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Javed SR, Lord S, El Badri S, Harman R, Holmes J, Kamzi F, Maughan T, McIntosh D, Mukherjee S, Ooms A, Radhakrishna G, Shaw P, Hawkins MA. CHARIOT: a phase I study of berzosertib with chemoradiotherapy in oesophageal and other solid cancers using time to event continual reassessment method. Br J Cancer 2024; 130:467-475. [PMID: 38129525 PMCID: PMC10844302 DOI: 10.1038/s41416-023-02542-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Berzosertib (M6620) is a highly potent (IC50 = 19 nM) and selective, first-in-class ataxia telangiectasia-mutated and Rad3-related protein kinase (ATR) inhibitor. This trial assessed the safety, preliminary efficacy, and tolerance of berzosertib in oesophageal cancer (A1 cohort) with RT and advanced solid tumours (A2 cohort) with cisplatin and capecitabine. METHODS Single-arm, open-label dose-escalation (Time-to-Event Continual Reassessment Method) trial with 16 patients in A1 and 18 in A2. A1 tested six dose levels of berzosertib with RT (35 Gy over 15 fractions in 3 weeks). RESULTS No dose-limiting toxicities (DLTs) in A1. Eight grade 3 treatment-related AEs occurred in five patients, with rash being the most common. The highest dose (240 mg/m2) was determined as the recommended phase II dose (RP2D) for A1. Seven DLTs in two patients in A2. The RP2D of berzosertib was 140 mg/m2 once weekly. The most common grade ≥3 treatment-related AEs were neutropenia and thrombocytopenia. No treatment-related deaths were reported. CONCLUSIONS Berzosertib combined with RT is feasible and well tolerated in oesophageal cancer patients at high palliative doses. Berzosertib with cisplatin and capecitabine was well tolerated in advanced cancer. Further investigation is warranted in a phase 2 setting. CLINICAL TRIALS IDENTIFIER EU Clinical Trials Register (EudraCT) - 2015-003965-27 ClinicalTrials.gov - NCT03641547.
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Affiliation(s)
- S R Javed
- Department of Oncology, University of Oxford, Oxford, UK
| | - S Lord
- Department of Oncology, University of Oxford, Oxford, UK
| | - S El Badri
- Department of Oncology, University of Oxford, Oxford, UK
| | - R Harman
- Department of Oncology, University of Oxford, Oxford, UK
| | - J Holmes
- Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - F Kamzi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - T Maughan
- Department of Oncology, University of Oxford, Oxford, UK
| | - D McIntosh
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - S Mukherjee
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A Ooms
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - P Shaw
- Velindre University NHS Trust, Cardiff, UK
| | - M A Hawkins
- UCL Medical Physics and Biomedical Engineering, University College London, London, UK.
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2
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Ylescupidez A, Speake C, Pietropaolo SL, Wilson DM, Steck AK, Sherr JL, Gaglia JL, Bender C, Lord S, Greenbaum CJ. OGTT Metrics Surpass Continuous Glucose Monitoring Data for T1D Prediction in Multiple-Autoantibody-Positive Individuals. J Clin Endocrinol Metab 2023; 109:57-67. [PMID: 37572381 PMCID: PMC10735531 DOI: 10.1210/clinem/dgad472] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/14/2023]
Abstract
CONTEXT The value of continuous glucose monitoring (CGM) for monitoring autoantibody (AAB)-positive individuals in clinical trials for progression of type 1 diabetes (T1D) is unknown. OBJECTIVE Compare CGM with oral glucose tolerance test (OGTT)-based metrics in prediction of T1D. METHODS At academic centers, OGTT and CGM data from multiple-AAB relatives were evaluated for associations with T1D diagnosis. Participants were multiple-AAB-positive individuals in a TrialNet Pathway to Prevention (TN01) CGM ancillary study (n = 93). The intervention was CGM for 1 week at baseline, 6 months, and 12 months. Receiver operating characteristic (ROC) curves of CGM and OGTT metrics for prediction of T1D were analyzed. RESULTS Five of 7 OGTT metrics and 29/48 CGM metrics but not HbA1c differed between those who subsequently did or did not develop T1D. ROC area under the curve (AUC) of individual CGM values ranged from 50% to 69% and increased when adjusted for age and AABs. However, the highest-ranking metrics were derived from OGTT: 4/7 with AUC ∼80%. Compared with adjusted multivariable models using CGM data, OGTT-derived variables, Index60 and DPTRS (Diabetes Prevention Trial-Type 1 Risk Score), had higher discriminative ability (higher ROC AUC and positive predictive value with similar negative predictive value). CONCLUSION Every 6-month CGM measures in multiple-AAB-positive individuals are predictive of subsequent T1D, but less so than OGTT-derived variables. CGM may have feasibility advantages and be useful in some settings. However, our data suggest there is insufficient evidence to replace OGTT measures with CGM in the context of clinical trials.
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Affiliation(s)
- Alyssa Ylescupidez
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA 98101, USA
| | - Cate Speake
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA 98101, USA
| | - Susan L Pietropaolo
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Darrell M Wilson
- Division of Pediatric Endocrinology, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Andrea K Steck
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Jennifer L Sherr
- Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Jason L Gaglia
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA
| | - Christine Bender
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA 98101, USA
| | - Sandra Lord
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA 98101, USA
| | - Carla J Greenbaum
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, WA 98101, USA
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Ylescupidez A, Bahnson HT, O'Rourke C, Lord S, Speake C, Greenbaum CJ. A standardized metric to enhance clinical trial design and outcome interpretation in type 1 diabetes. Nat Commun 2023; 14:7214. [PMID: 37940642 PMCID: PMC10632453 DOI: 10.1038/s41467-023-42581-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 10/13/2023] [Indexed: 11/10/2023] Open
Abstract
The use of a standardized outcome metric enhances clinical trial interpretation and cross-trial comparison. If a disease course is predictable, comparing modeled predictions with outcome data affords the precision and confidence needed to accelerate precision medicine. We demonstrate this approach in type 1 diabetes (T1D) trials aiming to preserve endogenous insulin secretion measured by C-peptide. C-peptide is predictable given an individual's age and baseline value; quantitative response (QR) adjusts for these variables and represents the difference between the observed and predicted outcome. Validated across 13 trials, the QR metric reduces each trial's variance and increases statistical power. As smaller studies are especially subject to random sampling variability, using QR as the outcome introduces alternative interpretations of previous clinical trial results. QR can provide model-based estimates that quantify whether individuals or groups did better or worse than expected. QR also provides a purer metric to associate with biomarker measurements. Using data from more than 1300 participants, we demonstrate the value of QR in advancing disease-modifying therapy in T1D. QR applies to any disease where outcome is predictable by pre-specified baseline covariates, rendering it useful for defining responders to therapy, comparing therapeutic efficacy, and understanding causal pathways in disease.
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Affiliation(s)
- Alyssa Ylescupidez
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Henry T Bahnson
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Colin O'Rourke
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Sandra Lord
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Cate Speake
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA.
| | - Carla J Greenbaum
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA.
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4
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Jaycox JR, Lucas C, Yildirim I, Dai Y, Wang EY, Monteiro V, Lord S, Carlin J, Kita M, Buckner JH, Ma S, Campbell M, Ko A, Omer S, Lucas CL, Speake C, Iwasaki A, Ring AM. SARS-CoV-2 mRNA vaccines decouple anti-viral immunity from humoral autoimmunity. Nat Commun 2023; 14:1299. [PMID: 36894554 PMCID: PMC9996559 DOI: 10.1038/s41467-023-36686-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/09/2023] [Indexed: 03/11/2023] Open
Abstract
mRNA-based vaccines dramatically reduce the occurrence and severity of COVID-19, but are associated with rare vaccine-related adverse effects. These toxicities, coupled with observations that SARS-CoV-2 infection is associated with autoantibody development, raise questions whether COVID-19 vaccines may also promote the development of autoantibodies, particularly in autoimmune patients. Here we used Rapid Extracellular Antigen Profiling to characterize self- and viral-directed humoral responses after SARS-CoV-2 mRNA vaccination in 145 healthy individuals, 38 patients with autoimmune diseases, and 8 patients with mRNA vaccine-associated myocarditis. We confirm that most individuals generated robust virus-specific antibody responses post vaccination, but that the quality of this response is impaired in autoimmune patients on certain modes of immunosuppression. Autoantibody dynamics are remarkably stable in all vaccinated patients compared to COVID-19 patients that exhibit an increased prevalence of new autoantibody reactivities. Patients with vaccine-associated myocarditis do not have increased autoantibody reactivities relative to controls. In summary, our findings indicate that mRNA vaccines decouple SARS-CoV-2 immunity from autoantibody responses observed during acute COVID-19.
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Affiliation(s)
- Jillian R Jaycox
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA
| | - Carolina Lucas
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA
| | - Inci Yildirim
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, New Haven, CT, USA
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Yile Dai
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA
| | - Eric Y Wang
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA
| | - Valter Monteiro
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA
| | - Sandra Lord
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | | | - Mariko Kita
- Virginia Mason Medical Center, Seattle, WA, USA
| | - Jane H Buckner
- Translational Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Melissa Campbell
- Department of Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
| | - Albert Ko
- Department of Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Saad Omer
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
- Department of Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Carrie L Lucas
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA
| | - Cate Speake
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA.
| | - Akiko Iwasaki
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA.
- Howard Hughes Medical Institute, Chevy Chase, MD, USA.
| | - Aaron M Ring
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA.
- Department of Pharmacology, Yale School of Medicine, New Haven, CT, USA.
