1
|
Amir T, Sheri A, Newby J, King J, Chopra N. 198P Complications associated with prolonged GCSF with dose-dense EC chemotherapy for early breast cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
2
|
Yang DD, Salciccioli JD, Marshall DC, Sheri A, Shalhoub J. Trends in malignant melanoma mortality in 31 countries from 1985 to 2015. Br J Dermatol 2020; 183:1056-1064. [PMID: 32133614 DOI: 10.1111/bjd.19010] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Malignant melanoma (MM) causes the highest absolute number of deaths among skin cancers. An up-to-date analysis of international MM mortality trends is required for assessing the burden of disease, and may support the assessment of the effectiveness of new diagnostic, therapeutic and preventative strategies. OBJECTIVES To report MM mortality trends between 1985 and 2015 using the World Health Organization (WHO) Mortality Database. MATERIALS AND METHODS We used country-level MM mortality data from the WHO Mortality Database for all countries with high usability death registration data. Mortality trends were described using Joinpoint regression modelling. RESULTS Thirty-one countries met the inclusion criteria. All countries, except the Czech Republic, demonstrated increased age-standardized death rates (ASDRs) in males over the observation period. More countries exhibited decreased or stable MM mortality in females. The median mortality rate for 2013-2015 was 2·57 deaths per 100 000 for males and 1·55 per 100 000 for females. Australia and Norway had the highest ASDRs for males (5·72 per 100 000 and 4·55 per 100 000, respectively). Norway and Slovenia had the highest ASDRs for females (3·02 per 100 000 and 2·58 per 100 000, respectively). MM mortality was greater for males than females in all countries, with sex disparity increasing across the period. Disparity in mortality between older and younger cohorts in several countries was also found. CONCLUSIONS An overall increase in MM mortality over the past 30 years was observed. However, there was notable variation in mortality trends between countries, as well as between males and females, and between different age groups.
Collapse
Affiliation(s)
- D D Yang
- North Central and East London Foundation School, London, UK
| | - J D Salciccioli
- Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA
| | - D C Marshall
- Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - A Sheri
- Department of Oncology, Royal Free London NHS Foundation Trust, London, UK
| | - J Shalhoub
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|
3
|
Sheri A, Smith IE, Hills M, Jones RL, Johnston SR, Dowsett M. Relationship between IHC4 score and response to neo-adjuvant chemotherapy in estrogen receptor-positive breast cancer. Breast Cancer Res Treat 2017; 164:395-400. [PMID: 28447240 PMCID: PMC5487724 DOI: 10.1007/s10549-017-4266-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 01/20/2023]
Abstract
AIMS To determine whether IHC4 score assessed on pre-treatment core biopsies (i) predicts response to neo-adjuvant chemotherapy in ER-positive (ER+) breast cancer; (ii) provides more predictive information than Ki67 alone. METHODS 113 patients with ER+ primary breast cancer treated with neo-adjuvant chemotherapy at the Royal Marsden Hospital between 2002 and 2010 were included in the study. Pathologic assessment of the excision specimen was made for residual disease. IHC4 was determined on pre-treatment core biopsies, blinded to clinical outcome, by immunohistochemistry using quantitative scoring of ER (H-score), PgR (%) and Ki67 (%). Determination of HER2 status was made by immunohistochemistry and fluorescent in situ hybridization for 2+ cases. IHC4 and Ki67 scores were tested for their association with pathological complete response (pCR) rate and residual cancer burden (RCB) score. RESULTS 18 (16%) of the 113 patients and 8 (9%) of the 88 HER2-ve cases achieved pCR. Ki67 and IHC4 score were both positively associated with achievement of pCR (P < 10-7 and P < 10-9, respectively) and RCB0+1 (P < 10-5 and P < 10-9, respectively) following neo-adjuvant chemotherapy in all patients. Rates of pCR+RCB1 were 45 and 66% in the highest quartiles of Ki67 and IHC4 scores, respectively. In ER+HER2-ve cases, pCR+RCB1 rates were 35% and in the highest quartile of both Ki67 and IHC4. There were no pCRs in the lower half of IHC4 or Ki67 scores. CONCLUSIONS IHC4 was strongly predictive of pCR or near pCR in ER+ breast cancers following neo-adjuvant chemotherapy. Ki67 was an important component of this predictive ability, but was not as predictive as IHC4.
