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Taylor S, Stallings A, Greenstein S, Ochoa A, Said A, Salinas N, Becerril N, Guevara W, Phan M. Serving IPV Survivors in Culturally Diverse Communities: Perspectives From Current Service Providers. Violence Against Women 2024; 30:1866-1882. [PMID: 38500374 DOI: 10.1177/10778012241239938] [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] [Indexed: 03/20/2024]
Abstract
This qualitative study examines current IPV service providers' perspectives on service delivery methods that best reach and serve IPV survivors from culturally diverse communities. Semi-structured interviews were conducted with 11 service providers, and transcripts were analyzed for themes related to service providers' experiences. Five themes emerged from the data that suggest best practices for reaching and serving survivors from culturally diverse backgrounds, including understanding survivors' backgrounds, promoting trust and inclusivity, building community relationships, providing culturally responsive education on IPV, and supporting current and future staff with training. Study findings provide implications for the education and training of future service providers.
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Affiliation(s)
- Sarah Taylor
- California State University, Long Beach, Long Beach, CA, USA
| | | | - Sage Greenstein
- California State University, Long Beach, Long Beach, CA, USA
| | - Alexis Ochoa
- California State University, Long Beach, Long Beach, CA, USA
| | - Ayah Said
- California State University, Long Beach, Long Beach, CA, USA
| | - Norma Salinas
- California State University, Long Beach, Long Beach, CA, USA
| | - Noemi Becerril
- California State University, Long Beach, Long Beach, CA, USA
| | - William Guevara
- California State University, Long Beach, Long Beach, CA, USA
| | - Michelle Phan
- California State University, Long Beach, Long Beach, CA, USA
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Coletta AM, Simon LH, Maslana K, Taylor S, Larson K, Hansen PA, Thomas VM, Ulrich CM, Kohli M, Chipman J, Swami U, Gupta S, Maughan BL, Agarwal N. Creatine supplementation and resistance training to preserve muscle mass and attenuate cancer progression (CREATINE-52): a protocol for a double-blind randomized controlled trial. BMC Cancer 2024; 24:493. [PMID: 38637770 PMCID: PMC11025211 DOI: 10.1186/s12885-024-12260-3] [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: 03/14/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Muscle mass is important for metastatic prostate cancer survival and quality of life (QoL). The backbone of treatment for men with metastatic castration sensitive prostate cancer (mCSPC) is androgen deprivation therapy (ADT) with an androgen signaling inhibitor. ADT is an effective cancer treatment, but it facilitates significant declines in muscle mass and adverse health outcomes important to mCSPC survivors, such as fatigue, and reductions in physical function, independence, insulin sensitivity, and QoL. In non-metastatic CSPC survivors, resistance training (RT) preserves muscle mass and improves these related health outcomes, but the biggest barrier to RT in CSPC survivors of all stages is fatigue. Creatine monohydrate supplementation coupled with RT (Cr + RT) may address this barrier since creatine plays a critical role in energy metabolism. Cr + RT in cancer-free older adults and other clinical populations improves muscle mass and related health outcomes. Evidence also suggests that creatine supplementation can complement cancer treatment. Thus, Cr + RT is a strategy that addresses gaps in survivorship needs of people with mCSPC. The purpose of this parallel, double-blind randomized controlled trial is to test the effects of 52-weeks of Cr + RT compared with placebo (PLA) and RT (PLA + RT) on muscle mass, other related health outcomes, and markers of cancer progression. METHODS We will carry out this trial with our team's established, effective, home-based, telehealth RT program in 200 mCSPC survivors receiving ADT, and evaluate outcomes at baseline, 24-, and 52-weeks. RT will occur twice weekly with elastic resistance bands, and an established creatine supplementation protocol will be used for supplementation delivery. Our approach addresses a major facilitator to RT in mCSPC survivors, a home-based RT program, while utilizing a supervised model for safety. DISCUSSION Findings will improve delivery of comprehensive survivorship care by providing a multicomponent, patient-centered lifestyle strategy to preserve muscle mass, improve health outcomes, and complement cancer treatment (NCT06112990).
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Affiliation(s)
- Adriana M Coletta
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | - Lea Haverbeck Simon
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Kelsey Maslana
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Sarah Taylor
- The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Kish Larson
- The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Pamela A Hansen
- The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Division of Physical Medicine and Rehabilitation, Salt Lake City, UT, USA
| | - Vinay Mathew Thomas
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Cornelia M Ulrich
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Manish Kohli
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jonathan Chipman
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Umang Swami
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Sumati Gupta
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- George E Whalen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Benjamin L Maughan
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Neeraj Agarwal
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Hough K, Grasmeder M, Parsons H, Jones WB, Smith S, Satchwell C, Hobday I, Taylor S, Newman T. Patient and public involvement and engagement (PPIE): how valuable and how hard? An evaluation of ALL_EARS@UoS PPIE group, 18 months on. Res Involv Engagem 2024; 10:38. [PMID: 38605382 PMCID: PMC11010367 DOI: 10.1186/s40900-024-00567-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND ALL_EARS@UoS is a patient and public involvement and engagement (PPIE) group for people with lived experience of hearing loss. The purpose of the group is to share experiences of hearing loss and hearing healthcare, inform research and improve services for patients at University of Southampton Auditory Implant Service. A year after inception, we wanted to critically reflect on the value and challenges of the group. Four members of ALL_EARS@UoS were recruited to an evaluation steering group. This paper reports the evaluation of the group using the UK Standards for Public Involvement. METHODS An anonymous, mixed-methods questionnaire was co-designed and shared with members of ALL_EARS@UoS using an online platform. The questionnaire was designed to capture satisfaction, individual feedback through free-text answers, and demographic information. Descriptive statistics have been used to express the satisfaction and demographic data. Reflexive thematic analysis has been used to analyse the free-text responses. Group engagement and activity data over time were monitored and collected. RESULTS The questionnaire response rate was 61% (11/18). Areas identified as strengths were 'Communication' and 'Working together'. Five themes were developed from the thematic analysis; (1) Increased knowledge and awareness around the topic of hearing health for group members and wider society, (2) supporting research, (3) inclusivity within the group, (4) opportunity to make a difference for people in the future and (5) running of the group/group organisation. The data highlighted the value and challenges of PPIE. Members described feeling listened to and appreciation of being able to share experiences. Time of day and meeting format were identified as challenges as they affected who could attend the meetings. The ability to secure and maintain sufficient funding and time to support inclusive and diverse PPIE activities is a challenge for researchers. CONCLUSIONS We have identified how PPIE added value to both group members and researchers, emphasising the true benefit of PPIE. We have highlighted challenges we are facing and our plan to tackle these. We aim to continue to develop and sustain a group that reflects the diversity of the Deaf/deaf or hard of hearing community and of our local community.
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Affiliation(s)
- Kate Hough
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Auditory Implant Service, University of Southampton, Southampton, UK
| | - Mary Grasmeder
- Auditory Implant Service, University of Southampton, Southampton, UK
| | - Heather Parsons
- NIHR Research Design Service, University of Southampton, Southampton, UK
- Southampton Centre for Research Involvement and Engagement, University Hospital Southampton, Southampton, UK
| | - William B Jones
- Wessex Public Involvement Network, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah Smith
- ALL_EARS@UoS PPIE Group Member, University of Southampton, Southampton, UK
| | - Chris Satchwell
- ALL_EARS@UoS PPIE Group Member, University of Southampton, Southampton, UK
| | - Ian Hobday
- ALL_EARS@UoS PPIE Group Member, University of Southampton, Southampton, UK
| | - Sarah Taylor
- ALL_EARS@UoS PPIE Group Member, University of Southampton, Southampton, UK
| | - Tracey Newman
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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Wu B, Shabanova V, Taylor S, Hawley NL. Pre-pregnancy BMI, rate of gestational weight gain, and preterm birth among US Pacific Islander individuals. Obesity (Silver Spring) 2024; 32:798-809. [PMID: 38304993 DOI: 10.1002/oby.23979] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/08/2023] [Accepted: 12/01/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The objective of this study was to examine the association between rate of gestational weight gain (GWG) and preterm birth (PTB) classified by pre-pregnancy BMI among Pacific Islander individuals in the United States. METHODS Pacific Islander mothers (n = 55,975) and singleton infants (22-41 gestational weeks) without congenital anomalies were included using data from the National Center for Health Statistics (2014-2018). PTB was compared by pre-pregnancy BMI among women in each stratum of rate of GWG using Cox proportional hazards models. RESULTS Compared with mothers with a rate of GWG within the guidelines, mothers with a rate of GWG below the guidelines and either pre-pregnancy underweight (adjusted hazard ratio [aHR] = 1.84, 95% CI: 1.10-3.06), healthy weight (aHR = 1.38, 95% CI: 1.15-1.65), obesity class I (aHR = 1.22, 95% CI: 0.97-1.52), or obesity class II (aHR = 1.43, 95% CI: 1.05-1.96) had an increased risk of PTB; mothers with a rate of GWG above the guidelines and either pre-pregnancy underweight (aHR = 1.57, 95% CI: 0.92-2.69) or obesity class II (aHR = 1.31, 95% CI: 0.98-1.76) had an increased risk of PTB. CONCLUSIONS The association between rate of GWG below or above the guidelines and PTB differs by pre-pregnancy BMI among Pacific Islander individuals.
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Affiliation(s)
- Bohao Wu
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Veronika Shabanova
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Biostatistics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sarah Taylor
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
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Morin N, Taylor S, Krahn D, Baghirzada L, Chong M, Harrison TG, Cameron A, Ruzycki SM. In reply: Comment on "In reply: Comment on 'Strategies for intraoperative glucose management: a scoping review'". Can J Anaesth 2024; 71:559-560. [PMID: 38459365 DOI: 10.1007/s12630-024-02711-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/10/2024] Open
Affiliation(s)
| | - Sarah Taylor
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Danae Krahn
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Leyla Baghirzada
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michael Chong
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tyrone G Harrison
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Anne Cameron
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shannon M Ruzycki
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Bucktrout SL, Banovich NE, Butterfield LH, Cimen-Bozkus C, Giles JR, Good Z, Goodman D, Jonsson VD, Lareau C, Marson A, Maurer DM, Munson PV, Stubbington M, Taylor S, Cutchin A. Publisher Correction: Advancing T cell-based cancer therapy with single-cell technologies. Nat Med 2024:10.1038/s41591-024-02841-x. [PMID: 38317023 DOI: 10.1038/s41591-024-02841-x] [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: 02/07/2024]
Affiliation(s)
| | - Nicholas E Banovich
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | | | - Cansu Cimen-Bozkus
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Josephine R Giles
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Zinaida Good
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Stanford Cancer Institute and Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Daniel Goodman
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Microbiology and Immunology, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Vanessa D Jonsson
- Department of Applied Mathematics, University of California, Santa Cruz, Santa Cruz, CA, USA
- Department of Biomolecular Engineering, University of California, Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Caleb Lareau
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Alexander Marson
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Gladstone-UCSF Institute for Genomic Immunology, San Francisco, CA, USA
| | - Deena M Maurer
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
| | - Paul V Munson
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
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Taylor S, Haselhorst R. Compatibility of Various Hormones in Phytobase and HRT Heavy Cream Bases. Int J Pharm Compd 2024; 28:75-81. [PMID: 38306623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
The release of United States Pharmacopeia Chapter <800> and the revisions to United States Pharmacopeia Chapter <795> (official November 1, 2023) indicates a changing regulatory climate and a trend towards increasingly high standards for the extension of beyond-use dates beyond the default recommended by the guidelines. Given the increased scrutiny and the additional requirements for establishing extended beyond-use dates, additional testing is required to help pharmacies provide the best formulations with scientifically robust data to support an extended beyond-use date for patient convenience. The objective of this study was to demonstrate the suitability of two vehicles, Phytobase and HRT Heavy, for compounded hormone therapy by evaluating the stability and antimicrobial effectiveness of the vehicles with common combinations of hormones.