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Wang Z, Lord S, Darby S, Dodwell D. Cytotoxic Chemotherapy for Pancreatic Adenocarcinoma in England 2010-2017: Survival Outcomes. Clin Oncol (R Coll Radiol) 2023; 35:382-396. [PMID: 36948915 DOI: 10.1016/j.clon.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/06/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
AIMS Cytotoxic chemotherapy is widely used in the management of pancreatic adenocarcinoma as adjuvant treatment after radical surgery and also in advanced disease. The results of randomised trials in selected patient groups provide reliable evidence of comparative treatment efficacy, but studies of population-based observational cohorts provide insight into survival outcomes in routine care. MATERIALS AND METHODS We conducted a large population-based observational cohort study of patients, diagnosed during 2010-2017, who received chemotherapy within the National Health Service in England. We considered overall survival and 30-day all-cause mortality risk after chemotherapy. We conducted a literature search to compare these results to published studies. RESULTS In total, 9390 patients were included in the cohort. For 1114 patients treated with radical surgery and chemotherapy with curative intent, overall survival from the start of chemotherapy was 75.8% (95% confidence interval 73.3-78.3) at 1 year and 22.0% (18.6-25.3) at 5 years. For 7468 patients treated with non-curative intent, overall survival was 29.6% (28.6-30.6) at 1 year and 2.0% (1.6-2.4) at 5 years. In both groups, poorer performance status at the start of chemotherapy was strongly associated with poorer survival. The risk of 30-day mortality in patients treated with non-curative intent was 13.6% (12.8-14.5). This was higher in younger patients and those with higher stage disease and a poorer performance status. CONCLUSIONS Survival in this general population was poorer than that published in randomised trials. This study will aid informed discussion with patients regarding anticipated outcomes in routine clinical care.
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Affiliation(s)
- Z Wang
- Nuffield Department of Population Health, Old Road Campus, University of Oxford, Oxford, UK
| | - S Lord
- Department of Oncology, University of Oxford, Churchill Hospital, Oxford, UK
| | - S Darby
- Nuffield Department of Population Health, Old Road Campus, University of Oxford, Oxford, UK
| | - D Dodwell
- Nuffield Department of Population Health, Old Road Campus, University of Oxford, Oxford, UK.
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O’Rourke C, Ylescupidez A, Bahnson HT, Bender C, Speake C, Lord S, Greenbaum CJ. Risk Modeling to Reduce Monitoring of an Autoantibody-Positive Population to Prevent DKA at Type 1 Diabetes Diagnosis. J Clin Endocrinol Metab 2023; 108:688-696. [PMID: 36227635 PMCID: PMC10210620 DOI: 10.1210/clinem/dgac594] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/07/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT The presence of islet autoimmunity identifies individuals likely to progress to clinical type 1 diabetes (T1D). In clinical research studies, autoantibody screening followed by regular metabolic monitoring every 6 months reduces incidence of diabetic ketoacidosis (DKA) at diagnosis. OBJECTIVE We hypothesized that DKA reduction can be achieved on a population basis with a reduced frequency of metabolic monitoring visits. We reasoned that prolonged time between the development of T1D and the time of clinical diagnosis ("undiagnosed time") would more commonly result in DKA and thus that limiting undiagnosed time would decrease DKA. METHODS An analysis was conducted of data from TrialNet's Pathway to Prevention (PTP), a cross-sectional longitudinal study that identifies and follows at-risk relatives of people with T1D. PTP is a population-based study enrolling across multiple countries. A total of 6193 autoantibody (AAB)-positive individuals participated in PTP from March 2004 to April 2019. We developed models of progression to clinical diagnosis for pediatric and adult populations with single or multiple AAB, and summarized results using estimated hazard rate. An optimal monitoring visit schedule was determined for each model to achieve a minimum average level of undiagnosed time for each population. RESULTS Halving the number of monitoring visits usually conducted in research studies is likely to substantially lower the population incidence of DKA at diagnosis of T1D. CONCLUSION Our study has clinical implications for the metabolic monitoring of at-risk individuals. Fewer monitoring visits would reduce the clinical burden, suggesting a path toward transitioning monitoring beyond the research setting.
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Affiliation(s)
- Colin O’Rourke
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Washington 98101, USA
| | - Alyssa Ylescupidez
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Washington 98101, USA
| | - Henry T Bahnson
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Washington 98101, USA
| | - Christine Bender
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Washington 98101, USA
| | - Cate Speake
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Washington 98101, USA
| | - Sandra Lord
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Washington 98101, USA
| | - Carla J Greenbaum
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Washington 98101, USA
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7
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Kinney M, You L, Sims EK, Wherrett D, Schatz D, Lord S, Krischer J, Russell WE, Gottlieb PA, Libman I, Buckner J, DiMeglio LA, Herold KC, Steck AK. Barriers to Screening: An Analysis of Factors Impacting Screening for Type 1 Diabetes Prevention Trials. J Endocr Soc 2023; 7:bvad003. [PMID: 36741943 PMCID: PMC9891344 DOI: 10.1210/jendso/bvad003] [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: 10/24/2022] [Indexed: 01/12/2023] Open
Abstract
Context Participants with stage 1 or 2 type 1 diabetes (T1D) qualify for prevention trials, but factors involved in screening for such trials are largely unknown. Objective To identify factors associated with screening for T1D prevention trials. Methods This study included TrialNet Pathway to Prevention participants who were eligible for a prevention trial: oral insulin (TN-07, TN-20), teplizumab (TN-10), abatacept (TN-18), and oral hydroxychloroquine (TN-22). Univariate and multivariate logistic regression models were used to examine participant, site, and study factors at the time of prevention trial accrual. Results Screening rates for trials were: 50% for TN-07 (584 screened/1172 eligible), 9% for TN-10 (106/1249), 24% for TN-18 (313/1285), 17% for TN-20 (113/667), and 28% for TN-22 (371/1336). Younger age and male sex were associated with higher screening rates for prevention trials overall and for oral therapies. Participants with an offspring with T1D showed lower rates of screening for all trials and oral drug trials compared with participants with other first-degree relatives as probands. Site factors, including larger monitoring volume and US site vs international site, were associated with higher prevention trial screening rates. Conclusions Clear differences exist between participants who screen for prevention trials and those who do not screen and between the research sites involved in prevention trial screening. Participant age, sex, and relationship to proband are significantly associated with prevention trial screening in addition to key site factors. Identifying these factors can facilitate strategic recruitment planning to support rapid and successful enrollment into prevention trials.
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Affiliation(s)
- Mara Kinney
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Lu You
- Health Informatics Institute, University of South Florida, Tampa, FL 33620, USA
| | - Emily K Sims
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Diane Wherrett
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto M5G 1X8, Canada
| | - Desmond Schatz
- Department of Pediatrics, University of Florida, Gainesville, FL 32611, USA
| | - Sandra Lord
- Diabetes Research Program, Benaroya Research Institute, Seattle, WA 98101, USA
| | - Jeffrey Krischer
- Health Informatics Institute, University of South Florida, Tampa, FL 33620, USA
| | | | - Peter A Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Ingrid Libman
- Division of Endocrinology, Diabetes and Metabolism, University of Pittsburgh and UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jane Buckner
- Diabetes Research Program, Benaroya Research Institute, Seattle, WA 98101, USA
| | - Linda A DiMeglio
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Kevan C Herold
- Departments of Immunobiology and Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Andrea K Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO 80045, USA
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Guyer P, Arribas-Layton D, Manganaro A, Speake C, Lord S, Eizirik DL, Kent SC, Mallone R, James EA. Recognition of mRNA Splice Variant and Secretory Granule Epitopes by CD4+ T Cells in Type 1 Diabetes. Diabetes 2023; 72:85-96. [PMID: 36201618 PMCID: PMC9797322 DOI: 10.2337/db22-0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/02/2022] [Indexed: 01/19/2023]
Abstract
A recent discovery effort resulted in identification of novel splice variant and secretory granule antigens within the HLA class I peptidome of human islets and documentation of their recognition by CD8+ T cells from peripheral blood and human islets. In the current study, we applied a systematic discovery process to identify novel CD4+ T cell epitopes derived from these candidate antigens. We predicted 145 potential epitopes spanning unique splice junctions and within conventional secretory granule antigens and measured their in vitro binding to DRB1*04:01. We generated HLA class II tetramers for the 35 peptides with detectable binding and used these to assess immunogenicity and isolate T cell clones. Tetramers corresponding to peptides with verified immunogenicity were then used to label T cells specific for these putative epitopes in peripheral blood. T cells that recognize distinct epitopes derived from a cyclin I splice variant, neuroendocrine convertase 2, and urocortin-3 were detected at frequencies that were similar to those of an immunodominant proinsulin epitope. Cells specific for these novel epitopes predominantly exhibited a Th1-like surface phenotype. Among the three epitopes, responses to the cyclin I peptide exhibited a distinct memory profile. Responses to neuroendocrine convertase 2 were detected among pancreatic infiltrating T cells. These results further establish the contribution of unconventional antigens to the loss of tolerance in autoimmune diabetes.
