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Shah S, Santos da Cruz NF, Staropoli P, Lopez-Font F, Peter Chang TC, Berrocal A. Non-nasal, atypical retinochoroidal coloboma in pediatric patients: Case series and review. Am J Ophthalmol Case Rep 2024; 34:102015. [PMID: 38384735 PMCID: PMC10876588 DOI: 10.1016/j.ajoc.2024.102015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/16/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Purpose To report 2 cases of atypically located, non-nasal colobomas in the pediatric population. Observations A 3-week-old female neonate with no known past ocular or medical history was diagnosed with temporal iris and chorioretinal coloboma with tractional membranes upon examination under anesthesia and imaging. A 9-year-old female with a history of bilateral sensorineural hearing loss and left mild hydronephrosis presented with a temporal chorioretinal coloboma associated with retinal detachment. Conclusions and importance Very few cases of atypically located, non-nasal pediatric colobomas have been reported, and they lack a clear cause or mechanism of formation. Continued documentation of their occurrence and research into their formation at a molecular and embryological level are warranted to better understand their pathogenesis.
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Affiliation(s)
- Serena Shah
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Natasha Ferreira Santos da Cruz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Patrick Staropoli
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Francisco Lopez-Font
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Ta Chen Peter Chang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Audina Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
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2
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Shah S, Santos da Cruz NF, Lopez-Font F, Kiryakoza L, Berrocal A. Optical coherence tomography angiography in pediatric ocular cutis marmorata telangiectatica congenita: A case series. Am J Ophthalmol Case Rep 2024; 34:102067. [PMID: 38707950 PMCID: PMC11066999 DOI: 10.1016/j.ajoc.2024.102067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/24/2024] [Accepted: 04/17/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose To report 2 cases of enlarged foveal avascular zone (FAZ) on optical coherence angiography (OCTA) imaging in pediatric patients with cutis marmorata telangiectatica congenita (CMTC). Observations A 10-week-old female and a 3-year-old male diagnosed with CMTC presented for retinal examination. Both had peripheral avascularity on fluorescein angiography (FA) and enlargement of the FAZ on OCTA in both eyes. Conclusions and Importance Pediatric patients with CMTC should undergo ocular evaluation with not only FA, but also OCTA to more robustly evaluate the affected retina in this rare disease.
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Affiliation(s)
- Serena Shah
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136, USA
| | - Natasha Ferreira Santos da Cruz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136, USA
| | - Francisco Lopez-Font
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136, USA
| | - Lauren Kiryakoza
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136, USA
| | - Audina Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136, USA
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3
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Özdek Ş, Özdemir Zeydanlı E, Baumal C, Hoyek S, Patel N, Berrocal A, Lopez-Cañizares A, Al-Khersan H, Kusaka S, Mano F, Jalali S, Lepore D, Akar S. Avascular Peripheral Retina in Infants. Turk J Ophthalmol 2023; 53:44-57. [PMID: 36847634 PMCID: PMC9973209 DOI: 10.4274/tjo.galenos.2022.76436] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Avascular peripheral retina in an infant is a common characteristic of numerous pediatric retinal vascular disorders and often presents a diagnostic challenge to the clinician. In this review, key features of each disease in the differential diagnosis, from retinopathy of prematurity, familial exudative vitreoretinopathy, Coats disease, incontinentia pigmenti, Norrie disease, and persistent fetal vasculature, to other rare hematologic conditions and telomere disorders, will be discussed by expert ophthalmologists in the field.
