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Papadakis V, Astigarraga I, van den Bos C, Donadieu J, Henter JI, Jacobs S, Lehrnbecher T, Munthe-Kaas MC, Naeije L, Nanduri V, Nguyen T, Nysom K, Pears J, Raciborska A, Sieni E, Svojgr K, Tzotzola V, Minkov M. The ECHO recommendations for dealing with vinblastine shortage affecting standard treatment of systemic Langerhans cell histiocytosis. Pediatr Blood Cancer 2024; 71:e30850. [PMID: 38185727 DOI: 10.1002/pbc.30850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Vassilios Papadakis
- Department of Pediatric Hematology-Oncology (TAO), Marianna V Vardinoyannis-ELPIDA Oncology Unit, Agia Sofia Children's Hospital, Athens, Greece
| | - Itziar Astigarraga
- Pediatric Oncology Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Pediatric Department, Hospital Universitario Cruces, Osakidetza, Barakaldo, Biscay, Spain
- Pediatric Department, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Cor van den Bos
- Department of Hemato-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jean Donadieu
- Centre de Référence des Histiocytoses Registre des histiocytoses, Service d'Hémato-Oncologie Pédiatrique Hopital Trousseau APHP Paris Sorbonne, Paris, France
| | - Jan-Inge Henter
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- Department of Pediatrics, Astrid Lindgrens Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Jacobs
- Pediatric Hematology Oncology, University Hospital Leuven, Leuven, Belgium
| | - Thomas Lehrnbecher
- Department of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | | | - Leonie Naeije
- Department of Hemato-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Vasanta Nanduri
- Department of Paediatrics, Watford General Hospital, Watford, UK
| | - Trung Nguyen
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Karsten Nysom
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jane Pears
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Anna Raciborska
- Department of Oncology and Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland
| | - Elena Sieni
- Pediatric Hematology/Oncology Department, Meyer Children's University Hospital, Florence, Italy
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Vasiliki Tzotzola
- Department of Pediatric Hematology-Oncology (TAO), Marianna V Vardinoyannis-ELPIDA Oncology Unit, Agia Sofia Children's Hospital, Athens, Greece
| | - Milen Minkov
- CCRI, St. Anna Kinderkrebsforschung, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
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Journy N, Bolle S, Brualla L, Dumas A, Fresneau B, Haddy N, Haghdoost S, Haustermans K, Jackson A, Karabegovic S, Lassen-Ramshad Y, Thariat J, Wette MR, Botzenhardt S, De Wit I, Demoor-Goldschmidt C, Christiaens M, Høyer M, Isebaert S, Jacobs S, Henriksen LT, Maduro JH, Ronckers C, Steinmeier T, Uyttebroeck A, Van Beek K, Walsh L, Thierry-Chef I, Timmermann B. Assessing late outcomes of advances in radiotherapy for paediatric cancers: Study protocol of the "HARMONIC-RT" European registry (NCT 04746729). Radiother Oncol 2024; 190:109972. [PMID: 37922994 DOI: 10.1016/j.radonc.2023.109972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Neige Journy
- National Institute for Medical Research (INSERM) U1018 Center for Research in Epidemiology and Population Health, Laboratory of "Radiation Epidemiology, Clinical Epidemiology and Cancer Survivorship", Paris-Saclay University, Gustave Roussy Cancer Campus, Villejuif, France.
| | - Stéphanie Bolle
- Department of Radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France; West German Proton Therapy Centre Essen (WPE), Hufelandstr. 55, Essen 45147, Germany
| | - Lorenzo Brualla
- West German Proton Therapy Centre Essen (WPE), Hufelandstr. 55, Essen 45147, Germany
| | - Agnès Dumas
- Inserm, Aix Marseille University, IRD, ISSPAM, SESSTIM (Economic and Social Sciences of Health and Medical Information Processing), Marseille, France
| | - Brice Fresneau
- National Institute for Medical Research (INSERM) U1018 Center for Research in Epidemiology and Population Health, Laboratory of "Radiation Epidemiology, Clinical Epidemiology and Cancer Survivorship", Paris-Saclay University, Gustave Roussy Cancer Campus, Villejuif, France; Department of Paediatric Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Nadia Haddy
- National Institute for Medical Research (INSERM) U1018 Center for Research in Epidemiology and Population Health, Laboratory of "Radiation Epidemiology, Clinical Epidemiology and Cancer Survivorship", Paris-Saclay University, Gustave Roussy Cancer Campus, Villejuif, France
| | - Siamak Haghdoost
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden; University of Caen Normandy, Advanced Resource Center for HADrontherapy in Europe (ARCHADE), 14000 Caen, France
| | - Karin Haustermans
- Department of Radiation Oncology, UZ Leuven & Department of Oncology, KU Leuven, Leuven 3000, Belgium
| | - Angela Jackson
- National Institute for Medical Research (INSERM) U1018 Center for Research in Epidemiology and Population Health, Paris-Saclay University, Villejuif, France; National Institute for Medical Research (INSERM) U1018 Center for Research in Epidemiology and Population Health, Paris-Saclay University, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sanja Karabegovic
- Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Yasmin Lassen-Ramshad
- Department of Pediatric and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark
| | - Juliette Thariat
- Centre Régional Francois Baclesse, Avenue Du General Harris 3, Caen Cedex 5 14076, France; Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, F-14000 Caen, France
| | - Martina Roxanne Wette
- Department of Particle Therapy - University Hospital Essen, West German Cancer Centre (WTZ), Hufelandstrasse 55, Essen 45147, Germany; West German Proton Therapy Centre Essen (WPE), Hufelandstr. 55, Essen 45147, Germany
| | - Suzan Botzenhardt
- Department of Particle Therapy - University Hospital Essen, West German Cancer Centre (WTZ), Hufelandstrasse 55, Essen 45147, Germany
| | - Inge De Wit
- Department of Radiation Oncology, UZ Leuven & Department of Oncology, KU Leuven, Leuven 3000, Belgium
| | - Charlotte Demoor-Goldschmidt
- National Institute for Medical Research (INSERM) U1018 Center for Research in Epidemiology and Population Health, Laboratory of "Radiation Epidemiology, Clinical Epidemiology and Cancer Survivorship", Paris-Saclay University, Gustave Roussy Cancer Campus, Villejuif, France; Centre Régional Francois Baclesse, Avenue Du General Harris 3, Caen Cedex 5 14076, France; Centre Hospitalier Universitaire d'Angers, Rue Larrey 4, Angers 49 000, France
| | - Melissa Christiaens
- Department of Radiation Oncology, UZ Leuven & Department of Oncology, KU Leuven, Leuven 3000, Belgium
| | - Morten Høyer
- Aarhus University (AU), Nordre Ringgade 1, Aarhus C 8000, Denmark
| | - Sofie Isebaert
- Department of Radiation Oncology, UZ Leuven & Department of Oncology, KU Leuven, Leuven 3000, Belgium
| | - Sandra Jacobs
- Department of Paediatric Oncology, UZ Leuven, Leuven 3000, Belgium; Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Louise Tram Henriksen
- Department of Pediatric and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark
| | - John H Maduro
- Department of Radiation Oncology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Cecile Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Theresa Steinmeier
- Department of Particle Therapy - University Hospital Essen, West German Cancer Centre (WTZ), Hufelandstrasse 55, Essen 45147, Germany; West German Proton Therapy Centre Essen (WPE), Hufelandstr. 55, Essen 45147, Germany
| | - Anne Uyttebroeck
- Department of Paediatric Oncology, UZ Leuven, Leuven 3000, Belgium
| | - Karen Van Beek
- Department of Radiation Oncology, UZ Leuven & Department of Oncology, KU Leuven, Leuven 3000, Belgium
| | - Linda Walsh
- Department of Physics, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
| | | | - Beate Timmermann
- University Hospital Essen (UK Essen), Hufelandstrasse 55, Essen 45147, Germany; Department of Particle Therapy - University Hospital Essen, West German Cancer Centre (WTZ), Hufelandstrasse 55, Essen 45147, Germany; West German Proton Therapy Centre Essen (WPE), Hufelandstr. 55, Essen 45147, Germany
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Vanderhaegen J, Prikken S, Van Laere E, Lemiere J, Claes L, Moons P, Uyttebroeck A, Jacobs S, Luyckx K. Identity Formation and General and Cancer-specific Functioning in Adolescent and Emerging Adult Survivors of Childhood Cancer: A Longitudinal Study into Directionality of Effects. Ann Behav Med 2023; 57:722-732. [PMID: 37036114 DOI: 10.1093/abm/kaac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Adolescent and emerging adult survivors of childhood cancer generally adjust well psychologically similar to their peers. Nevertheless, some survivors are at greater risk for developing psychological and physical difficulties. To shed light on the psychosocial functioning of adolescent and emerging adult survivors of childhood cancer, personal identity formation and its interplay with general and cancer-specific functioning need to be investigated. PURPOSE To examine the longitudinal associations linking identity formation to general and cancer-specific functioning in adolescent and emerging adult childhood cancer survivors using three-wave data over a 2-year period. METHODS Dutch-speaking survivors (at baseline: n = 125; 53% female; age range: 14-25 years) treated at the pediatric oncology department of the University Hospitals Leuven (Belgium), completed self-report questionnaires at three annual timepoints. Directionality of effects and correlated changes were examined using cross-lagged structural equation modeling. RESULTS Regarding general functioning, bidirectional effects occurred. Life satisfaction positively predicted identity synthesis and both life satisfaction and good physical functioning negatively predicted identity confusion over time. Identity synthesis, in turn, positively predicted life satisfaction and identity confusion negatively predicted good physical functioning over time. Regarding cancer-specific functioning, mainly unidirectional effects occurred. Post-traumatic stress symptoms negatively predicted identity synthesis and positively predicted identity confusion over time, whereas the reverse pattern of associations was found for benefit finding. Several correlated changes were found linking identity formation and psychosocial functioning as well. CONCLUSIONS The present study uncovered clinically meaningful pathways linking identity formation to psychosocial functioning over time in adolescents and emerging adults who survived childhood cancer.
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Affiliation(s)
- Janne Vanderhaegen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Sofie Prikken
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Elise Van Laere
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Pediatric Oncology, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Anne Uyttebroeck
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Pediatric Oncology, KU Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Pediatric Oncology, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- UNIBS, University of the Free State, Bloemfontein, South Africa
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Wademan DT, Viljoen L, Jacobs S, Meyerson K, Nombewu Y, Busakwe L, Schaaf HS, Hesseling AC, Winckler J, Garcia-Prats AJ, Hoddinott G. Children´s priorities to improve the acceptability of MDR-TB treatment: qualitative data from South Africa. Int J Tuberc Lung Dis 2023; 27:543-550. [PMID: 37353869 DOI: 10.5588/ijtld.22.0573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND: Multidrug-resistant TB (MDR-TB) treatment for children frequently includes unpalatable drugs with low overall acceptability. This can negatively impact children and their caregivers´ treatment experiences and is an important contributor to poor adherence, and potentially, poor treatment outcomes. Children and their caregivers´ preferences for MDR-TB treatment are not well documented. We describe children and caregivers´ priorities to inform future MDR-TB treatment regimens.METHODS: We conducted a cross-sectional qualitative study at a TB hospital in South Africa using semi-structured interviews and participatory research activities with caregivers and children routinely diagnosed and treated for MDR-TB between June and August 2018.RESULTS: We conducted 15 interviews with children and their caregivers. Children ranged from 2 to 17 years of age (median age: 8.3 years). Children and caregivers had an overall negative experience of MDR-TB treatment. Children and caregivers described how future MDR-TB drugs and regimens should prioritise sweeter flavours, fewer pills, brighter colours, and formulations that are easy to prepare and administer and dispensed in colourful, small and discrete packaging.CONCLUSIONS: MDR-TB treatment acceptability remains low, and negatively impacts children and their caregivers´ treatment experiences. Improving the overall acceptability of MDR-TB treatment requires engaging with children and their caregivers to better understand their priorities for new treatment regimens and child-friendly formulations.
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Affiliation(s)
- D T Wademan
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - L Viljoen
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - S Jacobs
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - K Meyerson
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Y Nombewu
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - L Busakwe
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - H S Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - J Winckler
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - A J Garcia-Prats
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa, Department of Paediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - G Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
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Seston EM, Willis SC, Fenton C, Hindi AMK, Moss A, Stearns S, Astbury J, Jacobs S, McDermott I, Schafheutle EI. Implementation of behaviour change training in practice amongst pharmacy professionals in primary care settings: Analysis using the COM-B model. Res Social Adm Pharm 2023:S1551-7411(23)00239-5. [PMID: 37121797 DOI: 10.1016/j.sapharm.2023.04.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND The Pharmacy Integration Fund (PhIF) was established in England in 2016, with funded learning programmes or 'pathways' designed to support the development of clinical pharmacy practice in a range of settings. Despite pharmacy staff being well positioned to provide more clinical work, limited research has investigated behaviour change training targeted at widespread practice transformation. OBJECTIVE(S) To investigate implementation of PhIF learning in practice, using the COM-B model of behaviour change. METHODS An online survey distributed in February and October 2020 included questions on motivations for learning, confidence in target behaviours and impact of PhIF training on behaviour. The October 2020 survey also included questions exploring the effect of the COVID-19 pandemic. Quantitative data were analysed in SPSS. v.27 (IBM). Inferential statistics were used to compare between the pathways (Primary care pathways [PCP], Post-registration pathway [PRP] and Accuracy Checking Pharmacy Technician [ACPT] pathway). Free text comments were categorised and themed. RESULTS Three-hundred and eighty-three responses were received (49% PRP learners, 39% PCP learners and 12% ACPT learners). Learners generally had the capacity and opportunities to apply learning, and were strongly motivated to implement behaviours in practice, although learners based in community pharmacy (those on the PRP) were less likely to report receiving employer support. Enhanced knowledge/skills (capacity) were more commonly reported than change to patient-facing activities, leading clinical services and conducting medication reviews with patients with complex needs (clinical practice behaviours targeted by the pathways). The COVID-19 pandemic heightened barriers to implementing practice change. CONCLUSIONS Implementation of a range of clinical practice behaviours following at scale training appears to have been largely successful. Despite this, the community pharmacy context, where funded service opportunities may be lacking, continues to present challenges to workforce transformation plans. More work is needed to understand how training can be implemented to promote practice change for pharmacy professionals in all settings.
