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Vickery BP, Vereda A, Casale TB, Beyer K, du Toit G, Hourihane JO, Jones SM, Shreffler WG, Marcantonio A, Zawadzki R, Sher L, Carr WW, Fineman S, Greos L, Rachid R, Ibáñez MD, Tilles S, Assa’ad AH, Nilsson C, Rupp N, Welch MJ, Sussman G, Chinthrajah S, Blumchen K, Sher E, Spergel JM, Leickly FE, Zielen S, Wang J, Sanders GM, Wood RA, Cheema A, Bindslev-Jensen C, Leonard S, Kachru R, Johnston DT, Hampel FC, Kim EH, Anagnostou A, Pongracic JA, Ben-Shoshan M, Sharma HP, Stillerman A, Windom HH, Yang WH, Muraro A, Zubeldia JM, Sharma V, Dorsey MJ, Chong HJ, Ohayon J, Bird JA, Carr TF, Siri D, Fernández-Rivas M, Jeong DK, Fleischer DM, Lieberman JA, Dubois AEJ, Tsoumani M, Ciaccio CE, Portnoy JM, Mansfield LE, Fritz SB, Lanser BJ, Matz J, Oude Elberink HNG, Varshney P, Dilly SG, Adelman DC, Burks AW. AR101 Oral Immunotherapy for Peanut Allergy. N Engl J Med 2018; 379:1991-2001. [PMID: 30449234 DOI: 10.1056/nejmoa1812856] [Citation(s) in RCA: 417] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Peanut allergy, for which there are no approved treatment options, affects patients who are at risk for unpredictable and occasionally life-threatening allergic reactions. METHODS In a phase 3 trial, we screened participants 4 to 55 years of age with peanut allergy for allergic dose-limiting symptoms at a challenge dose of 100 mg or less of peanut protein (approximately one third of a peanut kernel) in a double-blind, placebo-controlled food challenge. Participants with an allergic response were randomly assigned, in a 3:1 ratio, to receive AR101 (a peanut-derived investigational biologic oral immunotherapy drug) or placebo in an escalating-dose program. Participants who completed the regimen (i.e., received 300 mg per day of the maintenance regimen for approximately 24 weeks) underwent a double-blind, placebo-controlled food challenge at trial exit. The primary efficacy end point was the proportion of participants 4 to 17 years of age who could ingest a challenge dose of 600 mg or more, without dose-limiting symptoms. RESULTS Of the 551 participants who received AR101 or placebo, 496 were 4 to 17 years of age; of these, 250 of 372 participants (67.2%) who received active treatment, as compared with 5 of 124 participants (4.0%) who received placebo, were able to ingest a dose of 600 mg or more of peanut protein, without dose-limiting symptoms, at the exit food challenge (difference, 63.2 percentage points; 95% confidence interval, 53.0 to 73.3; P<0.001). During the exit food challenge, the maximum severity of symptoms was moderate in 25% of the participants in the active-drug group and 59% of those in the placebo group and severe in 5% and 11%, respectively. Adverse events during the intervention period affected more than 95% of the participants 4 to 17 years of age. A total of 34.7% of the participants in the active-drug group had mild events, as compared with 50.0% of those in the placebo group; 59.7% and 44.4% of the participants, respectively, had events that were graded as moderate, and 4.3% and 0.8%, respectively, had events that were graded as severe. Efficacy was not shown in the participants 18 years of age or older. CONCLUSIONS In this phase 3 trial of oral immunotherapy in children and adolescents who were highly allergic to peanut, treatment with AR101 resulted in higher doses of peanut protein that could be ingested without dose-limiting symptoms and in lower symptom severity during peanut exposure at the exit food challenge than placebo. (Funded by Aimmune Therapeutics; PALISADE ClinicalTrials.gov number, NCT02635776 .).