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Affiliation(s)
- Şengül Özdek
- Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Türkiye
| | | | - Caroline Baumal
- Tufts University Faculty of Medicine, Department of Ophthalmology, Tufts Medical Center, Boston, United States of America
| | - Sandra Hoyek
- Harvard Medical School, Massachusetts Eye and Ear, Department of Ophthalmology, Boston, United States of America
| | - Nimesh Patel
- Harvard Medical School, Massachusetts Eye and Ear, Department of Ophthalmology, Boston, United States of America
| | - Audina Berrocal
- University of Miami Miller Faculty of Medicine, Bascom Palmer Eye Institute, Department of Ophthalmology, Miami, United States of America
| | - Ashley Lopez-Cañizares
- University of Miami Miller Faculty of Medicine, Bascom Palmer Eye Institute, Department of Ophthalmology, Miami, United States of America
| | - Hasenin Al-Khersan
- University of Miami Miller Faculty of Medicine, Bascom Palmer Eye Institute, Department of Ophthalmology, Miami, United States of America
| | - Shunji Kusaka
- Kindai University Faculty of Medicine, Department of Ophthalmology, Osaka, Japan
| | - Fukutaro Mano
- Kindai University Faculty of Medicine, Department of Ophthalmology, Osaka, Japan
| | - Subhadra Jalali
- L V Prasad Eye Institute, Anant Bajaj Retina Institute and Child Sight Institute, Hyderabad, India
| | - Domenico Lepore
- Catholic University of the Sacred Heart, Department of Geriatrics and Neuroscience, A. Gemelli Foundation IRCSS, Rome, Italy
| | - Solmaz Akar
- Acıbadem Bakırkoy Hospital, Clinic of Ophthalmology, İstanbul, Türkiye
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4
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Cole ED, Park SH, Kim SJ, Kang KB, Valikodath NG, Al-Khaled T, Patel SN, Jonas KE, Ostmo S, Coyner A, Berrocal A, Drenser KA, Nagiel A, Horowitz JD, Lee TC, Kalpathy-Cramer J, Chiang MF, Campbell JP, Chan RVP. Variability in Plus Disease Diagnosis using Single and Serial Images. Ophthalmol Retina 2022; 6:1122-1129. [PMID: 35659941 DOI: 10.1016/j.oret.2022.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE To assess changes in retinopathy of prematurity (ROP) diagnosis in single and serial retinal images. DESIGN Cohort study. PARTICIPANTS Cases of ROP recruited from the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) consortium evaluated by 7 graders. METHODS Seven ophthalmologists reviewed both single and 3 consecutive serial retinal images from 15 cases with ROP, and severity was assigned as plus, preplus, or none. Imaging data were acquired during routine ROP screening from 2011 to 2015, and a reference standard diagnosis was established for each image. A secondary analysis was performed using the i-ROP deep learning system to assign a vascular severity score (VSS) to each image, ranging from 1 to 9, with 9 being the most severe disease. This score has been previously demonstrated to correlate with the International Classification of ROP. Mean plus disease severity was calculated by averaging 14 labels per image in serial and single images to decrease noise. MAIN OUTCOME MEASURES Grading severity of ROP as defined by plus, preplus, or no ROP. RESULTS Assessment of serial retinal images changed the grading severity for > 50% of the graders, although there was wide variability. Cohen's kappa ranged from 0.29 to 1.0, which showed a wide range of agreement from slight to perfect by each grader. Changes in the grading of serial retinal images were noted more commonly in cases of preplus disease. The mean severity in cases with a diagnosis of plus disease and no disease did not change between single and serial images. The ROP VSS demonstrated good correlation with the range of expert classifications of plus disease and overall agreement with the mode class (P = 0.001). The VSS correlated with mean plus disease severity by expert diagnosis (correlation coefficient, 0.89). The more aggressive graders tended to be influenced by serial images to increase the severity of their grading. The VSS also demonstrated agreement with disease progression across serial images, which progressed to preplus and plus disease. CONCLUSIONS Clinicians demonstrated variability in ROP diagnosis when presented with both single and serial images. The use of deep learning as a quantitative assessment of plus disease has the potential to standardize ROP diagnosis and treatment.
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Affiliation(s)
- Emily D Cole
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
| | - Shin Hae Park
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois; Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Jin Kim
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon; Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kai B Kang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
| | - Nita G Valikodath
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
| | - Tala Al-Khaled
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
| | | | - Karyn E Jonas
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
| | - Susan Ostmo
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Aaron Coyner
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Audina Berrocal
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida
| | - Kimberly A Drenser
- Department of Ophthalmology, Beaumont Eye Institute, Royal Oak, Michigan
| | - Aaron Nagiel
- Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Jason D Horowitz
- Department of Ophthalmology, Columbia University, New York, New York
| | - Thomas C Lee
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | | | - Michael F Chiang
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - J Peter Campbell
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - R V Paul Chan
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois.