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Affiliation(s)
- E M Seston
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - S C Willis
- Innovation Management and Policy Division, Alliance Manchester Business School, The University of Manchester, Booth Street West, Manchester, M15 6PB, UK.
| | - C Fenton
- ICF, Riverscape, 3rd Floor, 10 Queens Street Place, London, EC4R 1BE, UK
| | - A M K Hindi
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - A Moss
- ICF, Riverscape, 3rd Floor, 10 Queens Street Place, London, EC4R 1BE, UK
| | - S Stearns
- ICF, Riverscape, 3rd Floor, 10 Queens Street Place, London, EC4R 1BE, UK
| | - J Astbury
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - S Jacobs
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - I McDermott
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
| | - E I Schafheutle
- Centre for Pharmacy Workforce Studies Division of Pharmacy & Optometry Faculty of Biology, Medicine and Health Stopford Building, University of Manchester, M13 9PT, UK
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Kooij J, De Troy E, Vlasselaers D, Dauwe D, Janssens S, Vandenbriele C, Adriaenssens T, Dewolf P, Jacobs S, Meyns B. Using the SCAI Classification for Early Identification and Real-Time Monitoring of Cardiogenic Shock Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.626] [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: 04/05/2023] Open
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Payne C, Jacobs S, Shaboodien S, Jumaar C, Pretorius A, Kgatla T, Sanni O, Maarman G. A pulmonary arterial hypertension diagnostic algorithm for a third-world context: SYMQUICK. J Investig Med 2023; 71:542-544. [PMID: 36789665 DOI: 10.1177/10815589231155194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Thouvenin J, Van Marcke C, Decoster L, Raicevic G, Punie K, Vandenbulcke M, Salgado R, Van Valckenborgh E, Maes B, Joris S, Steichel DV, Vranken K, Jacobs S, Dedeurwaerdere F, Martens G, Devos H, Duhoux FP, Rasschaert M, Pauwels P, Geboes K, Collignon J, Tejpar S, Canon JL, Peeters M, Rutten A, Van de Mooter T, Vermeij J, Schrijvers D, Demey W, Lybaert W, Van Huysse J, Mebis J, Awada A, Claes KBM, Hebrant A, Van der Meulen J, Delafontaine B, Bempt IV, Maetens J, de Hemptinne M, Rottey S, Aftimos P, De Grève J. PRECISION: the Belgian molecular profiling program of metastatic cancer for clinical decision and treatment assignment. ESMO Open 2022; 7:100524. [PMID: 35970014 PMCID: PMC9434164 DOI: 10.1016/j.esmoop.2022.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
PRECISION is an initiative from the Belgian Society of Medical Oncology (BSMO) in collaboration with several stakeholders, encompassing four programs that aim to boost genomic and clinical knowledge with the ultimate goal to offer patients with metastatic solid tumors molecularly guided treatments. The PRECISION 1 study has led to the creation of a clinico-genomic database. The Belgian Approach for Local Laboratory Extensive Tumor Testing (BALLETT) and GeNeo studies will increase the number of patients with advanced cancer that have comprehensive genotyping of their cancer. The PRECISION 2 project consists of investigator-initiated phase II studies aiming to provide access to a targeted drug for patients whose tumors harbor actionable mutations in case the matched drug is not available through reimbursement or clinical trials in Belgium.
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Affiliation(s)
- J Thouvenin
- Hospices Civils de Lyon, Medical Oncology, Lyon, France; Institut Jules Bordet, Medical Oncology Clinic, Brussels, Belgium
| | | | - L Decoster
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Punie
- KU Leuven University Hospitals Leuven, General Medical Oncology, Leuven, Belgium
| | | | - R Salgado
- GasthuisZusters Antwerpen, Pathology, Antwerp, Belgium
| | | | - B Maes
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - S Joris
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Vranken
- Pediatric Oncology, WIV-ISP, Leuven, Belgium
| | | | | | - G Martens
- Laboratoriumgeneeskunde, AZ Delta, Roeselare, Belgium
| | - H Devos
- Laboratoriumgeneeskunde, AZ Sint-Jan, Bruges, Belgium
| | - F P Duhoux
- UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - M Rasschaert
- Universitair Ziekenhuis Antwerpen, Medical Oncology, Antwerpen, Belgium; Medical Oncology, AZ Monica, Deurne, Belgium
| | - P Pauwels
- Universitair Ziekenhuis Antwerpen, Pathology, Antwerpen, Belgium
| | - K Geboes
- Division of Digestive Oncology, Department of Gastroenterology, UZ Gent, Gent, Belgium; Department of Internal Medicine and Pediatrics, UZ Gent, Gent, Belgium
| | - J Collignon
- Medical Oncology, CHU de Liege - Hospital Sart Tilman, Liège, Belgium
| | | | - J-L Canon
- Grand Hôpital de Charleroi Site Notre Dame, Service d'Oncologie-Hématologie, Charleroi, Belgium
| | - M Peeters
- Universitair Ziekenhuis Antwerpen, Oncology, Antwerpen, Belgium
| | - A Rutten
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - T Van de Mooter
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Vermeij
- ZNA Middelheim, Medical Oncology, Antwerpen, Belgium
| | | | - W Demey
- AZ Klina, Medical Oncology, Brasschaat, Belgium
| | - W Lybaert
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Van Huysse
- AZ Sint-Jan Brugge-Oostende, Pathology, Brugge, Belgium
| | - J Mebis
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - A Awada
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | | | | | | | | | | | | | | | - S Rottey
- Medical Oncology Department, UZ Gent, Gent, Belgium
| | - P Aftimos
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | - J De Grève
- UZ Brussel, Medical Oncology, Brussels, Belgium.
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Nussbaumer G, Benesch M, Gielen GH, Castel D, Grill J, Alonso Roldán MM, Antonelli M, Bailey S, Baugh JN, Biassoni V, Carai A, Colditz N, Colefati GS, Corbacioglu S, Crampsie S, Entz-Werle N, Eyrich M, Frühwald MC, Garrè ML, Gerber NU, Giangaspero F, Gil-da-Costa MJ, Grabovska Y, Graf N, Hargrave D, Hauser P, Hoffmann M, Hulleman E, Jacobs S, Karremann M, Kattamis A, Kebudi R, Kortmann RD, Kwiecien R, Mackay A, Massimino M, Miele E, Mastronuzzi A, Morana G, Noack CM, Pentikainen V, Perwein T, Pfister SM, Pietsch T, Roka K, Rossi S, Rutkowski S, Schiavello E, Štěrba J, Sturm D, Sumerauer D, Temelso S, van Vuurden D, Varlet P, Veldhuijzen van Zanten SEM, Vinci M, von Bueren AO, Warmuth-Metz M, Wesseling P, Wiese M, Wolff JEA, Zamecnik J, Jones DTW, Bison B, La Madrid AM, Jones C, Kramm CM. HGG-49. Gliomatosis cerebri in children: A collaborative report from the European Society for Pediatric Oncology (SIOPE). Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac079.264] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Gliomatosis cerebri (GC), a radiologically defined diffusely infiltrating glioma, is no longer considered a distinct entity since the 2016 WHO classification for tumors of the CNS. Due to its rarity and dismal prognosis treatment recommendations in children remain ambiguous. Using central neuroradiological review, we performed a multi-institutional, retrospective study of GC providing comprehensive radiological, clinical, and (epi)genetic characterization. RESULTS: We included 104 patients between 1-19 years. Within a median follow-up of 15.5 months (range, 2.3-138.8), 93 patients (89.4 %) had died, 4 (3.8 %) were lost to follow-up and 7 (6.8 %) were alive with stable/progressive disease. Median progression-free- (PFS) and overall survival (OS) were 8.6 months (interquartile range, 4.3-14.0) and 15.5 months (10.9-27.7), respectively. Former WHO grading correlated significantly with median OS: WHO °II: 47.8 months (25.2-55.7); WHO °III: 15.9 months (11.4-26.3); WHO °IV: 10.4 months (8.8-14.4) (p<0.001). In high-grade gliomas (HGG), radiochemotherapy showed best PFS (p=0.002). Compared to hemispheric pediatric non-GC HGG, GC phenotype was associated with decreased OS (p=0.001). Methylation-based classification and exome sequencing were possible for 49 and 45 patients, respectively. According to the 2021 WHO classification, most cases were considered as IDH-/H3-wildtype gliomas (n=37/49, 75.5 %), mostly with a pedRTK2 subtype (n=15, 30.6%), followed by pedMYCN (n=5, 10.2 %). Within the IDH-/H3-wildtype gliomas, EGFR-altered tumors (n=10) seemed overrepresented. Survival analyses revealed a better OS for IDH1-mutant tumors (n=6; 54.6 vs. 15.2 months in IDH-wildtype; p=0.015) and a worse OS for TP53-mutant tumors (n=6; p=0.001). Despite the potential overrepresentation of EGFR-altered tumors, no other specific molecular markers for GC could be identified so far. Further analyses are ongoing. CONCLUSIONS: GC in children is confirmed as a poor prognostic phenotype include various epigenetic pediatric glioma subtypes, without a proven (epi)genetic mark of its own. The relevance of overrepresented EGFR alterations has to be determined yet.
