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Gabriel L, McVeigh T, Macmahon S, Avila Z, Donovan L, Hunt I, Draper A, Minchom A, Popat S, Davidson M, Bhosle J, Milner Watts C, Hubank M, Yuan L, O'Brien M. Familial rare EGFR-mutant lung cancer syndrome: Review of literature and description of R776H family. Lung Cancer 2024; 191:107543. [PMID: 38569279 DOI: 10.1016/j.lungcan.2024.107543] [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: 02/22/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Interest in hereditary lung cancer is increasing, in particular germline mutations in the Epidermal Growth Factor Receptor (EGFR) gene. We review the current literature on this topic, discuss risk of developing lung cancer, treatment and screening options and describe a family of 3 sisters with lung cancer and their unaffected mother all with a rare EGFR germline mutation (EGFR p.R776H). METHODS We searched PubMed, Medline, Embase, the Cochrane Library, Google Scholar and scanned reference lists of articles. Search terms included "EGFR germline" and "familial lung cancer" or "EGFR familial lung cancer". We also describe our experience of managing a family with rare germline EGFR mutant lung cancer. RESULTS Although the numbers are small, the described cases in the literature show several similarities. The patients are younger and usually have no or light smoking history. 50% of the patients were treated with a tyrosine kinase inhibitor (TKIs) with OS over six months. CONCLUSION Although rare, germline p.R776H EGFR lung cancer mutations are over-represented in light or never smoking female patients who often also possess an additional somatic EGFR mutation. Treatment with TKIs appears suitable but further research is needed into the appropriate screening regime for unaffected carriers or light/never smokers.
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Affiliation(s)
- L Gabriel
- Royal Marsden NHS Foundation Trust, London, England, UK.
| | - T McVeigh
- Royal Marsden NHS Foundation Trust, London, England, UK
| | - S Macmahon
- Royal Marsden NHS Foundation Trust, London, England, UK
| | - Z Avila
- St George's NHS Foundation Trust, London, England, UK
| | - L Donovan
- St George's NHS Foundation Trust, London, England, UK
| | - I Hunt
- St George's NHS Foundation Trust, London, England, UK
| | - A Draper
- St George's NHS Foundation Trust, London, England, UK
| | - A Minchom
- Royal Marsden NHS Foundation Trust, London, England, UK
| | - S Popat
- Royal Marsden NHS Foundation Trust, London, England, UK
| | - M Davidson
- Royal Marsden NHS Foundation Trust, London, England, UK
| | - J Bhosle
- Royal Marsden NHS Foundation Trust, London, England, UK
| | | | - M Hubank
- Royal Marsden NHS Foundation Trust, London, England, UK
| | - L Yuan
- Royal Marsden NHS Foundation Trust, London, England, UK
| | - Mer O'Brien
- Royal Marsden NHS Foundation Trust, London, England, UK
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Bonci EA, O’Connell R, McVeigh T, Kemp Z, George A, Cardoso MJ, Banerjee S, Gui G, Tasoulis MK. P064 Risk-reducing mastectomy in ovarian cancer patients with BRCA1/2 pathogenic variants: a comprehensive review. Breast 2023. [DOI: 10.1016/s0960-9776(23)00183-2] [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: 03/18/2023] Open
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3
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Worlikar H, Coleman S, Kelly J, O’Connor S, Murray A, McVeigh T, Doran J, McCabe I, O'Keeffe D. Mixed reality platforms in telehealth delivery: Scoping Review (Preprint). JMIR Biomedical Engineering 2022. [DOI: 10.2196/42709] [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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Copson E, McVeigh T, Frost A, Tatton-Brown K. GeNotes: a new online 'just in time' genomics resource for healthcare professionals. Future Healthc J 2022; 9:68-69. [PMID: 36310986 PMCID: PMC9601014 DOI: 10.7861/fhj.9-2-s68] [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: 11/05/2022]
Affiliation(s)
| | | | - Amy Frost
- CHealth Education England, London, UK
| | - Kate Tatton-Brown
- DSt George's University Hospitals NHS Foundation Trust, London, UK and Health Education England, London, UK