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Zaino ML, Pixley JN, Kontzias C, Feldman SR, McMichael AJ, Taylor S. Using Facial Skin Analysis to Capture Rosacea Patients' Response to Vascular Laser Therapy-A Single-Center Prospective Study. J Cutan Med Surg 2024; 28:69-71. [PMID: 37942569 DOI: 10.1177/12034754231211340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Affiliation(s)
- Mallory L Zaino
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jessica N Pixley
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christina Kontzias
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Amy J McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sarah Taylor
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Davis SR, Taylor S, Hemachandra C, Magraith K, Ebeling PR, Jane F, Islam RM. The 2023 Practitioner's Toolkit for Managing Menopause. Climacteric 2023; 26:517-536. [PMID: 37902335 DOI: 10.1080/13697137.2023.2258783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE The Practitioner's Toolkit for Managing the Menopause, developed in 2014, provided an accessible desk-top tool for health-care practitioners caring for women at midlife. To ensure the Toolkit algorithms and supporting information reflect current best practice, the Toolkit has been revised in accordance with the published literature. METHODS A systematic search for guidelines, position and consensus statements pertaining to the menopause and published after 2014 was undertaken, and key recommendations extracted from the Clinical Practice Guidelines determined to be the most robust by formal evaluation. The peer-reviewed literature was further searched for identified information gaps. RESULTS The revised Toolkit provides algorithms that guide the clinical assessment and care of women relevant to menopause. Included are the reasons why women present, information that should be ascertained, issues that may influence shared decision-making and algorithms that assist with determination of menopausal status, menopause hormone therapy (MHT) and non-hormonal treatment options for symptom relief. As clear guidelines regarding when MHT might be indicated to prevent bone loss and subsequent osteoporosis in asymptomatic women were found to be lacking, the Toolkit has been expanded to support shared decision-making regarding bone health. CONCLUSIONS The 2023 Toolkit and supporting document provide accessible desk-top information to support health-care providers caring for women at midlife.The Toolkit has been endorsed by the International Menopause Society, Australasian Menopause Society, British Menopause Society, Endocrine Society of Australia and Jean hailes for Women's Health.
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Affiliation(s)
- S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
| | - S Taylor
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - C Hemachandra
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Ministry of Health, Colombo, Sri Lanka
| | - K Magraith
- Cascade Road General Practice, TAS, Australia
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - F Jane
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R M Islam
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Morin N, Taylor S, Krahn D, Baghirzada L, Chong M, Harrison TG, Cameron A, Ruzycki SM. In reply: Comment on "Strategies for intraoperative glucose management: a scoping review". Can J Anaesth 2023; 70:1852-1853. [PMID: 37749364 DOI: 10.1007/s12630-023-02573-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 09/27/2023] Open
Affiliation(s)
| | - Sarah Taylor
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Danae Krahn
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Leyla Baghirzada
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michael Chong
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tyrone G Harrison
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Anne Cameron
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shannon M Ruzycki
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Taylor S, D'Souza D, Moinuddin S, Gains J, Gaze MN, Gaunt T, Veiga C, Lim P. Pancreas: An Organ-at-Risk to Consider in Future Pediatric Abdominal Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:S135. [PMID: 37784347 DOI: 10.1016/j.ijrobp.2023.06.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Irradiation to the pancreas during pediatric radiotherapy is associated with secondary late effects, yet the pancreas is not typically considered an organ-at-risk (OAR) during radiotherapy planning. This audit investigated incidental pancreatic doses to estimate the relative risk (RR) of developing diabetes in later life. MATERIALS/METHODS Incidental pancreas doses were audited from 92 patients aged 2 to 19 historically treated with photons for craniospinal irradiation (CSI, N = 73) and for abdominal neuroblastoma (N = 19). Prescription doses ranged 21-36 Gy and 21-39 Gy (with boost to spine up to 50 Gy) for neuroblastoma and CSI patients, respectively. The pancreas was segmented on all planning CT scans following RTOG guidelines. Furthermore, the pancreas was split into its sub-volumes (head, body and tail) for abdominal cases only, since these scans were acquired with contrast enhancement. The RR of developing subsequent diabetes was estimated as a function of dose (D): RR = 1+0.65 × D × exp(-0.3 × D). Dose to the pancreas tail was used for neuroblastoma cases, whereas dose to the whole pancreas was used for CSI patients given that the pancreas could not be split in non-contrast scans. RESULTS The mean dose delivered to the whole pancreas was 15.4±7.5 Gy for all patients, 12.7±4.7 Gy for CSI patients and 25.9±7.4 Gy for abdominal patients. Pancreas V10Gy was 61.2% for all patients, 51.5% for CSI, and 98.6% for abdominal patients; V30Gy = 0% in all cases. These doses represented an estimated diabetes RR of 7.3±1.5, 6.6±1.3, and 8.7±0.6, respectively; RR>5 in 88%, 85% and 100% of all patients, CSI and abdominal patients audited, respectively. CONCLUSION Current incidental doses were associated with a diabetes RR>5 in all patients treated for abdominal neuroblastoma and the majority who received CSI. These findings suggest the pancreas should be routinely delineated and considered as an OAR in radiotherapy planning. This may help to identify higher risk patients and inform late-effect monitoring during survivorship. Further work in underway to assess if proton therapy could reduce the RR of diabetes particularly in abdominal cases. Improved availability of high-quality imaging during radiotherapy planning, such as contrast administration or planning MRI, is becoming more necessary to accurately delineate subsegments of the pancreas for improved RR estimations.
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Affiliation(s)
- S Taylor
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - D D'Souza
- Radiotherapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - S Moinuddin
- Radiotherapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - J Gains
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - M N Gaze
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - T Gaunt
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - C Veiga
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - P Lim
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Elgohari B, Patwardhan PP, Abdelhakiem MK, Bhargava R, Sukumvanich P, Courtney-Brooks M, Boisen MM, Berger JL, Taylor S, Olawaiye A, Lesnock J, Edwards RP, Beriwal S, Soong TR, Vargo JAA. Is Programmed Death Ligand 1(PD-L1) Expression in Vulvar Cancer Prognostic for Locoregional Control? Int J Radiat Oncol Biol Phys 2023; 117:e511. [PMID: 37785600 DOI: 10.1016/j.ijrobp.2023.06.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Vulvar cancer is a rare female genital neoplasm in which surgery and radiotherapy play an integral role in the treatment paradigm; however, locoregional recurrence remains the predominant pattern of failure. Little is known about the impact of PD-L1 status in vulvar cancer and its value for clinical outcomes and response prediction to immunotherapy. We sought to explore clinical outcomes of patients with positive PD-L1 expression in vulvar cancer. MATERIALS/METHODS Single-institution retrospective analysis of patients with surgically resectable invasive vulvar carcinoma from 2001-2021 was performed. Patients with locally advanced disease not amendable to upfront surgery or de novo metastatic disease were excluded. Immunohistochemical PD-L1 expression was assessed using the Combined Positive Score (CPS) with positive expression defined as ≥1, and Tumor Proportion Score (TPS) with positive expression defined as ≥1%. Survival and disease control outcomes were calculated using the Kaplan-Meier Method with log-rank t-test. Multivariable analysis was conducted using a parsimonious cox regression analysis using forward conditional selection. RESULTS A total of 85 patients were identified with a median age of 69 years old (IQR: 59-78), 54% (n = 46) FIGO stage I-II, 97% (n = 82) squamous cell carcinoma histology, 41% (n = 35) p16 positive status, 74% (n = 63) without a history of lichen sclerosis, 40% (n = 34) without co-existing vulvar intraepithelial neoplasm (VIN), and 49% (n = 42) treated with surgery alone. There were 72% (n = 61) with positive PD-L1 TPS (≥1%), and 81% (n = 69) with positive PD-L1 CPS (≥1) expression. The median follow up was 49 months (IQR: 21-75 months). The 5-year OS was 79% (95% CI, 70%-89%), DFS 55% (95% CI, 43%-67%), local control (LC) 59% (95% CI, 47%-72%), regional control (RC) 86% (95% CI, 78%-94%), and distant metastasis (DM) 96% (95% CI, 92%-100%). PD-L1 expression was associated with lower LC and DFS by TPS ≥1%. The 5-year LC of 82% (95% CI, 65%-98%) for PD-L1 negative versus 50% (95% CI, 34%-65%) positive disease (p = 0.03). The 5-year DFS was 77% (95% CI, 59%-95%) for PD-L1 negative versus 46% (95% CI, 31%-61%) positive disease (p = 0.03). No significant DFS or LC difference was noted by CPS levels ≥1. No significant difference was observed for RC, DM, or OS. On multivariable analysis, PD-L1 TPS remained a significant predictor for LC (HR = 3.01, 95% CI, 1.07-8.95, p = 0.04). No significant difference in DFS was observed for PD-L1 TPS on multivariable analysis. CONCLUSION PD-L1 expression is associated with higher rates of local recurrence and may represents a potentially important actionable target independent of p16 status to improve the predominant pattern of relapse in this uncommon malignancy.
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Affiliation(s)
- B Elgohari
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - P P Patwardhan
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M K Abdelhakiem
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - R Bhargava
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - P Sukumvanich
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M Courtney-Brooks
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M M Boisen
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J L Berger
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Taylor
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - A Olawaiye
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J Lesnock
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - R P Edwards
- UPMC Hillman Cancer Center, Department of Gynecologic Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Beriwal
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - T R Soong
- UPMC Hillman Cancer Center, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J A A Vargo
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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13
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Thomas TH, Bender C, Donovan HS, Murray PJ, Taylor S, Rosenzweig M, Sereika SM, Brufsky A, Schenker Y. The feasibility, acceptability, and preliminary efficacy of a self-advocacy serious game for women with advanced breast or gynecologic cancer. Cancer 2023; 129:3034-3043. [PMID: 37243943 DOI: 10.1002/cncr.34887] [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: 02/21/2023] [Revised: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Cancer clinicians and systems aim to provide patient-centered care, but not all patients have the self-advocacy skills necessary to ensure their care reflects their needs and priorities. This study examines the feasibility, acceptability, and preliminary efficacy of a self-advocacy serious game (an educational video game) intervention in women with advanced breast or gynecologic cancer. METHODS Women with recently diagnosed (<3 months) metastatic breast or advanced gynecologic cancer were randomized 2:1 to receive a tablet-based serious game (Strong Together) (n = 52) or enhanced care as usual (n = 26). Feasibility was based on recruitment, retention, data completion, and intervention engagement. Acceptability was assessed via a postintervention questionnaire and exit interview. Preliminary efficacy was assessed on the basis of change scores from baseline to 3 and 6 months in self-advocacy (Female Self-Advocacy in Cancer Survivorship Scale) using intention-to-treat analysis. RESULTS Seventy-eight women (55.1% with breast cancer; 44.9% with gynecologic cancer) were enrolled. Feasibility was demonstrated by satisfactory recruitment (69% approach-to-consent rate; 93% enroll-to-randomize rate), retention (90% and 86% at 3 and 6 months, respectively; 85% data completion), and intervention engagement (84% completed ≥75% of the game). Participants endorsed the intervention's (75%) and trial's (87%) acceptability. Participants in the intervention group experienced significant improvements in self-advocacy at 3 and 6 months compared to participants in the control group. CONCLUSIONS Strong Together is feasible and acceptable among women with advanced breast or gynecologic cancer. This intervention demonstrates promising evidence of clinical efficacy. A future confirmatory trial is warranted to test the efficacy of the intervention for patient and health system outcomes.