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Affiliation(s)
- Gunther Nussbaumer
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria
| | - Martin Benesch
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria
| | - Gerrit H Gielen
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn , Bonn , Germany
| | - David Castel
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Center, Paris-Saclay University , Villejuif , France
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Center, Paris-Saclay University , Villejuif , France
| | | | - Manila Antonelli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences , Rome , Italy
| | - Simon Bailey
- Department of Paediatric Oncology, Sir James Spence Institute of Child Health, Royal Victoria Infirmary Queen, Newcastle upon Tyne, United Kingdom
| | - Joshua N Baugh
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy
| | - Andrea Carai
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital , Rome , Italy
| | - Niclas Colditz
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
| | | | - Selim Corbacioglu
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg , Regensburg , Germany
| | - Shauna Crampsie
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | - Natacha Entz-Werle
- Pediatric Onco-Hematology department - Pediatrics III, University Hospital of Strasbourg , Strasbourg , France
- UMR CNRS 7021, Laboratory of Bioimaging and pathologies , Illkirch , France
| | - Matthias Eyrich
- Children's Department of Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital , Wuerzburg , Germany
| | - Michael C Frühwald
- Swabian Children's Cancer Center, University Children's Hospital Augsburg , Augsburg , Germany
| | - Maria Luisa Garrè
- Neuro-Oncology Unit, IRCSS Istituto Giannina Gaslini , Genoa , Italy
| | - Nicolas U Gerber
- Department of Oncology and Children's Research Centre, University Children's Hospital , Zurich , Switzerland
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University , Rome , Italy
| | | | - Yura Grabovska
- Division of Molecular Pathology, The Institute of Cancer Research , London , United Kingdom
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University , Homburg , Germany
| | - Darren Hargrave
- Paediatric Oncology, Great Ormond Street Hospital for Children , London , United Kingdom
| | - Peter Hauser
- Second Department of Pediatrics, Semmelweis University , Budapest , Hungary
| | - Marion Hoffmann
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
| | - Esther Hulleman
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
| | - Sandra Jacobs
- Department of Microbiology and Immunology, Laboratory of Pediatric Immunology, KU Leuven , Leuven , Belgium
| | - Michael Karremann
- Department of Pediatric and Adolescent Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - Antonis Kattamis
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital , Athen , Greece
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University , Istanbul , Turkey
| | | | - Robert Kwiecien
- Institute of Biostatistics and Clinical Research, University of Muenster , Muenster , Germany
| | - Alan Mackay
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy
| | - Evelina Miele
- Department of Onco-haematology, Gene and Cell Therapy, Bambino Gesù Children's Hospital - IRCCS , Rome , Italy
| | - Angela Mastronuzzi
- Department of Onco-haematology, Gene and Cell Therapy, Bambino Gesù Children's Hospital - IRCCS , Rome , Italy
| | - Giovanni Morana
- Department of Radiology, Santa Maria di Ca' Foncello Hospital , Treviso , Italy
| | - Claudia M Noack
- Center of Radiology, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hospital of Fulda , Fulda , Germany
| | - Virve Pentikainen
- Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, Helsinki University Hospital , Helsinki , Finland
| | - Thomas Perwein
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria
| | - Stefan M Pfister
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Consortium for Translational Cancer Research (DKTK) , Heidelberg , Germany
| | - Torsten Pietsch
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn , Bonn , Germany
| | - Kleoniki Roka
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital , Athen , Greece
| | - Sabrina Rossi
- Pathology Unit-Department of Laboratories, Bambino Gesù Children's Hospital - IRCCS , Roma , Italy
| | - Stefan Rutkowski
- Departement of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy
| | - Jaroslav Štěrba
- Department of Pediatric Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University , Brno , Czech Republic
| | - Dominik Sturm
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - David Sumerauer
- Department of Pediatric Hematology and Oncology, Motol University Hospital, Charles University , Prague , Czech Republic
| | - Sara Temelso
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | | | - Pascale Varlet
- Department of Neuropathology, GHU Paris - Sainte-Anne Hospital , Paris , France
| | | | - Maria Vinci
- Department of Onco-haematology, Gene and Cell Therapy, Bambino Gesù Children's Hospital - IRCCS , Rome , Italy
| | - André O von Bueren
- Department of Pediatrics, Obstetrics and Gynecology, Division of Pediatric Hematology and Oncology, University Hospital Geneva , Geneva , Switzerland
| | - Monika Warmuth-Metz
- Institute of Diagnostic and Interventional Neuroradiology, University of Wuerzburg , Wuerzburg , Germany
| | - Pieter Wesseling
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
- Department of Pathology, Amsterdam UMC , Amsterdam , Netherlands
| | - Maria Wiese
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
| | | | - Josef Zamecnik
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol , Prague , Czech Republic
| | - David T W Jones
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Brigitte Bison
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg , Augsburg , Germany
| | - Andrés Morales La Madrid
- Pediatric Neuro-Oncology, Department of Pediatric Oncology, Hospital Sant Joan de Deu , Barcelona , Spain
| | - Chris Jones
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | - Christof M Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
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10
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Bullens K, Sleurs C, Van den Wyngaert L, Vandenabeele K, Vercruysse T, Claeys L, Prikken S, Jacobs S, Lemiere J. QOL-16. A 6-year longitudinal study of neurocognition in children treated for a brain tumor. Neuro Oncol 2022. [PMCID: PMC9165026 DOI: 10.1093/neuonc/noac079.499] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Long-term neurocognitive difficulties in children treated for a brain tumor are well documented and known to be affected by treatment. However, longitudinal studies of these neurocognitive difficulties are scarce. In the present study, we investigated the impact of radiotherapy (RT) on the evolution of neurocognition between different consecutive time points after diagnosis, and throughout treatment and survivorship. This study included 69 children diagnosed with a brain tumor at the University Hospitals Leuven who completed a comprehensive neuropsychological test battery (intelligence, memory, visuomotor functioning, and QoL) on at least three consecutive time points (2-year interval). Of all patients, 40 completed the test battery at 4 time points. The first assessment was conducted at the earliest possible moment after diagnosis and before the start of any adjuvant therapy. Mean age at diagnosis and first assessment were 7.75 and 7.92 years, respectively. The most common diagnoses were pilocytic astrocytoma (n=33) and medulloblastoma (n=11). 29.0% of the children received local RT and 15.9% received craniospinal RT. A repeated measures analysis with cranial irradiation (no, focal, craniospinal) as between-subjects factor and age at diagnosis as covariate demonstrated a significant interaction effect between time and type of irradiation for both overall intelligence (p=0.007) and QoL (p=0.006) for children with three and four assessments. Children who received craniospinal irradiation demonstrated a significant decline in overall intelligence and a significant worsening of QoL. For the non-irradiated group, an improvement of QoL was observed. For processing speed, a significant time effect was found for children with three and four assessments (p<0.001), with a significant improvement for the overall group. The results of this longitudinal study demonstrated diverse longitudinal trajectories. Children who received craniospinal irradiation are most often confronted with intellectual decline and worsening of QoL.
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Affiliation(s)
| | | | | | | | | | | | | | - Sandra Jacobs
- KU Leuven , Leuven , Belgium
- UZ Leuven , Leuven , Belgium
| | - Jurgen Lemiere
- KU Leuven , Leuven , Belgium
- UZ Leuven , Leuven , Belgium
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11
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Messiaen J, Antoranz A, Van Herck Y, Verhaaren B, Nazari P, Sebastian I, Milli G, Bosisio F, Pey J, Bempt IV, Sciot R, Jacobs S, De Smet F. HGG-56. Spatial mapping of the tumor micro-environment in pediatric glioma. Neuro Oncol 2022. [PMCID: PMC9165297 DOI: 10.1093/neuonc/noac079.271] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
High-grade glioma are the main cause of cancer-related death in children. The highly heterogeneous composition of the tumor cells and their interactions with the tumor micro-environment (TME), contribute substantially to the poor response to treatment and the high levels of morbidity and mortality. Here, we used high-dimensional, multiplexed immunohistochemistry to map the single-cell tissue architecture of 26 pediatric glioma samples covering 8 histologic diagnoses, allowing us to determine the spatial distribution of the various tumoral subtypes and how these interact with their local immune-microenvironment. Overall, this analysis showed that tumor grade anti-correlated with the amount of infiltrating cytotoxic T-lymphocytes (CTLs), which were typically more exhausted in the higher grade tumors. In addition, tumor associated macrophages were primarily infiltrating from the blood and presented an M2-like anti-inflammatory phenotype which became more extended with tumor grade. Using the spatial information, possible cell-cell interactions could be determined. In lower grade glioma, we observed an increased activation level of CTLs that were closely located to neighboring T-helper cells. In pediatric glioblastoma, on the other hand, CTLs, even though they were located close to a T-helper cell, could only minimally be activated, and showed more extended exhaustion when residing further away. Additionally, the activation of the CTLs was associated to the distance to the closest PD-L1 positive macrophage in pilocytic astrocytoma and desmoplastic infantile ganglioglioma. In conclusion, with the use of multiplex immunohistochemistry, we are able to study the tumor and TME of pediatric glioma in depth on a single-cell and spatial level, which allows us to further study the heterogeneous landscape of these tumors.
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Affiliation(s)
- Julie Messiaen
- Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Asier Antoranz
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Yannick Van Herck
- Department of Oncology, University Hospitals Leuven , Leuven , Belgium
- Department of Oncology, KU Leuven , Leuven , Belgium
| | - Ben Verhaaren
- Department of Radiology, University Hospitals Leuven , Leuven , Belgium
| | - Pouya Nazari
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Ivey Sebastian
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Giorgia Milli
- Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Francesca Bosisio
- Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
- Department of Pathology, University Hospitals Leuven , Leuven , Belgium
| | - Jon Pey
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Isabelle Vanden Bempt
- Department of Human Genetics, University Hospitals Leuven , Leuven , Belgium
- Department of Human Genetics, KU Leuven , Leuven , Belgium
| | - Raf Sciot
- Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
- Department of Pathology, University Hospitals Leuven , Leuven , Belgium
| | - Sandra Jacobs
- Department of Pediatric Hematology-Oncology, Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
- Department of Pediatric Oncology, KU Leuven , Leuven , Belgium
| | - Frederik De Smet
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
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12
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Messiaen J, Claeys A, Shetty A, Spans L, Derweduwe M, Uyttebroeck A, Depreitere B, Bempt IV, Sciot R, Ligon K, Jones D, Jacobs S, De Smet F. OTHR-39. Extraneural spreading of a diffuse leptomeningeal glioneuronal tumor in a child: patient-derived models show sensitivity to vinblastin and trametinib. Neuro Oncol 2022. [PMCID: PMC9164998 DOI: 10.1093/neuonc/noac079.577] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Diffuse leptomeningeal glioneuronal tumors (DLGNT) are rare neoplasms of the central nervous system. We describe the generation of patient-derived models from a DLGNT that metastasized to the peritoneal cavity via a ventriculoperitoneal shunt in a child. The original tumor contained a KIAA1549:BRAF fusion with a chromosome 1p deletion and corresponded with methylation subclass DLGNT-MC-2 From a sample of ascitic fluid, metastatic tumoral cells could be extracted and expanded ex vivo into a long-term cell culture model. This patient-derived cell line (PDCL) showed mixed morphological phenotypes and expressed MAP2 and SYP. The KIAA1549:BRAF fusion was preserved and the PDCL still corresponded to the original methylation subclass DLGNT-MC-2. Whole-genome sequencing showed additional mutations potentially contributing to the malignant behavior of the tumor. Cytotoxic assays performed on the PDCL indicated high sensitivity to vinblastine and trametinib (MEK-inhibitor) and intermediate sensitivity to DRD/ClpP-modulators. The PDCL underwent viral transduction to induce GFP-fLux positivity and was intraperitoneally injected into immunocompromised mice. A mouse model could be generated, with the growth of a peritoneal tumor in a localized manner. The cells grown from the mouse tumor were again put into culture and were afterwards subjected to the same treatments as the PDCL. This confirmed a similar profile, with high sensitivity to vinblastin and trametinib and an intermediate sensitivity to the DRD/ClpP-modulators. In conclusion, we were able to generate patient-derived models from a metastatic DLGNT, which recapitulate the molecular characteristics of the original tumor. The models showed high sensitivity to vinblastin and targeted therapy with MEK-inhibition, but further studies are necessary to define the adequate treatment for this kind of tumor.
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Affiliation(s)
- Julie Messiaen
- Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Annelies Claeys
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Aniket Shetty
- Center for Patient Derived Models, Dana-Farber Cancer Institute , Boston, MA , USA
| | - Lien Spans
- Department of Human Genetics, University Hospitals Leuven , Leuven , Belgium
| | - Marleen Derweduwe
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Oncology, KU Leuven , Leuven , Belgium
- Department of Pediatric Hematology-Oncology, Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
| | - Bart Depreitere
- Research Group Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, KU Leuven , Leuven , Belgium
- Department of Neurosurgery, University Hospitals Leuven , Leuven , Belgium
| | - Isabelle Vanden Bempt
- Department of Human Genetics, KU Leuven , Leuven , Belgium
- Department of Human Genetics, University Hospitals Leuven , Leuven , Belgium
| | - Raf Sciot
- Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
- Department of Pathology, University Hospitals Leuven , Leuven , Belgium
| | - Keith Ligon
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School , Boston, MA , USA
- Center for Patient Derived Models, Dana-Farber Cancer Institute , Boston, MA , USA
| | - David Jones
- Hopp Children′s Cancer Center at the NCT Heidelberg (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neuro-oncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Sandra Jacobs
- Department of Pediatric Oncology, KU Leuven , Leuven , Belgium
- Department of Pediatric Hematology-Oncology, Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
| | - Frederik De Smet
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
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Sleurs C, Lemiere J, Bullens K, Jacobs S. QOL-08. Visual memory and potential clinical risk factors in long-term survivors of a childhood brain tumor. Neuro Oncol 2022. [PMCID: PMC9165086 DOI: 10.1093/neuonc/noac079.491] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A brain tumor treatment has previously been associated with long-term neurocognitive sequelae. However, clinical profiles differ between certain patient subgroups. We investigated the impact of tumor location, radiotherapy (RT), and age at diagnosis in childhood brain tumor survivors on long-term cognitive outcomes. Adult survivors (n=32) of pediatric brain tumors (n=11 infratentorial, n=21 supratentorial; 14 astrocytomas, 3 craniopharyngiomas, 2 ependymomas, 2 germinomas, 1 hemangioblastomas, 4 medulloblastomas, 6 nervus opticus gliomas) participated in this neuropsychological study (n=11 RT) (16.8-35.1 years old, >2years after treatment, mean age at diagnosis = 9.2 years, 50% male). An extensive neurocognitive test battery was used to assess intelligence scales (n=5), verbal and visual memory (n=2), and language (n=3). In order to investigate the effects of tumor location (infra- versus supratentorial), RT (yes vs. no), and age at diagnosis on the cognitive scores, a multivariate ANCOVA model was tested including the main effects and interaction between age and RT. Of all included scales, only visual memory was significantly associated with the risk factors. More specifically, patients who received RT (F=10.3, p=.004) and were younger at diagnosis (F=6.9, p=.014) scored worse on this task. Furthermore, the interaction effect between these factors was also significant (F=8.8, p=.006). These findings suggest that younger patients could be more vulnerable to the radiotoxic effects to visual memory outcomes. Tumor location (supra- vs. infratentorial) was not significantly associated with any outcome. In this study, only visual memory appeared to be associated with the risk factors of interest. Both radiotherapy and age at radiotherapy, as well as their interaction, could be risk factors for altered neurodevelopmental patterns of brain areas associated with visual memory.