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Garrett A, Loveday C, King L, Butler S, Robinson R, Horton C, Yussuf A, Choi S, Torr B, Durkie M, Burghel GJ, Drummond J, Berry I, Wallace A, Callaway A, Eccles D, Tischkowitz M, Tatton-Brown K, Snape K, McVeigh T, Izatt L, Woodward ER, Burnichon N, Gimenez-Roqueplo AP, Mazzarotto F, Whiffin N, Ware J, Hanson H, Pesaran T, LaDuca H, Buffet A, Maher ER, Turnbull C. Quantifying evidence toward pathogenicity for rare phenotypes: The case of succinate dehydrogenase genes, SDHB and SDHD. Genet Med 2021; 24:41-50. [PMID: 34906457 PMCID: PMC8759765 DOI: 10.1016/j.gim.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 03/26/2021] [Accepted: 08/10/2021] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The weight of the evidence to attach to observation of a novel rare missense variant in SDHB or SDHD in individuals with the rare neuroendocrine tumors, pheochromocytomas and paragangliomas (PCC/PGL), is uncertain. METHODS We compared the frequency of SDHB and SDHD very rare missense variants (VRMVs) in 6328 and 5847 cases of PCC/PGL, respectively, with that of population controls to generate a pan-gene VRMV likelihood ratio (LR). Via windowing analysis, we measured regional enrichments of VRMVs to calculate the domain-specific VRMV-LR (DS-VRMV-LR). We also calculated subphenotypic LRs for variant pathogenicity for various clinical, histologic, and molecular features. RESULTS We estimated the pan-gene VRMV-LR to be 76.2 (54.8-105.9) for SDHB and 14.8 (8.7-25.0) for SDHD. Clustering analysis revealed an SDHB enriched region (ɑɑ 177-260, P = .001) for which the DS-VRMV-LR was 127.2 (64.9-249.4) and an SDHD enriched region (ɑɑ 70-114, P = .000003) for which the DS-VRMV-LR was 33.9 (14.8-77.8). Subphenotypic LRs exceeded 6 for invasive disease (SDHB), head-and-neck disease (SDHD), multiple tumors (SDHD), family history of PCC/PGL, loss of SDHB staining on immunohistochemistry, and succinate-to-fumarate ratio >97 (SDHB, SDHD). CONCLUSION Using methodology generalizable to other gene-phenotype dyads, the LRs relating to rarity and phenotypic specificity for a single observation in PCC/PGL of a SDHB/SDHD VRMV can afford substantial evidence toward pathogenicity.
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Affiliation(s)
- Alice Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Chey Loveday
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Laura King
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Samantha Butler
- Central and South Genomic Laboratory Hub, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Rachel Robinson
- North East and Yorkshire Genomic Laboratory Hub, Central Lab, The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | | | - Subin Choi
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Beth Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Miranda Durkie
- North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - George J Burghel
- The Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - James Drummond
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Ian Berry
- North East and Yorkshire Genomic Laboratory Hub, Central Lab, The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Andrew Wallace
- The Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Alison Callaway
- Central and South Genomics Laboratory Hub, Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury District Hospital, Salisbury, United Kingdom
| | - Diana Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; East Anglian Medical Genetics Unit, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - Katrina Tatton-Brown
- St. George's University, London, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Katie Snape
- St. George's University, London, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Terri McVeigh
- Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Louise Izatt
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Emma R Woodward
- Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), Manchester University NHS Foundation Trust, Manchester, United Kingdom; Division of Evolution and Genomic Sciences, School of Biological Sciences, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, United Kingdom
| | - Nelly Burnichon
- University of Paris, PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France; Genetics Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Anne-Paule Gimenez-Roqueplo
- University of Paris, PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France; Genetics Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Francesco Mazzarotto
- National Heart and Lung Institute and MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom; Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Nicola Whiffin
- The Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; The Centre for Personalised Medicine, St Anne's College, University of Oxford, Oxford, United Kingdom
| | - James Ware
- National Heart and Lung Institute and MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom; Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Helen Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | | | - Alexandre Buffet
- University of Paris, PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France; Genetics Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Eamonn R Maher
- Department of Medical Genetics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom.