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Affiliation(s)
- Teresa Hagan Thomas
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine Bender
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Heidi S Donovan
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
| | - Patty Jo Murray
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah Taylor
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
- Division of Hematology/Oncology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Margaret Rosenzweig
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adam Brufsky
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
- Division of Hematology/Oncology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yael Schenker
- Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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14
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Pagani I, Ottoboni L, Panina-Bordignon P, Martino G, Poli G, Taylor S, Turnbull JE, Yates E, Vicenzi E. Heparin Precursors with Reduced Anticoagulant Properties Retain Antiviral and Protective Effects That Potentiate the Efficacy of Sofosbuvir against Zika Virus Infection in Human Neural Progenitor Cells. Pharmaceuticals (Basel) 2023; 16:1385. [PMID: 37895856 PMCID: PMC10609960 DOI: 10.3390/ph16101385] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 10/29/2023] Open
Abstract
Zika virus (ZIKV) infection during pregnancy can result in severe birth defects, such as microcephaly, as well as a range of other related health complications. Heparin, a clinical-grade anticoagulant, is shown to protect neural progenitor cells from death following ZIKV infection. Although heparin can be safely used during pregnancy, it retains off-target anticoagulant effects if directly employed against ZIKV infection. In this study, we investigated the effects of chemically modified heparin derivatives with reduced anticoagulant activities. These derivatives were used as experimental probes to explore the structure-activity relationships. Precursor fractions of porcine heparin, obtained during the manufacture of conventional pharmaceutical heparin with decreased anticoagulant activities, were also explored. Interestingly, these modified heparin derivatives and precursor fractions not only prevented cell death but also inhibited the ZIKV replication of infected neural progenitor cells grown as neurospheres. These effects were observed regardless of the specific sulfation position or overall charge. Furthermore, the combination of heparin with Sofosbuvir, an antiviral licensed for the treatment of hepatitis C (HCV) that also belongs to the same Flaviviridae family as ZIKV, showed a synergistic effect. This suggested that a combination therapy approach involving heparin precursors and Sofosbuvir could be a potential strategy for the prevention or treatment of ZIKV infections.
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Affiliation(s)
- Isabel Pagani
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Linda Ottoboni
- Neuroimmunology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Paola Panina-Bordignon
- Neuroimmunology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Gianvito Martino
- Neuroimmunology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Guido Poli
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
- Human Immuno-Virology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Sarah Taylor
- Department of Biochemistry & Systems Biology, ISMIB, University of Liverpool, Liverpool L69 7ZB, UK
| | - Jeremy E Turnbull
- Department of Biochemistry & Systems Biology, ISMIB, University of Liverpool, Liverpool L69 7ZB, UK
- Department of Life Sciences, Keele University, Keele, Staffs ST5 5BG, UK
| | - Edwin Yates
- Department of Biochemistry & Systems Biology, ISMIB, University of Liverpool, Liverpool L69 7ZB, UK
- Department of Life Sciences, Keele University, Keele, Staffs ST5 5BG, UK
| | - Elisa Vicenzi
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
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15
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Pifer PM, Jaishankar S, Bhargava R, Schad MD, Keller A, Musunuru HB, Cohen M, Sukumvanich P, Courtney-Brooks M, Boisen M, Berger JL, Olawaiye A, Lesnock J, Edwards R, Taylor S, Vargo JA, Beriwal S. Is Substantial Lymphovascular Space Invasion Prognostic in Patients With Pathologically Lymph Node-Negative Endometrial Cancer? Int J Radiat Oncol Biol Phys 2023; 117:148-153. [PMID: 36893818 DOI: 10.1016/j.ijrobp.2023.02.053] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE Lymphovascular space invasion (LVSI) predicts for higher rates of recurrence and increased mortality in endometrial cancer. Using 3-tier LVSI scoring, a PORTEC-1 and -2 trials analysis demonstrated that substantial LVSI was associated with worse locoregional (LR-DFS) and distant metastasis disease-free survival (DM-DFS), and these patients possibly benefited from external beam radiation therapy (EBRT). Furthermore, LVSI is a predictor for lymph node (LN) involvement, but the significance of substantial LVSI is unknown in patients with a pathologically negative LN assessment. We aimed to evaluate clinical outcomes of these patients in relation to the 3-tier LVSI scoring system. METHODS AND MATERIALS We performed a single-institutional retrospective review of patients with stage I endometrioid-type endometrial cancer who underwent surgical staging with pathologically negative LN evaluation from 2017 to 2019 with 3-tier LVSI scoring (none, focal, or substantial). Clinical outcomes (LR-DFS, DM-DFS, and overall survival) were analyzed using the Kaplan-Meier method. RESULTS A total of 335 patients with pathologically LN-negative stage I endometrioid-type endometrial carcinoma were identified. Substantial LVSI was present in 17.6% of patients; 39.7% of patients received adjuvant vaginal brachytherapy and 6.9% of patients received EBRT. Adjuvant radiation treatment varied by LVSI status. In patients with focal LVSI, 81.0% received vaginal brachytherapy. Among patients with substantial LVSI, 57.9% received vaginal brachytherapy alone, and 31.6% of patients received EBRT. The 2-year LR-DFS rates were 92.5%, 98.0%, and 91.4% for no LVSI, focal LVSI, and substantial LVSI, respectively. The 2-year DM-DFS rates were 95.5%, 93.3%, and 93.8% for no LVSI, focal LVSI, and substantial LVSI, respectively. CONCLUSIONS In our institutional study, patients with pathologically LN-negative stage I endometrial cancer with substantial LVSI had similar rates of LR-DFS and DM-DFS compared with patients with none or focal LVSI. These findings highlight the need for multi-institutional studies to validate the prognostic value of substantial LVSI in this patient population.
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Affiliation(s)
- Phillip M Pifer
- Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sruthi Jaishankar
- Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Rohit Bhargava
- Department of Pathology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Michael D Schad
- Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Andrew Keller
- Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Hima Bindu Musunuru
- Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Michael Cohen
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Paniti Sukumvanich
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Madeleine Courtney-Brooks
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Michelle Boisen
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jessica L Berger
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Alexander Olawaiye
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jamie Lesnock
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Robert Edwards
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sarah Taylor
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - John Austin Vargo
- Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sushil Beriwal
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pennsylvania; Varian Medical Systems, Charlottesville, Virginia.
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16
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Wheelwright S, Maunsell R, Taylor S, Drinkwater N, Erridge C, Foster C, Hardcastle M, Hogden A, Lawson I, Lisiecka D, Mcdermott C, Morrison KE, Muir C, Recio-Saucedo A, White S. Development of 'gastrostomy tube - is it for me?', a web-based patient decision aid for people living with motor neurone disease considering having a gastrostomy tube placed. Amyotroph Lateral Scler Frontotemporal Degener 2023; 24:1-9. [PMID: 37332172 DOI: 10.1080/21678421.2023.2220743] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023]
Abstract
Objective: To develop and pilot a web-based patient decision aid (PDA) to support people living with motor neurone disease (plwMND) considering having a gastrostomy tube placed. Methods: In Phase 1, content and design were informed by semi-structured interviews, literature reviews and a prioritization survey. In Phase 2, the prototype PDA was tested with users and developed iteratively with feedback from surveys and 'think-aloud' interviews. Phase 1 and 2 participants were plwMND, carers and healthcare professionals (HCPs). In Phase 3, the PDA was evaluated by plwMND using validated questionnaires and HCPs provided feedback in focus groups. Results: Sixteen plwMND, 16 carers and 25 HCPs took part in Phases 1 and 2. Interviews and the literature review informed a prioritization survey with 82 content items. Seventy-seven per cent (63/82) of the content of the PDA was retained. A prototype PDA, which conforms to international standards, was produced and improved during Phase 2. In Phase 3, 17 plwMND completed questionnaires after using the PDA. Most plwMND (94%) found the PDA completely acceptable and would recommend it to others in their position, 88% had no decisional conflict, 82% were well prepared and 100% were satisfied with their decision-making. Seventeen HCPs provided positive feedback and suggestions for use in clinical practice. Conclusion: Gastrostomy Tube: Is it for me? was co-produced with stakeholders and found to be acceptable, practical and useful. Freely available from the MND Association website, the PDA is a valuable tool to support the shared decision-making process for gastrostomy tube placement.
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Affiliation(s)
| | - R Maunsell
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - S Taylor
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - N Drinkwater
- Motor Neurone Disease Association, Northampton, UK
| | - C Erridge
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Foster
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | | | - A Hogden
- School of Population Health, University of New South Wales, Sydney, Australia
| | - I Lawson
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - D Lisiecka
- Munster Technological University - Kerry Campus, Republic of Ireland, Tralee, UK
| | | | - K E Morrison
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - C Muir
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - A Recio-Saucedo
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | - S White
- University of Sheffield, Sheffield, UK, and
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17
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Wilson B, Flett C, Gemperle J, Lawless C, Hartshorn M, Hinde E, Harrison T, Chastney M, Taylor S, Allen J, Norman JC, Zacharchenko T, Caswell PT. Proximity labelling identifies pro-migratory endocytic recycling cargo and machinery of the Rab4 and Rab11 families. J Cell Sci 2023; 136:jcs260468. [PMID: 37232246 PMCID: PMC10323252 DOI: 10.1242/jcs.260468] [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: 07/28/2022] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
Endocytic recycling controls the return of internalised cargoes to the plasma membrane to coordinate their positioning, availability and downstream signalling. The Rab4 and Rab11 small GTPase families regulate distinct recycling routes, broadly classified as fast recycling from early endosomes (Rab4) and slow recycling from perinuclear recycling endosomes (Rab11), and both routes handle a broad range of overlapping cargoes to regulate cell behaviour. We adopted a proximity labelling approach, BioID, to identify and compare the protein complexes recruited by Rab4a, Rab11a and Rab25 (a Rab11 family member implicated in cancer aggressiveness), revealing statistically robust protein-protein interaction networks of both new and well-characterised cargoes and trafficking machinery in migratory cancer cells. Gene ontological analysis of these interconnected networks revealed that these endocytic recycling pathways are intrinsically connected to cell motility and cell adhesion. Using a knock-sideways relocalisation approach, we were further able to confirm novel links between Rab11, Rab25 and the ESCPE-1 and retromer multiprotein sorting complexes, and identify new endocytic recycling machinery associated with Rab4, Rab11 and Rab25 that regulates cancer cell migration in the 3D matrix.
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Affiliation(s)
- Beverley Wilson
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Chloe Flett
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Jakub Gemperle
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Craig Lawless
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Matthew Hartshorn
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Eleanor Hinde
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Tess Harrison
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Megan Chastney
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Sarah Taylor
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Jennifer Allen
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Jim C. Norman
- Cancer Research UK Beatson Institute, Glasgow, G61 1BD, UK
- School of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - Thomas Zacharchenko
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
| | - Patrick T. Caswell
- Wellcome Trust Centre for Cell-Matrix Research, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PT, UK
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18
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Wu B, Shabanova V, Arslanian K, Nyhan K, Izampuye E, Taylor S, Muasau-Howard B, Ekeroma A, Hawley NL. Global prevalence of preterm birth among Pacific Islanders: A systematic review and meta-analysis. PLOS Glob Public Health 2023; 3:e0001000. [PMID: 37315035 PMCID: PMC10266634 DOI: 10.1371/journal.pgph.0001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 05/04/2023] [Indexed: 06/16/2023]
Abstract
The epidemiology of preterm birth among Pacific Islanders is minimally understood. The purpose of this study was to estimate pooled prevalence of preterm birth among Pacific Islanders and to estimate their risk of preterm birth compared to White/European women. We searched MEDLINE, EMBASE, Web of Science Core Collection, Cochrane Library, CINAHL, Global Health, and two regional journals in March 2023. Observational studies were included if they reported preterm birth-related outcomes among Pacific Islanders. Random-effects models were used to estimate the pooled prevalence of preterm birth with 95% confidence interval (CI). Bayes meta-analysis was conducted to estimate pooled odds ratios (OR) with 95% highest posterior density intervals (HPDI). The Joanna Briggs Institute checklists were used for risk of bias assessment. We estimated preterm birth prevalence among Pacific Islanders in the United States (US, 11.8%, sample size [SS] = 209,930, 95% CI 10.8%-12.8%), the US-Affiliated Pacific Islands (USAPI, SS = 29,036, 6.7%, 95% CI 4.9%-9.0%), New Zealand (SS = 252,162, 7.7%, 95% CI 7.1%-8.3%), Australia (SS = 20,225, 6.1%, 95% CI 4.2%-8.7%), and Papua New Guinea (SS = 2,647, 7.0%, 95% CI 5.6%-8.8%). Pacific Islanders resident in the US were more likely to experience preterm birth compared to White women (OR = 1.45, 95% HPDI 1.32-1.58), but in New Zealand their risk was similar (OR = 1.00, 95% HPDI 0.83-1.16) to European women. Existing literature indicates that Pacific Islanders in the US had a higher prevalence of preterm birth and experienced health inequities. Learning from New Zealand's culturally-sensitive approach to health care provision may provide a starting point for addressing disparities. The limited number of studies identified may contribute to higher risk of bias and the heterogeneity in our estimates; more data is needed to understand the true burden of preterm birth in the Pacific region.