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Affiliation(s)
| | - Jurgen Lemiere
- KU Leuven , Leuven , Belgium
- UZ Leuven , Leuven , Belgium
| | | | - Sandra Jacobs
- KU Leuven , Leuven , Belgium
- UZ Leuven , Leuven , Belgium
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14
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Mossakowski M, Jacobs S, Hanseeuw B, Duprez T, Van Marcke C. Acute leukoencephalopathy and thyroiditis induced by capecitabine. Acta Neurol Belg 2022; 122:1373-1375. [PMID: 35152372 DOI: 10.1007/s13760-022-01893-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/05/2022] [Indexed: 01/16/2023]
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Eulert-Grehn JJ, Sterner I, Schoenrath F, Stein J, Mulzer J, Kurz S, Lanmüller P, Barthel F, Unbehaun A, Klein C, Jacobs S, Falk V, Potapov E, Starck C. Defibrillator Generator Replacements in Patients with Left Ventricular Assist Device Support: The Risks of Hematoma and Infection. J Heart Lung Transplant 2022; 41:810-817. [DOI: 10.1016/j.healun.2022.02.013] [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] [Received: 07/23/2021] [Revised: 02/13/2022] [Accepted: 02/23/2022] [Indexed: 11/16/2022] Open
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16
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Gielis M, Dirix V, Vanderhenst E, Uyttebroeck A, Feys H, Sleurs C, Jacobs S. Better detection of reduced motor functioning in brain tumor survivors based on objective motor assessments: an incentive for improved standardized follow-up. Eur J Pediatr 2022; 181:2731-2740. [PMID: 35476292 PMCID: PMC9192471 DOI: 10.1007/s00431-022-04472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/15/2022] [Accepted: 04/09/2022] [Indexed: 11/03/2022]
Abstract
Long-term sequelae are well-known in childhood brain tumor survivors, but motor functioning remains poorly described. This cross-sectional study aimed to assess objective motor functioning, patient-specific risk factors, and parental perceptions. Fifty-two childhood brain tumor patients (pilocytic astrocytoma, medulloblastoma, and other types) who were at least 6 months out of treatment were evaluated. Mean age at testing was 11.7 years. Objective motor functioning was assessed with the Movement Assessment Battery for Children (MABC-2-NL) and/or Bruininks-Oseretsky test of motor proficiency (BOT-2). Functional walking capacity was assessed with the 6-min walk test (6MWT). Parent-reported motor functioning was addressed using the ABILHAND-Kids, ABILOCO-Kids questionnaires, and a standardized anamnesis. Patients showed impaired motor functioning in all domains (p < 0.001). Regarding risk factors, younger age at diagnosis (< 5 year) was significantly associated with lower scores on body coordination (p = 0.006). Adjuvant treatment resulted in lower scores for fine manual control of the BOT-2 (p = 0.024) and balance of MABC-2-NL (p = 0.036). Finally, questionnaires revealed an underestimation of motor problems as perceived by the parents. In conclusion, many children who are in follow-up for a brain tumor show impaired motor functioning on multiple aspects, with younger age at diagnosis and adjuvant treatment as specific risk factors. Based on the questionnaires and anamnesis, motor problems appear to be underestimated by the parents. Conclusion: These findings point to the need for timely prospective screening of motor functioning. Based on a screening assessment, adequate rehabilitation programs can be applied in childhood brain tumor survivors, aiming to reduce the adverse impact on their daily lives, both for functional activities and cardiovascular fitness. What is Known: • A pediatric brain tumor and its treatment are associated with potential long-term motor sequelae. • Test assessments could enable us to objectify motor functioning of these patients. What is New: • Pediatric brain tumors survivors show lower motor performance compared to the norm, which is often underestimated by parents. • Younger age at diagnosis and adjuvant treatment could be specific risk factors.
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Affiliation(s)
- Marjoke Gielis
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Veerle Dirix
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ellen Vanderhenst
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Anne Uyttebroeck
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Oncology, KU Leuven, Leuven, Belgium
| | - Hilde Feys
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Charlotte Sleurs
- grid.5596.f0000 0001 0668 7884Department of Oncology, KU Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium. .,Department of Oncology, KU Leuven, Leuven, Belgium.
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Gielis M, Dirix V, Vanderhenst E, Uyttebroeck A, Feys H, Sleurs C, Jacobs S. Correction to: Better detection of reduced motor functioning in brain tumor survivors based on objective motor assessments: an incentive for improved standardized follow-up. Eur J Pediatr 2022; 181:3993. [PMID: 36074271 PMCID: PMC9546958 DOI: 10.1007/s00431-022-04605-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marjoke Gielis
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Veerle Dirix
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ellen Vanderhenst
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium ,Department of Oncology, KU Leuven, Leuven, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Sandra Jacobs
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium. .,Department of Oncology, KU Leuven, Leuven, Belgium.
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18
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Messiaen J, Nasari P, Van Herck Y, Verhaaren B, Sebastian I, Milli G, Bosisio F, Pey J, De Vleeschouwer S, De Vloo P, Depreitere B, Vanden Bempt I, Sciot R, Antoranz A, Jacobs S, De Smet F. PATH-21. THE SINGLE-CELL PATHOLOGY LANDSCAPE OF PEDIATRIC GLIOMA. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.473] [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: 11/14/2022] Open
Abstract
Abstract
High-grade glioma are the main cause of cancer-related death in children. Despite extensive research, their prognosis remains poor with very few treatment options. This can be attributed to the highly heterogeneous and plastic nature of glioma tumor cells and their interactions with the microenvironment, although quantitative data are still largely missing. Here, we used high-dimensional, multiplexed immunohistochemistry to map the spatial, single-cell tissue architecture of 31 pediatric glioma samples covering 9 histologic diagnoses. This novel approach allowed us to map the spatial distribution of the various tumoral subtypes, which typically occur in specific tumoral niches, and how these interact with their local immune-microenvironment. Finally, by aligning these findings to the clinical data of the patients and comparing these to adult glioblastoma, we are now able to more precisely describe the heterogeneous landscape of pediatric glioma at single-cell resolution.
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19
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Hall W, Li J, You Y, Gollub M, Grajo J, Rosen M, dePrisco G, Yothers G, Dorth J, Gross H, Peterson R, Faller B, Moxley K, Jacobs S, Stella P, Haddock M, Hong T, George T. Prospective Validation of the Magnetic Resonance Tumor Regression Grade (MR-TRG) and Correlation With Pathologic Endpoints Score in NRG Oncology GI002. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Sleurs C, Jacobs S, Counsell SJ, Christiaens D, Tournier JD, Sunaert S, Van Beek K, Uyttebroeck A, Deprez S, Batalle D, Lemiere J. Brain network hubs and cognitive performance of survivors of childhood infratentorial tumors. Radiother Oncol 2021; 161:118-125. [PMID: 34102233 DOI: 10.1016/j.radonc.2021.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 04/09/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Childhood infratentorial tumor patients frequently suffer from long-term cognitive deficits. As each constituent of their treatment can lead to neurotoxicity, cascade effects can lead to profound reorganization of the underlying brain network, the so-called 'connectome'. However, to date, few studies have assessed the relationship between brain network topology, the functional role of network hubs (i.e. highly connected regions), and neurocognitive outcomes in adult survivors of childhood infratentorial tumors. METHODS In this cross-sectional study, childhood infratentorial tumor survivors (n = 21: pilocytic astrocytoma (n = 8), ependymoma (n = 1) and medulloblastoma (n = 12)) and healthy controls (n = 21) were recruited. Using multishell diffusion-weighted MRI, microstructural organization and topology of supratentorial white matter was investigated; using a voxel-based approach, a fixel-based analysis, and a graph theoretical approach. In addition, neurocognitive subscales of the WAIS-IV intelligence test, and their relationship with nodal strength and network efficiency metrics were assessed. RESULTS Similar to earlier studies, we observed widespread decreases in fractional anisotropy (FA) in patients compared to controls, based on voxel-based analyses. In addition, the fixel-based analyses dissociated macro- from microstructural changes, which were encountered in in infratentorial versus supratentorial brain areas, respectively. Finally, regional reorganization (i.e. differences in local efficiency) occurred mainly in hubs, which suggests a specific vulnerability of these areas. These hubs were not only mostly affected, but also most strongly correlated with the intelligence subscales. CONCLUSION This study suggests that network hubs are functionally important for intellectual outcomes in infratentorial tumor survivors. Furthermore, these regions could be the primary targets of treatment toxicity. Validation of this specific hypothesis in larger samples is required.
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Affiliation(s)
| | - Sandra Jacobs
- Department of Oncology, KU Leuven, Belgium; Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Belgium
| | - Serena J Counsell
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, United Kingdom
| | - Daan Christiaens
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, United Kingdom; Department of Imaging and Pathology, KU Leuven, Belgium
| | - J-Donald Tournier
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, United Kingdom
| | - Stefan Sunaert
- Department of Radiology, University Hospitals Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Belgium
| | - Karen Van Beek
- Department of Radiotherapy, University Hospitals Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Oncology, KU Leuven, Belgium; Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, KU Leuven, Belgium
| | - Dafnis Batalle
- Centre for the Developing Brain, School of Imaging Sciences & Biomedical Engineering, King's College London, United Kingdom; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Jurgen Lemiere
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Belgium
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21
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Jacobs S, Maldonado-Slootjes S, Verhulst D, Gille M. Fatal encephalopathy with brainstem involvement under dabrafenib and trametinib in a BRAF-positive metastatic melanoma. Rev Neurol (Paris) 2021; 177:1195-1198. [PMID: 34167806 DOI: 10.1016/j.neurol.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 11/15/2022]
Affiliation(s)
- S Jacobs
- Departments of Neurology and Oncology, Cliniques de l'Europe, Brussels, Belgium
| | | | - D Verhulst
- Cliniques de l'Europe, Brussels, Belgium
| | - M Gille
- Departments of Neurology and Oncology, Cliniques de l'Europe, Brussels, Belgium.
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22
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von Hoff K, Haberler C, Schmitt-Hoffner F, Schepke E, de Rojas T, Jacobs S, Zapotocky M, Sumerauer D, Perek-Polnik M, Dufour C, van Vuurden D, Slavc I, Gojo J, Pickles JC, Gerber NU, Massimino M, Gil-da-Costa MJ, Garami M, Kumirova E, Sehested A, Scheie D, Cruz O, Moreno L, Cho J, Zeller B, Bovenschen N, Grotzer M, Alderete D, Snuderl M, Zheludkova O, Golanov A, Okonechnikov K, Mynarek M, Juhnke BO, Rutkowski S, Schüller U, Pizer B, Zezschwitz BV, Kwiecien R, Wechsung M, Konietschke F, Hwang EI, Sturm D, Pfister SM, von Deimling A, Rushing EJ, Ryzhova M, Hauser P, Łastowska M, Wesseling P, Giangaspero F, Hawkins C, Figarella-Branger D, Eberhart C, Burger P, Gessi M, Korshunov A, Jacques TS, Capper D, Pietsch T, Kool M. Therapeutic implications of improved molecular diagnostics for rare CNS-embryonal tumor entities: results of an international, retrospective study. Neuro Oncol 2021; 23:1597-1611. [PMID: 34077956 DOI: 10.1093/neuonc/noab136] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Only few data are available on treatment-associated behavior of distinct rare CNS-embryonal tumor entities previously treated as "CNS-primitive neuroectodermal tumors" (CNS-PNET). Respective data on specific entities, including CNS neuroblastoma, FOXR2 activated (CNS NB-FOXR2), and embryonal tumor with multi-layered rosettes (ETMR) are needed for development of differentiated treatment strategies. METHODS Within this retrospective, international study, tumor samples of clinically well-annotated patients with the original diagnosis of CNS-PNET were analyzed using DNA methylation arrays (n=307). Additional cases (n=66) with DNA methylation pattern of CNS NB-FOXR2 were included irrespective of initial histological diagnosis. Pooled clinical data (n=292) were descriptively analyzed. RESULTS DNA methylation profiling of "CNS-PNET" classified 58(19%) cases as ETMR, 57(19%) as HGG, 36(12%) as CNS NB-FOXR2, and 89(29%) cases were classified into 18 other entities. Sixty-seven (22%) cases did not show DNA methylation patterns similar to established CNS tumor reference classes. Best treatment results were achieved for CNS NB-FOXR2 patients (5-year PFS: 63%±7%, OS: 85%±5%, n=63), with 35/42 progression-free survivors after upfront craniospinal irradiation (CSI) and chemotherapy. The worst outcome was seen for ETMR and HGG patients with 5-year PFS of 18%±6% and 22%±7%, and 5-year OS of 24%±6% and 25%±7%, respectively. CONCLUSION The historically reported poor outcome of CNS-PNET patients becomes highly variable when tumors are molecularly classified based on DNA methylation profiling. Patients with CNS NB-FOXR2 responded well to current treatments and a standard-risk-CSI based regimen may be prospectively evaluated. The poor outcome of ETMR across applied treatment strategies substantiates the necessity for evaluation of novel treatments.