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Monahan KJ, Lincoln A, East JE, Benton S, Burn J, DeSouza B, Hanson H, Lalloo F, McVeigh T, Rutter MD, Snape K, Thomas HJW, Sasieni P. Management strategies for the colonoscopic surveillance of people with Lynch syndrome during the COVID-19 pandemic. Gut 2021; 70:624-626. [PMID: 32571974 DOI: 10.1136/gutjnl-2020-321993] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Kevin J Monahan
- The Lynch Syndrome and Family Cancer Clinic, St Mark's Hospital and Academic Institute, Harrow, London, UK
- Imperial College London, London, UK
| | - Anne Lincoln
- Comprehensive Cancer Centre, King's College London, London, UK
| | - James E East
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
| | - Sally Benton
- NHS Bowel Cancer Screening South of England Hub, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK
| | - John Burn
- Institute of Human Genetics, Newcastle upon Tyne, UK
| | - Bianca DeSouza
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Helen Hanson
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Fiona Lalloo
- Genetic Medicine, Central Manchester University Hospitals Foundation Trust, Manchester, UK
| | - Terri McVeigh
- Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Matthew D Rutter
- Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katie Snape
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Huw J W Thomas
- The Lynch Syndrome and Family Cancer Clinic, St Mark's Hospital and Academic Institute, Harrow, London, UK
- Imperial College London, London, UK
| | - Peter Sasieni
- Comprehensive Cancer Centre, King's College London, London, UK
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Ahmed K, McVeigh T, Cerneviciute R, Mohamed S, Tubassam M, Karim M, Walsh S. Effectiveness of contrast-associated acute kidney injury prevention methods; a systematic review and network meta-analysis. BMC Nephrol 2018; 19:323. [PMID: 30424723 PMCID: PMC6234687 DOI: 10.1186/s12882-018-1113-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 10/22/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Different methods to prevent contrast-associated acute kidney injury (CA-AKI) have been proposed in recent years. We performed a mixed treatment comparison to evaluate and rank suggested interventions. METHODS A comprehensive Systematic review and a Bayesian network meta-analysis of randomised controlled trials was completed. Results were tabulated and graphically represented using a network diagram; forest plots and league tables were shown to rank treatments by the surface under the cumulative ranking curve (SUCRA). A stacked bar chart rankogram was generated. We performed main analysis with 200 RCTs and three analyses according to contrast media and high or normal baseline renal profile that includes 173, 112 & 60 RCTs respectively. RESULTS We have included 200 trials with 42,273 patients and 44 interventions. The primary outcome was CI-AKI, defined as ≥25% relative increase or ≥ 0.5 mg/dl increase from baseline creatinine one to 5 days post contrast exposure. The top ranked interventions through different analyses were Allopurinol, Prostaglandin E1 (PGE1) & Oxygen (0.9647, 0.7809 & 0.7527 in the main analysis). Comparatively, reference treatment intravenous hydration was ranked lower but better than Placebo (0.3124 VS 0.2694 in the main analysis). CONCLUSION Multiple CA-AKI preventive interventions have been tested in RCTs. This network evaluates data for all the explored options. The results suggest that some options (particularly allopurinol, PGE1 & Oxygen) deserve further evaluation in a larger well-designed RCTs.
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Affiliation(s)
- Khalid Ahmed
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland. .,Department of Vascular surgery, Galway University Hospital, Galway, Republic of Ireland.