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Affiliation(s)
- Bohao Wu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | - Veronika Shabanova
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, United States of America
- Department of Biostatistics, Yale School of Medicine, New Haven, CT, United States of America
| | - Kendall Arslanian
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, United States of America
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Elizabeth Izampuye
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | - Sarah Taylor
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, United States of America
| | - Bethel Muasau-Howard
- Department of Obstetrics and Gynecology, Lyndon B Johnson Tropical Medical Center, Pago Pago, American Samoa
| | | | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
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19
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Abstract
This cohort study assesses 5-year race-stratified neonatal mortality and prevalence of preterm births in the US using birth-based and fetuses-at-risk approaches.
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Affiliation(s)
- Bohao Wu
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut
| | - Sarah Taylor
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Veronika Shabanova
- Department of Biostatistics, Yale University School of Medicine, New Haven, Connecticut
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut
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20
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Beumer JH, Behr S, Gallion H, Vargo J, Ueland F, Mahdi H, Orr B, Girda E, Christner S, Chu E, Kunos C, Ivy PS, Taylor S. Abstract 2800: Pharmacokinetics, bioavailability, and pharmacodynamics of oral triapine. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-2800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Background: Locally advanced cervical cancer accounts for most deaths from disease. Standard of care includes treatment with cisplatin-based chemoradiation with a 70% response rate. The addition of intravenous (IV) triapine to chemoradiation has shown promising clinical activity in phase 1 and 2 studies but comes with a more intensive treatment regimen. An ongoing phase 1 trial has finished the escalation phase, and we report the pharmacokinetics (PK) and pharmacodynamics (PD) of oral (PO) triapine.
Methods: This phase 1 study followed a 3+3 design for dose escalation of oral triapine, starting with initial dose of 100 mg five days a week for five weeks combined with external beam pelvic radiation and weekly IV cisplatin. PK was determined by LC-MS/MS, and PD included methemoglobin levels at 4 h post dose. Within patient PK variability after IV and PO dosing and PO bioavailability were calculated.
Results: PK data were available for 10 patients at 100 (the MTD) and 150 mg. PO parameter values were Tmax 1.3 h, t1/2 1.4 h, CL/F 104 L/h, and Vz/F 214 L. There was no discernable difference between triapine exposure at 100 vs. 150 mg PO (Cmax 520 (2.5) vs. 344 (1.9) µg/L; AUC 1209 (2.53) vs. 1034 (1.41) µg/L•h), and between patient variability at each dose level was substantial. The correlation of PO Vz/F vs Cl/F was high at R2=0.86, suggesting that the apparent clearance and volume variability is primarily due to variability in the oral bioavailability F. PO within patient variability of Cmax and AUC was also large at 43% and 55%. IV PK was less variable with lower geometric standard deviations across all parameters, including within patients where variability of Cmax and AUC was modest at 10 and 12% coefficient of variation, respectively. Oral bioavailability was estimated at 66%. We found a non-significant trend of smoking almost doubling triapine oral clearance from 68 to 156 L/h (p=0.056). There was no apparent relationship between occurrence of DLT and either IV or PO triapine AUC. Methemoglobin levels directly correlated with triapine exposure expressed as AUC or Cmax.
Conclusions: Triapine PK parameter values for PO and IV administration and PO bioavailability values observed in this trial were comparable to previous reports. Correlation of methemoglobin with exposure highlights the importance of optimizing triapine exposure. Additional data may support the exploration of a dose specific to current smokers.
Citation Format: Jan H. Beumer, Sarah Behr, Holly Gallion, John Vargo, Frederick Ueland, Haider Mahdi, Brian Orr, Eugenia Girda, Susan Christner, Edward Chu, Charles Kunos, Percy S. Ivy, Sarah Taylor. Pharmacokinetics, bioavailability, and pharmacodynamics of oral triapine [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2800.
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Affiliation(s)
| | - Sarah Behr
- 1UPMC Hillman Cancer Center, Pittsburgh, PA
| | | | - John Vargo
- 1UPMC Hillman Cancer Center, Pittsburgh, PA
| | | | | | - Brian Orr
- 1UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Eugenia Girda
- 3Rutgers Cancer Institute of New Jersey, Brunswick, NJ
| | | | - Edward Chu
- 4Montefiore Einstein Cancer Canter, Bronx, NY
| | | | - Percy S. Ivy
- 5Investigational Drug Branch, National Cancer Institute, Bethesda, MD
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21
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Mohabbat S, Singh H, Williams SR, Gutgesell LMM, Sukovich DJ, Kamath GM, Kim H, Janesick A, Shelansky R, Beliakoff G, Tentori AM, Kim A, Uytingco CR, Taylor S. Abstract 4708: Application of spatially resolved transcriptomics to screen multiple tumor biospecimens using tissue microarrays. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
The tumor microenvironment is composed of highly heterogeneous structures and cell types that dynamically influence and communicate with each other. Although examination of singular biospecimens is sufficient for diagnostic purposes, it is inadequate and cost prohibitive when scaling for complex and overarching studies. Thus, high density multi-tumor tissue microarrays (TMAs) have been a practical and effective solution for high-throughput molecular analysis of tissues. Introduced more than a decade ago, TMAs have been instrumental in the recent study of tumor biology, the development of diagnostic tests, the establishment of quality control, and the investigation and identification of oncological biomarkers. Here, we demonstrate the pairing of the 10x Genomics Visium Cytassist Spatial Gene Expression Solution and Xenium In-Situ Platform on multi-tumor TMAs to screen for common biomarkers among a cohort of samples. Spatial transcriptomics technology has proven valuable in mapping the whole transcriptome with spatial context (Visium), whereas In Situ (Xenium) enables high-throughput cellular characterization at single-cell resolution. With the addition of our CytAssist platform, we expand on the pre-existing standard Visium solution by facilitating the retrieval of RNA transcriptomic information from tissues placed on standard or archival slides. On the other hand, the novel Xenium platform compliments whole transcriptome Visium data by unlocking the potential to assign transcripts to a particular cell with spatial context and subcellular resolution. The combination of spatial transcriptomics and targeted in situ data with FFPE TMAs promotes a high-throughput method to accelerate the uncovering of molecular signatures suitable to understanding the tumor microenvironment. We showcase the ability to spatially and comprehensively resolve individual oncogene and tumor suppressor genes associated with multiple tumors from a cohort of cancer patients and from multiple different tumor samples. In addition, these markers are mapped back to distinct morphological features within each tissue core, and use differential gene expression data to identify distinct cell types throughout the different patient tissues. By combining the throughput of TMA samples and depth of the Visium and Xenium platforms, the strategy enables greater insights into cell-type specifics while also expanding the spectrum of biospecimen types that can be analyzed.
Citation Format: Syrus Mohabbat, Hardeep Singh, Stephen R. Williams, Lauren M M. Gutgesell, David J. Sukovich, Govinda M. Kamath, Hanyoup Kim, Amanda Janesick, Robert Shelansky, Ghezal Beliakoff, Augusto M. Tentori, Albert Kim, Cedric R. Uytingco, Sarah Taylor. Application of spatially resolved transcriptomics to screen multiple tumor biospecimens using tissue microarrays. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4708.
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22
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Brar P, Shramko M, Taylor S, Eisenberg M. The Moderating Influence of School Adult Connectedness on Adolescent Dating Violence and Mental Health. J Sch Health 2023; 93:297-304. [PMID: 36382738 DOI: 10.1111/josh.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Adolescent dating violence (ADV) continues to be a health concern. Most previous research has examined physical and or sexual ADV with little attention to verbal violence. METHODS Drawing on the social-ecological framework, the current study examined the moderating influence of school adult connectedness on experiences of verbal only, physical and/or sexual violence (combination ADV), and mental health outcomes among 11th graders (n = 31,459) in one Midwestern state. RESULTS Overall, 24.0% and 28.8% of adolescents met thresholds for depression and anxiety symptoms, respectively. Rates of mental health symptoms were higher among adolescents reporting ADV compared to those who did not report experience of ADV. In logistic regressions, higher level of school adult connectedness was associated with lower odds of depressive and anxiety symptoms, respectively. In moderation analyses, school adult connectedness was protective for mental health outcomes regardless of ADV experience. CONCLUSION Adolescent dating violence-including verbal violence alone-can be traumatic for young people. Schools can leverage the protective nature of school adult connection to promote mental health for all students, including adolescents who have experienced ADV. Incorporating trauma-informed education practice of providing unconditional positive regard toward adolescents might be 1-way schools can support adolescents in cultivating healthy relationships and well-being.
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Affiliation(s)
- Pooja Brar
- Department of Family Studies and Community Development, Towson University, MD, Towson, USA
| | - Maura Shramko
- Center for Advanced Studies in Child Welfare, School of Social Work, University of Minnesota, MN, Minneapolis, USA
| | - Sarah Taylor
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, USA
| | - Marla Eisenberg
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota, MN, Minneapolis, USA
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23
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Thomas TH, Taylor S, Rosenzweig M, Schenker Y, Bender C. Self-advocacy Behaviors and Needs in Women with Advanced Cancer: Assessment and Differences by Patient Characteristics. Int J Behav Med 2023; 30:211-220. [PMID: 35794411 DOI: 10.1007/s12529-022-10085-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Self-advocacy skills allow individuals with cancer to overcome challenges related to their health, care, and well-being. Understanding the self-advocacy behaviors and needs of individuals with cancer is critical to addressing the lack of evidence-based self-advocacy interventions. The aims of this study are to describe (1) self-advocacy behaviors and needs of women with advanced cancer and (2) associations between self-advocacy and sociodemographic, cancer, and patient-reported outcomes. METHODS We analyzed cross-sectional data from a clinical trial among women within 3 months of a metastatic breast or stage III or IV gynecologic cancer diagnosis. Descriptive and correlational statistics and tests of group difference were calculated for measures of self-advocacy (Female Self-Advocacy in Cancer Survivorship Scale), sociodemographic characteristics, quality of life (FACT-G), symptom burden (M.D. Anderson Symptom Inventory), and mood (Hospital Anxiety and Depression Scale). RESULTS Participants (N = 78) reported self-advocacy behaviors including making decisions based on their priorities, asking questions to their healthcare providers, and comparing their experiences to others' experiences. Self-advocacy needs focused on finding health information and talking with healthcare providers. Self-advocacy behaviors and needs did not differ by participants' sociodemographic characteristics or mood. Higher self-advocacy behaviors were associated with higher quality of life (p ≤ .01) and lower symptom severity (p < .05) with a trend for cancer recurrence (p = .05). CONCLUSIONS Women with advanced cancer report engaging in self-advocacy behaviors and these are associated with higher quality of life and lower symptom burden. Future research should determine if self-advocacy behaviors and needs change over time and how patient characteristics impact self-advocacy behaviors and needs.
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Affiliation(s)
- Teresa Hagan Thomas
- School of Nursing, University of Pittsburgh, 3500 Victoria Street Suite 440, Pittsburgh, PA, 15261, USA.
- Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, PA, USA.
| | - Sarah Taylor
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA, USA
| | - Margaret Rosenzweig
- Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, PA, USA
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA, USA
| | - Yael Schenker
- Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, PA, USA
- School of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Bender
- School of Nursing, University of Pittsburgh, 3500 Victoria Street Suite 440, Pittsburgh, PA, 15261, USA
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24
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Silkens MEWM, Alexander K, Viney R, O'Keeffe C, Taylor S, Noble LM, Griffin A. A national qualitative investigation of the impact of service change on doctors' training during Covid-19. BMC Med Educ 2023; 23:174. [PMID: 36941665 PMCID: PMC10027255 DOI: 10.1186/s12909-023-04143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The Covid-19 crisis sparked service reconfigurations in healthcare systems worldwide. With postgraduate medical education sitting within these systems, service reconfigurations substantially impact trainees and their training environment. This study aims to provide an in-depth qualitative understanding of the impact of service reconfiguration on doctors' training during the pandemic, identifying opportunities for the future as well as factors that pose risks to education and training and how these might be mitigated. METHODS Qualitative parallel multi-centre case studies examined three Trusts/Health Boards in two countries in the United Kingdom. Data were collected from online focus groups and interviews with trainees and supervisors using semi-structured interview guides (September to December 2020). A socio-cultural model of workplace learning, the expansive-restrictive continuum, informed data gathering, analysis of focus groups and coding. RESULTS Sixty-six doctors participated, representing 25 specialties/subspecialties. Thirty-four participants were male, 26 were supervisors, 17 were specialty trainees and 23 were foundation doctors. Four themes described the impact of pandemic-related service reconfigurations on training: (1) Development of skills and job design, (2) Supervision and assessments, (3) Teamwork and communication, and (4) Workload and wellbeing. Service changes were found to both facilitate and hinder education and training, varying across sites, specialties, and trainees' grades. Trainees' jobs were redesigned extensively, and many trainees were redeployed to specialties requiring extra workforce during the pandemic. CONCLUSIONS The rapid and unplanned service reconfigurations during the pandemic caused unique challenges and opportunities to doctors' training. This impaired trainees' development in their specialty of interest, but also presented new opportunities such as cross-boundary working and networking.
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Affiliation(s)
- M E W M Silkens
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
- Centre for Healthcare Innovation Research, Department of Health Services Research and Management, City University of London, London, UK
| | - K Alexander
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
- School of Medicine, University of Dundee, Dundee, UK
| | - R Viney
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK
| | - C O'Keeffe
- UCL Medical School, University College London, London, UK
| | - S Taylor
- Institute of Education, University College London, London, UK
| | - L M Noble
- UCL Medical School, University College London, London, UK
| | - A Griffin
- Research Department of Medical Education (RDME), UCL Medical School, University College London, The Directorate, 74 Huntley Street, London, WC1E 6AU, UK.
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25
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Sultana F, Davis SR, Bell RJ, Taylor S, Islam RM. Association between testosterone and cognitive performance in postmenopausal women: a systematic review of observational studies. Climacteric 2023; 26:5-14. [PMID: 36366914 DOI: 10.1080/13697137.2022.2139600] [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] [Indexed: 11/13/2022]
Abstract
This review was conducted to explore the association between endogenous testosterone blood concentrations and cognitive performance among community dwelling postmenopausal women. We searched Ovid MEDLINE, EMBASE, PsycINFO and Web of Science databases for observational studies with at least 100 postmenopausal participants. The results were categorized by study design, reporting of total or free testosterone and risk of bias assessments, narratively. Ten of the 26 articles retrieved for full-text review met the inclusion criteria, six provided cross-sectional data, seven provided longitudinal data and one provided case-control data. Cognitive performance tests differed between studies. Eight studies measured testosterone by immunoassay, one by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and one did not specify their methodology. Eleven different cognitive domains were tested by 37 different instruments. Irrespective of the study design, the findings were inconsistent and inconclusive. Both positive and inverse associations were reported for each of global cognition and immediate and delayed verbal recall. The majority of studies reported no association between total or free testosterone and cognitive performance. Although this review did not demonstrate an association between testosterone and cognitive performance in postmenopausal women, the findings should be considered inconclusive due to the imprecision of testosterone measurement and the methodological heterogeneity of the included studies.
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Affiliation(s)
- F Sultana
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Environmental Interventions Unit, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
| | - R J Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - S Taylor
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R M Islam
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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26
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Yau T, Rimmer SN, Taylor S. Can’t see, can’t climb a tree, can’t defecate pain free: reactive arthritis due to chlamydial proctitis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00326-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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27
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Morin N, Taylor S, Krahn D, Baghirzada L, Chong M, Harrison TG, Cameron A, Ruzycki SM. Strategies for intraoperative glucose management: a scoping review. Can J Anaesth 2023; 70:253-270. [PMID: 36450943 DOI: 10.1007/s12630-022-02359-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/04/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Perioperative hyperglycemia is associated with adverse outcomes for patients with and without diabetes. Guidelines and published protocols for intraoperative glycemic management have substantial variation in their recommendations. We sought to characterize the current evidence-guiding intraoperative glycemic management in a scoping review. SOURCES Our search strategy included MEDLINE (Ovid and EBSCO), PubMed, PubMed Central, EMBASE, CINAHL, Cochrane Library, SciVerse Scopus, and Web of Science and a gray literature search of Google, Google Scholar, hand searching of the reference lists of included articles, OAISter, institutional protocols, and ClinicalTrails.gov. PRINCIPAL FINDINGS We identified 41 articles that met our inclusion criteria, 24 of which were original research studies. Outcomes and exposures were defined heterogeneously across studies, which limited comparison and synthesis. Investigators often created arbitrary and differing categories of glucose values rather than analyzing glucose as a continuous variable, which limited our ability to combine results from different studies. In addition, the study populations and surgery types also varied considerably, with few studies performed during day surgeries and specific surgical disciplines. Study populations often included more than one type of surgery, indication, and urgency that were expected to have varying physiologic and inflammatory responses. Combining low- and high-risk patients in the same study population may obscure the harms or benefits of intraoperative glycemic management for high-risk procedures or patients. CONCLUSION Future studies examining intraoperative glycemic management should carefully consider the study population, surgical characteristics, and pre- and postoperative management of hyperglycemia.
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Affiliation(s)
| | - Sarah Taylor
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Danae Krahn
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Leyla Baghirzada
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michael Chong
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tyrone G Harrison
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 1422, 3330 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada
| | - Anne Cameron
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shannon M Ruzycki
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 1422, 3330 Hospital Drive NW, Calgary, AB, T2N 2T9, Canada.
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28
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Thomas TH, Murray PJ, Rosenzweig M, Taylor S, Brufsky A, Bender C, Larkin M, Schenker Y. "I was never one of those people who just jumped right in for me": patient perspectives on self-advocacy training for women with advanced cancer. Support Care Cancer 2023; 31:96. [PMID: 36598659 PMCID: PMC9811054 DOI: 10.1007/s00520-022-07531-3] [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: 03/24/2022] [Accepted: 11/19/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Patients with advanced cancer experience many complicated situations that can make self-advocacy (defined as the ability speak up for yourself in the face of a challenge) difficult. Few self-advocacy interventions exist, and most are atheoretical with minimal patient engagement. The purpose of this study is to describe participant perspectives of a novel, self-advocacy serious game intervention called Strong Together. METHODS This was a qualitative cross-sectional descriptive study among women receiving cancer care at an academic cancer center within 3 months of an advanced gynecologic or breast cancer diagnosis. Participants randomized to receive the intervention completed one-on-one semi-structured interviews 3-months post Strong Together and had the option to share voice journals about their experiences. Inductive qualitative approaches were used to descriptively analyze transcripts and voice journals. Descriptive content analysis approaches were used to group similar codes together into themes summarizing participants' experiences engaging with the Strong Together intervention. RESULTS Participants (N = 40) reported that the Strong Together intervention was acceptable, noting that it was realistic and reflective of their personal experiences. Overarching themes included seeing myself in most scenarios and wanting more content; giving me the go ahead to expect more; offering ideas for how to stand up for myself; reinforcing what I am already doing; and reminding me of what I have. Participants suggested adding additional content including diverse characters. CONCLUSION This study demonstrated that women with advanced cancer were receptive to a self-advocacy skills-building intervention. Future research should explore the mechanisms linking serious games to learning and health outcomes.
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Affiliation(s)
- Teresa Hagan Thomas
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Suite 440, Pittsburgh, PA 15261 USA ,Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213 USA
| | - Patty Jo Murray
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Suite 440, Pittsburgh, PA 15261 USA
| | - Margaret Rosenzweig
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Suite 440, Pittsburgh, PA 15261 USA ,Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213 USA ,University of Pittsburgh Medical Center Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213 USA
| | - Sarah Taylor
- University of Pittsburgh Medical Center Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213 USA ,Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of Pittsburgh, 1218 Scaife Hal, 3550 Terrace Street, Pittsburgh, PA 15261 USA
| | - Adam Brufsky
- University of Pittsburgh Medical Center Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213 USA ,Division of Hematology/Oncology, School of Medicine, University of Pittsburgh, 1218 Scaife Hal, 3550 Terrace Street, Pittsburgh, PA 15261 USA
| | - Catherine Bender
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Suite 440, Pittsburgh, PA 15261 USA
| | - Mikayla Larkin
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, 100 Technology Drive, Pittsburgh, PA 15219 USA
| | - Yael Schenker
- Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213 USA ,Division of General Internal Medicine, School of Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213 USA
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29
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Thomas TH, Bender C, Rosenzweig M, Taylor S, Sereika SM, Babichenko D, You KL, Terry MA, Sabik LM, Schenker Y. Testing the effects of the Strong Together self-advocacy serious game among women with advanced cancer: Protocol for the STRONG randomized clinical trial. Contemp Clin Trials 2023; 124:107003. [PMID: 36379436 PMCID: PMC9839496 DOI: 10.1016/j.cct.2022.107003] [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: 07/15/2022] [Revised: 10/27/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Women with advanced cancer experience significant barriers to achieving high-quality care and maximizing their physical and emotional health. Our novel serious game, Strong Together, aims to teach women with advanced cancer self-advocacy skills needed to improve their symptom burden, quality of life, and patient-centered care. METHODS This is a single-center, multi-site randomized clinical trial of the Strong Together intervention among 336 women within three months of an advanced breast or gynecologic cancer diagnosis. Randomization occurs to the 3-month Strong Together serious game or enhanced care as usual group. The aims are to: (1) evaluate the effects of the intervention on patient self-advocacy (primary outcome); (2) evaluate the effects of the intervention on quality of life, symptom burden, and patient-centered care (secondary outcomes); and (3) evaluate the behavioral and game mechanisms that influence the efficacy of the intervention. ELIGIBILITY CRITERIA female, age ≥ 18 years; diagnosis of advanced breast or gynecologic cancer within the past 3 months; Eastern Cooperative Oncology Group score of 0-2; English literacy; and ≥ 6-month life expectancy. Patient-reported outcome measures are collected at baseline, 3-months, and 6-months. CONCLUSION This protocol is the first large-scale intervention aimed at promoting self-advocacy in women with advanced cancer. Understanding the ability of serious games to impact patient outcomes provides critical information for researchers, clinicians, and stakeholders aiming to improve patient-centered care. TRIAL REGISTRATION NCT04813276.
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Affiliation(s)
- Teresa H Thomas
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA; Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh 15213, PA, USA.
| | - Catherine Bender
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA.
| | - Margaret Rosenzweig
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA; Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh 15213, PA, USA; University of Pittsburgh Medical Center Magee-Womens Hospital, 300 Halket Street, Pittsburgh 15213, PA, USA.
| | - Sarah Taylor
- University of Pittsburgh Medical Center Magee-Womens Hospital, 300 Halket Street, Pittsburgh 15213, PA, USA.
| | - Susan M Sereika
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA.
| | - Dmitriy Babichenko
- University of Pittsburgh School of Computing and Information, 135 North Bellefield Avenue, Pittsburgh 15213, PA, USA.
| | - Kai-Lin You
- University of Pittsburgh School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh 15261, PA, USA.
| | - Martha Ann Terry
- University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh 15261, PA, USA.
| | - Lindsay M Sabik
- University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh 15261, PA, USA.
| | - Yael Schenker
- Palliative Research Center (PaRC), University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh 15213, PA, USA; University of Pittsburgh School of Medicine, Division of General Internal Medicine, 200 Lothrop Street, Pittsburgh 15213, PA, USA.