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Affiliation(s)
- Perrin Guyer
- Center for Translational Immunology, Benaroya Research Institute, Virginia Mason Medical Center, Seattle, WA
| | - David Arribas-Layton
- Center for Translational Immunology, Benaroya Research Institute, Virginia Mason Medical Center, Seattle, WA
| | - Anthony Manganaro
- Division of Diabetes, Diabetes Center of Excellence, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA
| | - Cate Speake
- Diabetes Clinical Research Program and Center for Interventional Immunology, Benaroya Research Institute, Virginia Mason Medical Center, Seattle, WA
| | - Sandra Lord
- Diabetes Clinical Research Program and Center for Interventional Immunology, Benaroya Research Institute, Virginia Mason Medical Center, Seattle, WA
| | - Decio L. Eizirik
- ULB Center for Diabetes Research, Université Libre de Bruxelles, Brussels, Belgium
| | - Sally C. Kent
- Division of Diabetes, Diabetes Center of Excellence, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA
| | - Roberto Mallone
- INSERM, CNRS, Institut Cochin, Université de Paris, Paris, France
- Service de Diabétologie et Immunologie Clinique, Cochin Hospital, Hôpitaux Universitaires Paris Centre, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Eddie A. James
- Center for Translational Immunology, Benaroya Research Institute, Virginia Mason Medical Center, Seattle, WA
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Speake C, Habib T, Lambert K, Hundhausen C, Lord S, Dufort MJ, Skinner SO, Hu A, Kinsman M, Jones BE, Maerz MD, Tatum M, Hocking AM, Nepom GT, Greenbaum CJ, Buckner JH. IL-6-targeted therapies to block the cytokine or its receptor drive distinct alterations in T cell function. JCI Insight 2022; 7:159436. [PMID: 36282595 DOI: 10.1172/jci.insight.159436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022] Open
Abstract
Therapeutics that inhibit IL-6 at different points in its signaling pathway are in clinical use, yet whether the immunological effects of these interventions differ based on their molecular target is unknown. We performed short-term interventions in individuals with type 1 diabetes using anti-IL-6 (siltuximab) or anti-IL-6 receptor (IL-6R; tocilizumab) therapies and investigated the impact of this in vivo blockade on T cell fate and function. Immune outcomes were influenced by the target of the therapeutic intervention (IL-6 versus IL-6R) and by peak drug concentration. Tocilizumab reduced ICOS expression on T follicular helper cell populations and T cell receptor-driven (TCR-driven) STAT3 phosphorylation. Siltuximab reversed resistance to Treg-mediated suppression and increased TCR-driven phosphorylated STAT3 and production of IL-10, IL-21, and IL-27 by T effectors. Together, these findings indicate that the context of IL-6 blockade in vivo drives distinct T cell-intrinsic changes that may influence therapeutic outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | - Alex Hu
- Center for Systems Immunology, and
| | | | | | | | | | | | - Gerald T Nepom
- Immune Tolerance Network, Benaroya Research Institute at Virginia Mason, Seattle, Washington, USA
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Greene J, Wang Z, Harris B, Dodwell D, Lord S. The impact of body mass index on clinical outcomes for patients receiving systemic anti-cancer therapies for advanced renal cell carcinoma. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02556-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Mukherjee S, Lord S, Harman R, McIntosh D, Ooms A, Parkes M, Radhakrishna G, Shaw P, Hawkins M. 1251P CHARIOT: A phase I dose escalation study combining ATR inhibitor Berzosertib with chemoradiotherapy in oesophageal cancer using time to event continual reassessment (TiTE-CRM) method: Results from A1 cohort (combination with palliative RT). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1369] [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: 11/01/2022] Open
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12
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de Bono J, Lord S, Yap C, Rowinsky E, Gandhi N, Thakkar D, Ingram P, Padmanabhan N, Chandran K, Paschalis A, McGuigan L, Neal P, Paisley D, Walter H, Kelly F, Craigan J, Westwood N, Halbert G, Boyd-Kirkup J, Halford S. 493TiP A CRUK phase I/IIA, first in human dose-escalation and expansion trial of HMBD-001 (an anti-HER-3 antibody) in patients with advanced HER3-positive solid tumours. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.621] [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: 11/01/2022] Open
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13
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Dulloo S, Fennell D, Szlosarek P, Thistlethwaite F, Lord S, Rahman N, Greystoke A, Cunniff B, Dzialo J, Poile C, Panchal R, Duncan J, Graham P, Bexon A, Naumov G, Spicer J. 1643TiP First-in-human dose-escalation and expansion study (MITOPE) to evaluate mitochondrial PRX3 inhibition by RSO-021 in patients with mesothelioma and other advanced solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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14
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El Badri S, Lord S, Harman R, McIntosh D, Mukherjee S, Ooms A, Parkes M, Radhakrishna G, Shaw P, Hawkins M. 484P CHARIOT trial (cohort A2): A phase I dose-escalation study combining the ATR inhibitor berzosertib with cisplatin and capecitabine. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.612] [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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15
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Yuzefpolskiy Y, Morawski P, Fahning M, Speake C, Lord S, Chaudhary A, Morishima C, Wener MH, Kita M, McCarthy L, Buckner JH, Campbell DJ, Bettelli E. Cutting Edge: Effect of Disease-Modifying Therapies on SARS-CoV-2 Vaccine-Induced Immune Responses in Multiple Sclerosis Patients. J Immunol 2022; 208:1519-1524. [PMID: 35288472 DOI: 10.4049/jimmunol.2101142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Multiple sclerosis (MS) is a demyelinating inflammatory disease of the CNS treated by diverse disease-modifying therapies that suppress the immune system. Severe acute respiratory syndrome coronavirus 2 mRNA vaccines have been very effective in immunocompetent individuals, but whether MS patients treated with modifying therapies are afforded the same protection is not known. This study determined that dimethyl fumarate caused a momentary reduction in anti-Spike (S)-specific Abs and CD8 T cell response. MS patients treated with B cell-depleting (anti-CD20) or sphingosine 1-phosphate receptor agonist (fingolimod) therapies lack significant S-specific Ab response. Whereas S-specific CD4 and CD8 T cell responses were largely compromised by fingolimod treatment, T cell responses were robustly generated in anti-CD20-treated MS patients, but with a reduced proportion of CD4+CXCR5+ circulating follicular Th cells. These data provide novel information regarding vaccine immune response in patients with autoimmunity useful to help improve vaccine effectiveness in these populations.
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Affiliation(s)
- Yevgeniy Yuzefpolskiy
- Center for Fundamental Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Peter Morawski
- Center for Fundamental Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Mitch Fahning
- Center for Fundamental Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Cate Speake
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Sandra Lord
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA
| | - Anu Chaudhary
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA
| | - Chihiro Morishima
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA
| | - Mark H Wener
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Mariko Kita
- Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA
| | - Lucas McCarthy
- Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA
| | - Jane H Buckner
- Translational Research Program, Benaroya Research Institute at Virginia Mason, Seattle, WA; and
| | - Daniel J Campbell
- Center for Fundamental Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA
- Department of Immunology, University of Washington School of Medicine, Seattle, WA
| | - Estelle Bettelli
- Center for Fundamental Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA;
- Department of Immunology, University of Washington School of Medicine, Seattle, WA
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16
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So M, O'Rourke C, Ylescupidez A, Bahnson HT, Steck AK, Wentworth JM, Bruggeman BS, Lord S, Greenbaum CJ, Speake C. Characterising the age-dependent effects of risk factors on type 1 diabetes progression. Diabetologia 2022; 65:684-694. [PMID: 35041021 PMCID: PMC9928893 DOI: 10.1007/s00125-021-05647-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/23/2021] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS Age is known to be one of the most important stratifiers of disease progression in type 1 diabetes. However, what drives the difference in rate of progression between adults and children is poorly understood. Evidence suggests that many type 1 diabetes disease predictors do not have the same effect across the age spectrum. Without a comprehensive analysis describing the varying risk profiles of predictors over the age continuum, researchers and clinicians are susceptible to inappropriate assessment of risk when examining populations of differing ages. We aimed to systematically assess and characterise how the effect of key type 1 diabetes risk predictors changes with age. METHODS Using longitudinal data from single- and multiple-autoantibody-positive at-risk individuals recruited between the ages of 1 and 45 years in TrialNet's Pathway to Prevention Study, we assessed and visually characterised the age-varying effect of key demographic, immune and metabolic predictors of type 1 diabetes by employing a flexible spline model. Two progression outcomes were defined: participants with single autoantibodies (n=4893) were analysed for progression to multiple autoantibodies or type 1 diabetes, and participants with multiple autoantibodies were analysed (n=3856) for progression to type 1 diabetes. RESULTS Several predictors exhibited significant age-varying effects on disease progression. Amongst single-autoantibody participants, HLA-DR3 (p=0.007), GAD65 autoantibody positivity (p=0.008), elevated BMI (p=0.007) and HOMA-IR (p=0.002) showed a significant increase in effect on disease progression with increasing age. Insulin autoantibody positivity had a diminishing effect with older age in single-autoantibody-positive participants (p<0.001). Amongst multiple-autoantibody-positive participants, male sex (p=0.002) was associated with an increase in risk for progression, and HLA DR3/4 (p=0.05) showed a decreased effect on disease progression with older age. In both single- and multiple-autoantibody-positive individuals, significant changes in HR with age were seen for multiple measures of islet function. Risk estimation using prediction risk score Index60 was found to be better at a younger age for both single- and multiple-autoantibody-positive individuals (p=0.007 and p<0.001, respectively). No age-varying effect was seen for prediction risk score DPTRS (p=0.861 and p=0.178, respectively). Multivariable analyses suggested that incorporating the age-varying effect of the individual components of these validated risk scores has the potential to enhance the risk estimate. CONCLUSIONS/INTERPRETATION Analysing the age-varying effect of disease predictors improves understanding and prediction of type 1 diabetes disease progression, and should be leveraged to refine prediction models and guide mechanistic studies.
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Affiliation(s)
- Michelle So
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA.
- Immunology and Diabetes Unit, St Vincent's Institute, Fitzroy, VIC, Australia.
| | - Colin O'Rourke
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Alyssa Ylescupidez
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Henry T Bahnson
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Andrea K Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John M Wentworth
- Royal Melbourne Hospital Department of Diabetes and Endocrinology and Walter and Eliza Hall Institute Division of Population Health and Immunity, Parkville, VIC, Australia
| | - Brittany S Bruggeman
- Division of Pediatric Endocrinology, University of Florida, Gainesville, FL, USA
| | - Sandra Lord
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Carla J Greenbaum
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Cate Speake
- Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
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17
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Santarelli G, Bouvard J, Brethel SF, Gordon S, Lord S, Mavropoulou A, Oliveira P, Sykes KT, Swift S, Culshaw GJ. Non-cardiogenic pulmonary oedema complicating balloon valvuloplasty and stent angioplasty of severe pulmonary valve stenosis in four dogs. J Vet Cardiol 2021; 39:79-88. [PMID: 34999479 DOI: 10.1016/j.jvc.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 11/15/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
In dogs, balloon valvuloplasty is considered the treatment of choice for severe pulmonary valve stenosis, and this technique is currently performed routinely in specialist referral practices with low morbidity and mortality. Stent angioplasty has also been recently proposed as a viable treatment option. The present case series describes the clinical course of four dogs with severe pulmonary valve stenosis, treated with balloon valvuloplasty or stent angioplasty at four different institutions, which developed non-cardiogenic pulmonary oedema perioperatively after apparently successful dilation of the pulmonary valve. In three cases, there was evidence of some degree of pulmonary hypertension before ballooning. Despite intensive care, the complication proved fatal in three cases. Clinicians should therefore be aware of this life-threatening complication, previously undescribed in dogs.