| | - Terri McVeigh
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland
| | - Raminta Cerneviciute
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland
| | - Sara Mohamed
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland
| | - Mohammad Tubassam
- Department of Vascular surgery, Galway University Hospital, Galway, Republic of Ireland
| | - Mohammad Karim
- School of Population and Public Health, University of British Columbia, Scientist / Biostatistician, Centre for Health Evaluation and Outcome Sciences (CHEOS), St. Paul's Hospital, Vancouver, Canada
| | - Stewart Walsh
- Lambe Institute for Translational Research, Discipline of Surgery National University of Ireland, Galway, Republic of Ireland.,Department of Vascular surgery, Galway University Hospital, Galway, Republic of Ireland.,HRB Clinical Research Facility Galway, Galway, Republic of Ireland
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Sundar R, McVeigh T, Dolling D, Petruckevitch A, Diamantis N, Ang JE, Chenard-Poiriér M, Collins D, Lim J, Ameratunga M, Khan K, Kaye SB, Banerji U, Lopez J, George AJ, de Bono JS, van der Graaf WT. Clinical outcomes of adolescents and young adults with advanced solid tumours participating in phase I trials. Eur J Cancer 2018; 101:55-61. [PMID: 30025230 DOI: 10.1016/j.ejca.2018.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 04/27/2018] [Accepted: 06/12/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) patients with advanced solid tumours are often considered for phase I clinical trials with novel agents. The outcome of AYAs in these trials have not been described before. AIM To study the outcome of AYA patients in phase I clinical trials. METHODS Clinical trial data of AYAs (defined as aged 15-39 years at diagnosis) treated at the Drug Development Unit, Royal Marsden Hospital, between 2002 and 2016, were analysed. RESULTS From a prospectively maintained database of 2631 patients treated in phase I trials, 219 AYA patients (8%) were identified. Major tumour types included gynaecological cancer (25%) and sarcoma (18%). Twenty-five (11%) had a known hereditary cancer syndrome (most commonly BRCA). Molecular characterisation of tumours (n = 45) identified mutations most commonly in TP53 (33%), PI3KCA (18%) and KRAS (9%). Therapeutic targets of trials included DNA damage repair (16%), phosphoinositide 3-kinase (PI3K) (16%) and angiogenesis (16%). Grade 3/4 toxicities were experienced in 26% of patients. Of the 214 evaluable patients, objective response rate was 12%, with clinical benefit rate at 6 months of 22%. Median overall survival (OS) was 7.5 months (95% confidence interval: 6.3-9.5), and 2-year OS was 11%. Of patients with responses, 36% were matched to phase I trials based on germline or somatic genetic aberrations. CONCLUSION We describe the outcome of the largest cohort of AYA patients treated in phase I trials. A subgroup of these patients demonstrates benefit, with several durable responses beyond 2 years. A sizeable proportion of AYA patients have cancer syndromes, significant family history or somatic molecular aberrancies which may influence novel therapeutic treatment options.
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Affiliation(s)
- Raghav Sundar
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK; National University Health System, Singapore
| | - Terri McVeigh
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - David Dolling
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Ann Petruckevitch
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Nikolaos Diamantis
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Joo Ern Ang
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Maxime Chenard-Poiriér
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Dearbhaile Collins
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Joline Lim
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK; National University Health System, Singapore
| | - Malaka Ameratunga
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Khurum Khan
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Stan B Kaye
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Udai Banerji
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Juanita Lopez
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Angela J George
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK; Gynaecology Unit, The Royal Marsden NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Johann S de Bono
- Drug development Unit, The Royal Marsden Hospital NHS Foundation Trust, The Institute of Cancer Research, London, UK
| | - Winette T van der Graaf
- Sarcoma Unit, The Royal Marsden NHS Foundation Trust, The Institute of Cancer Research, London, UK.
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McVeigh U, McVeigh T, Miller N, Morris D, Kerin M. PO-343 Targeted resequencing identifies novel and ultra-rare high-impact variants in breast cancer susceptibility genes in an Irish population. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.373] [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: 11/03/2022] Open
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Abstract
Genetics is the backbone of Neurology, where a number of disorders have a genetic aetiology and are complex, requiring a dedicated Neurogenetics clinic. Genetics in the Republic of Ireland is under-resourced, with the lowest number of consultants per million of population in Europe. In November 2014, we established the monthly adult Neurogenetics clinic in Ireland, staffed by 2 consultants and 2 registrars from each speciality. We see patients with complex rare neurological conditions that may potentially have an underlying genetic basis, in the presence or absence of a family history. We performed a retrospective cohort analysis, reviewing symptoms and work-up data. Twenty-seven patients attended a pilot clinic over 12 months. Conditions encountered included Parkin-related PD, leucodystrophy, ataxia, fronto-temporal lobar degeneration, spinocerebellar ataxia type 6 (SCA6) and ataxia-telangiectasia. Identification of pathogenic mutations directed screening, treatment and facilitated onward genetic counselling (n = 10, 33%). A number of novel mutations were identified in MAPT gene ("missing tau mutation" McCarthy et al., Brain, 2015), SLCA1 gene and GRN (progranulin). Phenotypic features not previously reported were seen; e.g. writer's cramp in SCA6; paroxysmal myoclonus in the glucose transporter protein type 1 (GLUT1) deficiency. Breast cancer screening for ATM mutations carriers and referral to international experts in two undiagnosed patients were arranged. The establishment of a Neurogenetics clinic has addressed a gap in service and allowed identification of rare and atypical diagnoses.