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Jones SM, Beyer K, Burks AW, Casale TB, O'B. Hourihane J, Marcantonio A, Vereda A, Vickery BP, Zawadzki R, Adelman DC. Efficacy and Safety of AR101 in Peanut Allergy: Results from a Phase 3, Randomized, Double-Blind, Placebo-Controlled Trial (PALISADE). J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.941] [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: 10/18/2022]
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Murray JA, Kelly CP, Green PHR, Marcantonio A, Wu TT, Mäki M, Adelman DC. No Difference Between Latiglutenase and Placebo in Reducing Villous Atrophy or Improving Symptoms in Patients With Symptomatic Celiac Disease. Gastroenterology 2017; 152:787-798.e2. [PMID: 27864127 DOI: 10.1053/j.gastro.2016.11.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 11/04/2016] [Accepted: 11/09/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Gluten ingestion leads to symptoms and small intestinal mucosal injury in patients with celiac disease. The only option is the strict lifelong exclusion of dietary gluten, which is difficult to accomplish. Many patients following a gluten-free diet continue to have symptoms and have small intestinal mucosal injury. Nondietary therapies are needed. We performed a phase 2 study of the ability of latiglutenase, an orally administered mixture of 2 recombinant gluten-targeting proteases, to reduce mucosal morphometric measures in biopsy specimens from patients with celiac disease. METHODS We performed a double-blind, placebo-controlled, dose-ranging study to assess the efficacy and safety of latiglutenase in 494 patients with celiac disease (with moderate or severe symptoms) in North America and Europe, from August 2013 until December 2014. Participants reported following a gluten-free diet for at least 1 year before the study began. Patients with documented moderate or severe symptoms and villous atrophy (villous height:crypt depth ratio of ≤2.0) were assigned randomly to groups given placebo or 100, 300, 450, 600, or 900 mg latiglutenase daily for 12 or 24 weeks. Subjects completed the Celiac Disease Symptom Diary each day for 28 days and underwent an upper gastrointestinal endoscopy with duodenal biopsy of the distal duodenum at baseline and at weeks 12 and 24. The primary end point was a change in the villous height:crypt depth ratio. Secondary end points included numbers of intraepithelial lymphocytes, serology test results (for levels of antibodies against tissue transglutaminase-2 and deamidated gliadin peptide), symptom frequencies, and safety. RESULTS In a modified intent-to-treat population, there were no differences between latiglutenase and placebo groups in change from baseline in villous height:crypt depth ratio, numbers of intraepithelial lymphocytes, or serologic markers of celiac disease. All groups had significant improvements in histologic and symptom scores. CONCLUSIONS In a phase 2 study of patients with symptomatic celiac disease and histologic evidence of significant duodenal mucosal injury, latiglutenase did not improve histologic and symptom scores when compared with placebo. There were no significant differences in change from baseline between groups. ClinicalTrials.gov no: NCT01917630.
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Affiliation(s)
- Joseph A Murray
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
| | - Ciarán P Kelly
- Celiac Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Peter H R Green
- Columbia University College of Physicians and Surgeons, New York, New York
| | | | - Tsung-Teh Wu
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Markku Mäki
- School of Medicine, University of Tampere and Tampere University Hospital, Tampere, Finland
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Han HS, Wilks S, Paplomata E, Modiano MR, Becerra C, Braiteh FS, Spira AI, Pluard TJ, Richards DA, Conzen SD, Baker G, Fishman RS, Marcantonio A, O'Shaughnessy J, Nanda R. Abstract P6-12-15: Efficacy results of a phase 1/2 study of glucocorticoid receptor (GR) antagonist mifepristone (MIFE) in combination with eribulin in GR-positive triple-negative breast cancer (TNBC). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-12-15] [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: GR is variably expressed in TNBC and high expression is associated with poor prognosis in estrogen receptor-negative (ER-) early stage breast cancer. Treatment with mifepristone (MIFE) potentiates the effectiveness of chemotherapy in GR+ TNBC xenografts. Enrollment is complete in this study of patients with GR+ TNBC treated at the recommended Phase 2 dose (RP2D) of MIFE in combination with eribulin. Objectives: To determine the safety, tolerability, pharmacokinetics (PK) and clinical activity of the MIFE plus eribulin combination in pts with GR+ TNBC at the RP2D. Methods: Eligibility: In Part 1 (dose finding), pts with solid tumors; in Part 2 (expansion phase), pts with TNBC (GR result required at time of screening in Part 1, but could be pending at time of screening in Part 2). Up to 5 prior chemotherapy regimens for advanced disease; ECOG PS 0-1; adequate end-organ function. Design: 3 + 3 dose escalation scheme. After a 7-day lead-in of oral daily MIFE alone, MIFE was continued daily and eribulin was given on days 1 and 8 of a 21-day cycle. GR+ was defined as >10% of tumor cells with any intensity of GR staining. Results: 16 pts with metastatic breast cancer were treated in Part 1, and 21 pts with TNBC were treated in Part 2. Median age was 54 (range 30-81). MTD/RP2D was MIFE 300 mg/day + eribulin 1.1 mg/m2. Safety: DLT in Part 1 was neutropenia. Neutropenia occurred in 23/36 total patients (2 Grade [G] 1, 10 G3, 11 G4); 2 instances included neutropenic fever. Recovery of WBC was brisk with growth factor support. Neuropathy was observed in 8 pts (5 G1, 1 G2, 2 G3). Other most common AEs (fatigue, hypokalemia, nausea, alopecia) were mainly G1 or G2; among these, G3/G4 events were limited to fatigue (4 G3), hypokalemia (3 G3 and 1 G4) and nausea (1 G3). There were 2 instances of G1 vaginal bleeding. There was no impact of MIFE on eribulin PK. Efficacy: There were 23 evaluable pts with TNBC across Parts 1 and 2 treated at the RP2D: 21 GR+, 2 GR status unknown; median of 3 prior chemotherapy regimens; 1 patient had received prior eribulin. Responses were: 3 PR, 8 SD, 11 PD and one too early to assess. Median PFS was 9 weeks. Conclusions: MIFE plus eribulin was well tolerated and appears to be an active treatment regimen. Five TNBC patients had a PFS longer than the upper 95% CI for PFS (i.e., >15 wks) reported by Aogi et al. for TNBC treated with eribulin (Annals of Oncology 2012?23:144148). Clinical trial information: NCT02014337.