Collapse
Affiliation(s)
- A Sheri
- Royal Free Hospital, Pond Street, London, NW3 2QG, UK.
| | - I E Smith
- Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK
| | - M Hills
- Institute of Cancer Research, Fulham Road, London, SW3 6JB, UK
| | - R L Jones
- Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK
| | - S R Johnston
- Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK
| | - M Dowsett
- Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK
- Institute of Cancer Research, Fulham Road, London, SW3 6JB, UK
| |
Collapse
|
4
|
Okonji D, Assersohn L, Rigg A, Sheri A, Parton M, Dowsett M. A Multi-institutional Study of Risk Estimates Derived from Oncotype DX. Clin Oncol (R Coll Radiol) 2017. [DOI: 10.1016/j.clon.2017.01.029] [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: 10/19/2022]
|
5
|
Sheri A, Smith IE, Johnston SR, A'Hern R, Nerurkar A, Jones RL, Hills M, Detre S, Pinder SE, Symmans WF, Dowsett M. Residual proliferative cancer burden to predict long-term outcome following neoadjuvant chemotherapy. Ann Oncol 2015; 26:75-80. [PMID: 25361988 DOI: 10.1093/annonc/mdu508] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The purpose of this study was (i) to test the hypothesis that combining Ki67 with residual cancer burden (RCB) following neoadjuvant chemotherapy, as the residual proliferative cancer burden (RPCB), provides significantly more prognostic information than either alone; (ii) to determine whether also integrating information on ER and grade improves prognostic power. PATIENTS AND METHODS A total of 220 patients treated with neoadjuvant chemotherapy for primary breast cancer were included in the study. Analyses employed a Cox proportional hazard model. Prognostic indices (PIs) were created adding in Ki67, grade and ER to RCB. Leave-one-out cross-validation was used to reduce bias. The overall change in χ(2) of the best model for each index was used to compare the prognostic ability of the different indices. RESULTS All PIs provided significant prognostic information for patients with residual disease following neoadjuvant chemotherapy. RPCB (χ(2) = 61.4) was significantly more prognostic than either RCB (χ(2) = 38.1) or Ki67 (χ(2) = 53.8) alone P < 0.001. A PI incorporating RCB, Ki67 grade and ER provided the most prognostic information overall and gave χ(2) = 73.8. CONCLUSIONS This study provides proof of principle that the addition of post-treatment Ki67 to RCB improves the prediction of long-term outcome. Prediction may be further improved by addition of post-treatment grade and ER and warrants further investigation for estimating post-neoadjuvant risk of recurrence. These indices may have utility in stratifying patients for novel therapeutic interventions after neoadjuvant chemotherapy.
Collapse
Affiliation(s)
- A Sheri
- Breast Unit, Royal Marsden Hospital, London; Academic Department of Biochemistry, Royal Marsden Hospital, London; Breakthrough Breast Cancer Research Centre, London.
| | - I E Smith
- Breast Unit, Royal Marsden Hospital, London
| | | | - R A'Hern
- Clinical Trials and Statistics Unit, Institute of Cancer Research, London
| | - A Nerurkar
- Department of Pathology, Royal Marsden Hospital, London, UK
| | - R L Jones
- Division of Medical Oncology, Seattle Cancer Care Alliance, Seattle, USA
| | - M Hills
- Academic Department of Biochemistry, Royal Marsden Hospital, London
| | - S Detre
- Academic Department of Biochemistry, Royal Marsden Hospital, London
| | - S E Pinder
- Department of Research Oncology, Kings College, London, UK
| | - W F Symmans
- Department of Pathology, M.D. Anderson Cancer Centre, USA
| | - M Dowsett
- Breast Unit, Royal Marsden Hospital, London; Academic Department of Biochemistry, Royal Marsden Hospital, London; Breakthrough Breast Cancer Research Centre, London
| |
Collapse
|
6
|
Sheri A, Smith IE, A'Hern R, Jones R, Parton M, Johnston SRD, Dowsett M. Abstract P1-08-03: Prediction of response to neoadjuvant chemotherapy in estrogen receptor positive (ER+) breast cancer by IHC4 or Ki67 alone. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-08-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Aims To determine whether IHC4 score assessed on pre-treatment core biopsies (i) predicts response to neoadjuvant chemotherapy in ER positive breast cancer; (ii) provides more predictive information than Ki67 alone.
Background The IHC4 score, a composite of ER, PgR, Ki67 and HER2 scores provides prognostic information similar to the OncotypeDx 21-gene Recurrence Score in ER + primary breast cancer treated with endocrine therapy but it is unknown if it also predicts response to chemotherapy. Pathological complete response (pCR) following neoadjuvant chemotherapy is established as an intermediate marker of long-term outcome. More recently the residual cancer burden (RCB) has also been shown to be prognostic, with those patients with minimal residual disease (RCB1) following neoadjuvant chemotherapy having a similar prognosis to those with a pCR (RCB0). The development of these intermediate markers provides an opportunity to study the predictive role of pre-treatment biomarkers for benefit to a particular therapy.
Methods A total of 114 ER+ patients treated with neoadjuvant chemotherapy at the Royal Marsden Hospital between 2002-2010 were included in the study.
An assessment of the excision specimen was made for residual disease. IHC4 was determined on pre-treatment core biopsies, blinded to clinical outcome, by immunohistochemistry using quantitative scoring of ER (H-score), PgR (%) and Ki67 (%). Determination of HER2 status was made by immunohistochemistry and fluorescent in situ hybridization for 2+ cases. IHC4 and Ki67 scores were tested for their association with pCR rate and RCB score.
