Qin B, Boughey JC, Moyer AM, Visscher DW, Sinnwell JP, Yin P, Thompson KJ, Docter TJ, Kalari KR, Suman VJ, Wieben ED, Felten SJ, Conners AL, Jones KN, McLaughlin SA, Copland JA III, Moreno Aspitia A, Northfelt DW, Gray RJ, Ingle JN, Lou Z, Weinshilboum R, Goetz MP, Wang L. Regulation of DNA methyltransferases via TRAF6 determines breast cancer response to decitabine. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-51.
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Affiliation(s)
- J Yu
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - B Qin
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JC Boughey
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - AM Moyer
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - DW Visscher
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JP Sinnwell
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - P Yin
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - KJ Thompson
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - TJ Docter
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - KR Kalari
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - VJ Suman
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - ED Wieben
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - SJ Felten
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - AL Conners
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - KN Jones
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - SA McLaughlin
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - III Copland JA
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - A Moreno Aspitia
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - DW Northfelt
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - RJ Gray
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JN Ingle
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - Z Lou
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - R Weinshilboum
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - MP Goetz
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - L Wang
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
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Doria D, Kar S, Ahmed H, Alejo A, Fernandez J, Cerchez M, Gray RJ, Hanton F, MacLellan DA, McKenna P, Najmudin Z, Neely D, Romagnani L, Ruiz JA, Sarri G, Scullion C, Streeter M, Swantusch M, Willi O, Zepf M, Borghesi M. Calibration of BAS-TR image plate response to high energy (3-300 MeV) carbon ions. Rev Sci Instrum 2015; 86:123302. [PMID: 26724017 DOI: 10.1063/1.4935582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The paper presents the calibration of Fuji BAS-TR image plate (IP) response to high energy carbon ions of different charge states by employing an intense laser-driven ion source, which allowed access to carbon energies up to 270 MeV. The calibration method consists of employing a Thomson parabola spectrometer to separate and spectrally resolve different ion species, and a slotted CR-39 solid state detector overlayed onto an image plate for an absolute calibration of the IP signal. An empirical response function was obtained which can be reasonably extrapolated to higher ion energies. The experimental data also show that the IP response is independent of ion charge states.
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Affiliation(s)
- D Doria
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - S Kar
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - H Ahmed
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - A Alejo
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - J Fernandez
- Instituto de Fusión Nuclear, Universidad Politécnica de Madrid, Madrid 28006, Spain
| | - M Cerchez
- Institut für Laser-und Plasmaphysik, Heinrich-Heine-Universität, Düsseldorf 40225, Germany
| | - R J Gray
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - F Hanton
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - D A MacLellan
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - P McKenna
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - Z Najmudin
- John Adams Institute for Accelerator Science, The Blackett Laboratory, Imperial College, London SW7 2BW, United Kingdom
| | - D Neely
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - L Romagnani
- LULI, Ecole Polytechnique, CNRS, Route de Saclay, Palaiseau Cedex 91128, France
| | - J A Ruiz
- Colegio Los Naranjos, Fuenlabrada, Madrid 28941, Spain
| | - G Sarri
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - C Scullion
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Streeter
- John Adams Institute for Accelerator Science, The Blackett Laboratory, Imperial College, London SW7 2BW, United Kingdom
| | - M Swantusch
- Institut für Laser-und Plasmaphysik, Heinrich-Heine-Universität, Düsseldorf 40225, Germany
| | - O Willi
- Institut für Laser-und Plasmaphysik, Heinrich-Heine-Universität, Düsseldorf 40225, Germany
| | - M Zepf
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Borghesi
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
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18
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Vaisseau X, Debayle A, Honrubia JJ, Hulin S, Morace A, Nicolaï P, Sawada H, Vauzour B, Batani D, Beg FN, Davies JR, Fedosejevs R, Gray RJ, Kemp GE, Kerr S, Li K, Link A, McKenna P, McLean HS, Mo M, Patel PK, Park J, Peebles J, Rhee YJ, Sorokovikova A, Tikhonchuk VT, Volpe L, Wei M, Santos JJ. Enhanced relativistic-electron-beam energy loss in warm dense aluminum. Phys Rev Lett 2015; 114:095004. [PMID: 25793822 DOI: 10.1103/physrevlett.114.095004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Indexed: 06/04/2023]
Abstract
Energy loss in the transport of a beam of relativistic electrons in warm dense aluminum is measured in the regime of ultrahigh electron beam current density over 2×10^{11} A/cm^{2} (time averaged). The samples are heated by shock compression. Comparing to undriven cold solid targets, the roles of the different initial resistivity and of the transient resistivity (upon target heating during electron transport) are directly observable in the experimental data, and are reproduced by a comprehensive set of simulations describing the hydrodynamics of the shock compression and electron beam generation and transport. We measured a 19% increase in electron resistive energy loss in warm dense compared to cold solid samples of identical areal mass.
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Affiliation(s)
- X Vaisseau
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
| | - A Debayle
- ETSI Aeronáuticos, Universidad Politécnica de Madrid, Madrid, Spain
- CEA, DAM, DIF, F-91297 Arpajon, France
- LRC MESO, Ecole Normale Supérieure de Cachan - CMLA, 94235 Cachan, France
| | - J J Honrubia
- ETSI Aeronáuticos, Universidad Politécnica de Madrid, Madrid, Spain
| | - S Hulin
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
| | - A Morace
- University of California, San Diego, La Jolla, California 92093, USA
| | - Ph Nicolaï
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
| | - H Sawada
- University of California, San Diego, La Jolla, California 92093, USA
| | - B Vauzour
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
| | - D Batani
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
| | - F N Beg
- University of California, San Diego, La Jolla, California 92093, USA
| | - J R Davies
- Fusion Science Center for Extreme States of Matter, Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - R Fedosejevs
- Department of Electrical Engineering, University of Alberta, Edmonton T6G 2G7, Canada
| | - R J Gray
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - G E Kemp
- Physics Department, The Ohio State University, Columbus, Ohio 43210, USA
| | - S Kerr
- Department of Electrical Engineering, University of Alberta, Edmonton T6G 2G7, Canada
| | - K Li
- GoLP, Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, 1049-001 Lisboa, Portugal
| | - A Link
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - P McKenna
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - H S McLean
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M Mo
- Department of Electrical Engineering, University of Alberta, Edmonton T6G 2G7, Canada
| | - P K Patel
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Park
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Peebles
- University of California, San Diego, La Jolla, California 92093, USA
| | - Y J Rhee
- Korea Atomic Energy Research Institute (KAERI), Daejon 305-600, South Korea
| | - A Sorokovikova
- University of California, San Diego, La Jolla, California 92093, USA
| | - V T Tikhonchuk
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
| | - L Volpe
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
| | - M Wei
- General Atomics, San Diego, California 92121, USA
| | - J J Santos
- Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence, France
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MacLellan DA, Carroll DC, Gray RJ, Booth N, Burza M, Desjarlais MP, Du F, Neely D, Powell HW, Robinson APL, Scott GG, Yuan XH, Wahlström CG, McKenna P. Tunable mega-ampere electron current propagation in solids by dynamic control of lattice melt. Phys Rev Lett 2014; 113:185001. [PMID: 25396375 DOI: 10.1103/physrevlett.113.185001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Indexed: 06/04/2023]
Abstract
The influence of lattice-melt-induced resistivity gradients on the transport of mega-ampere currents of fast electrons in solids is investigated numerically and experimentally using laser-accelerated protons to induce isochoric heating. Tailoring the heating profile enables the resistive magnetic fields which strongly influence the current propagation to be manipulated. This tunable laser-driven process enables important fast electron beam properties, including the beam divergence, profile, and symmetry to be actively tailored, and without recourse to complex target manufacture.