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Affiliation(s)
- G Santarelli
- Cardiopulmonary Service, Hospital for Small Animals, Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Roslin, EH25 9RG, UK.
| | - J Bouvard
- Cardiopulmonary Service, Hospital for Small Animals, Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - S F Brethel
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, 32608, USA
| | - S Gordon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843, USA
| | - S Lord
- Anesthesia Service, Roslin, EH25 9RG, UK
| | - A Mavropoulou
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, SG5 3HR, UK
| | - P Oliveira
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, SG5 3HR, UK
| | - K T Sykes
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843, USA
| | - S Swift
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, 32608, USA
| | - G J Culshaw
- Cardiopulmonary Service, Hospital for Small Animals, Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Roslin, EH25 9RG, UK
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Lord S, Duncan J, Gozalo‐Marcilla M, Woodhouse K. In vitro flow rates through five different catheters intended for intravenous use in horses at two different heights. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13590] [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: 11/28/2022]
Affiliation(s)
- S. Lord
- Veterinary Clinical Sciences The Royal (Dick) School of Veterinary Studies and The Roslin Institute The University of Edinburgh MidlothianUK
| | - J. Duncan
- Veterinary Clinical Sciences The Royal (Dick) School of Veterinary Studies and The Roslin Institute The University of Edinburgh MidlothianUK
| | - M. Gozalo‐Marcilla
- Veterinary Clinical Sciences The Royal (Dick) School of Veterinary Studies and The Roslin Institute The University of Edinburgh MidlothianUK
| | - K. Woodhouse
- School of Medicine, Veterinary Medicine and Life Sciences University of Glasgow Glasgow UK
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Greenbaum CJ, Serti E, Lambert K, Weiner LJ, Kanaparthi S, Lord S, Gitelman SE, Wilson DM, Gaglia JL, Griffin KJ, Russell WE, Raskin P, Moran A, Willi SM, Tsalikian E, DiMeglio LA, Herold KC, Moore WV, Goland R, Harris M, Craig ME, Schatz DA, Baidal DA, Rodriguez H, Utzschneider KM, Nel HJ, Soppe CL, Boyle KD, Cerosaletti K, Keyes-Elstein L, Long SA, Thomas R, McNamara JG, Buckner JH, Sanda S. IL-6 receptor blockade does not slow β cell loss in new-onset type 1 diabetes. JCI Insight 2021; 6:150074. [PMID: 34747368 PMCID: PMC8663550 DOI: 10.1172/jci.insight.150074] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/22/2021] [Indexed: 12/30/2022] Open
Abstract
BackgroundIL-6 receptor (IL-6R) signaling drives development of T cell populations important to type 1 diabetes pathogenesis. We evaluated whether blockade of IL-6R with monoclonal antibody tocilizumab would slow loss of residual β cell function in newly diagnosed type 1 diabetes patients.MethodsWe conducted a multicenter, randomized, placebo-controlled, double-blind trial with tocilizumab in new-onset type 1 diabetes. Participants were screened within 100 days of diagnosis. Eligible participants were randomized 2:1 to receive 7 monthly doses of tocilizumab or placebo. The primary outcome was the change from screening in the mean AUC of C-peptide collected during the first 2 hours of a mixed meal tolerance test at week 52 in pediatric participants (ages 6-17 years).ResultsThere was no statistical difference in the primary outcome between tocilizumab and placebo. Immunophenotyping showed reductions in downstream signaling of the IL-6R in T cells but no changes in CD4 memory subsets, Th17 cells, Tregs, or CD4+ T effector cell resistance to Treg suppression. A DC subset decreased during therapy but regressed to baseline once therapy stopped. Tocilizumab was well tolerated.ConclusionTocilizumab reduced T cell IL-6R signaling but did not modulate CD4+ T cell phenotypes or slow loss of residual β cell function in newly diagnosed individuals with type 1 diabetes.Trial RegistrationClinicalTrials.gov NCT02293837.FundingNIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and National Institute of Allergy and Infectious Diseases (NIAID) UM1AI109565, UL1TR000004 from NIH/National Center for Research Resources (NCRR) Clinical and Translational Science Award (CTSA), NIH/NIDDK P30DK036836, NIH/NIDDK U01DK103266, NIH/NIDDK U01DK103266, 1UL1TR000064 from NIH/NCRR CTSA, NIH/National Center for Advancing Translational Sciences (NCATS) UL1TR001878, UL1TR002537 from NIH/CTSA; National Health and Medical Research Council Practitioner Fellowship (APP1136735), NIH/NIDDK U01-DK085476, NIH/CTSA UL1-TR002494, Indiana Clinical and Translational Science Institute Award UL1TR002529, Vanderbilt Institute for Clinical and Translational Research UL1TR000445. NIH/NCATS UL1TR003142, NIH/CTSA program UL1-TR002494, Veteran Affairs Administration, and 1R01AI132774.
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Affiliation(s)
- Carla J Greenbaum
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, Washington, USA
| | | | - Katharina Lambert
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, Washington, USA
| | | | | | - Sandra Lord
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, Washington, USA
| | | | | | - Jason L Gaglia
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Philip Raskin
- University of Texas, Southwestern, Dallas, Texas, USA
| | | | - Steven M Willi
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Linda A DiMeglio
- Riley Children's Hospital, Indiana University, Indianapolis, Indiana, USA
| | | | - Wayne V Moore
- University of Missouri, Kansas City, Kansas City, Missouri, USA
| | | | - Mark Harris
- Children's Health Queensland Hospital, South Brisbane, Australia.,University of Queensland, Queensland, Brisbane, Australia
| | - Maria E Craig
- University of Sydney, Sydney New South Wales, Australia
| | | | | | | | | | - Hendrik J Nel
- University of Queensland, Queensland, Brisbane, Australia
| | | | | | - Karen Cerosaletti
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, Washington, USA
| | | | - S Alice Long
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, Washington, USA
| | - Ranjeny Thomas
- University of Queensland, Queensland, Brisbane, Australia
| | - James G McNamara
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Jane H Buckner
- Center for Interventional Immunology and Diabetes Program, Benaroya Research Institute, Seattle, Washington, USA
| | - Srinath Sanda
- Immune Tolerance Network, Seattle, Washington, USA.,University of California, San Francisco, San Francisco, California, USA
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Spiliopoulou P, Kazmi F, Aroldi F, Holmes J, Graham J, Holmes T, Lord S, Veal G, Qi C, Coyle V, Evans T, Blagden S. 549P Results of a first-in-human study of the ProTide thymidylate synthase inhibitor NUC-3373, in patients with advanced solid tumours (NuTide:301). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Krebs M, Lord S, Kenny L, Baird R, MacPherson I, Bahl A, Clack G, Ainscow E, Barrett A, Dickinson P, Fuchter M, Lehnert M, Ali S, Mcintosh S, Coombes R. 230MO First in human, modular study of samuraciclib (CT7001), a first-in-class, oral, selective inhibitor of CDK7, in patients with advanced solid malignancies. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.513] [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: 11/15/2022] Open
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22
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Howell S, Krebs M, Lord S, Kenny L, Bahl A, Clack G, Ainscow E, Arkenau HT, Mansi J, Palmieri C, Richards P, Jeselsohn R, Mitri Z, Gradishar W, Sardesai S, O'Shaughnessy J, Lehnert M, Ali S, McIntosh S, Coombes R. 265P Study of samuraciclib (CT7001), a first-in-class, oral, selective inhibitor of CDK7, in combination with fulvestrant in patients with advanced hormone receptor positive HER2 negative breast cancer (HR+BC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.548] [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] Open
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Simon S, Francis K, Dalrymple J, Gebski V, Lord S, Friedlander M, Lee C. 753P Adverse events experienced by patients in the placebo arm of maintenance therapy trials in advanced ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Woodford R, Lee C, Cooper W, Lewis C, John T, Lord S, Marschner I, Zhou D, Yang JH. 1370P PD-L1 expression as a predictive biomarker for chemotherapy response in metastatic non-small cell lung cancer (mNSCLC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1684] [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: 11/16/2022] Open
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25
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Chandarlapaty S, Bardia A, Lord S, Linden H, Pelekanou V, Ternes N, Ming J, Boutet V, Boitier E, Gosselin A, Lee JS, Dos-Santos Bele W, Protopopov A, Celanovic M, Bauchet AL, Campone M. 277MO SAR439859, an oral selective estrogen receptor (ER) degrader (SERD), in ER+/ HER2- metastatic breast cancer (mBC): Biomarker analyses from a phase I/II study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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26
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Yoon WH, Kok P, Marschner I, Lord S, Friedlander M, Lee C. 1042P Objective response rate as an intermediate surrogate endpoint to predict overall survival at 12 months. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
Despite the clear evidence that type 1 diabetes (T1D) begins well before hyperglycemia is evident, there are no clinically available disease-modifying therapies for early-stage disease. However, following the exciting results of the Teplizumab Prevention Study, the first study to demonstrate that overt T1D can be delayed with immunotherapy, there is renewed optimism that in the future, T1D will be treated before hyperglycemia develops. A different treatment paradigm is needed, as a majority of people with T1D do not meet the glycemic targets that are associated with a lower risk of T1D complications and therefore remain vulnerable to complications and shortened life expectancy. The following review will outline the history and current status of immunotherapy for T1D and highlight some challenges and ideas for the future. Although such efforts have been worldwide, we will focus particularly on the activities of Diabetes TrialNet, a National Institutes of Health consortium launched in 2004.
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Affiliation(s)
- Sandra Lord
- Benaroya Research Institute at Virginia Mason, Seattle, WA, 98101, USA
| | - Carla J Greenbaum
- Benaroya Research Institute at Virginia Mason, Seattle, WA, 98101, USA
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McInnes L, Jones E, Rochester L, Lord S, Chastin SFM, Watson AW, Little L, Briggs P. Mobility in Community Dwelling Older Adults: Predicting Successful Mobility Using an Instrumented Battery of Novel Measures. J Frailty Aging 2020; 9:68-73. [PMID: 32259179 DOI: 10.14283/jfa.2019.35] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mobility in older adults is associated with better quality of life. However, evidence suggests that older people spend less time out-of-home than younger adults. Traditional methods for assessing mobility have serious limitations. Wearable technologies provide the possibility of objectively assessing mobility over extended periods enabling better estimates of levels of mobility to be made and possible predictors to be explored. Eighty-six community dwelling older adults (mean age 79.8 years) had their mobility assessed for one week using GPS, accelerometry and self-report. Outcomes were: number of steps, time spent in dynamic outdoor activity, total distance travelled and total number of journeys made over the week. Assessments were also made of personal, cognitive, psychological, physical and social variables. Four regression models were calculated (one for each outcome). The models predicted 32 to 43% of the variance in levels of mobility. The ability to balance on one leg significantly predicted all four outcomes. In addition, cognitive ability predicted number of journeys made per week and time spent engaged in dynamic outdoor activity, and age significantly predicted total distance travelled. Overall estimates of mobility indicated step counts that were similar to those shown by previous research but distances travelled, measured by GPS, were lower. These findings suggest that mobility in this sample of older adults is predicted by the ability to balance on one leg. Possible interventions to improve out-of-home mobility could target balance. The fact that participants travelled shorter distances than those reported in previous studies is interesting since this high-functioning subgroup would be expected to demonstrate the highest levels.