Results 19 (17%) of the 114 patients and 9 (10%) of the 90 HER2-ve cases showed a pCR. Ki67 and the IHC4 score were both positively associated with achievement of pCR (P<10-7 and P<10-9 respectively) and RCB0+1 (P<10-5 and P<10-9 respectively) following neoadjuvant chemotherapy in all patients. Rates of RCB0+1 were 45% and 66% in the highest quartiles of Ki67 and IHC4 scores respectively. In ER + HER2-ve cases pCR and RCB0+ 1 rates were 35% and 39%, respectively in the highest quartile of IHC4 and 30% and 39%, respectively in the highest quartile of Ki67 (Table 1). There were no pCRs in the lower half of IHC4 or Ki67 scores.
Conclusions A high IHC4 was strongly predictive of a pCR or near pCR in ER + breast cancers following neoadjuvant chemotherapy. Ki67 was an important component of this predictive ability.
Response according to IHC4 and Ki67 quartile in HER2 negative, ER+ breast cancersIntermediate endpointpCRpCRRCB0+RCB1RCB0+RCB1ScoreIHC4Ki67IHC4Ki67Quartile 10% (0/22)0% (0/22)5% (1/22)9% (2/22)Quartile 20% (0/23)0% (0/23)4% (1/23)0% (0/23)Quartile 35%(1/22)9% (2/23)9% (2/22)9% (2/23)Quartile 435% (8/23)30% (7/23)39% (9/23)39% (9/23)
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-03.
Collapse
Affiliation(s)
- A Sheri
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - IE Smith
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - R A'Hern
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - R Jones
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - M Parton
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - SRD Johnston
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| | - M Dowsett
- Royal Marsden Hospital, London, United Kingdom; Institute of Cancer Research, London, United Kingdom; Breakthrough Breast Cancer Centre, Institute of Cancer Research, London; Seattle Cancer Alliance, Seattle, WA
| |
Collapse
|
7
|
Sheri A, Dowsett M. Developments in Ki67 and other biomarkers for treatment decision making in breast cancer. Ann Oncol 2012; 23 Suppl 10:x219-27. [DOI: 10.1093/annonc/mds307] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
8
|
Trani L, Myerson J, Ashley S, Young K, Sheri A, Hubner R, Puglisi M, Popat S, O'Brien MER. Histology classification is not a predictor of clinical outcomes in advanced non-small cell lung cancer (NSCLC) treated with vinorelbine or gemcitabine combinations. Lung Cancer 2010; 70:200-4. [PMID: 20227784 DOI: 10.1016/j.lungcan.2010.02.003] [Citation(s) in RCA: 5] [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] [Received: 12/07/2009] [Revised: 02/01/2010] [Accepted: 02/06/2010] [Indexed: 11/27/2022]
Abstract
BACKGROUND Until recently, histology has not been clearly or consistently described in the literature as a prognostic or predictive variable in advanced NSCLC studies. We have categorised patients treated with vinorelbine and gemcitabine based first line chemotherapy regimes for advanced NSCLC as either squamous or non-squamous, and also as either adenocarcinoma and non-adenocarcinoma, and compared outcome. MATERIAL AND METHODS 420 patients treated with platinum/gemcitabine, platinum/vinorelbine or single agent gemcitabine or vinorelbine as first line chemotherapy for advanced NSCLC were identified. The influence of pathology on progression free survival (PFS) and overall survival (OS) has been investigated by means of a Cox regression analysis. Hazard ratios with 95% CIs have been given for each pathological type after adjusting for the effects of age, gender, stage (III vs. IV), PS (0/1 vs. 2/3) and treatment type (platinum doublet vs. single agent). RESULTS Neither univariate nor multivariate analysis suggested that there was a significant difference in the response rates for adenocarcinoma vs. non-adenocarcinoma or between squamous and non-squamous pathology. There was no difference in PFS between adenocarcinoma and non-adenocarcinoma pathologies until 8 months (p = 0.98), and there was a statistically significant advantage in PFS for squamous vs. non-squamous pathologies (p = 0.04). Using multivariate Cox regression analysis to adjust for the effects of age, gender, stage, PS, and treatment type, the pathology subtype was not significant. There was no difference in OS in any group. CONCLUSIONS These results suggest that histology may not be considered as a predictor of clinical outcome using these drugs.
Collapse
Affiliation(s)
- L Trani
- Department of Experimental Medicine, La Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Kotsori A, Dolly S, Sheri A, Parton M, Shaunak N, Ashley S, Walsh G, Johnston S, Smith I. Is Capecitabine Efficacious in Triple Negative Metastatic Breast Cancer? Oncology 2010; 79:331-6. [DOI: 10.1159/000323175] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 10/18/2010] [Indexed: 11/19/2022]
|
10
|
Trani L, Myerson J, Young K, Sheri A, Hubner R, Puglisi M, Popat S, O'Brien M. 9054 Histology classification is not a predictor of clinical outcomes in advanced non-small cell lung cancer (NSCLC) treated with vinorelbine or gemcitabine combinations. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71767-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|