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Affiliation(s)
- Katja von Hoff
- Department of Pediatric Oncology and Hematology, Charité University Medicine, Berlin, Germany
| | - Christine Haberler
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria
| | - Felix Schmitt-Hoffner
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Elizabeth Schepke
- The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Teresa de Rojas
- Pediatric OncoGenomics Unit, Children's University Hospital Niño Jesús, Madrid, Spain
| | - Sandra Jacobs
- Department of Pediatrics, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Michal Zapotocky
- Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - David Sumerauer
- Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marta Perek-Polnik
- Department of Oncology, The Children's Memorial Health Institute, University of Warsaw, Warsaw, Poland
| | - Christelle Dufour
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Villejuif, France.,Paris-Saclay University, INSERM, Molecular predictors and New targets in Oncology, Villejuif, France
| | | | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine and Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Johannes Gojo
- Department of Pediatrics and Adolescent Medicine and Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Jessica C Pickles
- Developmental Biology and Cancer Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Nicolas U Gerber
- Department of Oncology, University Children's Hospital, Zurich, Switzerland
| | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale die Tumori, Milan, Italy
| | | | - Miklos Garami
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Ella Kumirova
- Department of Neuro-Oncology, Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Astrid Sehested
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - David Scheie
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Frederik Vs vej 11, 2100 Copenhagen, Denmark
| | - Ofelia Cruz
- Pediatric Oncology Department. Hospital Sant Joan de Deu. Barcelona, Spain
| | - Lucas Moreno
- Paediatric Haematology & Oncology Division, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jaeho Cho
- Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Bernward Zeller
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Niels Bovenschen
- Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Michael Grotzer
- Department of Oncology, University Children's Hospital, Zurich, Switzerland
| | - Daniel Alderete
- Service of Hematology/Oncology, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health and School of Medicine, New York, NY, USA
| | - Olga Zheludkova
- Department of Neurooncology, Russian Scientific Center of Radiology, Moscow, Russia
| | - Andrey Golanov
- Department of Neuroradiology, Burdenko Neurosurgical Institute, Moscow, Russia
| | - Konstantin Okonechnikov
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Martin Mynarek
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - B Ole Juhnke
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Ulrich Schüller
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg.,Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - Barry Pizer
- Institute of Translational Research, University of Liverpool, UK
| | - Barbara V Zezschwitz
- Department of Pediatric Oncology and Hematology, Charité University Medicine, Berlin, Germany
| | - Robert Kwiecien
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Maximilian Wechsung
- Institute of Biometry and Clinical Epidemiology, Charité University Medicine and Berlin Institute of Health, Berlin, Germany
| | - Frank Konietschke
- Institute of Biometry and Clinical Epidemiology, Charité University Medicine and Berlin Institute of Health, Berlin, Germany
| | - Eugene I Hwang
- Department of Pediatric Hematology-Oncology, Center for Cancer and Immunology Research and Neuroscience Research, Children's National Medical Center, Washington DC, USA
| | - Dominik Sturm
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elisabeth J Rushing
- Institute of Neuropathology, University Medical Center Zurich, Zurich, Switzerland
| | - Marina Ryzhova
- Department of Neuropathology, Burdenko Neurosurgical Institute, Moscow, Russia
| | - Peter Hauser
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Maria Łastowska
- Department of Pathomorphology, Children's Memorial Health Institute, Warsaw, Poland
| | - Pieter Wesseling
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Amsterdam University Medical Center / VUmc, Amsterdam, The Netherlands
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Cynthia Hawkins
- Division of Pathology, The Hospital for Sick Children, Toronto, Canada
| | - Dominique Figarella-Branger
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Charles Eberhart
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Peter Burger
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Marco Gessi
- Neuropathology Unit, Division of Pathology, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica S.Cuore, Rome, Italy
| | - Andrey Korshunov
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tom S Jacques
- Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - David Capper
- Department of Neuropathology, Charité University Medicine, and Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK), partner site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Torsten Pietsch
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, DZNE German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Marcel Kool
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Ruttens D, Messiaen J, Ferster A, Piette C, Schifflers S, Van Damme A, van der Werff Ten Bosch J, Verlooy J, Willems L, Jacobs S. Retrospective study of diffuse intrinsic pontine glioma in the Belgian population: a 25 year experience. J Neurooncol 2021; 153:293-301. [PMID: 33939103 DOI: 10.1007/s11060-021-03766-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Diffuse intrinsic pontine glioma is a rare disease with a high mortality. Our primary aim was to determine the incidence of this disease in Belgium. Secondly, we wanted to compare the treatment approach of Belgian pediatric oncology centres, to investigate possibilities for improvement. METHODS We retrospectively collected and analysed data on DIPG-patients diagnosed between 1994 and 2018 and recorded in the Belgian Cancer Registry. We included patients ≤ 18 years who were followed in one of the eight Belgian pediatric oncology centres. RESULTS We included 100 patients. Files were complete in 87 patients. We observed an increase in diagnoses with an incidence of 3.1 per 1,000,000 persons (aged 0-≤ 18) per year over the last 5 years compared to an overall incidence of 1.8. Biopsy was performed at diagnosis in 51.7% of patients. In one fifth this was study-related. Mutation analysis was known in eight patients, of which six showed the H3 K27M-mutation. 58.8% of patients received chemotherapy, without a significant survival benefit. 12.6% of patients were included in a clinical trial. Biopsy rate and the use of chemotherapy differed widely between centres. Mean OS and PFS were 10.49 and 4.87 months respectively. We observed an improved survival over time. CONCLUSIONS Over the past 25 years, we observed an increase of new DIPG-diagnoses. Outcome in our cohort is comparable with literature findings. We demonstrate an important heterogeneity in treatment approach between different centres and limited inclusion in clinical trials. Therefore, collaboration between centres and inclusion of patients in clinical trials is much needed.
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Affiliation(s)
- Dries Ruttens
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.
| | - Julie Messiaen
- Department of Pediatric Hematology-Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Alina Ferster
- Department of Pediatric Hematology-Oncology, Queen Fabiola Children's University Hospital, Brussels, Belgium
| | - Caroline Piette
- Department of Pediatrics, Division of Hematology-Oncology, CHU of Liège, Liège, Belgium
| | - Stefan Schifflers
- Department of Pediatric Hematology-Oncology, CHC MontLégia, Liège, Belgium
| | - An Van Damme
- Department of Pediatric Hematology-Oncology, Saint-Luc University Hospital, Brussels, Belgium
| | | | - Joris Verlooy
- Department of Pediatric Hematology-Oncology, University Hospital of Antwerp, Edegem, Belgium
| | - Leen Willems
- Department of Pediatric Hematology-Oncology, University Hospital Ghent, Ghent, Belgium
| | - Sandra Jacobs
- Department of Pediatric Hematology-Oncology, University Hospitals Leuven, Leuven, Belgium
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24
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Vandersmissen K, Roppe M, Droogne W, Jacobs S, Meyns B. Driveline Infections after Implantation of a Left Ventricular Assist Device. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1109] [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: 11/15/2022] Open
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25
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Hindi A, Willis S, Jacobs S, Schafheutle E. Cross-sector pre-registration pharmacist placements in general practice in England: lessons from a national evaluation. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
In 2019/2020, the Pharmacy Integration Fund commissioned delivery of cross-sector pre-registration pharmacist training incorporating 3–6 month placements in general practice (GP). GP placements were managed by Health Education England (HEE) and organised as one (or more) blocks, or as spilt weeks/days across base sector (hospital/community) and GP. Trainees had a pharmacist tutor at base and in GP.
Aim
to evaluate the implementation of cross-sector pre-registration pharmacy placements in GP in England, and to identify barriers and enablers of a successful placement.
Methods
A qualitative approach was taken, with case study sites purposively sampled for maximum variation: pharmacy base (hospital/community), number of pre-registration pharmacist trainees in base doing GP placement, length of GP placement, organisation of GP placement and geographical location. With consent, trainees and tutors identified as meeting sampling criteria were emailed invitation letters and participant information sheets. Where the trainee and their tutor(s) agreed to participate, semi-structured telephone interviews were conducted January - July 2020. Questions developed from literature(1, 2) and the HEE handbook were tailored to understanding trainees’ and tutors’ views on the implementation of pre-registration pharmacist placements in GP, including benefits, unintended consequences and impacts. Thematic analysis across sites was undertaken with a focus on exploring inter and intra group themes.
Results
Thirty-four interviews were completed in 11 study sites (5 GP/hospital; 6 GP/community pharmacy). Trainees and tutors considered GP placements had been successful. Contributing factors were: placement planning (induction, contingency arrangements for cover should GP tutor be unavailable); tutors working together (good communication and collaboration); GP tutor support (regular contact, reflection; identifying learning needs; opportunities for learning); integration of GP placements within training year (specific learning/training activities at base during GP placement); and GP tutors having backing of their organisation to supervise effectively. A lack of these impacted negatively. Trainees completed a wide spectrum of activities and gradually moved from administrative to clinical tasks. They built up confidence to undertake patient-facing activities, with more direct supervision at the beginning moving to indirect supervision using debriefing. Thirteen weeks in GP was considered an appropriate minimum duration by all trainees and tutors; those based in community felt that 26 weeks in GP provided more opportunities for clinical and consultation skills learning. Cross-sector experience facilitated a better understanding of patient pathways and the importance of holistic patient care. All trainees considered working in GP in future but highlighted the lack of a cross-sector GP foundation programme. Base tutors felt the time commitment was comparable to single sector placements. Base and GP tutors felt that a clear set of competencies for GP placements and a broader governance framework would ensure standards and consistency.
Conclusion
This is the first national evaluation of cross-sector pre-registration pharmacists in general practice placements in England. Sampling as case studies enabled data triangulation and generated a multi-faceted understanding on factors impacting GP placements. A key limitation was the volunteer bias associated with recruitment. Key attributes of a successful pre-registration cross-sector training experience are highlighted and can inform policy reforms including change from pre-registration to foundation year training.
References
1. Gray N. Review of Experience of Pre-registration Pharmacist Placements in the General Practice Setting – Final Report. 2019.
2. Jee SD, Schafheutle EI, Noyce PR. Is pharmacist pre-registration training equitable and robust? Higher Education, Skills and Work-Based Learning. 2019;9(3):347–58.
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Affiliation(s)
- A Hindi
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - S Willis
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - S Jacobs
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - E Schafheutle
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Van Praet K, Kofler M, Schambach J, Akansel S, Meyer A, Jacobs S, Falk V, Kempfert J. The Conventional Median Sternotomy Approach versus Minimally Invasive Surgical Treatment of Patients with Native Mitral Valve Infective Endocarditis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lemiere J, Van den Wyngaert L, Vandereydt J, Vandenabeele K, Vercruysse T, Sleurs C, Jacobs S. QOL-18. A LONGITUDINAL STUDY OF NEUROCOGNITION IN CHILDREN TREATED FOR A BRAIN TUMOR. Neuro Oncol 2020. [PMCID: PMC7715696 DOI: 10.1093/neuonc/noaa222.680] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
It is well known that neurocognition in children treated for a brain tumor can be affected. However, studies on the trajectory of these neurocognitive problems are scarce. In the present study we investigated the evolution of neurocognition between timepoints of diagnosis, 2, 4 and 6 years later. A total of 53 children diagnosed with a brain tumor were recruited in this study, of which all completed a comprehensive neuropsychological test battery at three successive timepoints and 30 at 4 timepoints. The first assessment was conducted as soon as possible after diagnosis and before initiation of chemo- and/or radiotherapy. Mean age at diagnosis was 8.06 years. The most common diagnoses were pilocytic astrocytoma (n=28) and medulloblastoma (n=10). 24.5% and 18.9% of these patient groups received focal or craniospinal irradiation, respectively. A repeated measures analysis with cranial irradiation (no, focal, craniospinal) as between-subjects factor demonstrated a significant interaction effect between time and type of irradiation for overall intelligence (p=0.02) for children with three assessments. The same interaction effect was found for overall intelligence and processing speed for children with four assessments (p=.005 and p=.002, respectively). The group who received craniospinal irradiation demonstrated the most pronounced decline. Interestingly, no main time effect or interaction effect was found for general memory functioning. Our results demonstrate that not all neurocognitive functions in children treated for a brain tumor decline after treatment. Overall IQ and processing speed are the most vulnerable outcomes in our cohort, especially for the children treated with craniospinal irradiation.
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Sleurs C, Lemiere J, Blommaert J, Deprez S, Van Beek K, Uyttebroeck A, Jacobs S. QOL-07. CORTICAL VOLUME AND THICKNESS IN ADULT SURVIVORS OF CHILDHOOD POSTERIOR FOSSA TUMORS. Neuro Oncol 2020. [PMCID: PMC7715883 DOI: 10.1093/neuonc/noaa222.672] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE A brain tumor treatment including cranial radiotherapy has previously been associated with long-term neurocognitive sequelae. Since underlying neurological mechanisms remain inconclusive, we investigated cortical features in childhood posterior fossa tumor survivors. METHODS T1-weighted MRI (MPRAGE, resolution=.98x.98x1.2mm) was acquired to investigate the cortical structure in adult survivors of childhood infratentorial tumors (n=19, 15males) (16.4–34.8 years old, >2years after treatment). These scans were compared to age- and gender- matched controls. Supratentorial cortical volume and thickness were investigated using voxel-based morphometry (VBM) and surface-based morphometry (SBM), respectively. We compared patients and controls, irradiated (n=13) versus non-irradiated patients, and investigated the age at radiotherapy (peak level: p<.001). RESULTS Lower GM volumes were encountered in multiple brain areas of patients compared to controls, with the largest clusters in the right and left occipital fusiform gyri. Irradiated patients showed lower GM volumes then non-irradiated patients in the superior and middle frontal gyri, the right supramarginal gyrus and precuneus. Age at radiotherapy was associated with GM volume in the inferior frontal gyrus. SBM yielded larger cortical thickness in patients in the left precuneus, inferior temporal and fusiform gyrus. The opposite effect was only marginally significant, in the left temporal lingual gyrus. Age at radiotherapy was not associated with cortical thickness, but radiotherapy was associated with lower thickness of the left pars opercularis. CONCLUSION Widespread differences in cortical volumes and thickness were observed in posterior fossa tumor survivors. Both radiotherapy and age at radiotherapy could be suggested as risk factors for long-term cortical development.