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Affiliation(s)
- Diana A Olszewska
- Department of Neurology, The Dublin Neurological Institute at the Mater Misericordiae University Hospital, 57 Eccles Street, Dublin, Ireland.
| | - Terri McVeigh
- Department of Genetics, Mater Misericordiae University Hospital, Dublin, Ireland.,Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - Emer M Fallon
- Department of Neurology, The Dublin Neurological Institute at the Mater Misericordiae University Hospital, 57 Eccles Street, Dublin, Ireland
| | - Gregory M Pastores
- National Center for Inherited Metabolic Disorders, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Tim Lynch
- Department of Neurology, The Dublin Neurological Institute at the Mater Misericordiae University Hospital, 57 Eccles Street, Dublin, Ireland
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Olszewska D, McVeigh T, Lynch T. THE EXPERIENCE OF THE FIRST ADULT NEUROGENETIC CLINIC IN IRELAND. J Neurol Neurosurg Psychiatry 2016. [DOI: 10.1136/jnnp-2016-315106.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lydon S, O'Connor P, McVeigh T, Offiah C, Byrne D. Medical speciality choice: does personality matter? Ir Med J 2015; 108:75-78. [PMID: 25876298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There has been increasing interest in the personalities of doctors. This study examined whether personality differed based upon gender, level of training or medical speciality among 200 physicians and 134 medical students. Post-internship doctors scored significantly higher on conscientiousness (p = .001) than those pursuing basic medical training. Among those pursuing basic medical training, females scored significantly higher than males on agreeableness (p < .001) and conscientiousness (p = .001). Among post-internship respondents, females scored significantly higher on agreeableness (p = .004). There were no personality differences between post-internship doctors working in different specialities. However, among those pursuing basic medical training, those interested in person-focused medical specialities scored significantly higher on extraversion (p < .001), conscientiousness (p = .001), and lower on neuroticism (p = .01) than those who had no strong preference. These results suggest that there is no unique personality profile associated with medical practice, or medical speciality. Instead, it appears that medical school may shape personality.
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Waters PS, McVeigh T, Kelly BD, Flaherty GT, Devitt D, Barry K, Kerin MJ. The acquisition and retention of urinary catheterisation skills using surgical simulator devices: teaching method or student traits. BMC Med Educ 2014; 14:264. [PMID: 25527869 PMCID: PMC4323138 DOI: 10.1186/s12909-014-0264-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 12/08/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND The acquisition of procedural skills is an essential component of learning for medical trainees. The objective of this study was to assess which teaching method of performing urinary catheterisation is associated with most efficient procedural skill acquisition and retention. We evaluated factors affecting acquisition and retention of skills when using simulators as adjuncts to medical training. METHODS Forty-two second year medical students were taught urinary catheter insertion using different teaching methods. The interactive group (n = 19) were taught using a lecture format presentation and a high fidelity human urinary catheter simulator. They were provided with the use of simulators prior to examination. The observer group (n = 12) were taught using the same method but without with simulator use prior to examination. The didactic group (n = 11) were taught using the presentation alone. Student characteristics such as hand dexterity and IQ were measured to assess for intrinsic differences. All students were examined at four weeks to measure skill retention. RESULTS Catheter scores were significantly higher in the interactive group (p < 0.005). Confidence scores with catheter insertion were similar at index exam however were significantly lower in the didactic group at the retention testing (p < 0.05). Retention scores were higher in the interactive group (p < 0.001). A significant positive correlation was observed between laparoscopy scores and time to completion with overall catheter score (p < 0.05). Teaching method, spatial awareness and time to completion of laparoscopy were significantly associated with higher catheter scores at index exam (p = 0.001). Retention scores at 4 weeks were significantly associated with teaching method and original catheter score (p = 0.001). CONCLUSION The importance of simulators in teaching a complex procedural skill has been highlighted. Didactic teaching method was associated with a significantly higher rate of learning decay at retention testing.