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Affiliation(s)
- D A MacLellan
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - D C Carroll
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - R J Gray
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - N Booth
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire OX11 0QX, United Kingdom
| | - M Burza
- Department of Physics, Lund University, P.O. Box 118, S-22100 Lund, Sweden
| | - M P Desjarlais
- Sandia National Laboratories, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - F Du
- Beijing National Laboratory of Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190, China
| | - D Neely
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire OX11 0QX, United Kingdom
| | - H W Powell
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - A P L Robinson
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire OX11 0QX, United Kingdom
| | - G G Scott
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom and Central Laser Facility, STFC Rutherford Appleton Laboratory, Oxfordshire OX11 0QX, United Kingdom
| | - X H Yuan
- Key Laboratory for Laser Plasmas (Ministry of Education) and Department of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai 200240, China
| | - C-G Wahlström
- Department of Physics, Lund University, P.O. Box 118, S-22100 Lund, Sweden
| | - P McKenna
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 0NG, United Kingdom
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Schneider BP, Li L, Shen F, Miller KD, Radovich M, O'Neill A, Gray RJ, Lane D, Flockhart DA, Jiang G, Wang Z, Lai D, Koller D, Pratt JH, Dang CT, Northfelt D, Perez EA, Shenkier T, Cobleigh M, Smith ML, Railey E, Partridge A, Gralow J, Sparano J, Davidson NE, Foroud T, Sledge GW. Genetic variant predicts bevacizumab-induced hypertension in ECOG-5103 and ECOG-2100. Br J Cancer 2014; 111:1241-8. [PMID: 25117820 PMCID: PMC4453857 DOI: 10.1038/bjc.2014.430] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 06/26/2014] [Accepted: 07/08/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Bevacizumab has broad anti-tumour activity, but substantial risk of hypertension. No reliable markers are available for predicting bevacizumab-induced hypertension. METHODS A genome-wide association study (GWAS) was performed in the phase III bevacizumab-based adjuvant breast cancer trial, ECOG-5103, to evaluate for an association between genotypes and hypertension. GWAS was conducted in those who had experienced systolic blood pressure (SBP) >160 mm Hg during therapy using binary analysis and a cumulative dose model for the total exposure of bevacizumab. Common toxicity criteria (CTC) grade 3-5 hypertension was also assessed. Candidate SNP validation was performed in the randomised phase III trial, ECOG-2100. RESULTS When using the phenotype of SBP>160 mm Hg, the most significant association in SV2C (rs6453204) approached and met genome-wide significance in the binary model (P=6.0 × 10(-8); OR=3.3) and in the cumulative dose model (P=4.7 × 10(-8); HR=2.2), respectively. Similar associations with rs6453204 were seen for CTC grade 3-5 hypertension but did not meet genome-wide significance. Validation study from ECOG-2100 demonstrated a statistically significant association between this SNP and grade 3/4 hypertension using the binary model (P-value=0.037; OR=2.4). CONCLUSIONS A genetic variant in SV2C predicted clinically relevant bevacizumab-induced hypertension in two independent, randomised phase III trials.
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Affiliation(s)
- B P Schneider
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - L Li
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - F Shen
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - K D Miller
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - M Radovich
- Department of General Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - A O'Neill
- Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - R J Gray
- Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - D Lane
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - D A Flockhart
- Indiana Institute for Personalized Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - G Jiang
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Z Wang
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - D Lai
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - D Koller
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - J H Pratt
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - C T Dang
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - D Northfelt
- Department of Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - E A Perez
- Mayo Clinic, Jacksonville, FL 32224, USA
| | - T Shenkier
- BCCA – Vancouver Cancer Center, Vancouver, BC, V5Z 4E6, USA
| | - M Cobleigh
- Department of Internal Medicine , Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA
| | - M L Smith
- Research Advocacy Network, Plano, TX 75093, USA
| | - E Railey
- Research Advocacy Network, Plano, TX 75093, USA
| | - A Partridge
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - J Gralow
- University of Washington, Seattle, WA 98195, USA
| | - J Sparano
- Department of Oncology, Montefiore Hospital and Medical Center, Bronx, NY 10467, USA
| | - N E Davidson
- Cancer Institute and University of Pittsburgh Cancer Center, Pittsburgh, PA 15232, USA
| | - T Foroud
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - G W Sledge
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
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21
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Daley DJ, Deane KHO, Gray RJ, Clark AB, Pfeil M, Sabanathan K, Worth PF, Myint PK. Adherence therapy improves medication adherence and quality of life in people with Parkinson's disease: a randomised controlled trial. Int J Clin Pract 2014; 68:963-71. [PMID: 24750544 DOI: 10.1111/ijcp.12439] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Many factors are associated with medication non-adherence in Parkinson's disease (PD), including complex treatment regimens, mood disorders and impaired cognition. However, interventions to improve adherence which acknowledge such factors are lacking. A phase II randomised controlled trial was conducted investigating whether Adherence Therapy (AT) improves medication adherence and quality of life (QoL) compared with routine care (RC) in PD. METHODS Eligible PD patients and their spouse/carers were randomised to intervention (RC plus AT) or control (RC alone). Primary outcomes were change in adherence (Morisky Medication Adherence Scale) and QoL (Parkinson's Disease Questionnaire-39) from baseline to week-12 follow up. Secondary outcomes were MDS-UPDRS (part I, II, IV), Beliefs about Medication Questionnaire (BMQ), EuroQol (EQ-5D) and the Caregiving Distress Scale. Blinded data were analysed using logistic and linear regression models based on the intention-to-treat principle. RESULTS Seventy-six patients and 46 spouse/carers completed the study (intervention: n = 38 patients, n = 24 spouse/carers). At week-12 AT significantly improved adherence compared with RC (OR 8.2; 95% CI: 2.8, 24.3). Numbers needed to treat (NNT) were 2.2 (CI: 1.6, 3.9). Compared with RC, AT significantly improved PDQ-39 (-9.0 CI: -12.2, -5.8), BMQ general harm (-1.0 CI: -1.9, -0.2) and MDS-UPDRS part II (-4.8 CI: -8.1, -1.4). No significant interaction was observed between the presence of a spouse/carer and the effect of AT. CONCLUSION Adherence Therapy improved self-reported adherence and QoL in a PD sample. The small NNT suggests AT may be cost-effective. A larger pragmatic trial to test the efficacy and cost-effectiveness of AT by multiple therapists is required.