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Affiliation(s)
- L McInnes
- Lynn McInnes, Department of Psychology, Northumberland Building, Northumbria University, Newcastle upon Tyne, NE1 8ST, Tel: +44 1912273238,
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Swinson D, Hall P, Lord S, Marshall H, Ruddock S, Allmark C, Cairns D, Waters J, Wadsley J, Falk S, Roy R, Joseph M, Nicoll J, Kamposioras K, Tillett T, Cummins S, Grumett S, Stokes Z, Waddell T, Chatterjee A, Garcia A, Khan M, Petty R, Seymour M. OPTIMIZING CHEMOTHERAPY FOR FRAIL AND/OR ELDERLY PATIENTS WITH ADVANCED GASTROESOPHAGEAL CANCER (AGOAC): THE GO2 PHASE III TRIAL. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31133-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Hall P, Swinson D, Lord S, Handforth C, Cairns D, Marshall H, Petty R, Bennett M, Velikova G, Seymour M. Chemotherapy for frail and elderly patients (pts) with advanced gastroesophageal cancer (aGOAC): Quality of Life (QoL) results from the GO2 phase III trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.037] [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: 11/14/2022] Open
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, 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Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy B, Burroughs C, Cuthbertson D, Deemer M, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Browning G, Coughenour T, Sulk M, Tsalikan E, Tansey M, Cabbage J, Dixit N, Pasha S, King M, Adcock K, Geyer S, Atterberry H, Fox L, Englert K, Mauras N, Permuy J, Sikes K, Berhe T, Guendling B, McLennan L, Paganessi L, Hays B, Murphy C, Draznin M, Kamboj M, Sheppard S, Lewis V, Coates L, Moore W, Babar G, Bedard J, Brenson-Hughes D, Henderson C, Cernich J, Clements M, Duprau R, Goodman S, Hester L, Huerta-Saenz L, Karmazin A, Letjen T, Raman S, Morin D, Henry M, Bestermann W, Morawski E, White J, Brockmyer A, Bays R, Campbell S, Stapleton A, Stone N, Donoho A, Everett H, Heyman K, Hensley H, Johnson M, Marshall C, Skirvin N, Taylor P, Williams R, Ray L, Wolverton C, Nickels D, Dothard C, Hsiao B, Speiser P, Pellizzari M, Bokor L, Izuora K, Abdelnour S, Cummings P, Paynor S, Leahy M, Riedl M, Shockley S, Karges C, Saad R, Briones T, Casella S, Herz C, Walsh K, Greening J, Hay F, Hunt S, Sikotra N, Simons L, Keaton N, Karounos D, Oremus R, Dye L, Myers L, Ballard D, Miers W, Sparks R, Thraikill K, Edwards K, Fowlkes J, Kinderman A, Kemp S, Morales A, Holland L, Johnson L, Paul P, Ghatak A, Phelen K, Leyland H, Henderson T, Brenner D, Law P, Oppenheimer E, Mamkin I, Moniz C, Clarson C, Lovell M, Peters A, Ruelas V, Borut D, Burt D, Jordan M, Leinbach A, Castilla S, Flores P, Ruiz M, Hanson L, Green-Blair J, Sheridan R, Wintergerst K, Pierce G, Omoruyi A, Foster M, Linton C, Kingery S, Lunsford A, Cervantes I, Parker T, Price P, Urben J, Doughty I, Haydock H, Parker V, Bergman P, Liu S, Duncum S, Rodda C, Thomas A, Ferry R, McCommon D, Cockroft J, Perelman A, Calendo R, Barrera C, Arce-Nunez E, Lloyd J, Martinez Y, De la Portilla M, Cardenas I, Garrido L, Villar M, Lorini R, Calandra E, D’Annuzio G, Perri K, Minuto N, Malloy J, Rebora C, Callegari R, Ali O, Kramer J, Auble B, Cabrera S, Donohoue P, Fiallo-Scharer R, Hessner M, Wolfgram P, Maddox K, Kansra A, Bettin N, McCuller R, Miller A, Accacha S, Corrigan J, Fiore E, Levine R, Mahoney T, Polychronakos C, Martin J, Gagne V, Starkman H, Fox M, Chin D, Melchionne F, Silverman L, Marshall I, Cerracchio L, Cruz J, Viswanathan A, Miller J, Wilson J, Chalew S, Valley S, Layburn S, Lala A, Clesi P, Genet M, Uwaifo G, Charron A, Allerton T, Milliot E, Cefalu W, Melendez-Ramirez L, Richards R, Alleyn C, Gustafson E, Lizanna M, Wahlen J, Aleiwe S, Hansen M, Wahlen H, Moore M, Levy C, Bonaccorso A, Rapaport R, Tomer Y, Chia D, Goldis M, Iazzetti L, Klein M, Levister C, Waldman L, Muller S, Wallach E, Regelmann M, Antal Z, Aranda M, Reynholds C, Leech N, Wake D, Owens C, Burns M, Wotherspoon J, Nguyen T, Murray A, Short K, Curry G, Kelsey S, Lawson J, Porter J, Stevens S, Thomson E, Winship S, Wynn L, O’Donnell R, Wiltshire E, Krebs J, Cresswell P, Faherty H, Ross C, Vinik A, Barlow P, Bourcier M, Nevoret M, Couper J, Oduah V, Beresford S, Thalagne N, Roper H, Gibbons J, Hill J, Balleaut S, Brennan C, Ellis-Gage J, Fear L, Gray T, Pilger J, Jones L, McNerney C, Pointer L, Price N, Few K, Tomlinson D, Denvir L, Drew J, Randell T, Mansell P, Roberts A, Bell S, Butler S, Hooton Y, Navarra H, Roper A, Babington G, Crate L, Cripps H, Ledlie A, Moulds C, Sadler K, Norton R, Petrova B, Silkstone O, Smith C, Ghai K, Murray M, Viswanathan V, Henegan M, Kawadry O, Olson J, Stavros T, Patterson L, Ahmad T, Flores B, Domek D, Domek S, Copeland K, George M, Less J, Davis T, Short M, Tamura R, Dwarakanathan A, O’Donnell P, Boerner B, Larson L, Phillips M, Rendell M, Larson K, Smith C, Zebrowski K, Kuechenmeister L, Wood K, Thevarayapillai M, Daniels M, Speer H, Forghani N, Quintana R, Reh C, Bhangoo A, Desrosiers P, Ireland L, Misla T, Xu P, Torres C, Wells S, Villar J, Yu M, Berry D, Cook D, Soder J, Powell A, Ng M, Morrison M, Young K, Haslam Z, Lawson M, Bradley B, Courtney J, Richardson C, Watson C, Keely E, DeCurtis D, Vaccarcello-Cruz M, Torres Z, Alies P, Sandberg K, Hsiang H, Joy B, McCormick D, Powell A, Jones H, Bell J, Hargadon S, Hudson S, Kummer M, Badias F, Sauder S, Sutton E, Gensel K, Aguirre-Castaneda R, Benavides Lopez V, Hemp D, Allen S, Stear J, Davis E, Jones T, Baker A, Roberts A, Dart J, Paramalingam N, Levitt Katz L, Chaudhary N, Murphy K, Willi S, Schwartzman B, Kapadia C, Larson D, Bassi M, McClellan D, Shaibai G, Kelley L, Villa G, Kelley C, Diamond R, Kabbani M, Dajani T, Hoekstra F, Magorno M, Beam C, Holst J, Chauhan V, Wilson N, Bononi P, Sperl M, Millward A, Eaton M, Dean L, Olshan J, Renna H, Boulware D, Milliard C, Snyder D, Beaman S, Burch K, Chester J, Ahmann A, Wollam B, DeFrang D, Fitch R, Jahnke K, Bounmananh L, Hanavan K, Klopfenstein B, Nicol L, Bergstrom R, Noland T, Brodksy J, Bacon L, Quintos J, Topor L, Bialo S, Bream S, Bancroft B, Soto A, Lagarde W, Lockemer H, Vanderploeg T, Ibrahim M, Huie M, Sanchez V, Edelen R, Marchiando R, Freeman D, Palmer J, Repas T, Wasson M, Auker P, Culbertson J, Kieffer T, Voorhees D, Borgwardt T, DeRaad L, Eckert K, Gough J, Isaacson E, Kuhn H, Carroll A, Schubert M, Francis G, Hagan S, Le T, Penn M, Wickham E, Leyva C, Ginem J, Rivera K, Padilla J, Rodriguez I, Jospe N, Czyzyk J, Johnson B, Nadgir U, Marlen N, Prakasam G, Rieger C, Granger M, Glaser N, Heiser E, Harris B, Foster C, Slater H, Wheeler K, Donaldson D, Murray M, Hale D, Tragus R, Holloway M, Word D, Lynch J, Pankratz L, Rogers W, Newfield R, Holland S, Hashiguchi M, Gottschalk M, Philis-Tsimikas A, Rosal R, Kieffer M, Franklin S, Guardado S, Bohannon N, Garcia M, Aguinaldo T, Phan J, Barraza V, Cohen D, Pinsker J, Khan U, Lane P, Wiley J, Jovanovic L, Misra P, Wright M, Cohen D, Huang K, Skiles M, Maxcy S, Pihoker C, Cochrane K, Nallamshetty L, Fosse J, Kearns S, Klingsheim M, Wright N, Viles L, Smith H, Heller S, Cunningham M, Daniels A, Zeiden L, Parrimon Y, Field J, Walker R, Griffin K, Bartholow L, Erickson C, Howard J, Krabbenhoft B, Sandman C, Vanveldhuizen A, Wurlger J, Paulus K, Zimmerman A, Hanisch K, Davis-Keppen L, Cotterill A, Kirby J, Harris M, Schmidt A, Kishiyama C, Flores C, Milton J, Ramiro J, Martin W, Whysham C, Yerka A, Freels T, Hassing J, Webster J, Green R, Carter P, Galloway J, Hoelzer D, Ritzie AQL, Roberts S, Said S, Sullivan P, Allen H, Reiter E, Feinberg E, Johnson C, Newhook L, Hagerty D, White N, Sharma A, Levandoski L, Kyllo J, Johnson M, Benoit C, Iyer P, Diamond F, Hosono H, Jackman S, Barette L, Jones P, Shor A, Sills I, Bzdick S, Bulger J, Weinstock R, Douek I, Andrews R, Modgill G, Gyorffy G, Robin L, Vaidya N, Song X, Crouch S, O’Brien K, Thompson C, Thorne N, Blumer J, Kalic J, Klepek L, Paulett J, Rosolowski B, Horner J, Terry A, Watkins M, Casey J, Carpenter K, Burns C, Horton J, Pritchard C, Soetaert D, Wynne A, Kaiserman