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Affiliation(s)
- Peadar S Waters
- Discipline of Surgery, School of medicine, National University of Ireland Galway, Galway, Ireland.
| | - Terri McVeigh
- Discipline of Surgery, School of medicine, National University of Ireland Galway, Galway, Ireland.
| | - Brian D Kelly
- Discipline of Surgery, School of medicine, National University of Ireland Galway, Galway, Ireland.
| | - Gerard T Flaherty
- Department of Medicine, School of medicine, National University of Ireland Galway, Galway, Ireland.
| | - Dara Devitt
- Discipline of Surgery, School of medicine, National University of Ireland Galway, Galway, Ireland.
| | - Kevin Barry
- Discipline of Surgery, School of medicine, National University of Ireland Galway, Galway, Ireland.
| | - Michael J Kerin
- Discipline of Surgery, School of medicine, National University of Ireland Galway, Galway, Ireland.
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Dorairaj JJ, Salzman DW, Wall D, Rounds T, Preskill C, Sullivan CAW, Lindner R, Curran C, Lezon-Geyda K, McVeigh T, Harris L, Newell J, Kerin MJ, Wood M, Miller N, Weidhaas JB. A germline mutation in the BRCA1 3'UTR predicts Stage IV breast cancer. BMC Cancer 2014; 14:421. [PMID: 24915755 PMCID: PMC4059881 DOI: 10.1186/1471-2407-14-421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 05/14/2014] [Indexed: 01/22/2023] Open
Abstract
Background A germline, variant in the BRCA1 3’UTR (rs8176318) was previously shown to predict breast and ovarian cancer risk in women from high-risk families, as well as increased risk of triple negative breast cancer. Here, we tested the hypothesis that this variant predicts tumor biology, like other 3’UTR mutations in cancer. Methods The impact of the BRCA1-3’UTR-variant on BRCA1 gene expression, and altered response to external stimuli was tested in vitro using a luciferase reporter assay. Gene expression was further tested in vivo by immunoflourescence staining on breast tumor tissue, comparing triple negative patient samples with the variant (TG or TT) or non-variant (GG) BRCA1 3’UTR. To determine the significance of the variant on clinically relevant endpoints, a comprehensive collection of West-Irish breast cancer patients were tested for the variant. Finally, an association of the variant with breast screening clinical phenotypes was evaluated using a cohort of women from the High Risk Breast Program at the University of Vermont. Results Luciferase reporters with the BRCA1-3’UTR-variant (T allele) displayed significantly lower gene expression, as well as altered response to external hormonal stimuli, compared to the non-variant 3’UTR (G allele) in breast cancer cell lines. This was confirmed clinically by the finding of reduced BRCA1 gene expression in triple negative samples from patients carrying the homozygous TT variant, compared to non-variant patients. The BRCA1-3’UTR-variant (TG or TT) also associated with a modest increased risk for developing breast cancer in the West-Irish cohort (OR = 1.4, 95% CI 1.1-1.8, p = 0.033). More importantly, patients with the BRCA1-3’UTR-variant had a 4-fold increased risk of presenting with Stage IV disease (p = 0.018, OR = 3.37, 95% CI 1.3-11.0). Supporting that this finding is due to tumor biology, and not difficulty screening, obese women with the BRCA1-3’UTR-variant had significantly less dense breasts (p = 0.0398) in the Vermont cohort. Conclusion A variant in the 3’UTR of BRCA1 is functional, leading to decreased BRCA1 expression, modest increased breast cancer risk, and most importantly, presentation with stage IV breast cancer, likely due to aggressive tumor biology.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Joanne B Weidhaas
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT 06510, USA.