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Affiliation(s)
- D J Daley
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK; Norfolk & Norwich University Hospital NHS Foundation Trust, Norwich, UK
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Gwynne D, Kar S, Doria D, Ahmed H, Cerchez M, Fernandez J, Gray RJ, Green JS, Hanton F, MacLellan DA, McKenna P, Najmudin Z, Neely D, Ruiz JA, Schiavi A, Streeter M, Swantusch M, Willi O, Zepf M, Borghesi M. Modified Thomson spectrometer design for high energy, multi-species ion sources. Rev Sci Instrum 2014; 85:033304. [PMID: 24689572 DOI: 10.1063/1.4866021] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A modification to the standard Thomson parabola spectrometer is discussed, which is designed to measure high energy (tens of MeV/nucleon), broad bandwidth spectra of multi-species ions accelerated by intense laser plasma interactions. It is proposed to implement a pair of extended, trapezoidal shaped electric plates, which will not only resolve ion traces at high energies, but will also retain the lower energy part of the spectrum. While a longer (along the axis of the undeflected ion beam direction) electric plate design provides effective charge state separation at the high energy end of the spectrum, the proposed new trapezoidal shape will enable the low energy ions to reach the detector, which would have been clipped or blocked by simply extending the rectangular plates to enhance the electrostatic deflection.
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Affiliation(s)
- D Gwynne
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - S Kar
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - D Doria
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - H Ahmed
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Cerchez
- Institut für Laser-und Plasmaphysik, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - J Fernandez
- Instituto de Fusión Nuclear UPM, Jose Gutierrez Abascal 2, E28006 Madrid, Spain
| | - R J Gray
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - J S Green
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - F Hanton
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - D A MacLellan
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - P McKenna
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
| | - Z Najmudin
- Blackett Laboratory, Imperial College, London SW7 2AZ, United Kingdom
| | - D Neely
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - J A Ruiz
- Instituto de Fusión Nuclear UPM, Jose Gutierrez Abascal 2, E28006 Madrid, Spain
| | - A Schiavi
- Dipartimento SBAI, Università di Roma "La Sapienza," 00161 Rome, Italy
| | - M Streeter
- Blackett Laboratory, Imperial College, London SW7 2AZ, United Kingdom
| | - M Swantusch
- Institut für Laser-und Plasmaphysik, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - O Willi
- Institut für Laser-und Plasmaphysik, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - M Zepf
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Borghesi
- Centre for Plasma Physics, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
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23
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Goetz MP, Boughey JC, Kalari KR, Eckel-Passow J, Suman VJ, Sicotte H, Hart SN, Moyer AM, Visscher DW, Yu J, Gao B, Sinnwell JP, Mahoney DW, Barman P, Vedell P, Tang X, Thompson K, Dockter TJ, Jones KN, Conners AL, McLaughlin SA, Moreno-Aspitia A, Northfelt DW, Gray RJ, Wieben ED, Farrugia G, Schultz C, Ingle JN, Wang L, Weinshilboum RW. Abstract P1-08-10: Integration of next generation sequencing (NGS) and patient derived xenografts (PDX) to identify novel markers of paclitaxel (T) response in the breast cancer genome guided therapy study (BEAUTY). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-08-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Based upon the association between pathologic response and disease free survival, the neoadjuvant setting is increasingly being used for drug development. NGS has identified unique and recurrent genetic alterations in breast cancer (BC) that are potentially targetable; however, the clinical implications are mostly unknown. We developed a prospective neoadjuvant study (BEAUTY) in high risk BC patients (pts) using weekly T followed by anthracycline-based chemo wherein percutaneous tumor biopsies (PTB) are obtained before/during/after chemo for NGS and PDX. Our goal is to identify novel biomarkers/pathways and develop PDX to test new therapeutic approaches.
Methods: Pts underwent PTB at baseline and after 12 wks of T. Response to T was defined based upon 12 week Ki-67: responder (<15%) vs non-responder (≥15%). Pts with histologic response and absence of invasive BC at 12 wks were classified as responders. NGS was performed using PTB/blood DNA (exome) and PTB (RNA seq). MRI response was classified using RECIST criteria. NGS data were used to identify somatic copy number variants (cnvs) and expressed single nucleotide variants (eSNVs). Non-SCID mice (estrogen supplemented) were implanted ≤ 30 minutes with PTB samples.
Results: Of the first 78 pts, 44 have completed T. Here we focus on 18 pts with either triple negative or luminal B BC. Clinical characteristics according to Ki-67 response are shown in Table 1. Comparison of genomic alterations in BEAUTY pts with TCGA identified a greater overlap with copy number gains (73%) compared to deletions (40%), along with similar observations of mutations in TP53, PTEN, RYR2, and AKT1 genes. Association analysis of CNVs and eSNVs between responders/non-responders identified 33 genes (predominantly located in chromosomes 1, 8, 13) and 580 eSNVs (corresponding to 497 genes) with a p < 0.05. Differential gene expression (DGE) analysis of responders/non-responders identified 198 genes with a p-value < 0.05. Integrated analysis of 539 genes (CNVs, eSNVs and DGE) identified pathways such as TGF-beta, Jak-Stat, WNT and NOTCH signalling. PDX take rate was 44% [triple negative (6/10); Luminal B (2/8)]. PDX growth rate was significantly associated with clinical baseline Ki-67 (p = 0.00014).