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Lemiere J, Sleurs C, Van den Wyngaert L, Vandenabeele K, Vandereydt J, Vercruysse T, Jacobs S. QOL-19. PARENT-REPORTED COGNITIVE PROBLEMS AND DIRECT ASSESSMENT OF COGNITION IN CHILDREN TREATED FOR A BRAIN TUMOR. Neuro Oncol 2020. [PMCID: PMC7715165 DOI: 10.1093/neuonc/noaa222.681] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The Pediatric Perceived Cognitive Function (PedsPCF) item bank is a short parent and self-reported cognitive screening questionnaire developed in the context of pediatric oncology. The PedsPCF demonstrated satisfactory psychometric properties and the scores of the PedsPCF are found to be associated with clinical outcomes. Today little research is available to evaluate whether the PedsPCF is correlated with direct assessments of neurocognitive domains. The aim of the current study is to investigate whether important cognitive domains, such as different aspects of intelligence, memory, visuomotor integration can predict the PedsPCF score. We obtained 100 PedsPCF filled in by parents from children treated for a brain tumor. All these children completed a comprehensive neuropsychological battery. Mean age at diagnosis was 7.47 years and mean age at completion of PedsPCF and testing 13.84. The most common diagnoses were pilocytic astrocytoma (n=43) and medulloblastoma (n=14). A linear regression model with verbal comprehension, perceptual reasoning, processing speed, visuomotor integration as predictors for overall PedsPCF score was significant (p.005), but the overall model fit was limited (adjusted R2: 14%). Visuomotor integration and processing speed were significant predictors (beta = 0.56 and -0.29). Our results are in line with the overall finding that the correlation between questionnaires assessing quality of survival and direct assessments of cognition are low. For clinical practice these results are important as the PedsPCF can’t be used to replace direct cognitive assessments or vice versa.
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Vandenbriele C, Balthazar T, Wilson J, Ledot S, Smith R, Caetano A, Adriaenssens T, Goetschalckx K, Janssens S, Dubois C, Jacobs S, Meyns B, Davies S, Price S. Left heart Impella-device to bridge acute mitral regurgitation to MitraClip-procedure: a novel implementation of percutaneous mechanical circulatory support. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Acute mitral regurgitation (MR) is an emergency, often requiring urgent surgery. Severe acute MR presenting with hemodynamic collapse is usually caused by papillary muscle rupture or dysfunction after acute myocardial infarction (AMI) or chordal rupture, resulting in flail mitral leaflet(s). Preoperative stabilization is complex due to concomitant hemodynamic collapse and hypoxic respiratory failure. Finding the right balance between both preload and inotropic support is challenging. When patients are too sick for immediate surgical intervention, mechanical circulatory support can be considered because of its ability to both unload and reduce of cardiac work while increasing coronary perfusion and cardiac output. Nevertheless, even after initial stabilization, surgical risk remains high in critically ill acute severe MR patients and transcatheter treatments such as MitraClip are increasingly being explored.
Methods
Between August 2017 and September 2019, patients presenting with acute severe mitral regurgitation and considered too ill for immediate surgical intervention (EURO-II score >11.2% plus pulmonary oedema necessitating mechanical ventilation and/or hemodynamic instability), were selected for an Impella-assisted LV unloading technique as bridge to MitraClip-procedure. Five patients were selected for the combined left Impella/MitraClip-procedure in two tertiary cardiac ICUs.
Results
The mean age was 72 years. The cause of MR was ischemic in 20% and all patients presented in cardiogenic shock state, necessitating mechanical ventilation. The overall cardiac operative risk assessment (Euro-II) score predicted a 35% chance of in-hospital mortality. Cardiac output was severely impaired (mean LVOT VTI 8.2 cm). All patients were on inotropic support and supported by an Impella-CP pVAD (mean flow 2.5 Liter per minute; mean 6.3 days of support). In all cases, we managed to reduce the LVEDP below 15 mmHg using the combination of medical therapy (afterload reduction, inotropes), mechanical ventilation and pVAD-therapy. The MR was significantly reduced by a MitraClip-procedure in each Impella supported patient. The overall survival at discharge was 80%. One patient with late referral and multiple organ failure at presentation deceased due to refractory cardiogenic shock. Overall, severe MR was reduced to grade 1+ and all four patients survived 6 months after discharge with only one readmission for decompensated heart failure.
Conclusions
A combined strategy of Impella and MitraClip appears to be a novel, feasible alternative for patients presenting with acute, severe MR unable to proceed to a corrective surgical procedure at presentation due to severe left ventricular forward flow failure. In these cases, the early initiation of pVAD-support may reduce the risk of development of irreversible end- organ damage and dysfunction. Exploration in a larger, randomised population is warranted to investigate this strategy further.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Vandenbriele
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - T Balthazar
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - J Wilson
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - S Ledot
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - R Smith
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - A.F Caetano
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | | | | | - S Janssens
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - C Dubois
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - S Jacobs
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - B Meyns
- University Hospitals (UZ) Leuven, Leuven, Belgium
| | - S Davies
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
| | - S Price
- Royal Brompton and Harefield NHS Foundation Trust, Adult Intensive Care, London, United Kingdom
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Gottlieb D, Jacobs S, Berman A, Donegan D, Steele F, Abecassis S, Sayeen Nagarajan M, Davis F, Willis H, Kwon N. 253 Investigating the Relationship between 72-hour Revisits to the Emergency Department and Initial Emergency Service Index Triage Levels. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Farid L, Jacobs D, Moreau C, Baille G, Jacobs S. Évaluation à domicile de la marche chez les patients parkinsoniens à l’aide de semelles connectées. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Schroyen G, Meylaers M, Deprez S, Blommaert J, Smeets A, Jacobs S, Sunaert S, Sleurs C, Uyttebroeck A. Prevalence of leukoencephalopathy and its potential cognitive sequelae in cancer patients. J Chemother 2020; 32:327-343. [PMID: 32799637 DOI: 10.1080/1120009x.2020.1805239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Due to the rising use of chemotherapy treatment in cancer patients and growing survival rates, therapy-induced neurotoxic side effects are increasingly reported. Given the ambiguity about the prevalence and severity of leukoencephalopathy, one of such toxic side effects, in non-central nervous system (CNS) cancer patients, we performed a systematic literature search using the PubMed/Medline database to summarize existing literature regarding leukoencephalopathy epidemiology in non-CNS cancer patients and its potential cognitive sequelae. The search was based on the following terms: ('MRI' OR 'T2-weighted MRI' OR 'FLAIR') AND ('cancer' OR 'tumour' OR 'leukaemia' OR 'neoplasms') AND ('chemotherapy' OR 'radiotherapy') AND ('posterior reversible encephalopathy' OR 'leukoencephalopathy' OR 'cerebral ischaemia' OR 'stroke'). Thirty-two studies discussing the occurrence of leukoencephalopathy in cancer patients were included, of which the majority investigated Acute Lymphoblastic Leukaemia (ALL) patients (n = 22).Regularly scanned ALL patients showed a prevalence of leukoencephalopathy between 17 - 87%, and 15 - 83% of patients presented with leukoencephalopathy when only scanned after a CNS event. When diagnosed with posterior reversible encephalopathy syndrome, 100% of patients showed leukoencephalopathy because its diagnosis is based in part on observable lesions. An increased prevalence was observed in ALL patients treated with higher doses of methotrexate (5 g/m2 MTX, 42 - 87%) when compared to lower doses (< 5 g/m2, 32 - 67%). By contrast, in breast cancer patients, white matter lesions were mainly detected in case of neurological symptoms, but not (yet) clearly associated with chemotherapy administration. However, chemotherapy treatment was associated with more infratentorial microbleeds in breast cancer patients . Up to 50% of other (neurologically asymptomatic) solid tumour patients presented white matter lesions, even years after treatment. When cognitive data were investigated, lesioned patients showed lower scores on neurocognitive tests in 50% of studies, years after ending therapy.In conclusion, leukoencephalopathy is well-documented for ALL patients (with a focus on methotrexate), but there is a lack of knowledge for other intravenous chemotherapeutics, other oncological populations, wider age ranges and possible risk factors (e.g. history of CNS event). Furthermore, the long-term neuropsychological impact and potential risk for neurodegenerative processes due to leukoencephalopathy remains inconclusive. Hence, large international databanks, epidemiological and prospective case-control studies are necessary to stratify risk groups for CNS-related side effects.
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Affiliation(s)
- Gwen Schroyen
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Sabine Deprez
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Ann Smeets
- Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Department of Radiology University Hospitals Leuven, Leuven, Belgium
| | - Charlotte Sleurs
- Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Oncology, KU Leuven, Leuven, Belgium.,Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
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Wilkoff BL, Birnie D, Gold MR, Hersi AS, Jacobs S, Gerritse B, Kusano K, Leclercq C, Mullens W, Filippatos G. Differences in clinical characteristics and reported quality of life of men and women undergoing cardiac resynchronization therapy. ESC Heart Fail 2020; 7:2972-2982. [PMID: 32790108 PMCID: PMC7524066 DOI: 10.1002/ehf2.12914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/06/2020] [Revised: 06/13/2020] [Accepted: 07/13/2020] [Indexed: 01/15/2023] Open
Abstract
Aims Response to cardiac resynchronization therapy (CRT) is known to be associated with a number of clinical characteristics, including QRS duration and morphology, gender, height, and the aetiology of heart failure (HF). We assessed the relation of gender and baseline characteristics with QRS duration and Kansas City Cardiomyopathy Questionnaire. Methods and results AdaptResponse is a global randomized trial. The trial enrolled CRT‐indicated patients with New York Heart Association classes II–IV HF, left bundle branch block (QRS ≥ 140 ms in men, ≥130 ms in women), and baseline PR interval ≤200 ms. In total, 3620 patients were randomized, including 1569 women (43.3%) approaching the actual proportion of women in the HF population. Women were older and more often New York Heart Association class III or IV than men (55.6% vs. 48.7%), had less frequent ischaemic cardiomyopathy (21.2% vs. 39.5%), and had a 5.1 ms shorter QRS duration than men. Women were more often depressed (18.5% vs. 9.7%), had a significantly lower Kansas City Cardiomyopathy Questionnaire score, and had differences in medication prescriptions. Conclusions AdaptResponse is the largest randomized CRT trial and enrolled more women than any other landmark CRT trial. Women differed from men with regard to baseline characteristics and quality of life. Whether these differences translate into clinical outcome differences will be examined further in the AdaptResponse trial.
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Affiliation(s)
| | - David Birnie
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Michael R Gold
- Department of Cardiology, Medical University of South Carolina, Charleston, SC, USA
| | - Ahmad S Hersi
- Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sandra Jacobs
- Medtronic Bakken Research Center, Maastricht, The Netherlands
| | - Bart Gerritse
- Medtronic Bakken Research Center, Maastricht, The Netherlands
| | - Kengo Kusano
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Wilfried Mullens
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium and Hasselt University, Hasselt, Belgium
| | - Gerasimos Filippatos
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,School of Medicine, University of Cyprus, Nicosia, Cyprus
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Rahman F, Dunn D, Baneman E, Sullivan T, Fuller R, Jacobs S, Pinney S, Barghash M, Rana M, Taimur S. Strongyloides Screening in Heart Transplant Candidates. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kok TB, Koerts J, Lemiere J, Post WJ, de Bont ESJM, Gidding C, Happé F, Jacobs S, Oostrom K, Schieving J, Tucha O, Kingma A. Social competence in newly diagnosed pediatric brain tumor patients. Pediatr Hematol Oncol 2020; 37:41-57. [PMID: 31682775 DOI: 10.1080/08880018.2019.1682089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Brain tumors (BTs) are a common pediatric malignancy. Improved treatment has resulted in higher survival rates. There is, however, increasing concern about adverse effects of the disease and its treatment, including effects on social competence (i.e. effective social functioning in everyday life). The aim of this study is to examine multiple levels of social competence (i.e. social skills and social adjustment) in newly diagnosed pediatric BT patients. Thirty newly diagnosed BT patients aged 5-12 years were assessed shortly after diagnosis with a neuropsychological test battery focusing on social competence, including tests for IQ, social skills (i.e. social-affective and executive functioning) and social adjustment (rated by parents and teachers). Their performance was compared to 95 healthy controls who completed the same assessment. Patients and healthy controls were largely comparable with regard to demographic and environmental factors and did not differ on measures of IQ, social skills and social adjustment. Furthermore, age was found to have a positive significant effect on social skills independent of group. Shortly after diagnosis, pediatric BT patients did not perform different from healthy controls on IQ and measures of social skills and social adjustment. This is an encouraging finding. However, because of potentially neurotoxic adjuvant therapy and the ongoing development of social skills, longitudinal follow-up studies are needed to investigate long-term outcome regarding social competence in BT survivors.