K, Halvorson M, Weinberger J, Chin C, Molina O, Patel C, Senguttuvan R, Wheeler M, Furet O, Steuhm C, Jelley D, Goudeau S, Chalmers L, Wootten M, Greer D, Panagiotopoulos C, Metzger D, Nguyen D, Horowitz M, Christiansen M, Glades E, Morimoto C, Macarewich M, Norman R, Harding P, Patin K, Vargas C, Barbanica A, Yu A, Vaidyanathan P, Osborne W, Mehra R, Kaster S, Neace S, Horner J, McDonough S, Reeves G, Cordrey C, Marrs L, Miller T, Dowshen S, Doyle D, Walker S, Catte D, Dean H, Drury-Brown M, McGee PF, Hackman B, Lee M, Malkani S, Cullen K, Johnson K, Hampton P, McCarrell M, Curtis C, Paul E, Zambrano Y, Hess KO, Phoebus D, Quinlan S, Raiden E, Batts E, Buddy C, Kirpatrick K, Ramey M, Shultz A, Webb C, Romesco M, Fradkin J, Blumberg E, Beck G, Brillon D, Gubitosi-Klug R, Laffel L, Veatch R, Wallace D, Braun J, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Zinman B, Loechelt B, Baden L, Green M, Weinberg A, Marcovina S, Palmer JP, Weinberg A, Yu L, Babu S, Winter W, Eisenbarth GS, Bingley P, Clynes R, DiMeglio L, Eisenbarth G, Hays B, Marks J, Matheson D, Rodriguez H, Wilson D, Redondo MJ, Gomez D, Zheng X, Pena S, Pietropaolo M, Batts E, Brown T, Buckner J, Dove A, Hammond M, Hefty D, Klein J, Kuhns K, Letlau M, Lord S, McCulloch-Olson M, Miller L, Nepom G, Odegard J, Ramey M, Sachter E, St. Marie M, Stickney K, VanBuecken D, Vellek B, Webber C, Allen L, Bollyk J, Hilderman N, Ismail H, Lamola S, Sanda S, Vendettuoli H, Tridgell D, Monzavi R, Bock M, Fisher L, Halvorson M, Jeandron D, Kim M, Wood J, Geffner M, Kaufman F, Parkman R, Salazar C, Goland R, Clynes R, Cook S, Freeby M, Gallagher MP, Gandica R, Greenberg E, Kurland A, Pollak S, Wolk A, Chan M, Koplimae L, Levine E, Smith K, Trast J, DiMeglio L, Blum J, Evans-Molina C, Hufferd R, Jagielo B, Kruse C, Patrick V, Rigby M, Spall M, Swinney K, Terrell J, Christner L, Ford L, Lynch S, Menendez M, Merrill P, Pescovitz M, Rodriguez H, Alleyn C, Baidal D, Fay S, Gaglia J, Resnick B, Szubowicz S, Weir G, Benjamin R, Conboy D, deManbey A, Jackson R, Jalahej H, Orban T, Ricker A, Wolfsdorf J, Zhang HH, Wilson D, Aye T, Baker B, Barahona K, Buckingham B, Esrey K, Esrey T, Fathman G, Snyder R, Aneja B, Chatav M, Espinoza O, Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Sanders-Branca N, Sosenko J, Arazo L, Arce R, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Eck SP, Finney L, Fischer TA, Martin A, Muzamhindo CJ, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Ricci MJ, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Muscato MT, Viscardi M, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del Rio A, Logan A, Collier H, Rishton C, Whalley G, Ali A, Ramtoola S, Quattrin T, Mastrandea L, House A, Ecker M, Huang C, Gougeon C, Ho J, Pacuad D, Dunger D, May J, O’Brien C, Acerini C, Salgin B, Thankamony A, Williams R, Buse J, Fuller G, Duclos M, Tricome J, Brown H, Pittard D, Bowlby D, Blue A, Headley T, Bendre S, Lewis K, Sutphin K, Soloranzo C, Puskaric J, Madison H, Rincon M, Carlucci M, Shridharani R, Rusk B, Tessman E, Huffman D, Abrams H, Biederman B, Jones M, Leathers V, Brickman W, Petrie P, Zimmerman D, Howard J, Miller L, Alemzadeh R, Mihailescu D, Melgozza-Walker R, Abdulla N, Boucher-Berry C, Ize-Ludlow D, Levy R, Swenson Brousell C, Scott R, Heenan H, Lunt H, Kendall D, Willis J, Darlow B, Crimmins N, Edler D, Weis T, Schultz C, Rogers D, Latham D, Mawhorter C, Switzer C, Spencer W, Konstantnopoulus P, Broder S, Klein J, Bachrach B, Gardner M, Eichelberger D, Knight L, Szadek L, Welnick G, Thompson B, Hoffman R, Revell A, Cherko J, Carter K, Gilson E, Haines J, Arthur G, Bowen B, Zipf W, Graves P, Lozano R, Seiple D, Spicer K, Chang A, Fregosi J, Harbinson J, Paulson C, Stalters S, Wright P, Zlock D, Freeth A, Victory J, Maheshwari H, Maheshwari A, Holmstrom T, Bueno J, Arguello R, Ahern J, Noreika L, Watson V, Hourse S, Breyer P, Kissel C, Nicholson Y, Pfeifer M, Almazan S, Bajaj J, Quinn M, Funk K, McCance J, Moreno E, Veintimilla R, Wells A, Cook J, Trunnel S, Transue D, Surhigh J, Bezzaire D, Moltz K, Zacharski E, Henske J, Desai S, Frizelis K, Khan F, Sjoberg R, Allen K, Manning P, Hendry G, Taylor B, Jones S, Couch R, Danchak R, Lieberman D, Strader W, Bencomo M, Bailey T, Bedolla L, Roldan C, Moudiotis C, Vaidya B, Anning C, Bunce S, Estcourt S, Folland E, Gordon E, Harrill C, Ireland J, Piper J, Scaife L, Sutton K, Wilkins S, Costelloe M, Palmer J, Casas L, Miller C, Burgard M, Erickson C, Hallanger-Johnson J, Clark P, Taylor W, Galgani J, Banerjee S, Banda C, McEowen D, Kinman R, Lafferty A, Gillett S, Nolan C, Pathak M, Sondrol L, Hjelle T, Hafner S, Kotrba J, Hendrickson R, Cemeroglu A, Symington T, Daniel M, Appiagyei-Dankah Y, Postellon D, Racine M, Kleis L, Barnes K, Godwin S, McCullough H, Shaheen K, Buck G, Noel L, Warren M, Weber S, Parker S, Gillespie I, Nelson B, Frost C, Amrhein J, Moreland E, Hayes A, Peggram J, Aisenberg J, Riordan M, Zasa J, Cummings E, Scott K, Pinto T, Mokashi A, McAssey K, Helden E, Hammond P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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Telli ML, Lord S, Dean E, Abramson V, Arkenau HT, Murias C, Becerra C, Tang R, Penney MS, Pollard J, Conboy G, Fields SZ, Shapiro G, Tolaney SM. Abstract OT2-07-07: ATR inhibitor M6620 (formerly VX-970) with cisplatin in metastatic triple-negative breast cancer: Preliminary results from a phase 1 dose expansion cohort (NCT02157792). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-07-07] [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: ATR is a critical regulator of the cellular response to replication stress; it signals DNA damage repair, mediated through homologous recombination. Many cancers depend on ATR to survive DNA damage. M6620 is a potent, selective inhibitor of ATR that augments the anticancer activity of cisplatin in preclinical triple-negative breast cancer (TNBC) models. Given the high prevalence of TP53 mutations in TNBC and limited platinum responsiveness in patients lacking a BRCA1/2 mutation, this study was designed to evaluate the safety and efficacy of M6620 in combination with cisplatin in an expansion cohort of patients with BRCA1/2 wild-type advanced/metastatic TNBC.
Methods: Eligible patients had advanced/metastatic ER-, PR-, and HER2- breast cancer with 0-2 prior non–platinum-based therapies and measurable disease per RECIST 1.1. First line patients were eligible if relapse occurred ≥3 months after prior (neo)adjuvant chemotherapy. Of a maximum 50 patients planned for enrollment, ≥30 were required to have BRCA1/2 germline wild-type status and basaloid molecular subtype tumors on central testing. Patients received intravenous cisplatin 75 mg/m2 on day 1 with intravenous M6620 140 mg/m2 on days 2 and 9 of each 21-day cycle. In patients intolerant of cisplatin or at investigator's discretion, cisplatin could be switched to carboplatin AUC 5 with M6620 90 mg/m2.
Results: At the time of abstract submission, 35 female patients were enrolled in this study; 18 patients with confirmed BRCA1/2 wild-type and basaloid metastatic TNBC who received ≥1 cycle of study drug and had ≥1 baseline scan and ≥1 on-treatment scan at the time of the data cut were included in the primary efficacy analysis. Median progression-free survival (PFS) was 4.1 months (90% CI, 1.6-6.9 months). PFS was ≥ 6 months in 2 patients and ≥ 3 months in 8 patients. Preliminary unconfirmed objective response [complete response or partial response (PR)] was observed in 38.9% (90% CI, 19.9%-60.8%) of patients. All 7 patients with preliminary objective response had PR as best overall response; the longest duration of response was 183 days. Response was ongoing in 4 patients with PR at the time of data cutoff. Grade ≥3 related treatment-emergent adverse events occurred in 16 of 35 patients: neutropenia (n=8), anemia (n=5), vomiting (n=4), nausea (n=3), and, in 1 patient each, thrombocytopenia, neutrophil count decreased, platelet count decreased, hypokalemia, generalized weakness, rigors, and acute kidney injury.