Conclusion: This is the first prospective study to demonstrate the feasibility of using PTB to obtain both NGS data and PDX in the neoadjuvant setting. PDX take rate is associated with BC subtype and baseline Ki-67. Studies are ongoing to 1) validate genes/pathways associated with treatment response in subsequent BEAUTY pts; 2) genomically characterize and assess PDX in vivo response to T and 3) Use NGS data to prioritize new drugs/drug combinations in PDX.
Funded by Mayo Clinic Center for Individualized Medicine and MC Cancer Center.
Clinical CharacteristicsOverallResponders: 12 week Ki-67 < 15% (n = 9)Non-Responders: 12 week Ki-67 ≥ 15% (n = 9)Median Age495345T stage T2/T314 (78%)7 (78%)7 (78%)Node Positive8 (44%)4 (44%)4 (44%)Triple negative10 (56%)6 (67%)4 (44%)Luminal B8 (44%)3 (33%)5 (56%)Ki-67 after 12 Weeks of T Median 5% (0-11%)Median 35% (17-60%)Complete/Partial MRI Response after T 6 (67%)2 (22%)
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-10.
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Affiliation(s)
- MP Goetz
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JC Boughey
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - KR Kalari
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - J Eckel-Passow
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - VJ Suman
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - H Sicotte
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - SN Hart
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - AM Moyer
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - DW Visscher
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - J Yu
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - B Gao
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JP Sinnwell
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - DW Mahoney
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - P Barman
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - P Vedell
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - X Tang
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - K Thompson
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - TJ Dockter
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - KN Jones
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - AL Conners
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - SA McLaughlin
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - A Moreno-Aspitia
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - DW Northfelt
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - RJ Gray
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - ED Wieben
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - G Farrugia
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - C Schultz
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - JN Ingle
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - L Wang
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
| | - RW Weinshilboum
- Mayo Clinic, Rochester, MN; Mayo Clinic, Jacksonville, FL; Mayo Clinic, Scottsdale, AZ
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24
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MacLellan DA, Carroll DC, Gray RJ, Booth N, Burza M, Desjarlais MP, Du F, Gonzalez-Izquierdo B, Neely D, Powell HW, Robinson APL, Rusby DR, Scott GG, Yuan XH, Wahlström CG, McKenna P. Annular fast electron transport in silicon arising from low-temperature resistivity. Phys Rev Lett 2013; 111:095001. [PMID: 24033041 DOI: 10.1103/physrevlett.111.095001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Indexed: 06/02/2023]
Abstract
Fast electron transport in Si, driven by ultraintense laser pulses, is investigated experimentally and via 3D hybrid particle-in-cell simulations. A transition from a Gaussian-like to an annular fast electron beam profile is demonstrated and explained by resistively generated magnetic fields. The results highlight the potential to completely transform the beam transport pattern by tailoring the resistivity-temperature profile at temperatures as low as a few eV.
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Affiliation(s)
- D A MacLellan
- Department of Physics, SUPA, University of Strathclyde, Glasgow G4 0NG, United Kingdom
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25
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Colgan J, Abdallah J, Faenov AY, Pikuz SA, Wagenaars E, Booth N, Culfa O, Dance RJ, Evans RG, Gray RJ, Kaempfer T, Lancaster KL, McKenna P, Rossall AL, Skobelev IY, Schulze KS, Uschmann I, Zhidkov AG, Woolsey NC. Exotic dense-matter states pumped by a relativistic laser plasma in the radiation-dominated regime. Phys Rev Lett 2013; 110:125001. [PMID: 25166812 DOI: 10.1103/physrevlett.110.125001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Indexed: 06/03/2023]
Abstract
In high-spectral resolution experiments with the petawatt Vulcan laser, strong x-ray radiation of KK hollow atoms (atoms without n = 1 electrons) from thin Al foils was observed at pulse intensities of 3 × 10(20) W/cm(2). The observations of spectra from these exotic states of matter are supported by detailed kinetics calculations, and are consistent with a picture in which an intense polychromatic x-ray field, formed from Thomson scattering and bremsstrahlung in the electrostatic fields at the target surface, drives the KK hollow atom production. We estimate that this x-ray field has an intensity of >5 × 10(18) W/cm(2) and is in the 3 keV range.
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Affiliation(s)
- J Colgan
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Abdallah
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A Ya Faenov
- Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow 125412, Russia and Quantum Beam Science Directorate, Japan Atomic Energy Agency, Kizugawa, Kyoto 619-0215, Japan
| | - S A Pikuz
- Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow 125412, Russia
| | - E Wagenaars
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - N Booth
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - O Culfa
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - R J Dance
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - R G Evans
- Department of Physics, Imperial College, London SW7 2AZ, United Kingdom
| | - R J Gray
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 ONG, United Kingdom
| | - T Kaempfer
- Helmholtzinstitut Jena, Fröbelstieg 1, D-07743 Jena, Germany
| | - K L Lancaster
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - P McKenna
- SUPA, Department of Physics, University of Strathclyde, Glasgow G4 ONG, United Kingdom
| | - A L Rossall
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
| | - I Yu Skobelev
- Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow 125412, Russia
| | - K S Schulze
- Helmholtzinstitut Jena, Fröbelstieg 1, D-07743 Jena, Germany
| | - I Uschmann
- Helmholtzinstitut Jena, Fröbelstieg 1, D-07743 Jena, Germany and Institut für Optik und Quantenelektronic, Friedrich-Schiller-Universität Jena, Max-Wien Platz 1, D-07743 Jena, Germany
| | - A G Zhidkov
- PPC Osaka University and JST, CREST, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - N C Woolsey
- York Plasma Institute, Department of Physics, University of York, York YO10 5DD, United Kingdom
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Scott RHH, Beaucourt C, Schlenvoigt HP, Markey K, Lancaster KL, Ridgers CP, Brenner CM, Pasley J, Gray RJ, Musgrave IO, Robinson APL, Li K, Notley MM, Davies JR, Baton SD, Santos JJ, Feugeas JL, Nicolaï P, Malka G, Tikhonchuk VT, McKenna P, Neely D, Rose SJ, Norreys PA. Controlling fast-electron-beam divergence using two laser pulses. Phys Rev Lett 2012; 109:015001. [PMID: 23031109 DOI: 10.1103/physrevlett.109.015001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 04/18/2012] [Indexed: 06/01/2023]
Abstract
This Letter describes the first experimental demonstration of the guiding of a relativistic electron beam in a solid target using two colinear, relativistically intense, picosecond laser pulses. The first pulse creates a magnetic field that guides the higher-current, fast-electron beam generated by the second pulse. The effects of intensity ratio, delay, total energy, and intrinsic prepulse are examined. Thermal and Kα imaging show reduced emission size, increased peak emission, and increased total emission at delays of 4-6 ps, an intensity ratio of 10∶1 (second:first) and a total energy of 186 J. In comparison to a single, high-contrast shot, the inferred fast-electron divergence is reduced by 2.7 times, while the fast-electron current density is increased by a factor of 1.8. The enhancements are reproduced with modeling and are shown to be due to the self-generation of magnetic fields. Such a scheme could be of considerable benefit to fast-ignition inertial fusion.