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Affiliation(s)
- Tessa B Kok
- Department of Pediatric Oncology/Hematology, University of Groningen, Groningen, The Netherlands.,Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Jurgen Lemiere
- Department of Pediatric Oncology/Hematology, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
| | - Wendy J Post
- Department of Orthopedagogy, University of Groningen, Groningen, The Netherlands
| | - Eveline S J M de Bont
- Department of Pediatric Oncology/Hematology, University of Groningen, Groningen, The Netherlands
| | - Corrie Gidding
- Department of Pediatric Oncology/Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Franscesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sandra Jacobs
- Department of Pediatric Oncology/Hematology, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
| | - Kim Oostrom
- Department of Psychology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Jolanda Schieving
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Annette Kingma
- Department of Pediatric Oncology/Hematology, University of Groningen, Groningen, The Netherlands
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Allender S, Hayward J, Gupta S, Sanigorski A, Rana S, Seward H, Jacobs S, Venkatesh S. Bayesian strategy selection identifies optimal solutions to complex problems using an example from GP prescribing. NPJ Digit Med 2020; 3:7. [PMID: 31993505 PMCID: PMC6971230 DOI: 10.1038/s41746-019-0205-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 07/11/2019] [Accepted: 11/26/2019] [Indexed: 11/12/2022] Open
Abstract
Complex health problems require multi-strategy, multi-target interventions. We present a method that uses machine learning techniques to choose optimal interventions from a set of possible interventions within a case study aiming to increase General Practitioner (GP) discussions of physical activity (PA) with their patients. Interventions were developed based on a causal loop diagram with 26 GPs across 13 clinics in Geelong, Australia. GPs prioritised eight from more than 80 potential interventions to increase GP discussion of PA with patients. Following a 2-week baseline, a multi-arm bandit algorithm was used to assign optimal strategies to GP clinics with the target outcome being GP PA discussion rates. The algorithm was updated weekly and the process iterated until the more promising strategies emerged (a duration of seven weeks). The top three performing strategies were continued for 3 weeks to improve the power of the hypothesis test of effectiveness for each strategy compared to baseline. GPs recorded a total of 11,176 conversations about PA. GPs identified 15 factors affecting GP PA discussion rates with patients including GP skills and awareness, fragmentation of care and fear of adverse outcomes. The two most effective strategies were correctly identified within seven weeks of the algorithm-based assignment of strategies. These were clinic reception staff providing PA information to patients at check in and PA screening questionnaires completed in the waiting room. This study demonstrates an efficient way to test and identify optimal strategies from multiple possible solutions.
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Affiliation(s)
- S. Allender
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - J. Hayward
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - S. Gupta
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - A. Sanigorski
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - S. Rana
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - H. Seward
- School of Medicine, Deakin University, 1 Gheringhap St, Geelong, VIC 3221 Australia
| | - S. Jacobs
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - S. Venkatesh
- Applied Artificial Intelligence Institute, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
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Sleurs C, Lemiere J, Radwan A, Verly M, Elens I, Renard M, Jacobs S, Sunaert S, Deprez S, Uyttebroeck A. Long-term leukoencephalopathy and neurocognitive functioning in childhood sarcoma patients treated with high-dose intravenous chemotherapy. Pediatr Blood Cancer 2019; 66:e27893. [PMID: 31276297 DOI: 10.1002/pbc.27893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Knowledge is limited regarding the prevalence and persistence of chemotherapy-induced leukoencephalopathy in childhood sarcoma patients. This study explored the presence, clinical relevance, and potential risk factors of leukoencephalopathy in childhood bone and soft tissue sarcoma survivors, treated with intravenous chemotherapy. METHODS We acquired cross-sectional neurocognitive data in adult survivors (n = 34) (median age at diagnosis [AaD] = 13.32 years, age range = 16-35 years) and healthy age-matched controls (n = 34). Additionally, magnetic resonance imaging included T2-weighted FLAIR (leukoencephalopathy Fazekas rating), multiexponential T2 relaxation (MET2), and multishell diffusion MRI to estimate myelin integrity-related metrics and fluid movement restrictions. Finally, chemotherapy subgroups (methotrexate, alkylating agents, or combination), AaD, and Apoε and MTHFRC677T polymorphisms were explored as potential risk factors for leukoencephalopathy. RESULTS At the group level, quality of life, working memory, processing speed, and visual memory were significantly lower in patients compared to controls. Furthermore, long-term leukoencephalopathy was observed in 27.2% of the childhood sarcoma survivors, which was related to attentional processing speed. Lesions were related to diffusion-derived, but not to myelin-sensitive metrics. A significant interaction effect between AaD and chemotherapy group demonstrated more lesions in case of high-dose methotrexate (HD-MTX) (F = 3.434, P = .047). However, patients treated with alkylating agents (without HD-MTX) also showed lesions in younger patients. Genetic predictors were nonsignificant. CONCLUSION AND IMPLICATION This study suggests long-term leukoencephalopathy with possibly underlying changes in vasculature, inflammation, or axonal injury, but not necessarily long-term demyelination. Such lesions could affect processing speed, and as such long-term daily life functioning of these patients.
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Affiliation(s)
- Charlotte Sleurs
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Ahmed Radwan
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Iris Elens
- Department of Biological Psychology, KU Leuven, Belgium
| | - Marleen Renard
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Sabine Deprez
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
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El-Khouly FE, Veldhuijzen van Zanten SEM, Santa-Maria Lopez V, Hendrikse NH, Kaspers GJL, Loizos G, Sumerauer D, Nysom K, Pruunsild K, Pentikainen V, Thorarinsdottir HK, Rutkauskiene G, Calvagna V, Drogosiewicz M, Dragomir M, Deak L, Kitanovski L, von Bueren AO, Kebudi R, Slavc I, Jacobs S, Jadrijevic-Cvrlje F, Entz-Werle N, Grill J, Kattamis A, Hauser P, Pears J, Biassoni V, Massimino M, Lopez Aguilar E, Torsvik IK, Joao Gil-da-Costa M, Kumirova E, Cruz-Martinez O, Holm S, Bailey S, Hayden T, Thomale UW, Janssens GOR, Kramm CM, van Vuurden DG. Diagnostics and treatment of diffuse intrinsic pontine glioma: where do we stand? J Neurooncol 2019; 145:177-184. [PMID: 31522324 PMCID: PMC6775536 DOI: 10.1007/s11060-019-03287-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/05/2019] [Indexed: 01/31/2023]
Abstract
Introduction Diffuse intrinsic pontine glioma (DIPG) is a rare clinically, neuro-radiologically, and molecularly defined malignancy of the brainstem with a median overall survival of approximately 11 months. Our aim is to evaluate the current tendency for its treatment in Europe in order to develop (inter)national consensus guidelines. Methods Healthcare professionals specialized in DIPG were asked to fill in an online survey with questions regarding usual treatment strategies at diagnosis and at disease progression in their countries and/or their centers, respectively. Results Seventy-four healthcare professionals responded to the survey, of which 87.8% were pediatric oncologists. Only 13.5% of the respondents biopsy all of their patients, 41.9% biopsy their patients infrequently. More than half of the respondents (54.1%) treated their patients with radiotherapy only at diagnosis, whereas 44.6% preferred radiotherapy combined with chemotherapy. When the disease progresses, treatment strategies became even more diverse, and the tendency for no treatment increased from 1.4% at diagnosis to 77.0% after second progression. 36.5% of the healthcare professionals treat children younger than 3 years differently than older children at diagnosis. This percentage decreased, when the disease progresses. Most of the participants (51.4%) included less than 25% of their patients in clinical trials. Conclusion This survey demonstrates a large heterogeneity of treatment regimens, especially at disease progression. We emphasize the need for international consensus guidelines for the treatment of DIPG, possible by more collaborative clinical trials. Electronic supplementary material The online version of this article (10.1007/s11060-019-03287-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fatma E El-Khouly
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
- Department of Pediatric Oncology/Hematology, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Sophie E M Veldhuijzen van Zanten
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Vicente Santa-Maria Lopez
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, St Joan de Déu Children´s Hospital, Barcelona, Spain
| | - N Harry Hendrikse
- Department of Clinical Pharmacology & Pharmacy, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gertjan J L Kaspers
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - G Loizos
- Pediatric Oncology-Hematology Clinic, Archbishop Makarios III Hospital, Nicosia, Cyprus
| | - David Sumerauer
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - Karsten Nysom
- Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kaie Pruunsild
- Department of Hematology and Oncology, Tallinn Children's Hospital, Tallinn, Estonia
| | - Virve Pentikainen
- Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | | | - Giedre Rutkauskiene
- Department of Pediatric Oncology and Hematology, Hospital of Lithuanian University of Health Sciences Kaunas Clinic, Kaunas, Lithuania
| | | | | | - Monica Dragomir
- Department of Pediatric Oncology, Oncology Institute Professor Doctor Alexandru Trestioreanu, Bucharest, Romania
| | - Ladislav Deak
- Department of Pediatric Oncology/Hematology, Children University Hospital, Kosice, Slovakia
| | - Lidija Kitanovski
- Division of Hemato-Oncology, Department of Pediatrics, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Andre O von Bueren
- Pediatric Oncology and Hematology, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Rejin Kebudi
- Pediatric Hematology-Oncology, Cerrahpasa Medical Faculty & Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | | | | | - Natacha Entz-Werle
- CHRU Hautepierre Strasbourg, Service de Pédiatrie Onco-Hématologie, Strasbourg, France
| | - Jacques Grill
- Département de Cancérologie de l'enfant et de l'adoloscent, CLCC Institut Gustave Roussy, Villejuif, France
| | - Antonis Kattamis
- First Department of Pediatrics, 'Aghia Sofia' Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Peter Hauser
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Jane Pears
- Department of Pediatric Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Enrique Lopez Aguilar
- Hospital de Pediatría, Centro Médico National Siglo XXI, Instituto Mexicano del Seguro Social, Jefatura de Servicio de Oncologia, Distrito Federal, Mexico
| | - Ingrid K Torsvik
- Division of Oncology/Hematology, Department of Pediatrics, Haukeland University Hospital, Mons, Norway
| | - Maria Joao Gil-da-Costa
- Pediatric Hematology and Oncology Division, University Hospital S. João Alameda Hernani Monteiro, Porto, Portugal
| | - Ella Kumirova
- Department of Neurooncology, Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology (FRC-PHOI), Moscow, Russia
| | - Ofelia Cruz-Martinez
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, St Joan de Déu Children´s Hospital, Barcelona, Spain
| | - Stefan Holm
- Department of Pediatric Hematology and Oncology, Department of Woman and Child Health, Karolinska University Hospital, Stockholm, Sweden
| | - Simon Bailey
- Great North Children's Hospital, Victoria Wing, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | | | - Ulrich W Thomale
- Pediatric Neurosurgery, Charité University Medical Center Berlin, Berlin, Germany
| | - Geert O R Janssens
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Christof M Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Geottingen, Göttingen, Germany
| | - Dannis G van Vuurden
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Shagalow S, Facchini R, Masur D, Weiss E, Schneider S, Jacobs S, Yozawitz E, McGinley J. A-58 Rare Case of Klinefelter Syndrome with 13/14 Balanced Translocation and Absence Epilepsy: Impact of Combined Genotypes on Cognitive Neuropsychological Phenotype. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
Klinefelter syndrome (KS) and Robertsonian translocation of 13/14 [rob t(13;14)] are the most common sex-chromosome disorder and chromosome rearrangement, respectively (Engels et al., 2008; Skakkebæk, Wallentin, & Gravholt, 2015). Both are associated with increased risk of cognitive/intellectual disability (ID). A case of KS and de novo (i.e., unbalanced) rob t(13;14) was previously reported (Gül & Şayli, 1994). A case of KS with balanced rob t(13;14) and well-controlled generalized absence epilepsy will be presented with consideration for pediatric neuropsychological practice.
Method
Neuropsychological evaluation of a 12-year-old, right-handed boy diagnosed with comorbid KS, rob t(13;14), and generalized absence epilepsy. Particular attention was given to language given his KS diagnosis. The patient is in a 12:1:1 self-contained classroom with speech-language therapy and social skills groups in place. The patient’s mother is confirmed to have rob t(13;14), whereas paternal contribution is unknown.
Results
Adolescent with a history of language difficulties, especially comprehension. Recent school-based WISC-V FSIQ was in the extremely low range (SS = 53), with weaker verbal comprehension and working memory. Academic achievement was globally very low. Expressive and receptive language, visual perception and motor coordination were extremely low to low average. Verbal list learning and visual attention were near average to average.
Conclusions
This case contributes to the very limited body of pediatric neuropsychological data on the combined genotype of KS with rob t(13;14) and absence epilepsy. Both the KS and rob t(13;14) cognitive phenotypes have been characterized as highly variable, with the comorbidity a likely increased risk for ID.
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Schneider S, Weiss E, Facchini R, Shagalow S, Jacobs S, McGinley J, Masur D. B-32 The Use of Repeat Neuropsychological Assessment to Guide Treatment of Possible Normal Pressure Hydrocephalus in a Complex Case. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Normal Pressure Hydrocephalus (NPH) is a condition that is characterized by the buildup of cerebrospinal fluid (CSF) in the brain that can cause urinary incontinence, gait disturbance, and cognitive impairment. NPH can be progressive but may be managed or reversed with shunt placement. External Lumbar Drainage (ELD) trials in determining if shunt placement is appropriate are common, but the role of repeat neuropsychological assessments during ELD procedures is not well documented in the literature. Repeat, pre-, peri and post- ELD trial, assessment in a complex case of possible NPH is presented.