Citation Format: Han HS, Wilks S, Paplomata E, Modiano MR, Becerra C, Braiteh FS, Spira AI, Pluard TJ, Richards DA, Conzen SD, Baker G, Fishman RS, Marcantonio A, O'Shaughnessy J, Nanda R. Efficacy results of a phase 1/2 study of glucocorticoid receptor (GR) antagonist mifepristone (MIFE) in combination with eribulin in GR-positive triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-12-15.
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Affiliation(s)
- HS Han
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - S Wilks
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - E Paplomata
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - MR Modiano
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - C Becerra
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - FS Braiteh
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - AI Spira
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - TJ Pluard
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - DA Richards
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - SD Conzen
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - G Baker
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - RS Fishman
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - A Marcantonio
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - J O'Shaughnessy
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
| | - R Nanda
- Texas Oncology San Antonio; ACRC/Arizona Clinical Research Center and Arizona Oncology; Virginia Cancer Specialists Research Institute; Texas Oncology - Baylor Charles A Sammons Cancer Center; Moffitt Cancer Center; The US Oncology Network/Mckesson Specialty Health; Emory University Winship Cancer Institute Midtown; Saint Luke's Cancer Institute; Tyler Cancer Center, US Oncology Research; Baylor University Medical Center Texas Oncology US Oncology, Dallas, TX; Corcept Therapeutics, Inc; University of Chicago Medical Center; Beth Israel Deaconess Medical Center
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Lähdeaho ML, Kaukinen K, Laurila K, Vuotikka P, Koivurova OP, Kärjä-Lahdensuu T, Marcantonio A, Adelman DC, Mäki M. Glutenase ALV003 attenuates gluten-induced mucosal injury in patients with celiac disease. Gastroenterology 2014; 146:1649-58. [PMID: 24583059 DOI: 10.1053/j.gastro.2014.02.031] [Citation(s) in RCA: 157] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 02/15/2014] [Accepted: 02/19/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Gluten ingestion leads to small intestinal mucosal injury in patients with celiac disease, necessitating strict life-long exclusion of dietary gluten. Despite adherence to a gluten-free diet, many patients remain symptomatic and still have small intestinal inflammation. In this case, nondietary therapies are needed. We investigated the ability of ALV003, a mixture of 2 recombinant gluten-specific proteases given orally, to protect patients with celiac disease from gluten-induced mucosal injury in a phase 2 trial. METHODS We established the optimal daily dose of gluten to be used in a 6-week challenge study. Then, in the intervention study, adults with biopsy-proven celiac disease were randomly assigned to groups given ALV003 (n = 20) or placebo (n = 21) together with the daily gluten challenge. Duodenal biopsies were collected at baseline and after gluten challenge. The ratio of villus height to crypt depth and densities of intraepithelial lymphocytes were the primary end points. RESULTS A daily dose of 2 g gluten was selected for the intervention study. Sixteen patients given ALV003 and 18 given placebo were eligible for efficacy evaluation. Biopsies from subjects in the placebo group showed evidence of mucosal injury after gluten challenge (mean villus height to crypt depth ratio changed from 2.8 before challenge to 2.0 afterward; P = .0007; density of CD3(+) intraepithelial lymphocytes changed from 61 to 91 cells/mm after challenge; P = .0003). However, no significant mucosal deterioration was observed in biopsies from the ALV003 group. Between groups, morphologic changes and CD3(+) intraepithelial lymphocyte counts differed significantly from baseline to week 6 (P = .0133 and P = .0123, respectively). There were no statistically significant differences in symptoms between groups. CONCLUSIONS Based on a phase 2 trial, the glutenase ALV003 appears to attenuate gluten-induced small intestinal mucosal injury in patients with celiac disease in the context of an everyday gluten-free diet containing daily up to 2 g gluten. Clinicaltrial.gov, NUMBERS NCT00959114 and NCT01255696.