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Affiliation(s)
- R H H Scott
- Department of Physics, The Blackett Laboratory, Imperial College London, Prince Consort Road, London, SW7 2AZ, United Kingdom.
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McGhan LJ, Pockaj BA, Gray RJ, Bagaria SP, McLaughlin SA, Casey WJ, Rebecca AM, Wasif N. The impact of breast reconstruction on the decision to undergo contralateral prophylactic mastectomy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
96 Background: In the last decade there has been an increase in the incidence of contralateral prophylactic mastectomy (CPM) for unilateral breast cancer. Although many factors have been proposed to explain this trend, the impact of breast reconstruction on the decision to undergo CPM has not been extensively studied. Methods: A retrospective review of breast cancer patients from Surveillance, Epidemiology and End Results (SEER) registry data (2004-2008) was conducted. Characteristics of patients undergoing CPM were evaluated. Results: 71,176 patients with a diagnosis of stage I-III infiltrating ductal or lobular breast cancer underwent mastectomy for their primary lesion. Among these, 10,558 patients (15%) underwent a CPM. A significantly higher proportion of women undergoing CPM had reconstruction performed (44%) than those patients not undergoing CPM (13%), p<0.001. On multivariate analysis (Table), significant variables predicting CPM included age <50 years (OR 10.12), breast reconstruction (OR 3.58), and lobular histology (OR 1.41), all p<0.001. Of the 12,466 patients (18%) who underwent reconstruction, 4,636 (37%) had implant reconstruction, 4,498 (36%) had tissue reconstruction, and 1,122 (9%) had combined tissue/implant reconstruction (no data for 18%). On multivariate analysis, predictors of reconstruction included age <50 years (OR 20.5; CI 18.5-22.7), year of surgery (2008 vs. 2004; OR 1.60; CI 1.49-1.71), low tumor grade (OR 1.19; CI 1.13-1.25) and ER+ status (OR 1.16; 95% CI 1.10-1.23). The use of radiation therapy was associated with a lower likelihood of pursuing reconstruction (OR 0.61; CI 0.58-0.65). Conclusions: Apart from age, the factor most strongly associated with CPM is the decision to have reconstructive surgery performed. This suggests that CPM may not be purely associated with risk-reduction but also with treatment factors such as cosmesis. [Table: see text]
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Affiliation(s)
- L. J. McGhan
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
| | - B. A. Pockaj
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
| | - R. J. Gray
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
| | - S. P. Bagaria
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
| | - S. A. McLaughlin
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
| | - W. J. Casey
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
| | - A. M. Rebecca
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
| | - N. Wasif
- Mayo Clinic, Phoenix, AZ; Mayo Clinic, Scottsdale, AZ; Mayo Clinic, Jacksonville, FL
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Johnson KN, Stucky CH, Pockaj BA, Gray RJ, Rose PS, Wasif N. Differences between neurofibromatosis-1-associated malignant peripheral nerve sheath tumors (MPNST) and sporadic MPNST: The Mayo Clinic experience. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10066] [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: 11/20/2022] Open
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29
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McKenna P, Robinson APL, Neely D, Desjarlais MP, Carroll DC, Quinn MN, Yuan XH, Brenner CM, Burza M, Coury M, Gallegos P, Gray RJ, Lancaster KL, Li YT, Lin XX, Tresca O, Wahlström CG. Effect of lattice structure on energetic electron transport in solids irradiated by ultraintense laser pulses. Phys Rev Lett 2011; 106:185004. [PMID: 21635098 DOI: 10.1103/physrevlett.106.185004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Indexed: 05/30/2023]
Abstract
The effect of lattice structure on the transport of energetic (MeV) electrons in solids irradiated by ultraintense laser pulses is investigated using various allotropes of carbon. We observe smooth electron transport in diamond, whereas beam filamentation is observed with less ordered forms of carbon. The highly ordered lattice structure of diamond is shown to result in a transient state of warm dense carbon with metalliclike conductivity, at temperatures of the order of 1-100 eV, leading to suppression of electron beam filamentation.
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Affiliation(s)
- P McKenna
- SUPA, Department of Physics, University of Strathclyde, Glasgow, United Kingdom.
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Abstract
Molecular dynamics simulations have been used to model the interaction between ethanol, water, and the {1014} surface of calcite. Our results demonstrate that a single ethanol molecule is able to form two interactions with the mineral surface (both Ca-O and O-H), resulting in a highly ordered, stable adsorption layer. In contrast, a single water molecule can only form one or other of these interactions and is thus less well bound, resulting in a more unstable adsorption layer. Consequently, when competitive adsorption is considered, ethanol dominates the adsorption layer that forms even when the starting configuration consists of a complete monolayer of water at the surface. The computational results are in good agreement with the results from atomic force microscopy experiments where it is observed that a layer of ethanol remains attached to the calcite surface, decreasing its ability to interact with water and for growth at the {1014} surface to occur. This observation, and its corresponding molecular explanation, may give some insight into the ability to control crystal form using mixtures of different organic solvents.
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Affiliation(s)
- D J Cooke
- Department of Chemical and Biological Sciences, University of Huddersfield, United Kingdom.