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Aristizabal N, Holder MP, Durham L, Ashraf AP, Taylor S, Salas AA. Safety and Efficacy of Early Vitamin D Supplementation in Critically Ill Extremely Preterm Infants: An Ancillary Study of a Randomized Trial. J Acad Nutr Diet 2023; 123:87-94. [PMID: 35728797 DOI: 10.1016/j.jand.2022.06.012] [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: 01/31/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite substantial evidence that vitamin D deficiency is highly prevalent among infants born extremely preterm (≤28 weeks' of gestation), several consensus statements do not recommend vitamin D doses >400 IU/day for these infants. Safety remains a concern. OBJECTIVE The study aim was to determine safety and efficacy profiles of enteral vitamin D in Black and White infants randomized to three different vitamin D doses soon after birth. DESIGN Ancillary study of a masked randomized clinical trial. PARTICIPANTS/SETTING Seventy-three infants born extremely preterm between 2012 and 2015 at a southern US academic neonatal unit (33' latitude) who had >90% compliance with the assigned intervention were included. INTERVENTION Infants were randomized to receive placebo (placebo group), 200 IU/day vitamin D (200 IU group), or 800 IU/day vitamin D (800 IU group) during the first 28 days after birth. MAIN OUTCOME MEASURES Safety outcomes included serum 25-hydroxy vitamin D (25[OH]D) and calcium concentrations. Efficacy outcomes included the predictive risk of bronchopulmonary dysplasia. STATISTICAL ANALYSIS Per-protocol analysis using unadjusted, repeated-measures mixed models. RESULTS Mean birth weight was 815 ± 199 g. Half were male and 56% were Black. Of 58 infants with 25(OH)D measurements at birth, 40 (69%) had vitamin D deficiency (<20 ng/mL). The mean difference in 25(OH)D in nanograms per milliliter between Postnatal Day 28 and Postnatal Day 1 was +9 in the placebo group, +23 in the 200 IU group, and +62 in the 800 IU group (P < 0.0001). The increase observed in 25(OH)D was more significant among Black infants. The predictive risk of severe bronchopulmonary dysplasia in the 200 IU and 800 IU groups was lower, but this difference did not reach statistical significance. No vitamin D or calcium toxicity was observed. CONCLUSIONS A vitamin D dose of 800 IU/day safely corrected vitamin D deficiency by Postnatal Day 14.
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Affiliation(s)
- Natalia Aristizabal
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mary Pat Holder
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Leandra Durham
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ambika P Ashraf
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sarah Taylor
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | - Ariel A Salas
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
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Slayter EM, Kattari SK, Yakas L, Singh RCB, Goulden A, Taylor S, Wernick LJ, Simmons LD, Prince D. Beyond Ramps, Curb Cuts, and Captions: A Call for Disability Justice in Social Work. Soc Work 2022; 68:89-92. [PMID: 36409996 DOI: 10.1093/sw/swac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/18/2021] [Accepted: 11/09/2021] [Indexed: 06/16/2023]
Affiliation(s)
- Elspeth M Slayter
- PhD, MSW, MA is professor, School of Social Work, Salem State University, 352 Lafayette Street, Salem, MA 01970, USA
| | - Shanna K Kattari
- PhD, MEd, is associate professor, School of Social Work and Department of Women's and Gender Studies, University of Michigan, Ann Arbor, MI, USA
| | - Laura Yakas
- PhD, MSW, MA, is lecturer, School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Rose C B Singh
- MSW, is a PhD candidate Memorial University of Newfoundland and Labrador, St. John's, Newfoundland, Canada
| | - Ami Goulden
- PhD, MA, MSW, is assistant professor, Memorial University of Newfoundland and Labrador, St. John's, Newfoundland, Canada
| | - Sarah Taylor
- PhD, MSW, is professor and department chair, Department of Social Work, California State University, East Bay, Hayward, CA, USA
| | - Laura J Wernick
- PhD, MSW, MPA, MA, is associate professor, School of Social Service, Fordham University, New York, NY, USA
| | - Lamont D Simmons
- PhD, MA, MSW, is assistant professor, School of Social Work, Salem State University, Salem, MA, USA
| | - Dana Prince
- PhD, MPH, is assistant professor, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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Barrie J, Taylor S, Barwell L, Cameron I. HPB P43 Stereotactic ablative radiotherapy is a safe and feasible option for non-surgical candidates with colorectal liver metastases. Br J Surg 2022. [DOI: 10.1093/bjs/znac404.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Stereotactic ablative radiotherapy (SABR) has been associated with an improvement in over-all survival in patients with oligometastatic colorectal cancer with a controlled primary tumour and one to five oligometastatic lesions. We report our centre's experience of SABR as an alternative local therapy for non-surgical candidates with colorectal liver metastases.
Methods
All patients were identified who received SABR irradiation for colorectal liver metastases in a tertiary HPB centre between June 2016 and February 2022. SABR criteria included patients with 1–3 liver metastasis with maximum tumour diameter < 6 cm, liver confined disease and a suitable performance status with pre-treatment Child-Pugh status A. A retrospective review of the patient's scans, letters and MDT outcomes was performed to analyse the pathology, indications and outcomes.
Results
18 patients with oligometastatic colorectal cancer received SABR to metastases in the liver over the study period. Five were female and 13 were male. Median age was 71. Performance status was 1 in the majority of cases (10/18). Only 2 patients had synchronous disease. 4 patients had concomitant metastatic disease to the lung and all 4 had had a lung resection. Half of the patients had a previous liver resection with 2 of these having two previous liver resections and 1 having 3 liver resections. 4/18 patients underwent SABR because they were deemed unfit for surgery, 6/18 were for anatomical indications with risk of an R1 resection and one was down to patient choice. Metastases were of median size 30 mm (9–87 mm). 89% (16/18) patients had a single metastasis, 1 patient had 2 metastases and 1 patient had 3 metastases.
Overall survival was 19 months (4–60 months). 3 patients achieved complete resolution of disease and 4 patients had partial resolution. 6 patients were deemed to have stable disease and 4 patients had disease progression. Outcome data was not available in 1 patient. Only 2/18 pa
Conclusions
We observed that SABR is feasible, well tolerated and effective in this cohort of patients. Longer-term follow up data is required to assess a survival benefit.
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Affiliation(s)
- Jenifer Barrie
- Nottingham University Hospitals , Nottingham , United Kingdom
| | - Sarah Taylor
- Nottingham University Hospitals , Nottingham , United Kingdom
| | - Lynsey Barwell
- Nottingham University Hospitals , Nottingham , United Kingdom
| | - Iain Cameron
- Nottingham University Hospitals , Nottingham , United Kingdom
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Tobita M, Fanchiang SP, Saldivar A, Taylor S, Jordan B. Complex Hallucinations in Hospitalized Rehabilitation Patients With COVID-19. Arch Rehabil Res Clin Transl 2022; 4:100234. [PMID: 36277732 PMCID: PMC9574548 DOI: 10.1016/j.arrct.2022.100234] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives To explore the characteristics of hallucinations in hospitalized rehabilitation patients with COVID-19. Design Retrospective review using medical records of patients with COVID-19 and admitted to the acute inpatient rehabilitation unit (ARU). Setting A public hospital in southern California, specializing in rehabilitation medicine. Participants: Patients with COVID-19 and hallucinations who were consecutively admitted from January 1st to April 30th, 2021. Interventions Not applicable. Main Outcome Measures Types and themes of hallucinations. Results Eight of the 37 patients (21.6%) admitted to the ARU with COVID-19 exhibited hallucinations. All were Hispanic and 7 of them were men; their average age was 56.5 (range: 38-71). Seven patients had COVID-19 pneumonia and 1 developed respiratory distress secondary to Guillain-Barre Syndrome. One patient had posterior reversible encephalopathy syndrome. The average length of stay in the intensive care unit (ICU) was 31.3 days (range: 8-48). Most of the hallucinations occurred during their ICU stay and 2 continued to their ARU stay. All recalled details of hallucinations with 7 exhibiting visual hallucinations, consistent with peduncular hallucinosis with or without auditory and/or tactile components. One patient experienced tactile hallucinations. The themes of hallucinations identified to reflect the contents of the hallucinations were patients' comfort-seeking, fearfulness, and seeing deceased family members. All patients had impaired cognition at the ARU admission but improved at discharge. Four patients had depressed mood/anxiety and 1 had depressed mood alone but without a history of psychiatric illness. ICU delirium was documented in 5 patients. The negative experience of hallucinations seemed to affect their participation of the ARU stay. Conclusions More than 20% of patients with COVID-19 who were transferred to attend inpatient rehabilitation exhibited hallucinations. It remains uncertain if these hallucinations were related to the SARS-CoV-2 infection. Multidisciplinary rehabilitation team should be aware to support patients with COVID-19 who experience hallucinations.
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Affiliation(s)
- Mari Tobita
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA,Rancho Research Institute, Downey, CA,Corresponding author Mari Tobita, MD, 7601 E Imperial Highway, Downey, CA 90242
| | - Shan-Pin Fanchiang
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA,Rancho Research Institute, Downey, CA,Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Aida Saldivar
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA
| | - Sarah Taylor
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA
| | - Barry Jordan
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA,Rancho Research Institute, Downey, CA,Department of Neurology, Keck Medicine of University of Southern California, Los Angeles, CA
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Elgohari B, Abdelhakiem M, Lesnock J, Sukumvanich P, Courtney-Brooks M, Boisen M, Berger J, Taylor S, Mahdi H, Olawaiye A, Edwards R, Beriwal S, Vargo J. Can Adjuvant Chemoradiotherapy Replace Inguinal Lymph Node Dissection after a Positive Sentinel Lymph Node Biopsy in Vulvar Cancer? Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1289] [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: 10/31/2022]
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Gama F, Rosmini S, Bandula S, Patel KP, Thornton GD, Bennett JB, Wechelakar A, Gillmore JD, Whelan C, Lachmann H, Taylor S, Fontana M, Moon J, Hawkins PN, Treibel T. Extracellular volume fraction by computed tomography predicts long-term prognosis among patients with cardiac amyloidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
This study sought to investigate the association of extracellular volume fraction by computed tomography (ECVCT), myocardial remodeling and mortality in patients with systemic amyloidosis.
Background
Light chain (AL) and transthyretin (ATTR) amyloid fibrils are deposited in the extracellular space of the myocardium, resulting in heart failure and premature mortality. Extracellular expansion can be quantified by CT, offering a rapid and cost-effective alternative to cardiovascular magnetic resonance (CMR), especially among patients with cardiac devices or on renal dialysis.
Methods
Patients with confirmed systemic amyloidosis and varying degrees of cardiac involvement underwent ECG-gated cardiac CT. ECVCT was analysed in the inter-ventricular septum. All patients also underwent clinical assessment, ECG, echocardiography, serum amyloid protein component (SAP) and/or technetium-99m (99mTc) 3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy. ECVCT was compared across different extents of cardiac infiltration (ATTR Perugini Grade / AL Mayo Class) and evaluated for its association with myocardial remodelling and all-cause mortality.
Results
72 patients were studied (AL n=35, ATTR n=37; age 67 (59–76) years, 71% males). Mean septal ECVCT was 42.7±13.1% and 55.8±10.9% in AL and ATTR, respectively, and correlated with indexed left ventricular (LV) mass (r=0.426, p<0.001), LV ejection fraction [LVEF, (r=0.460, p<0.001)], NT-proBNP (r=0.563, p<0.001) and hsTnT (r=0.546, p=0.02). ECVCT increased with cardiac amyloid involvement in both AL and ATTR (Figure 1). Over a mean follow-up of 5.3±2.4 years, 40 deaths occurred (AL 14 [35%]; ATTR 26 [65%]). ECVCT was independently associated with all-cause mortality in ATTR (not AL) after adjustment for age and IV septal wall thickness (HR: 1.046, 95% CI: 1.003–1.090, p=0.037).
Conclusion
Cardiac amyloid burden quantified by ECVCT is associated with adverse cardiac remodelling as well as all-cause mortality among ATTR amyloid patients. ECVCT may address the need for better identification and risk stratification of amyloid patients, using a widely-accessible imaging modality (Figure 2).