Conclusions: Combination of M6620 and cisplatin shows encouraging antitumor activity and tolerability in patients with advanced/metastatic TNBC. The study is ongoing; updated safety and efficacy results will be presented.
Citation Format: Telli ML, Lord S, Dean E, Abramson V, Arkenau H-T, Murias C, Becerra C, Tang R, Penney MS, Pollard J, Conboy G, Fields SZ, Shapiro G, Tolaney SM. ATR inhibitor M6620 (formerly VX-970) with cisplatin in metastatic triple-negative breast cancer: Preliminary results from a phase 1 dose expansion cohort (NCT02157792) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-07-07.
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Affiliation(s)
- ML Telli
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - S Lord
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - E Dean
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - V Abramson
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - H-T Arkenau
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - C Murias
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - C Becerra
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - R Tang
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - MS Penney
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - J Pollard
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - G Conboy
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - SZ Fields
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - G Shapiro
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
| | - SM Tolaney
- Stanford University School of Medicine, Stanford, CA; Churchill Hospital, Oxford, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Vanderbilt University Medical Center, Nashville, TN; Sarah Cannon Research Institute, London, United Kingdom; Texas Oncology, P.A., Dallas, TX; Vertex Pharmaceuticals Incorporated, Boston, MA; Vertex Pharmaceuticals Limited, Milton Park, United Kingdom; Dana-Farber Cancer Institute, Boston, MA
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Vratsistas-Curto A, Tiedemann A, Treacy D, Lord S, Sherrington C. External validation of approaches to prediction of falls during hospital rehabilitation stays and development of a new simpler tool. J Rehabil Med 2018; 50:216-222. [DOI: 10.2340/16501977-2290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
PURPOSE OF REVIEW This review seeks to characterize emerging concepts related to disease-modifying therapy in type 1 diabetes. RECENT FINDINGS We begin by describing the new understanding that islet autoimmunity, as identified by the presence of islet autoantibodies, inevitably leads to clinical type 1 diabetes. This understanding informs the new staging paradigm for type 1 diabetes, which suggests that type 1 diabetes may be recognized and diagnosed long before symptoms develop. Although it is known that nearly all individuals with established islet autoimmunity will eventually develop symptomatic type 1 diabetes (T1D), individual characteristics such as age and biomarker profile may predict rate of disease progression and response to treatment and may therefore be used to individualize therapy. Key research supports the use of immunotherapy in TID, although a paradigm shift is necessary before immunotherapy may transition from clinical trials to clinical practice. Recent and ongoing research as it relates to these concepts is described throughout.
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Affiliation(s)
| | - Sandra Lord
- Benaroya Research Institute, Seattle, WA, USA
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Telli M, Lord S, Dean E, Abramson V, Arkenau HT, Becerra C, Tolaney S, Tang R, Penney M, Pollard J, Conboy G, Fields S, Shapiro G. Initial results of a phase 1 dose expansion cohort of M6620 (formerly VX-970), an ATR inhibitor, in combination with cisplatin in patients with advanced triple-negative breast cancer NCT02157792). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.005] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Ritchie G, Gasper H, Man J, Lord S, Friedlander M, Lee C, Marschner I. Is objective response rate (ORR) a valid primary endpoint in phase 2 trials (Ph2t) of immune checkpoint inhibitors (ICI) for advanced solid cancers? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.023] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Lord S. CURRENT AND FUTURE APPROACHES TO EVALUATING AND TREATING AGE-RELATED MOBILITY PROBLEMS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2773] [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)
- S. Lord
- Neuroscience Research Australia, Sydney, New South Wales, Australia
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Davis J, Best J, Khan K, Dian L, Lord S, Delbaere K, Hsu C, Liu-Ambrose T. SLOW PROCESSING SPEED PREDICTS FALLS IN OLDER ADULTS WITH A FALLS HISTORY: 1-YEAR PROSPECTIVE COHORT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.882] [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: 11/13/2022] Open
Affiliation(s)
- J. Davis
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - J. Best
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - K. Khan
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - L. Dian
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - S. Lord
- Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
| | - K. Delbaere
- Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
| | - C. Hsu
- University of British Columbia, Vancouver, British Columbia, Canada,
| | - T. Liu-Ambrose
- University of British Columbia, Vancouver, British Columbia, Canada,
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Studenski S, Lord S. KEYNOTE: EMERGING ISSUES IN MOBILITY AND AGING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2771] [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)
| | - S. Lord
- Neuroscience Research Australia, Sydney, New South Wales, Australia
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Cameron I, Fairhall N, John B, Lockwood K, Monaghan N, Sherrington C, Lord S, Kurrle S. A MULTIFACTORIAL INTERDISCIPLINARY INTERVENTION IN PRE-FRAIL OLDER PEOPLE: RANDOMISED TRIAL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- I. Cameron
- University of Sydney, St Leonards, New South Wales, Australia,
| | - N. Fairhall
- University of Sydney, St Leonards, New South Wales, Australia,
| | - B. John
- Hornsby Ku-ring-gai Health Service, Hornsby, New South Wales, Australia,
| | - K. Lockwood
- University of Sydney, St Leonards, New South Wales, Australia,
| | - N. Monaghan
- University of Sydney, St Leonards, New South Wales, Australia,
| | - C. Sherrington
- University of Sydney, St Leonards, New South Wales, Australia,
| | - S. Lord
- University of New South Wales, Randwick, New South Wales, Australia
| | - S. Kurrle
- University of Sydney, St Leonards, New South Wales, Australia,
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López-Miranda E, Gávila J, Pernas S, Saura C, Oliveira M, Serra V, Schmid P, Lord S, Paez D, Perez J, Llombart A, Petrovic K, Dimitrijevic S, Cortes J. Abstract OT1-01-06: PIQHASSO: Open label, non-randomized, multicenter phase 1/2b study investigating safety and efficacy of PQR309 and eribulin combination in patients (pts) with locally advanced (LA) or metastatic HER2 (-) and triple-negative breast cancer (TNBC) (study PQR309-007). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-01-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND:
The PI3K/AKT/mTOR (PAT) pathway alteration has been strongly implicated in breast cancer and may contribute to resistance to available therapy. PQR309 is an oral pan-PI3K and mTOR inhibitor that penetrates the blood-brain barrier. Experiments of eribulin in combination with PI3K inhibitors in luminal and TNBC pre-clinical models enhanced antitumor activity.
TRIAL OBJECTIVES:
The primary objectives of the study are: to identify the maximum tolerated dose (MTD), evaluate the efficacy, safety and tolerability as well as the pharmacokinetics (PK) of PQR309 in combination with eribulin. In addition, exploratory objectives include assessments of: PAT pathway alterations prior to treatment, pharmacodynamics (PD) activity of PQR309 in combination with eribulin and correlation of PAT pathway alterations and PD activity with PQR309 and eribulin PK.
TRIAL DESIGN:
This is an open label, non-randomized, multicenter phase 1/2b clinical trial (dose escalation followed by expansion part) of PQR309 p.o. in combination with the standard dose of eribulin mesylate (1.4 mg/m2) in patients with LAMBC until progression or unacceptable adverse events (AE).
The dose escalation part of the study will first investigate PQR309 administered in a continuous daily (q.d.) and two intermittent treatment schedules in combination with standard administration of eribulin mesylate in patients with HER2 negative LAMBC following the “modified” 3 by 3 design. MTD is defined as the highest dose level at which ≤1 of 6 pts experiences dose-limiting toxicity (DLT) during the 1st cycle. After the MTD of PQR309 in combination with eribulin has been defined in all the three treatment schedules, one schedule will be selected, based on the overall evaluation of clinical data from the dose escalation part of the study, for further evaluation of efficacy in the expansion part of the study.
The expansion part of the trial applies Simon's MiniMax two-stage design. At the first stage, > 3 pts with TNBC with clinical benefit (CB) among 14 pts will be necessary to continue to the second stage. At the study end, > 9 pts with CB out of 28 pts are required to reject the null hypothesis. With this design, there is an 80% probability of a positive finding if the true clinical benefit rate (CBR) is ≥ 43% and a 5% probability of a positive finding if the true CBR is ≤ 21%.
ELIGIBILITY:
Women with HER2- LAMBC with two to 5 prior chemotherapy regimens in advanced disease. Adequate organ function and performance status. Phase II specific selection criteria are: triple negative LAMBC and RECIST v1.1 evaluable disease.
ACCRUAL:
Approximately 60 patients will be enrolled in approximately 10 sites
Recruitment opened in March 2016.
TRIAL REGISTRATION: NCT02723877. Date of registration: 21/12/2015. First patient included: 04/04/2016.
Citation Format: López-Miranda E, Gávila J, Pernas S, Saura C, Oliveira M, Serra V, Schmid P, Lord S, Paez D, Perez J, Llombart A, Petrovic K, Dimitrijevic S, Cortes J. PIQHASSO: Open label, non-randomized, multicenter phase 1/2b study investigating safety and efficacy of PQR309 and eribulin combination in patients (pts) with locally advanced (LA) or metastatic HER2 (-) and triple-negative breast cancer (TNBC) (study PQR309-007) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-01-06.