Method
33-year-old Hispanic English-Speaking female with cognitive/memory complaints following intraventricular hemorrhage (IVH) secondary to vasculopathy was initially seen for post IVH outpatient neuropsychological evaluation. MRI showed enlarged ventricles/communicating hydrocephalus and workup for NPH was initiated. Repeat inpatient evaluations were completed during the ELD trial, with annual outpatient neuropsychological follow-up.
Results
Gait evaluation was inconclusive. Inpatient testing demonstrated minor improvement immediately following ELD opening, but performances were variable across the 4 days of re-evaluation. Shunt placement was rejected due to neuropsychological findings. Outpatient follow-up of patient over several years has demonstrated mild improvement and not evidence of cognitive decline since ELD trial.
Conclusions
Assessment of cognitive functioning in outpatient and inpatient settings before, during, and for several years following ELD testing was beneficial to ascertain the decision not to place a shunt. Repeat neuropsychological assessment in inpatient and outpatient settings provided crucial information for guiding treatment decisions.
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Jacobs S, Facchini R, Weiss E, McGinley J, Masur D. A-34 An Atypical Case of Primary Progressive Aphasia: Implications for Differentiating the Semantic Variant. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Primary progressive aphasia is a neurodegenerative condition consisting of three primary variants. The semantic variant (svPPA) is typically associated with anomia and word-finding issues paired with fluent speech, although other symptoms can arise over time including non-verbal deficits and behavioral changes. A complex case of svPPA with evidence of robust impairment across multiple domains in the presence of notable psychosocial and medical factors is presented.
Method
Sixty-year-old woman with complaints of worsening memory and language changes in the context of marked behavioral disinhibition, deterioration of daily functioning, and indication of delusions was seen for outpatient neuropsychological evaluation. Medical history includes severe depression, anxiety, hypertension, and rheumatic heart disease. CT scan was significant for frontal and temporal atrophy and chronic right cerebellar infarct.
Results
Neuropsychological evaluation revealed uniformly extremely low scores. Presentation was notable for inappropriate behaviors, and expressive and receptive language difficulties. Significant confusion and functional impairment were evident. Her time awareness varied and she at some moments spoke about events from 20-30 years ago as if they were recent. Global language impairment was evident on formal testing and clearly moderated all other performances, including tasks of memory which were impaired. Notable weakness in visual-spatial processing and executive function were also present.
Conclusions
Complex medical and psychosocial history, and atypical decline patterns complicated the diagnosis of a patient with profound progressive expressive language impairment. SvPPA is offered as the diagnosis.
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Filippatos G, Birnie D, Essebag V, Ggold MR, Hersi A, Kantipudi C, Kusano K, Leclercq C, Mullens W, Gerritse B, Jacobs S, Wilkoff BL. Clinical Predictors of QRS Duration in Patients with LBBB: Data from the AdaptResponse Trial. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sleurs C, Madoe A, Lagae L, Jacobs S, Deprez S, Lemiere J, Uyttebroeck A. Genetic Modulation of Neurocognitive Development in Cancer Patients throughout the Lifespan: a Systematic Review. Neuropsychol Rev 2019; 29:190-219. [DOI: 10.1007/s11065-019-09399-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 02/19/2019] [Indexed: 12/14/2022]
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Dowsett M, Jacobs S, Johnston S, Bliss J, Wheatley D, Holcombe C, Stein R, McIntosh S, Barry P, Dolling D, Snowdon C, Perry S, Batten L, Dodson A, Martins V, Modi A, Cornman C, Puhalla S, Wolmark N, Julian T, Pogue-Geile K, Robidoux A, Provencher L, Boileau JF, Shalaby I, Thirlwell M, Fisher K, Huang Bartlett C, Koehler M, Osborne K, Rimawi M. Abstract GS3-02: PALLET: A neoadjuvant study to compare the clinical and antiproliferative effects of letrozole with and without palbociclib. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs3-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CDK4/6 inhibitors, such as palbociclib, are used to treat ER+ metastatic breast cancer in combination with endocrine therapy with trials ongoing in patients with primary disease. No biomarkers exist to identify those who do/do not benefit from added CDK4/6 inhibition. PALLET is an investigator-initiated/led phase II randomized trial collaboration between UK and NSABP investigators evaluating the biological and clinical effects of palbociclib with letrozole combination as neoadjuvant therapy.
Methods: Postmenopausal women with ER+ primary breast cancer and tumors >2.0cm (ultrasound) were randomized to one of 4 treatment groups (3:2:2:2 ratio): Group A: letrozole (2.5mg/d) for 14 weeks; Group B: letrozole for 2 weeks followed by letrozole + palbociclib to 14 weeks; Group C: palbociclib for 2 weeks followed by letrozole + palbociclib to 14 weeks; Group D: letrozole + palbociclib for 14 weeks. Palbociclib was given 125mg/d PO on a 21 days on, 7 days off schedule. Post-14 week treatment was at the discretion of the treating clinician including letrozole until surgery. Core-cut biopsies were taken at baseline, 2 weeks and 14 weeks. Co-primary endpoints for letrozole alone vs palbociclib groups (Group A vs Groups B+C+D) were: (i) change in Ki67 (IHC) between baseline and 14 weeks (log-fold change, Mann-Whitney test); (ii) clinical response (ultrasound) after 14 weeks (4 group, ordinal, Mann-Whitney test). Complete cell-cycle arrest (CCCA) (Ki67≤2.7%) was analyzed using a logistic regression model adjusting for recruitment region. Pre-specified exploratory biomarkers included c-PARP (apoptosis).
Results: 307 patients were recruited between 27 Feb 2015 and 08 Mar 2018; 103 were randomized to letrozole alone and 204 to letrozole + palbociclib. 279 (90.9%) patients were evaluable for 14 week clinical response. Clinical response was not significantly different between letrozole vs letrozole + palbociclib groups [(p=0.20; CR+PR 49.5% (46/93) vs 54.3% (101/186) and PD 5.4% (5/93) vs 3.2% (6/186)] nor was the small proportion of patients with pathological CR (1/87, 1.1% vs 6/180, 3.3%; p=0.43). 190 (61.9%) patients were evaluable for 14 week change in Ki67. The median log-fold change in Ki67 was greater with letrozole + palbociclib vs letrozole alone (-4.1 vs -2.2; p<0.001) corresponding to a geometric mean change of -97.4% vs -88.5%. Similarly, a greater proportion of patients who received letrozole + palbociclib achieved CCCA (90% vs 59%, p<0.001). 146 (47.6%) patients were evaluable for c-PARP and the log-fold change (suppression) was greater with letrozole + palbociclib vs letrozole alone (-0.80 vs -0.42; p=0.003) corresponding to a geometric mean change of -56.8% vs -31.4%. Other biomarkers of response / resistance are being evaluated. A higher proportion of patients had a grade ≥3 toxicity on letrozole + palbociclib than letrozole alone (49.8% vs 17.0%; p<0.001) mainly due to asymptomatic neutropenia.
Conclusion: Adding palbociclib to letrozole markedly enhanced the suppression of malignant cell proliferation as assessed by Ki67 but did not substantially increase the clinical response of primary ER+ breast cancer over a 14-week period. Concurrent reductions in cell death may have reduced the speed of tumor shrinkage.
Citation Format: Dowsett M, Jacobs S, Johnston S, Bliss J, Wheatley D, Holcombe C, Stein R, McIntosh S, Barry P, Dolling D, Snowdon C, Perry S, Batten L, Dodson A, Martins V, Modi A, Cornman C, Puhalla S, Wolmark N, Julian T, Pogue-Geile K, Robidoux A, Provencher L, Boileau JF, Shalaby I, Thirlwell M, Fisher K, Huang Bartlett C, Koehler M, Osborne K, Rimawi M. PALLET: A neoadjuvant study to compare the clinical and antiproliferative effects of letrozole with and without palbociclib [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 GS3-02.
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Affiliation(s)
- M Dowsett
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Jacobs
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Johnston
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - J Bliss
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - D Wheatley
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Holcombe
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - R Stein
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S McIntosh
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - P Barry
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - D Dolling
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Snowdon
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Perry
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - L Batten
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Dodson
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - V Martins
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Modi
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Cornman
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - S Puhalla
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - N Wolmark
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - T Julian
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Pogue-Geile
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - A Robidoux
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - L Provencher
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - JF Boileau
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - I Shalaby
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Thirlwell
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Fisher
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - C Huang Bartlett
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Koehler
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - K Osborne
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
| | - M Rimawi
- The Institute of Cancer Research, London, United Kingdom; The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh; Pfizer Inc, New York; Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom; Belfast Health and Social Care Trust, Belfast, United Kingdom; Baylor College of Medicine, Houston; International Drug Development Institute, Brussels, Belgium; Montreal Jewish General Hospital Segal Cancer Centre, Montreal, Canada; CHU de Quebec-Universite Laval, Quebec, Canada; Joe Arrington Cancer Research & Treatment Center, Lubbock, TX; Allegheny Health Network Cancer Institute, Pittsburgh; UPMC Cancer Center, Pittsburgh; Centre Hospitalier Université de Montréal, Montreal, Canada; McGill University Health Centre, Montreal, Canada
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47
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Cassiman C, Laenen A, Jacobs S, Demaerel P, Legius E, Casteels I. Ophthalmological examination in neurofibromatosis type 1: a long-term retrospective analysis. Acta Ophthalmol 2018; 96:e1044-e1046. [PMID: 30259655 DOI: 10.1111/aos.13831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Catherine Cassiman
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | - Annouschka Laenen
- Department of Biostatistics; Catholic University of Leuven; Leuven Belgium
| | - Sandra Jacobs
- Department of Pediatrics; University Hospitals Leuven; Leuven Belgium
| | - Philippe Demaerel
- Department of Radiology; University Hospitals Leuven; Leuven Belgium
| | - Eric Legius
- Department of Human Genetics; University Hospitals Leuven; Leuven Belgium
| | - Ingele Casteels
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
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48
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Muntifering JR, Linklater WL, Naidoo R, !Uri‐≠Khob S, Preez PD, Beytell P, Jacobs S, Knight AT. Sustainable close encounters: integrating tourist and animal behaviour to improve rhinoceros viewing protocols. Anim Conserv 2018. [DOI: 10.1111/acv.12454] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J. R. Muntifering
- Minnesota Zoo Apple Valley MN USA
- Save the Rhino Trust Swakopmund Namibia
- Department of Conservation Ecology and Entomology Stellenbosch University Matieland South Africa
| | - W. L. Linklater
- Centre for Biodiversity and Restoration Ecology School of Biological Sciences Victoria University of Wellington Wellington New Zealand
- Centre for African Conservation Ecology Department of Zoology Nelson Mandela Metropolitan University Port Elizabeth South Africa
| | | | | | - P. D. Preez
- Ministry of Environment and Tourism Windhoek Namibia
| | - P. Beytell
- Ministry of Environment and Tourism Windhoek Namibia
| | - S. Jacobs
- Department of Conservation Ecology and Entomology Stellenbosch University Matieland South Africa
| | - A. T. Knight
- Department of Life Sciences Imperial College London Ascot UK
- ARC Centre of Excellence in Environmental Decisions The University of Queensland St. Lucia QLD Australia
- Department of Botany Nelson Mandela Metropolitan University Port Elizabeth Eastern Cape South Africa
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49
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Lemiere J, Vandereydt J, Van den Wyngaert L, Vercruysse T, Sleurs C, Jacobs S. QOL-34. A FOUR-YEAR FOLLOW-UP STUDY OF NEUROCOGNITION IN CHILDREN TREATED FOR A BRAIN TUMOR. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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50
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Doz F, Clifford S, Pietsch T, Avula S, Mynarek M, Riechers R, Benesch M, Gerber NU, Massimino M, Sabel M, Jacobs S, Ariza MG, Michalski A, Sterba J, Pentikäinen V, Rutkowski S. MBCL-29. FEASIBILITY OF SCREENING AND REASONS FOR SCREENING FAILURES IN THE SIOPE PNET 5 MB TRIAL. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- François Doz
- Institute Curie, Paris Cedex 05, France
- University Paris Descartes, Paris, France
| | - Steven Clifford
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Torsten Pietsch
- Department of Neuropathology, University Bonn, Bonn, Germany
| | - Shivaram Avula
- Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - Martin Mynarek
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Regine Riechers
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Benesch
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Nicolas U Gerber
- Department of Oncology, University Children’s Hospital, Zürich, Switzerl
| | | | - Magnus Sabel
- Barncancercentrum, Drottning Silvias Barn-och ungdomssjukhus, Göteborg, Sweden
| | - Sandra Jacobs
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Miguel Garcia Ariza
- Unit of Paediatric Haematology, Oncology Hospital Cruces Bilbao, Plaza de Cruces s/n, Baracaldo Bizkaia, Spain
| | - Antony Michalski
- Department of Paediatric Oncology, Great Ormond Street Hospital for Children, London, UK
| | - Jaroslav Sterba
- Department of Paediatric Oncology, University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Virve Pentikäinen
- Department of Pediatric Oncology, Haematology and Stem Cell Transplantations, Helsinki University Central Hospital, Helsinki, Finl
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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