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31
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Ruggeri BA, Gray RJ, Watkins TR, Tomlins RI. Effects of Low-Temperature Acclimation and Oxygen Stress on Tocopheron Production in Euglena gracilis Z. Appl Environ Microbiol 2010; 50:1404-8. [PMID: 16346941 PMCID: PMC238771 DOI: 10.1128/aem.50.6.1404-1408.1985] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [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
The effects of low-temperature acclimation and oxygen stress on tocopheron production were examined in the unicellular phytoflagellate Euglena gracilis Z. Cells were cultured photoheterotrophically at 27.5 +/- 1 degrees C with 5% carbon dioxide-95% air and 740 microeinsteins m s (photosynthetically active radiation) and served as controls. Low-temperature acclimation (12.5 +/- 1 degrees C) and high-oxygen stress (5% carbon dioxide-95% oxygen) were individually examined in the mass culturing of the algae. Chromatographic analyses demonstrated a six-to sevenfold enhancement of alpha-tocopherol production in temperature-stressed cells, along with a concomitant decline in the levels of alpha-tocotrienol and the absence of other tocopherol homologs. Oxygen-stressed cultures demonstrated the presence of high levels of alpha-tocopherylquinone; alpha-tocopheron and its homologs and precursors were absent or declined markedly. These findings are discussed in terms of the feasibility of microbial production of natural tocopherols. In addition, these results lend themselves to speculation regarding the biological role(s) of tocopherols as antioxidants and free radical scavengers in reducing photo-induced oxidative damage or lipid peroxidation toxicities or both in photosynthetically active E. gracilis Z.
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Affiliation(s)
- B A Ruggeri
- Department of Food Science and Human Nutrition, University of Delaware, Newark, Delaware 19716
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32
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Wasif N, Gray RJ, Pockaj BA. Report card for compliance with NCCN guidelines in the surgical management of cutaneous melanoma across the United States: Time for remedial classes? J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8515] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
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33
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O'Shaughnessy J, Miles D, Gray RJ, Dieras V, Perez EA, Zon R, Cortes J, Zhou X, Phan S, Miller K. A meta-analysis of overall survival data from three randomized trials of bevacizumab (BV) and first-line chemotherapy as treatment for patients with metastatic breast cancer (MBC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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34
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Maynes DL, Hunt KS, Pockaj BA, Gray RJ, Tong WP, Bothe MR, Dueck AC, Northfelt DW. Are HER2-positive breast cancer and BRCA mutation-associated breast cancer mutually exclusive diseases? Evidence from the Mayo Clinic Arizona Cohort. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e21075] [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: 11/20/2022] Open
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35
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Goldstein LJ, Gray RJ, Bugarini R, Shak S, Badve SS, Baehner FL, Davidson NE, Sledge GW, Sparano JA. Predictive utility of progesterone receptor (PR) and multigene expression in identifying benefit from adjuvant doxorubicin plus cyclophosphamide (AC) or docetaxel (AT) in intergroup trial E2197. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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36
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Gor PP, Gray RJ, Horn M, Rebbeck TR, Gimotty PA, Aplenc R, Pins M, Tallman MS, DeMichele A. Association of polymorphic drug metabolizing enzymes (DME) with outcomes in breast cancer patients treated on the ECOG 2190/Intergroup 0121 (E2190/Int0121) study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
596 Background: Disparate outcomes of breast cancer patients after adjuvant chemotherapy may be influenced by variation in drug metabolism due to genetic polymorphisms in DME. Cyclophosphamide and thiotepa require activation by cytochrome P450 (CYP) and detoxification by glutathione-S-transferase, two highly polymorphic enzymes. We hypothesized that variants in CYP3A4(*1B), GSTM1 and GSTT1 would impact survival outcomes after adjuvant chemotherapy, with effects potentially modulated by chemotherapy dose. Methods: We performed a retrospective cohort study of patients enrolled on E2190/Int0121, a randomized trial of cyclophosphamide (C), doxorubicin (A), and fluorouracil (F) versus CAF + high dose chemotherapy (HDC) using cyclophosphamide and thiotepa followed by stem cell rescue; disease-free survival (DFS) and overall survival (OS) were equivalent in the clinical trial. PCR-based methods were used to genotype hematologic stem cells. Hazard ratios for genotypes were obtained using Cox regression. Results: Stem cell samples and clinical data from August 1, 1991 through August 1, 2005 were available for 347/540 of patients enrolled; 151 patients on CAF and 196 on CAF + HDC arms, respectively. Median follow-up was 9.8 years. See table . CYP3A4*1B allele carriers had significantly poorer DFS (HR 1.84) in the combined cohort and CAF arm (HR 1.87), but not in the HDC arm; OS was not significant by CYP3A4 genotype. GSTM1 null homozygotes in the combined cohort and HDC arm had significantly better DFS (HR 0.70 and 0.66, respectively) and OS (HR 0.67 and 0.57, respectively), but not in the CAF arm. GSTT1 null homozygotes had significantly worse DFS (HR 2.3) and OS (2.02) in the CAF arm, but not in the HDC arm or combined cohort. Conclusions: In the overall E2190/Int0121 cohort, polymorphisms in activating (CYP3A4*1B) and inactivating (GSTM1) DME significantly impact DFS and OS. The detrimental effect of GSTT1 in the CAF arm appears to be ameliorated by HDC. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- P. P. Gor
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - R. J. Gray
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - M. Horn
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - T. R. Rebbeck
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - P. A. Gimotty
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - R. Aplenc
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - M. Pins
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - M. S. Tallman
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
| | - A. DeMichele
- University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL
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Kirkham SG, Gray RJ. Multiple carpometacarpal dislocations and an ipsilateral scapho-trapezium-trapezoid fracture-dislocation: a rare pattern of injury. J Orthop Surg (Hong Kong) 2004; 12:267-9. [PMID: 15621921 DOI: 10.1177/230949900401200226] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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] [Indexed: 11/17/2022] Open
Abstract
We report a rare case of simultaneous dorsal dislocation of 4 ulnar carpometacarpal joints and dorsoradial dislocation of the trapezium with an associated fracture of the scaphoid tuberosity. The injuries were diagnosed early and treated successfully with closed reduction and transfixation using Kirschner wires. The functional results were excellent at 17-month follow-up.