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Affiliation(s)
- E López-Miranda
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - J Gávila
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - S Pernas
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - C Saura
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - M Oliveira
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - V Serra
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - P Schmid
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - S Lord
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - D Paez
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - J Perez
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - A Llombart
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - K Petrovic
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - S Dimitrijevic
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
| | - J Cortes
- Hospital Ramón y Cajal, Madrid, Spain; IVO, Valencia, Spain; ICO L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain; Hospital Vall Hebrón, Barcelona, Spain; Barts Cancer Institute, London, United Kingdom; Churchill Hospital, Oxford, Headington, United Kingdom; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Baselga Institute of Oncology - Quiron, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Medica Scientia Innovation-MedSIR ARO, Barcelona, Spain; PIQUR Therapeutics AG, Basel, Bassel, Switzerland
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Hill E, Stuart S, Lord S, Del Din S, Rochester L. Vision, visuo-cognition and postural control in Parkinson's disease: An associative pilot study. Gait Posture 2016; 48:74-76. [PMID: 27477712 DOI: 10.1016/j.gaitpost.2016.04.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Received: 11/06/2015] [Revised: 04/01/2016] [Accepted: 04/24/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Impaired postural control (PC) is common in patients with Parkinson's disease (PD) and is a major contributor to falls, with significant consequences. Mechanisms underpinning PC are complex and include motor and non-motor features. Research has focused predominantly on motor and sensory inputs. Vision and visuo-cognitive function are also integral to PC but have largely been ignored to date. The aim of this observational cross-sectional pilot study was to explore the relationship of vision and visuo-cognition with PC in PD. METHODS Twelve people with PD and ten age-matched healthy controls (HC) underwent detailed assessments for vision, visuo-cognition and postural control. Vision assessments included visual acuity and contrast sensitivity. Visuo-cognition was measured by visuo-perception (object identification), visuo-construction (ability to copy a figure) and visuo-spatial ability (judge distances and location of object within environment). PC was measured by an accelerometer for a range of outcomes during a 2-min static stance. Spearman's correlations identified significant associations. RESULTS Contrast sensitivity, visuo-spatial ability and postural control (ellipsis) were significantly impaired in PD (p=0.017; p=0.001; and p=0.017, respectively). For PD only, significant correlations were found for higher visuo-spatial function and larger ellipsis (r=0.64; p=0.024) and impaired attention and reduced visuo-spatial function (r=-0.62; p=0.028). CONCLUSIONS Visuo-spatial ability is associated with PC deficit in PD, but in an unexpected direction. This suggests a non-linear pattern of response. Further research is required to examine this novel and important finding.
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Affiliation(s)
- E Hill
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - S Stuart
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - S Lord
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - S Del Din
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - L Rochester
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom.
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Cobbold A, Lord S. Reflecting on the development of the decontamination services: pondering the past, presenting the future. J Perioper Pract 2016; 26:78-83. [PMID: 27290757 DOI: 10.1177/175045891602600404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This paper explores the historical developments of the UK decontamination services workforce over the past century. It will look back at how the services originated and look forward towards what the future could hold. This evolving workforce has progressed from traditional in-house training programmes towards accredited education, aiming to pave the way towards becoming a new profession--the healthcare scientist. The paper also explores some of the main drivers behind how previous healthcare professions have developed, and how these may impact on evolving professions such as decontamination services. The paper concludes by highlighting the importance of ensuring that staff are educated to national standards and keep abreast of current healthcare advances, in order to develop and retain the sterile services leaders of the future.
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Stuart S, Alcock L, Godfrey A, Lord S, Rochester L, Galna B. Accuracy and re-test reliability of mobile eye-tracking in Parkinson's disease and older adults. Med Eng Phys 2016; 38:308-15. [PMID: 26786676 DOI: 10.1016/j.medengphy.2015.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 05/09/2015] [Revised: 10/29/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
Abstract
Mobile eye-tracking is important for understanding the role of vision during real-world tasks in older adults (OA) and people with Parkinson's disease (PD). However, accuracy and reliability of such devices have not been established in these populations. We used a novel protocol to quantify accuracy and reliability of a mobile eye-tracker in OA and PD. A mobile eye-tracker (Dikablis) measured the saccade amplitudes of 20 OA and 14 PD on two occasions. Participants made saccades between targets placed 5°, 10° and 15° apart. Impact of visual correction (glasses) on saccadic amplitude measurement was also investigated in 10 OA. Saccade amplitude accuracy (median bias) was -1.21° but a wide range of bias (-7.73° to 5.81°) was seen in OA and PD, with large vertical saccades (15°) being least accurate. Reliability assessment showed a median difference between sessions of <1° for both groups, with poor to good relative agreement (Spearman rho: 0.14 to 0.85). Greater accuracy and reliability was observed in people without visual correction. Saccade amplitude can be measured with variable accuracy and reliability using a mobile eye-tracker in OA and PD. Human, technological and study-specific protocol factors may introduce error and are discussed along with methodological recommendations.
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Affiliation(s)
- S Stuart
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom.
| | - L Alcock
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - A Godfrey
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - S Lord
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - L Rochester
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - B Galna
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, United Kingdom
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Tjokrowidjaja A, Lee CK, Houssami N, Lord S. Metastatic breast cancer in young women: a population-based cohort study to describe risk and prognosis. Intern Med J 2015; 44:764-70. [PMID: 24863750 DOI: 10.1111/imj.12481] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 05/22/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is limited information on the risk of metastatic breast cancer (MBC) to inform younger women, particularly those under 40 years. AIMS We conducted a retrospective analysis of a population-based cohort study to describe the risk, site and prognosis of MBC in young women under 40 years with an initial diagnosis of non-metastatic breast cancer and compared with older women. METHODS Data were extracted from the New South Wales Central Cancer Registry and the Admitted Patient Data Collection database between 2001-2007. Main outcome measures were 5-year cumulative incidence of MBC, prognostic factors for MBC and overall survival (OS) from the date of MBC diagnosis. RESULTS Three hundred and ninety-five (6%) of 6640 women with non-metastatic BC were <40 years. The 5-year cumulative incidence of MBC was 24% (95% CI 20-29%) for women <40 years with non-metastatic BC, compared with 9% (95% CI 9-10%) for women ≥40 years. Significant independent risk factors for MBC ≤ 5 years were age <40, regional disease at diagnosis, low socioeconomic status and the presence of other non-breast primary. At first record of MBC, visceral sites were more common for women <40 years than ≥40 (54% vs 43%; P = 0.03). Median survival for women with MBC within 5 years was not significantly different between young and older women (<40 years 18 months vs ≥40 years 14 months; log-rank P = 0.21). CONCLUSIONS Women with non-metastatic BC before age 40 have a higher 5-year risk of developing MBC than older women. There were no significant differences in median survival following MBC between young and older women.
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Affiliation(s)
- A Tjokrowidjaja
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia; School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Grice J, Reid A, Peterson A, Blackburn K, Tubbs L, Lord S, Huber P, Horricks R, Dixon B, Bols NC, Lumsden JS. Walleye Sander vitreus (Mitchill) are relatively resistant to experimental infection with VHSV IVb and extant walleye strains vary in susceptibility. J Fish Dis 2015; 38:859-872. [PMID: 25219756 DOI: 10.1111/jfd.12298] [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] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/03/2014] [Accepted: 05/07/2014] [Indexed: 06/03/2023]
Abstract
Compared to fathead minnow, walleye demonstrate low susceptibility to experimental infection with VHSV IVb, regardless of route of exposure or water temperature at time of infection. In triplicate and duplicate groups, walleye were intraperitoneally (i.p.) injected (102 -108 pfu/fish) or waterborne-exposed (w; 1.4 × 107 pfu mL-1 ) with VHSV IVb. High cumulative mortality (64-100%) and severe gross lesions associated with VHSV IVb infection were evident only in fish i.p. injected with 108 pfu at 12 °C. These fish had multifocal necrosis of several tissues including the gill and heart. There was no difference in mortality between walleye infected (w or i.p.) at 12 °C (spring stocking) compared with a declining temperature profile from 18 to 12 °C (fall stocking). There were significant differences (P < 0.05) in mortality between four extant walleye strains following i.p. infection, indicating that the choice of walleye strain for stocking might be an important consideration. Viral antigen was found in both i.p. and w-exposed walleye using immunohistochemistry, mostly within the gill and skin of w-exposed fish and most prominently in dermal fibrocytes. VHSV IVb was detected in multiple tissues from 6 to 21 days post-infection using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR).
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Affiliation(s)
- J Grice
- Fish Pathology Laboratory, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - A Reid
- Fish Pathology Laboratory, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - A Peterson
- Fish Pathology Laboratory, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - K Blackburn
- Fish Pathology Laboratory, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - L Tubbs
- Department of Biology, University of Waterloo, Waterloo, ON, Canada
| | - S Lord
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - P Huber
- Fish Pathology Laboratory, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - R Horricks
- Fish Pathology Laboratory, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - B Dixon
- Novartis Animal Health Inc., Victoria, PEI, Canada
| | - N C Bols
- Novartis Animal Health Inc., Victoria, PEI, Canada
| | - J S Lumsden
- Fish Pathology Laboratory, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Abstract
With more than four decades of clinical research and 25 years of clinical trials, much is known about the natural history of T1D before and after clinical diagnosis. We know that autoimmunity occurs early in life, that islet autoimmunity inevitably leads to clinically overt disease, and that some immune therapies can alter the disease course. In the future, we will likely conduct trials to more deeply explore mechanisms of disease and response to therapy, employ combinations of agents including those aimed at supporting beta cells, consider the use of chronic, intermittent therapy, focus studies on preventing progression from islet autoimmunity, and consider the potential benefits of studying children independently from adults. Much of this work will depend upon clinical trial networks such as Diabetes TrialNet. Such networks not only have the expertise to conduct studies but their sharing of data and samples also allows for discovery work by multiple investigators, laying the groundwork for the future. Working with patients, families, funders and industry, such collaborative networks can accelerate the translation of science to clinical practice to improve the lives of those living with T1D.
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Affiliation(s)
- Sandra Lord
- Diabetes Clinical Research Program, Benaroya Research Institute, Seattle, WA, USA.
| | - Carla J Greenbaum
- Diabetes Clinical Research Program, Benaroya Research Institute, Seattle, WA, USA
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Fairhall N, Sherrington C, Lord S, Susan K, Cameron I. A multifactorial interdisciplinary intervention reduces frailty, increases function and is cost-effective in older adults who are frail: randomised controlled trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.588] [Citation(s) in RCA: 3] [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]
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Braun T, Rieckmann A, Weber F, Coppers A, Leimer S, Tofaute L, Reinke J, Urner C, Krämer H, Thiel C, Lord S, Schulz RJ, Grüneberg C. The De Morton Mobility Index (DEMMI) as a predictive measure of fall risk after inpatient rehabilitation—preliminary results. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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