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15
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Chen X, Paranjape T, Stahlhut C, McVeigh T, Keane F, Nallur S, Miller N, Kerin M, Deng Y, Yao X, Zhao H, Weidhaas JB, Slack FJ. Targeted resequencing of the microRNAome and 3'UTRome reveals functional germline DNA variants with altered prevalence in epithelial ovarian cancer. Oncogene 2014; 34:2125-37. [PMID: 24909162 DOI: 10.1038/onc.2014.117] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/26/2014] [Indexed: 12/24/2022]
Abstract
Ovarian cancer is a major cause of cancer deaths, yet there have been few known genetic risk factors identified, the best known of which are disruptions in protein coding sequences (BRCA1 and 2). Recent findings indicate that there are powerful genetic markers of cancer risk outside of these regions, in the noncoding mRNA control regions. To identify additional cancer-associated, functional non-protein-coding sequence germline variants associated with ovarian cancer risk, we captured DNA regions corresponding to all validated human microRNAs and the 3' untranslated regions (UTRs) of ~6000 cancer-associated genes from 31 ovarian cancer patients. Multiple single-nucleotide polymorphisms in the 3'UTR of the vascular endothelial growth factor receptor/FLT1, E2F2 and PCM1 oncogenes were highly enriched in ovarian cancer patients compared with the 1000 Genome Project. Sequenom validation in a case-control study (267 cases and 89 controls) confirmed a novel variant in the PCM1 3'UTR is significantly associated with ovarian cancer (P=0.0086). This work identifies a potential new ovarian cancer locus and further confirms that cancer resequencing efforts should not ignore the study of noncoding regions of cancer patients.
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Affiliation(s)
- X Chen
- 1] Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA [2] Program in Computational Biology and Bioinformatics, Yale University School of Medicine, New Haven, CT, USA
| | - T Paranjape
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - C Stahlhut
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
| | - T McVeigh
- Discipline of Surgery, National University of Ireland Galway and Galway University, Hospitals, Galway, Ireland
| | - F Keane
- Yale University School of Medicine, New Haven, CT, USA
| | - S Nallur
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - N Miller
- Discipline of Surgery, National University of Ireland Galway and Galway University, Hospitals, Galway, Ireland
| | - M Kerin
- Discipline of Surgery, National University of Ireland Galway and Galway University, Hospitals, Galway, Ireland
| | - Y Deng
- Yale Center for Analytical Sciences, Yale University School of Medicine, New Haven, CT, USA
| | - X Yao
- Yale Center for Analytical Sciences, Yale University School of Medicine, New Haven, CT, USA
| | - H Zhao
- 1] Program in Computational Biology and Bioinformatics, Yale University School of Medicine, New Haven, CT, USA [2] Department of Genetics, Yale University School of Medicine, New Haven, CT, USA [3] Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - J B Weidhaas
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - F J Slack
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
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McVeigh T, Hynes N, Tawfick W, Sultan S. Endovascular Aneurysm Repair for Multiple Aneurysms as a Sequel of Hypereosinophilic Syndrome. Vasc Endovascular Surg 2014; 48:277-80. [DOI: 10.1177/1538574413518610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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
This case represents the first report of multiple arterial aneurysms including aortic, iliac, visceral, and coronary aneurysms associated with hypereosinophilic syndrome. It presents an interesting case of epinephrine abuse and the unfortunate sequelae. This case illustrates novel approaches in emergency repair of internal iliac artery aneurysm rupture and the management of visceral artery aneurysms and exemplifies how multiple endovascular technologies can be utilized even in the high-risk polymorbid patient.