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Pockaj BA, Wong WW, Gray RJ, Halyard MY, Vora SA, Schild SE, Apsey HA. Intra-operative electron irradiation and external beam irradiation after lumpectomy in patients with T1/T2N0M0 breast cancer: Preliminary results. Ann Surg Oncol 2004. [DOI: 10.1007/bf02524125] [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: 11/30/2022]
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39
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al-Ani MZ, Gray RJ, Davies SJ, Sloan P. A study of the relationship between lateral guidance and temporomandibular joint internal derangement. Eur J Prosthodont Restor Dent 2003; 11:65-70. [PMID: 12868209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The aim of this study was to examine the relationship between lateral retrusive and lateral protrusive tooth guidance and temporomandibular joint disc displacement. The control group comprised 55 symptomless students and dental nurses. The patient group consisted of 117 patients (90 women and 27 men). Fifty-four patients had temporomandibular joint clicking on the right side and 63 patients had clicking on the left side. The incidence of ipsilateral lateral retrusive tooth guidance was significantly higher in the patient group (87%) than in the control group (18.5%).
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Affiliation(s)
- M Z al-Ani
- University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK.
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40
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Goldhirsch A, Gelber RD, Yothers G, Gray RJ, Green S, Bryant J, Gelber S, Castiglione-Gertsch M, Coates AS. Adjuvant therapy for very young women with breast cancer: need for tailored treatments. J Natl Cancer Inst Monogr 2002:44-51. [PMID: 11773291 DOI: 10.1093/oxfordjournals.jncimonographs.a003459] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.0] [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: 11/14/2022] Open
Abstract
Breast cancer rarely occurs in women below the age of 35 years. Data from various sources indicate that diagnosis at such an age is associated with a dire prognosis mainly because of a more aggressive presentation. Although the effect of chemotherapy for premenopausal patients is substantial, recent evidence on 2233 patients suggested that very young women with endocrine-responsive tumors had a statistically significantly higher risk of relapse than older premenopausal patients with such tumors. In contrast, results for younger and older premenopausal patients were similar if their tumors were classified as endocrine nonresponsive. Information from studies on 7631 patients who were treated with chemotherapy alone in trials of three major U.S. cooperative groups showed a similar interaction between the effect of age and steroid hormone receptor status of the primary tumor. Better treatments for very young patients are required and may involve ovarian function suppression in addition to other endocrine agents in patients with endocrine responsive tumors and a more precise investigation of chemotherapy and its timing, duration, and intensity in those with endocrine nonresponsive tumors. Very young women with this disease are faced with personal, family, professional, and quality-of-life issues, which further complicate the phase of treatment decision making. The development of more effective therapies for younger patients requires tailored treatment investigations and cannot rely on information predominantly contributed from older premenopausal women.
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Affiliation(s)
- A Goldhirsch
- International Breast Cancer Study Group (IBCSG), Bern, Switzerland.
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41
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Abstract
The difference between paediatric dentistry and most other branches of dentistry is that in the child the occlusion is changing. Consequently 'Good Occlusal Practice' in children is a matter of making the right clinical decisions for the future occlusion. The clinician needs to be able to predict the influence that different treatment options will have on the occlusion when the child's development is complete.
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Affiliation(s)
- S J Davies
- University Dental Hospital of Manchester.
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42
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Abstract
Periodontal disease does not directly affect the occluding surfaces of teeth, consequently some may find a section on periodontics a surprising inclusion. Trauma from the occlusion, however, has been linked with periodontal disease for many years. Karolyi published his pioneering paper, in 1901 'Beobachtungen uber Pyorrhoea alveolaris' (occlusal stress and 'alveolar pyorrhoea'). (1) However, despite extensive research over many decades, the role of occlusion in the aetiology and pathogenesis of inflammatory periodontitis is still not completely understood.
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Affiliation(s)
- S J Davies
- University Dental Hospital of Manchester.
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Gray RJ, Salud C, Nguyen K, Dauway E, Friedland J, Berman C, Peltz E, Whitehead G, Cox CE. Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 2001; 8:711-5. [PMID: 11597011 DOI: 10.1007/s10434-001-0711-3] [Citation(s) in RCA: 217] [Impact Index Per Article: 9.4] [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: 10/25/2022]
Abstract
BACKGROUND Standard wire localization (WL) and excision of nonpalpable breast lesions has several shortcomings. METHODS Ninety-seven women with nonpalpable breast lesions were prospectively randomized to radioactive seed localization (RSL) or WL. For RSL, a titanium seed containing 125I was placed at the site of the lesion by using radiographical guidance. The surgeon used a handheld gamma detector to locate and excise the seed and lesion. RESULTS Both techniques resulted in 100% retrieval of the lesions. Fewer RSL patients required resection of additional margins than WL patients (26% vs. 57%, respectively, P = .02). There were no significant differences in mean times for operative excision (5.4 vs. 6.1 minutes) or radiographical localization (13.9 vs. 13.2 minutes). There were also no significant differences in the subjective ease of the procedures as rated by surgeons, radiologists, and patients. All WLs were carried out on the same day as the excision, whereas RSL was performed up to 5 days before the operative procedure. CONCLUSIONS RSL is as effective as WL for the excision of nonpalpable breast lesions and reduces the incidence of pathologically involved margins of excision. RSL also reduces scheduling conflicts and may allow elimination of intraoperative specimen mammography. RSL is an attractive alternative to WL.
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Affiliation(s)
- R J Gray
- Department of Surgery, H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, Tampa 33612, USA
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Abstract
BACKGROUND Radioguided surgery can also be used for the simultaneous guidance to a nonpalpable primary tumor and sentinel lymph nodes. METHODS Retrospective review of a prospective database. The surgeon used a gamma probe for guidance to an iodine-125 labeled titanium seed at the primary lesion and technetium-99 labeled sulfur colloid at the sentinel lymph node. RESULTS Forty-three patients with nonpalpable breast carcinoma underwent dual isotope radioguided surgery. The radioactive seed and primary lesion were retrieved in the first excision in all 44 patients (100%). Eleven patients (25%) had pathologically involved margins. Sentinel lymph node mapping was successful in 42 patients (98%). A mean of 2.4 sentinel nodes were excised and metastatic carcinoma was present in four patients (10%). CONCLUSIONS Dual isotopes can be effectively used in breast cancer patients for simultaneous radioguidance to both a nonpalpable primary lesion and sentinel lymph node and allows for improved logistics.