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Gama
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - S Rosmini
- Barts Heart Centre , London , United Kingdom
| | - S Bandula
- University College of London , London , United Kingdom
| | - K P Patel
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - G D Thornton
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - J B Bennett
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - A Wechelakar
- Queen Mary University of London , London , United Kingdom
| | - J D Gillmore
- Queen Mary University of London , London , United Kingdom
| | - C Whelan
- University College of London , London , United Kingdom
| | - H Lachmann
- Queen Mary University of London , London , United Kingdom
| | - S Taylor
- University College of London , London , United Kingdom
| | - M Fontana
- University College of London , London , United Kingdom
| | - J Moon
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
| | - P N Hawkins
- Queen Mary University of London , London , United Kingdom
| | - T Treibel
- Barts Heart Centre, St Bartholomew's Hospital, Cardiac imaging , London , United Kingdom
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Roberts LR, Do NT, Panizzo VN, Taylor S, Watts M, Hamilton E, McGowan S, Trinh DA, Leng MJ, Salgado J. In flux: Annual transport and deposition of suspended heavy metals and trace elements in the urbanised, tropical Red River Delta, Vietnam. Water Res 2022; 224:119053. [PMID: 36088771 DOI: 10.1016/j.watres.2022.119053] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Due to the depositional environment, river deltas are said to act as filters and sinks for pollutants. However, many deltas are also densely populated and rapidly urbanizing, creating new and increased sources of pollutants. These sources pose the risk of tipping these environments from pollution sinks to sources, to the world's oceans. We provide detailed seasonal and annual assessments of metal contaminants in riverine suspended particulate matter (SPM) across the densely populated Red River Delta (RRD), Vietnam. The global contributions of elements from the RRD are all <0.2% with many elemental fluxes <0.01%, suggesting the RRD is not a major source of elemental pollution to the ocean. However, 'hotspots' of metal pollution due to human activity and the impacts of tropical storm Son Tinh (July 2018) exceed both national level regulations and international measures of toxicity (e.g. enrichment factors). There is widespread 'extreme pollution' of Cd (enrichment factor >40) and concentrations of As higher than national regulation limits (>17 mg/Kg) at all sites other than one upstream, agricultural-dominated tributary in the dry season. These 'hotspots' are characterised by high inputs of organic matter (e.g. manure fertiliser and urban wastewater), which influences elemental mobility in the particulate and dissolved phases, and are potentially significant sources of pollution downstream. In addition, in the marine and fresh water mixing zone, salinity effects metal complexation with organic matter increasing metals in the particulate phase. Our calculations indicate that the delta is currently acting as a pollutant sink (as determined by high levels of pollutant deposition ∼50%). However, increased in-washing of pollutants and future projected increases in monsoon intensity, saline intrusion, and human activity could shift the delta to become a source of toxic metals. We show the importance of monitoring environmental parameters (primarily dissolved organic matter and salinity) in the RRD to assess the risk of transport and accumulation of toxic metals in the delta sediments, which can lead to net-increases in anthropogenic pollution in the coastal zone and the incorporation of toxic elements in the food chain.
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Affiliation(s)
- Lucy R Roberts
- Centre for Environmental Geochemistry, School of Geography, University of Nottingham, Nottingham, NG7 2RD, UK; Department of Ecoscience, Aarhus University, C. F. Møllers Allé 4-6, 8000 Aarhus, Denmark.
| | - Nga T Do
- Nuclear Training Center, Vietnam Atomic Energy Institute, 140 Nguyen Tuan, Thanh Xuan, Hanoi, Vietnam; Electric Power University, 235 Hoang Quoc Viet, Cau Giay, Hanoi, Vietnam
| | - Virginia N Panizzo
- Centre for Environmental Geochemistry, School of Geography, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Sarah Taylor
- Centre for Environmental Geochemistry, School of Geography, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Michael Watts
- British Geological Survey, Keyworth, Nottingham, NG12 5GG, UK
| | - Elliot Hamilton
- British Geological Survey, Keyworth, Nottingham, NG12 5GG, UK
| | - Suzanne McGowan
- Centre for Environmental Geochemistry, School of Geography, University of Nottingham, Nottingham, NG7 2RD, UK; Department of Aquatic Ecology, Netherlands Institute of Ecology, Droevendaalsesteeg 10, 6708 PB Wageningen, The Netherlands
| | - Duc A Trinh
- Nuclear Training Center, Vietnam Atomic Energy Institute, 140 Nguyen Tuan, Thanh Xuan, Hanoi, Vietnam
| | - Melanie J Leng
- National Environmental Isotope Facility, British Geological Survey, Keyworth, Nottingham, NG12 5GG, UK; Centre for Environmental Geochemistry, School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK
| | - Jorge Salgado
- Centre for Environmental Geochemistry, School of Geography, University of Nottingham, Nottingham, NG7 2RD, UK
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Rodrigues JCL, O'Regan T, Darekar A, Taylor S, Goh V. Current pressure on the UK imaging workforce deters imaging research in the NHS and requires urgent attention. Clin Radiol 2022; 77:913-919. [PMID: 36167569 DOI: 10.1016/j.crad.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/08/2022] [Accepted: 07/15/2022] [Indexed: 11/25/2022]
Abstract
Medical imaging is a multidisciplinary specialty, combining clinical expertise from medical physics, radiography, and radiology, and plays a key role in patient care. Research is vital to ensure the care delivered to patients is evidence-based, and is a core component of clinical governance; however, there are pressures on the imaging workforce, which are significantly impeding imaging research. This commentary presents a research gap analysis pertaining to the multidisciplinary imaging workforce on behalf of the National Institute for Health Research (NIHR) Imaging Workforce Group. Data were summarised from membership surveys of the Royal College of Radiologists, Society and College of Radiographers, and Institute of Physics and Engineering in Medicine; national reports; and feedback from NIHR Clinical Research Network Imaging Champions meeting in 2020/2021. Common barriers to delivering research were found across the multidisciplinary workforce. The key issues were lack of staff, lack of time, and lack of funding to backfill clinical services. Given the ongoing workforce shortages and increasing clinical demands on radiologists, diagnostic radiographers, and medical physicists, these issues must be tackled with a high priority to ensure the future of clinical research within the NHS.
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Affiliation(s)
- J C L Rodrigues
- Department of Radiology, Royal United Hospitals Bath NHS Foundation Trust and Department of Health, University of Bath, Bath, UK.
| | - T O'Regan
- Society and College of Radiographers, UK
| | - A Darekar
- Department of Medical Physics, University Hospital Southampton NHS Trust, Southampton, UK
| | - S Taylor
- Centre for Medical Imaging, University College London and Department of Radiology, University College Hospital NHS Foundation Trust, London, UK
| | - V Goh
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London and Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK
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Bai S, Taylor S, Jamalruddin MA, McGonigal S, Grimley E, Yang D, Bernstein KA, Buckanovich RJ. Targeting Therapeutic Resistance and Multinucleate Giant Cells in CCNE1-Amplified HR-Proficient Ovarian Cancer. Mol Cancer Ther 2022; 21:1473-1484. [PMID: 35732503 PMCID: PMC9452459 DOI: 10.1158/1535-7163.mct-21-0873] [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: 10/26/2021] [Revised: 03/30/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022]
Abstract
Approximately 20% of high-grade serous ovarian cancers (HGSOC) have CCNE1 amplification. CCNE1-amplified tumors are homologous recombination (HR) proficient and resistant to standard therapies. Therapy resistance is associated with increased numbers of polyploid giant cancer cells (PGCC). We sought to identify new therapeutic approaches for patients with CCNE1-amplified tumors. Using TCGA data, we find that the mTOR, HR, and DNA checkpoint pathways are enriched in CCNE1-amplified ovarian cancers. Furthermore, Interactome Mapping Analysis linked the mTOR activity with upregulation of HR and DNA checkpoint pathways. Indeed, we find that mTOR inhibitors (mTORi) downregulate HR/checkpoint genes in CCNE1-amplified tumors. As CCNE1-amplified tumors are dependent on the HR pathway for viability, mTORi proved selectively effective in CCNE1-amplified tumors. Similarly, via downregulation of HR genes, mTORi increased CCNE1-amplifed HGSOC response to PARPi. In contrast, overexpression of HR/checkpoint proteins (RAD51 or ATR), induced resistance to mTORi. In vivo, mTORi alone potently reduced CCNE1-amplified tumor growth and the combination of mTORi and PARPi increased response and tumor eradication. Tumors treated with mTORi demonstrated a significant reduction in ALDH+ PGCCs. Finally, as a proof of principle, we identified three patients with CCNE1 amplified tumors who were treated with an mTORi. All three obtained clinical benefits from the therapy. Our studies and clinical experience indicate mTORi are a potential therapeutic approach for patients with CCNE1-amplified tumors.
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Affiliation(s)
- Shoumei Bai
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, UPMC Hillman Cancer Center and the Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sarah Taylor
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, UPMC Hillman Cancer Center and the Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mohd Azrin Jamalruddin
- Dept of Microbiology and Molecular. Genetics, University of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Stacy McGonigal
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, UPMC Hillman Cancer Center and the Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Edward Grimley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, UPMC Hillman Cancer Center and the Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dongli Yang
- Department of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kara A. Bernstein
- Dept of Microbiology and Molecular. Genetics, University of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Ronald J. Buckanovich
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, UPMC Hillman Cancer Center and the Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Morgan R, Clamp A, Barnes B, Schlecht H, Yarram-Smith L, Wallis Y, Morgan S, Valganon M, Hudson E, McKenna S, Sundar S, Nicum S, Brenton J, Kristeleit R, Banerjee S, McNeish I, Ledermann J, Taylor S, Evans G, Jayson G. 575P Homologous recombination deficiency in newly diagnosed FIGO stage III/IV high-grade serous or endometrioid ovarian cancer: A multi-national observational study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.703] [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: 11/17/2022] Open
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Herbold J, Rajaraman D, Taylor S, Agayby K, Babyar S. Activity Measure for Post-Acute Care “6-Clicks” Basic Mobility Scores Predict Discharge Destination After Acute Care Hospitalization in Select Patient Groups: A Retrospective, Observational Study. Arch Rehabil Res Clin Transl 2022; 4:100204. [PMID: 36123982 PMCID: PMC9482026 DOI: 10.1016/j.arrct.2022.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A standardized Basic Mobility score of 42.9 predicts home vs institution discharge. Orthopedic diagnoses may have a cutoff score of 41.5 to predict home discharge. Cutoff scores vary by diagnostic group and discharge destination. Cutoff scores vary by time of assessment relative to admission for some diagnoses.
Objectives To establish cutoff scores for the Activity Measure for Post-Acute Care “6-Clicks” standardized Basic Mobility scores (sBMSs) for predicting discharge destination after acute care hospitalization for diagnostic subgroups within an acute care population and to evaluate the need for a second score to improve predictive ability. Design Retrospective, observational design. Setting Major medical center in metropolitan area. Participants Electronic medical records of 1696 adult patients (>18 years) admitted to acute care from January to October 2018. Records were stratified by orthopedic, cardiac, pulmonary, stroke, and other neurological diagnoses (N=1696). Interventions: None Main Outcome Measure Physical therapists scored patients’ sBMSs after referral for physical therapy and prior to discharge. Receiver operating characteristic curves delineated sBMS cutoff scores distinguishing various pairings of home, home with services, inpatient rehabilitation, or skilled nursing facility discharges. First and second sBMSs were compared with percentage change of the area under the curve and inferential statistics. Results Home vs institution cutoff score was 42.88 for combined sample, pulmonary and neurological cases. The cutoff score for orthopedic diagnoses score was 41.46. Cardiac and stroke model quality invalidated cutoff scores. Home without services vs skilled nursing discharges and home with services vs skilled nursing discharges were predicted with varying cutoff scores per diagnosis. sBMS cutoff scores collected closer to discharge were either the same or higher than first cutoffs, with varying effects on predictive ability. Conclusions sBMSs can help decide institution vs home discharge and finer distinctions among discharge settings for some diagnostic groups. A single sBMS may provide sufficient assistance with discharge destination decisions but timing of scoring and diagnostic group may influence cutoff score selection.