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Affiliation(s)
- Marja-Leena Lähdeaho
- School of Medicine, University of Tampere, Tampere University Hospital, Tampere, Finland
| | - Katri Kaukinen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Tampere, Finland; Department of Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Kaija Laurila
- School of Medicine, University of Tampere, Tampere University Hospital, Tampere, Finland
| | | | | | | | | | | | - Markku Mäki
- School of Medicine, University of Tampere, Tampere University Hospital, Tampere, Finland
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Panebianco V, Sciarra A, Marcantonio A, Forte V, Biondi T, Laghi A, Catalano C. Conventional imaging and multiparametric magnetic resonance (MRI, MRS, DWI, MRP) in the diagnosis of prostate cancer. Q J Nucl Med Mol Imaging 2012; 56:331-342. [PMID: 23013663] [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: 06/01/2023]
Abstract
The evaluation and management of prostate cancer (PCa) are based mainly on parameters such as the serum prostate-specific antigen level, clinical stage, and pathologic findings at biopsy or after surgery. The aim of this paper was to review the current roles of conventional imaging and multiparametric magnetic resonance imaging (mpMRI) techniques in the diagnosis of PCa. A non systematic literature search using the Medline and Cochrane Library databases was performed up to January 2012. Bibliographies of retrieved articles and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review (i.e., diagnosis, staging) were selected. The advent of a high performance (1.5T) and higher fields strength (3T), and thus, higher spatial resolution, increased the potentiality and the diffusion of MR examinations. Intense research has focused on the use of complementary techniques to improve the detection, characterization, and staging of PCa by MRI. This review article is divided into two major parts: the first one considers the technical aspects of mpMRI; the second part is intended to provide the impact of this technique on patients with PCa. Published data indicate an emerging role for MRI (particularly mpMRI combining T2 weighted imaging, diffusion weighted imaging, contrast enhanced MR, and spectroscopy) as the most sensitive and specific tool available for imaging PCa. MpMRI can provide metabolic information, characterize tissue and tumor vascularity, as well as tissue cellularity and correlate with tumor aggressiveness.
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Affiliation(s)
- V Panebianco
- Department of Radiological Sciences, Oncology and Anatomical Pathology, La Sapienza University, Rome, Italy.
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De Castro S, Di Angelantonio E, Celotto A, Fiorelli M, Passaseo I, Papetti F, Caselli S, Marcantonio A, Cohen A, Pandian N. Short-term evolution (9 months) of aortic atheroma in patients with or without embolic events: a follow-up transoesophageal echocardiographic study. European Journal of Echocardiography 2009; 10:96-102. [DOI: 10.1093/ejechocard/jen172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Sahner D, van Paaschen H, Marcantonio A, Eldon M. (210) Results from a phase I, double-blind, randomized, placebo-controlled, multiple-dose study evaluating the safety, tolerability, and pharmacokinetics of oral doses of NKTR-118. The Journal of Pain 2008. [DOI: 10.1016/j.jpain.2008.01.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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D'Ottavio G, Laganà A, Marcantonio A, Toscana C. [Pseudoneoplastic occlusion of the colon. Considerations on 7 cases]. MINERVA CHIR 1987; 42:625-7. [PMID: 3614717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Laganà A, D'Ottavio G, Marcantonio A, Zappavigna D. [Our experience on the subject of reinterventions after gastric resection]. MINERVA CHIR 1987; 42:621-4. [PMID: 3614716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Marcantonio A, Laganà A, D'Ottavio G, Pozza D, Zappavigna D. [5-year follow-up of total gastrectomy and subtotal resection in patients operated on for neoplasms of the gastric antrum]. MINERVA CHIR 1987; 42:287-90. [PMID: 3587672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Hepps SA, Bradley DD, Marcantonio A, Gazzaniga A, Hohman WR, Simmons JQ. A combat casualty course for increasing the operational readiness of reserve component health care professionals. Mil Med 1985; 150:97-101. [PMID: 3919342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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