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Affiliation(s)
- R J Gray
- Department of Surgery, H. Lee Moffitt Cancer Center at the University of South Florida, 12902 Magnolia Dr., Tampa, FL 33612, USA
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Abstract
Axillary lymph node metastases dramatically worsen the prognosis of patients with breast cancer. Despite this prognostic significance, routine histologic examination of axillary lymph nodes examines less than 1% of the submitted material. It is therefore obvious that micrometastatic disease is missed with this rather cursory examination, and the question arises as to the significance of this missed disease. Most lines of evidence suggest that missed axillary micrometastases exist and contribute to patient mortality. Most large studies of breast cancer micrometastases have suggested that undetected axillary micrometastases can be identified with more detailed examinations of the regional lymph nodes and that this group of patients has a poorer prognosis than those with no metastases identified. In addition, small-volume nodal disease, too small to be detected by traditional hematoxylin and eosin staining, has been shown to be capable of producing tumors in animal models. Finally, micrometastases have been shown to be of significance in other diseases. This article reviews the lines of evidence and the ongoing studies that are attempting to clarify the significance of micrometastatic disease in patients with breast cancer.
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Affiliation(s)
- R J Gray
- Department of Surgery, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, Florida 33612, USA
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Cox CE, Nguyen K, Gray RJ, Salud C, Ku NN, Dupont E, Hutson L, Peltz E, Whitehead G, Reintgen D, Cantor A. Importance of lymphatic mapping in ductal carcinoma in situ (DCIS): why map DCIS? Am Surg 2001; 67:513-9; discussion 519-21. [PMID: 11409797] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The appropriateness of sentinel lymph node biopsy in the management of patients with biopsy diagnoses of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCISM) has not been established. Three hundred forty-one patients presented with a biopsy diagnosis of DCIS or DCISM. Two hundred forty (70%) underwent sentinel node biopsy at their definitive procedure. All clinical and pathologic data were collected prospectively. Of 224 patients with a biopsy diagnosis of DCIS 23 (10%) were upstaged to infiltrating ductal carcinoma (IDC) at their definitive therapy and of 16 patients with a biopsy diagnosis of DCISM seven (44%) were upstaged to IDC. Excisional biopsies were no more sensitive for detecting IDC than was core biopsy. Lymph node metastases were detected in 26 of 195 (13%) patients with a definitive diagnosis of DCIS, in three of 15 (20%) with a definitive diagnosis of DCISM, and in eight of 30 (27%) with a definitive diagnosis of IDC. Sentinel lymph node biopsy is a valuable tool in the treatment of patients with DCIS and DCISM and is particularly needed in those undergoing mastectomy. No "high-risk" group of patients can be identified for selective sentinel lymph node biopsy.
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Affiliation(s)
- C E Cox
- Department of Surgery, University of South Florida College of Medicine, Tampa, USA
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47
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Abstract
Occlusal splints are one form of treatment in the management of patients with a temporomandibular disorder. Appliances are often used in conjunction with other forms of treatment such as physiotherapy or medication. A variety of splints is described in the literature and the dentist must ensure that the splint prescribed is of a design that has a proven success rate for the specific diagnosis. General principles that apply to the provision of all splints are outlined in this paper.
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Affiliation(s)
- R J Gray
- Department of Dental Medicine and Surgery, University Dental Hospital of Manchester, Manchester
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48
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Abstract
UNLABELLED We present a prospective study of manipulation of the temporomandibular joint (TMJ) under a general anaesthetic undertaken to find out the success rate in an effort to reduce the number of patients referred for invasive surgery. RESULTS Of the 55 patients invited to participate in this study, 15 improved, 15 did not, 6 showed partial improvement, and 19 were not treated. The median pre-treatment opening was 20mm (range 13-27). Among those who improved after manipulation, the median opening after treatment was 38mm (range 35-56). Some of those who improved experienced a return of TMJ clicking but not of joint or muscle tenderness. CONCLUSION Manipulation under general anaesthesia helps some patients with disc displacement without reduction.
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Affiliation(s)
- M E Foster
- Consultant Oral and Maxillofacial Surgeon, University Dental Hospital of Manchester, Manchester, UK
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49
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Gray RJ, Levitin A, Buck D, Brown LC, Sparling YH, Jablonski KA, Fessahaye A, Gupta AK. Percutaneous fibrin sheath stripping versus transcatheter urokinase infusion for malfunctioning well-positioned tunneled central venous dialysis catheters: a prospective, randomized trial. J Vasc Interv Radiol 2000; 11:1121-9. [PMID: 11041467 DOI: 10.1016/s1051-0443(07)61352-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.6] [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: 11/17/2022] Open
Abstract
PURPOSE To compare central dialysis catheter patency rates after stripping procedures with those after urokinase (UK) infusion. MATERIALS AND METHODS Fifty-seven tunneled catheters with either (i) flow rates less than 250 mL/min and established baseline flow rates > or = 300 mL/min or (ii) flow rates 50 mL/min less than higher established baseline flows were prospectively randomized to undergo stripping procedures (n = 28) or UK infusion (n = 29) at 30,000 U/h via each port concurrently, for a total 250,000 U. Success and patency were determined by dialysis at normal flow rates (> or = 300 mL/min) or at the previously established higher baseline rate. Flow rates were monitored weekly. Primary patency ended with catheter malfunction or removal. Kaplan-Meier survival analysis was used to construct survival curves. RESULTS In the stripping group, initial clinical success was 89% (25 of 28). The 15-, 30-, and 45-day primary patency rates were 75% (n = 20), 52% (n = 13), and 35% (n = 8), respectively. The median duration of additional function was 32 days (95% CI: 18-48 d). In the UK group, initial clinical success was 97% (28 of 29). The 15-, 30-, and 45-day primary patency rates were 86% (n = 21), 63% (n = 13), and 48% (n = 9), respectively. The median duration of additional patency was 42 days (95% CI: 22-153 d). The Wilcoxon test for equality detected no significant difference in the survival curves for the two treatment groups (P = .236). CONCLUSION There is no significant difference in time to primary patency between the two methods. Both allow temporary catheter salvage in most patients.
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Affiliation(s)
- R J Gray
- Department of Radiology, Washington Hospital Center, DC 20010, USA.
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Abstract
An estimator of the regression parameters in a semiparametric transformed linear survival model is examined. This estimator consists of a single Newton-like update of the solution to a rank-based estimating equation from an initial consistent estimator. An automated penalized likelihood algorithm is proposed for estimating the optimal weight function for the estimating equations and the error hazard function that is needed in the variance estimator. In simulations, the estimated optimal weights are found to give reasonably efficient estimators of the regression parameters, and the variance estimators are found to perform well. The methodology is applied to an analysis of prognostic factors in non-Hodgkin's lymphoma.
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Affiliation(s)
- R J Gray
- Department of Biostatistical Science, Dana Farber Cancer Institute and Harvard School of Public Health, Boston, Massachusetts 02115, USA.
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