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Affiliation(s)
- Janet Herbold
- Post Acute Services, Burke Rehabilitation Hospital, White Plains, NY
| | - Divya Rajaraman
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Sarah Taylor
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Kirollos Agayby
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Suzanne Babyar
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
- Corresponding author Suzanne Babyar, PT, PhD, Department of Physical Therapy, Hunter College, The City University of New York, 425 East 25th Street, New York, NY 10010.
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Bucktrout SL, Banovich NE, Butterfield LH, Cimen-Bozkus C, Giles JR, Good Z, Goodman D, Jonsson VD, Lareau C, Marson A, Maurer DM, Munson PV, Stubbington M, Taylor S, Cutchin A. Advancing T cell-based cancer therapy with single-cell technologies. Nat Med 2022; 28:1761-1764. [PMID: 36127419 DOI: 10.1038/s41591-022-01986-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Nicholas E Banovich
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | | | - Cansu Cimen-Bozkus
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Josephine R Giles
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Zinaida Good
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Stanford Cancer Institute and Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Daniel Goodman
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Microbiology and Immunology, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Vanessa D Jonsson
- Department of Applied Mathematics, University of California, Santa Cruz, Santa Cruz, CA, USA
- Department of Biomolecular Engineering, University of California, Santa Cruz, Santa Cruz, CA, USA
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Caleb Lareau
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Alexander Marson
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
- Gladstone-UCSF Institute for Genomic Immunology, San Francisco, CA, USA
| | - Deena M Maurer
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
| | - Paul V Munson
- Parker Institute of Cancer Immunotherapy, San Francisco, CA, USA
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Orellana T, Kim H, Berger J, Bhargava R, Boisen M, Buckanovich R, Coffman L, Courtney-Brooks M, Edwards R, Mahdi H, Olawaiye A, Sukumvanich P, Taylor S, Smith K, Beriwal S, Lesnock J. Cost-effectiveness analysis of tumor molecular testing in stage III endometrial cancer (089). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01314-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Simpson C, Taylor S. Could Alveogyl cause nerve injury? Br Dent J 2022; 233:245. [PMID: 36028664 DOI: 10.1038/s41415-022-4930-2] [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: 11/09/2022]
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Garrett A, Wield A, Mumford B, Janmey I, MacArthur E, Edwards R, Mahdi H, Courtney-Brooks M, Buckanovich R, Coffman L, Olawaiye A, Sukumvanich P, Boisen M, Berger J, Taylor S, Lesnock J. Clinical factors associated with failed sentinel lymph node mapping in endometrial cancer (527). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01748-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mumford B, Mumford B, Lemon L, Taylor S. CA-125 monitoring in gynecologic cancer patients with COVID-19: A case series (413). Gynecol Oncol 2022. [PMCID: PMC9462872 DOI: 10.1016/s0090-8258(22)01635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Wield A, Liu A, McGough C, Berger J, Boisen M, Coffman L, Edwards R, Courtney-Brooks M, Lesnock J, Olawaiye A, Sukumvanich P, Buckanovich R, Mahdi H, Taylor S. BRCA/HRD genetic status does not increase toxicity to PARP inhibitors or next-line cytotoxic chemotherapy in women with epithelial ovarian cancer (479). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01700-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Folsom SM, Mumford B, Lemon L, Taylor S. CA-125 monitoring in gynecologic cancer patients with COVID-19: A case series. Gynecol Oncol Rep 2022; 42:101029. [PMID: 35747786 PMCID: PMC9212932 DOI: 10.1016/j.gore.2022.101029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Susan M. Folsom
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States
- Corresponding author.
| | - Brigid Mumford
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States
| | - Lara Lemon
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States
- University of Pittsburgh Medical Center, Department of Clinical Analytics, United States
| | - Sarah Taylor
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States
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Radolec M, Olawaiye A, Sukumvanich P, Taylor S, Soong TR, Mai P, Buckanovich R, Berger J, Boisen M, Coffman L, Courtney-Brooks M, Mahdi H, Edwards R, Lesnock J. Clinical and genetic findings of incidental serous tubal intraepithelial carcinoma (145). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01372-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Radolec M, Orr B, Strange M, Zhang L, Mahdi H, Taylor S, Willis G, Edwards R, Vlad A. Abstract 6134: Combined loco-regional and systemic, triple agent chemoimmunotherapy increases biomarkers of T cell chemotaxis in ovarian cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-6134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Rationale: Most ovarian tumors show some level of infiltration by T lymphocytes, and increasing levels of tumor-infiltrating lymphocytes (TIL) correlate with improved outcomes. The field of cancer immunotherapy has rapidly evolved and made a significant impact on many tumor types, including gynecologic cancers. However, single agent immune therapies have not yet demonstrated significant clinical success in epithelial ovarian cancer (EOC). We hypothesize that a combination of intraperitoneal (IP) chemotherapy (cisplatin) with dual agent immunotherapy using intravenous (IV) pembrolizumab (anti-PD1) and IP rintatolimod (TLR-3 agonist) will help overcome immune suppressive mechanisms for improved tumor response by promoting increased T cell chemotaxis and cytolytic function.
Methods: To test our hypothesis, we are running an investigator initiated, phase II, single arm, efficacy/safety trial (NCT03734692). Peritoneal fluid aspiration (IP wash) was performed in 13 patients at multiple time points during each cycle of treatment. Washes were collected on Days 1-3 of each cycle, before and after each treatment. Washes from cycle 1, 4 and 6, were included in this analysis. The MesoScale Delivery (MSD) platform was used to profile different biomarkers in the peritoneal samples throughout treatment.
Results: In this ongoing Phase II study, a total of 17 patients were enrolled and 13 were evaluable for response. The observed clinical responses were: 2 complete responses (15.4%), 3 partial responses (23.1%), 3 stable disease (23.1%), 5 progressions (38.4%) for an clinical benefit rate (CR+PR+SD) of 61.6%. From 13 patients, 7 IP wash samples were collected at serial time points. MSD measurements in IP washes revealed an acute increase in granzyme B, perforin, TNF alpha, CXCL9, CXCL10, CXCL11 after treatment (p<0.05). Longitudinal data revealed a progressive increase in some biomarkers in the locoregional environment; CXCL9, CXCL10, CXCL11, perforin and TNF alpha were all increased from baseline levels at cycle 1 to baseline of cycle 6 (p<0.05). CXCL12 was also increased acutely after treatment (p<0.05).
Discussion: This is a novel, triple drug combination for EOC that leads to a locoregional acute response with an increase in biomarkers associated with T cell chemotaxis and cytolytic function. Longitudinal comparison of these biomarkers showed a gradual, durable response over time in T lymphotactic CXCR3 ligands. While an acute response was also noted in CXCL12, a marker of secondary suppression, a progressive increase over time was not detected. While these are interim analyses and ongoing evaluation of additional samples from the trial are needed to confirm our findings, the preliminary results show promise for novel treatment regimen.
Citation Format: Mackenzy Radolec, Brian Orr, Mary Strange, Lixin Zhang, Haider Mahdi, Sarah Taylor, Gregory Willis, Robert Edwards, Anda Vlad. Combined loco-regional and systemic, triple agent chemoimmunotherapy increases biomarkers of T cell chemotaxis in ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6134.
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Affiliation(s)
| | - Brian Orr
- 2Medical University of South Carolina, Charleston, SC
| | - Mary Strange
- 1Magee Women's Research Institute, Pittsburgh, PA
| | - Lixin Zhang
- 1Magee Women's Research Institute, Pittsburgh, PA
| | | | | | | | | | - Anda Vlad
- 1Magee Women's Research Institute, Pittsburgh, PA
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Perets R, Gutierrez M, Rha SY, Taylor S, Stein B, Jimeno A, Winer I, Chen D, Keenan T, Rajasagi M, Lala M, Healy J, Shapira-Frommer R. Abstract CT180: Safety and efficacy of vibostolimab (vibo) plus pembrolizumab (pembro) and coformulation of vibo/pembro in ovarian cancer naive to PD-1/PD-L1 inhibitors. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-ct180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The anti-TIGIT antibody vibo in combination with pembro has shown promising antitumor activity in anti-PD-1/PD-L1-naive NSCLC. In the ongoing phase 1 trial (NCT02964013), we evaluated the safety and efficacy of these drugs given in combination (vibo + pembro) or as a coformulation (vibo/pembro) for the treatment of ovarian cancer naive to PD-1/PD-L1 inhibitors.
Methods: Patients had locally advanced unresectable or metastatic ovarian cancer naive to PD-1/PD-L1 inhibitors that progressed after ≥1 line of therapy, including platinum therapy. Patients were nonrandomly assigned to receive vibo (200 mg IV Q3W) + pembro (200 mg IV Q3W) or as the coformulation (vibo/pembro) at the same dose for ≤35 cycles (~2 years) or until disease progression (PD), toxicity, or patient withdrawal. Primary end points were safety and tolerability. Secondary and exploratory end points included PK, objective response rate (ORR), duration of response (DOR), and progression-free survival (PFS) by investigator review per RECIST v1.1. PD-L1 positivity was defined as a combined positive score (CPS) of ≥1 or when CPS was missing, as a tumor proportion score of ≥1% or as a mononuclear immune cell density score of ≥2.
Results: Of 61 patients enrolled, 21 received vibo + pembro, and 40 received vibo/pembro. Median age was 58 years; 48% of patients had ECOG performance status 1, 15% had BRCA1 and/or BRCA2 mutations, 87% received ≥2 lines of prior therapy (66%, bevacizumab; 41%, PARP inhibitor), and 74% had platinum-resistant disease (PD <6 months after platinum). PD-L1 status was positive in 21 patients, negative in 31 patients, and unknown in 9 patients. Median follow-up was 13 months (range, 9-15). Treatment-related adverse events (TRAEs) occurred in 79% of all patients; 13% were grade 3 or 4. No deaths due to TRAEs were reported. The most common TRAEs (≥20%) were fatigue (23%), pruritus (23%), and rash (20%). PK exposure was similar between treatment groups. ORR was 8% (95% CI, 3-18) in all patients and 24% (95% CI, 8-47) in patients with PD-L1-positive tumors. Median DOR was 19 months (range, 4-19). The disease control rate at 6 months was 11% (95% CI, 5-22) in all patients and 24% (95% CI, 8-47) in patients with PD-L1-positive tumors. Median PFS was 2 months (95% CI, 2-2) in all patients and 2 months (95% CI, 2-8) in patients with PD-L1-positive tumors.
Conclusions: Safety and PK were comparable with vibo + pembro combination and the vibo/pembro coformulation in patients with platinum-resistant locally advanced unresectable or metastatic ovarian cancer naive to PD-1/PD-L1 inhibitors. Antitumor activity was equivalent between the combination and coformulation, with responses limited to PD-L1-positive tumors. Vibo/pembro coformulation may offer a safe and convenient treatment option in these patients; further investigations of antitumor activity by PD-L1 status are needed.
Citation Format: Ruth Perets, Martin Gutierrez, Sun Young Rha, Sarah Taylor, Brian Stein, Antonio Jimeno, Ira Winer, Diana Chen, Tanya Keenan, Mohini Rajasagi, Mallika Lala, Jane Healy, Ronnie Shapira-Frommer. Safety and efficacy of vibostolimab (vibo) plus pembrolizumab (pembro) and coformulation of vibo/pembro in ovarian cancer naive to PD-1/PD-L1 inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT180.
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Affiliation(s)
- Ruth Perets
- 1Clinical Research Institute at Rambam, Rambam Medical Center and Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Sun Young Rha
- 3Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Sarah Taylor
- 4Department of Obstetrics, Gynecology and Reproductive Science, UPMC, Pittsburgh, PA
| | - Brian Stein
- 5Royal Adelaide Cancer Center and Adelaide Cancer Centre, Adelaide, Australia
| | - Antonio Jimeno
- 6Department of Medicine, University of Colorado Hospital, Aurora, CO
| | - Ira Winer
- 7Wayne State University, School of Medicine, Department of Oncology and Karmanos Cancer Institute, Department of Oncology, Division of Gynecologic Oncology, Detroit, MI
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