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Affiliation(s)
- T. McVeigh
- Western Vascular Institute, Department of Vascular and Endovascular Surgery, Galway University Hospital, Galway, Ireland
| | - N. Hynes
- Department of Vascular and Endovascular Surgery, Galway Clinic, Doughiska, Galway, Ireland
| | - W. Tawfick
- Western Vascular Institute, Department of Vascular and Endovascular Surgery, Galway University Hospital, Galway, Ireland
| | - S. Sultan
- Western Vascular Institute, Department of Vascular and Endovascular Surgery, Galway University Hospital, Galway, Ireland
- Department of Vascular and Endovascular Surgery, Galway Clinic, Doughiska, Galway, Ireland
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McVeigh T, Staines A, Sweeney MR, Dee AP, Perry IJ, O'Neill C, Doherty E, Callan A, Sharp L, Kearns K, O'Dwyer V, Kee F, Hughes J, Balanda K. Annual productivity losses due to co-morbidities of overweight and obesity in the Republic of Ireland. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Dee AP, Perry IJ, O’Neill C, Doherty E, Callan A, Kearns K, O’Dwyer V, Staines A, McVeigh T, Sweeney MR, Sharp L, Balanda K, Hughes J, Kee F. PP47 The Cost of Overweight and Obesity on the Island of Ireland. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McVeigh T, Al-Azawi D, Sweeney K, Malone C, Keane M, McLaughlin R, Kerin M. Investigating the impact of neoadjuvant chemotherapy and herceptin on the surgical management of patients with invasive breast cancer. Int J Surg 2012. [DOI: 10.1016/j.ijsu.2012.06.078] [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: 10/27/2022]
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20
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Raux E, McVeigh T, Peters SE, Leustek T, Warren MJ. The role of Saccharomyces cerevisiae Met1p and Met8p in sirohaem and cobalamin biosynthesis. Biochem J 1999; 338 ( Pt 3):701-8. [PMID: 10051442 PMCID: PMC1220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
MET1 and MET8 mutants of Saccharomyces cerevisiae can be complemented by Salmonella typhimurium cysG, indicating that the genes are involved in the transformation of uroporphyrinogen III into sirohaem. In the present study, we have demonstrated complementation of defined cysG mutants of Sal. typhimurium and Escherichia coli, with either MET1 or MET8 cloned in tandem with Pseudomonas denitrificans cobA. The conclusion drawn from these experiments is that MET1 encodes the S-adenosyl-l-methionine uroporphyrinogen III transmethylase activity, and MET8 encodes the dehydrogenase and chelatase activities (all three functions are encoded by Sal. typhimurium and E. coli cysG). MET8 was further cloned into pET14b to allow expression of the protein with an N-terminal His-tag. After purification, the functions of the His-tagged Met8p were studied in vitro by assay with precorrin-2 in the presence of NAD+ and Co2+. The results demonstrated that Met8p acts as a dehydrogenase and chelatase in the biosynthesis of sirohaem. Moreover, despite the fact that S. cerevisiae does not make cobalamins de novo, we have shown also that MET8 is able to complement cobalamin cobaltochelatase mutants and have revealed a subtle difference in the early stages of the anaerobic cobalamin biosynthetic pathways between Sal. typhimurium and Bacillus megaterium.
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Affiliation(s)
- E Raux
- Department of Molecular Genetics, Institute of Ophthalmology, University College London, 11-43 Bath Street, London EC1V 9EL, UK
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Abstract
The Pseudomonas aeruginosa polyvalent vaccine PEV and its 16 constituent monovalent extracts from International Antigenic Typing System serotypes 1 through 13 and 15 through 17 (J. J. Miler, J. F. Spilsbury, R. J. Jones, E. A. Roe, and E. J. L. Lowbury, J. Med. Microbiol. 10:19-27, 1977) were subjected to biochemical analysis and to detailed immunochemical analysis with rabbit anti-PEV immunoglobulins. The results of chemical analysis, of analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis performed in conjunction with silver staining, and of analysis by crossed immunoelectrophoresis, sodium dodecyl sulfate-polyacrylamide gel-crossed immunoelectrophoresis, and Western blotting showed clearly that lipopolysaccharide was a major constituent of each monovalent extract and that it was probably the dominant antigen present in at least 15 of the 16 monovalent extracts. A 16.2-kilodalton protein, which was pronase resistant and nonsedimentable at 105,000 X g and which appeared to be biochemically and antigenically unrelated to pili, was a common although minor antigen for all extracts. Several other proteins, some of outer membrane origin, were also detected in unformalinized extracts, but these were also minor antigenic constituents of the vaccine. Neither pilin nor flagellin appeared to be major protein constituents of tested monovalent extracts, although anti-flagella antibodies could be demonstrated in rabbit anti-PEV by Western blotting. Preliminary analysis by crossed immunoelectrophoresis of serum raised in volunteers to PEV also indicated the presence therein of antibodies to lipopolysaccharide antigens.
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