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5
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Danford ID, Scruggs BA, Capone A, Trese MT, Drenser KA, Thanos A, Nudleman E, Amphornphruet A, Tipsuriyaporn B, Hubbard GB, Ells A, Harper CA, Goldstein J, Calvo C, Wallace-Carrete C, Berry D, Chang E, Leishman L, Shapiro M, Blair M, Mikhail M, Shields CL, Schwendeman R, Yonekawa Y, Gupta MP, Orlin A, Prakhunhungsit S, Mukai S, Berrocal A, Hartnett ME, Campbell JP. The Prevalence of Retinal Disease and Associated CNS Disease in Young Patients with Incontinentia Pigmenti. Ophthalmol Retina 2022; 6:1113-1121. [PMID: 35691580 DOI: 10.1016/j.oret.2022.05.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE To evaluate the prevalence of retinal disease on fluorescein angiography (FA) in patients with incontinentia pigmenti (IP) and to compare the severity of retinal disease in those with and without known central nervous system (CNS) disease. DESIGN Multi-institutional consecutive retrospective case series. SUBJECTS New patients with a diagnosis of IP were seen at the Casey Eye Institute at the Oregon Health and Science University (OHSU), Moran Eye Center, University of Utah, or Bascom Palmer Eye Institute, University of Miami from December 2011 to September 2018. METHODS Detailed ophthalmoscopic examination and FA were recommended for all new patients and performed on every patient who had parental consent. Ophthalmoscopic findings and FA images were graded for severity by 2 masked graders on a 3-point scale: 0 = no disease, 1 = vascular abnormalities without leakage, 2 = leakage or neovascularization, and 3 = retinal detachment. The presence of known CNS disease was documented. Additional cases were obtained from a pediatric retina listserv for examples of phenotypic variation. MAIN OUTCOME MEASURES The proportion of eyes noted to have disease on ophthalmoscopy compared with FA and the severity of retinal disease in those with and without known CNS disease. RESULTS Retinal pathology was detected in 18 of 35 patients (51%) by indirect ophthalmoscopy and 26 of 35 patients (74%) by FA (P = 0.048) in a predominantly pediatric population (median age, 9 months). Ten patients (29%) had known CNS disease at the time of the eye examination. A Wilcoxon rank-sum test indicated that the retinal severity scores for patients with CNS disease (median, 2) were significantly higher than the retinal severity scores for patients without CNS disease (median, 1), z = -2.12, P = 0.034. CONCLUSIONS Retinal disease is present in the majority of patients with IP, and ophthalmoscopic examination is less sensitive than FA for detection of disease. There may be a correlation between the severity of retinal and CNS disease.
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Affiliation(s)
- Ian D Danford
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Brittni A Scruggs
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | | | | | - Kim A Drenser
- Associated Retinal Consultants, PC, Royal Oak, Michigan
| | - Aristomenis Thanos
- Associated Retinal Consultants, PC, Royal Oak, Michigan; Legacy Devers Eye Institute, Portland, Oregon
| | - Eric Nudleman
- Associated Retinal Consultants, PC, Royal Oak, Michigan; Shiley Eye Institute, University of California, San Diego, La Jolla, California
| | - Atchara Amphornphruet
- Queen Sirikit National Institute of Child Health, Department of Ophthalmology, Bangkok, Thailand
| | - Boontip Tipsuriyaporn
- Queen Sirikit National Institute of Child Health, Department of Ophthalmology, Bangkok, Thailand
| | | | - Anna Ells
- Calgary Retina Consultants, Calgary, Alberta, Canada
| | | | | | | | | | - Duncan Berry
- Charlotte Eye, Ear, Nose & Throat Associates, P.A., Charlotte, North Carolina
| | | | | | | | | | - Mikel Mikhail
- Lakeridge Health, Queen's University, Ontario, Canada
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University Philadelphia, Pennsylvania
| | - Rachel Schwendeman
- Ocular Oncology Service, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University Philadelphia, Pennsylvania
| | - Yoshihiro Yonekawa
- Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mrinali P Gupta
- Retina Associates of Orange County, Laguna Hills, California; Weill Cornell Medical College, New York, New York
| | - Anton Orlin
- Weill Cornell Medical College, New York, New York
| | | | - Shizuo Mukai
- Massachusetts Eye and Ear Infirmary, Harvard University, Boston, Massachusetts
| | - Audina Berrocal
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, Florida
| | | | - J Peter Campbell
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
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6
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Kalavar M, Ashkenazy N, Acon Ramirez D, Berrocal A. Paradoxical Exudative Retinopathy and Macular Star Formation After Treatment Initiation in Coats Disease. J Vitreoretin Dis 2022; 6:452-456. [PMID: 37009530 PMCID: PMC9954773 DOI: 10.1177/24741264221075962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: This work describes a unique clinical feature in Coats disease. Methods: A retrospective series of 2 cases is reported. Results: Two pediatric patients receiving treatment for Coats disease were included. In both cases, vision worsened secondary to paradoxically increased exudation and macular star formation following standard treatment with intravitreal bevacizumab, sub-Tenon triamcinolone acetonide, and laser photocoagulation. After serial treatments under general anesthesia, the exudates in both cases consolidated. Conclusions: A paradoxical exudative retinopathy can occur in some patients when initiating standard treatment of Coats disease. Longitudinal follow-up with continued intravitreal antivascular endothelial growth factor agents, laser photocoagulation, and corticosteroids might help control persistent exudation in these cases.
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Affiliation(s)
- Meghana Kalavar
- Department of Ophthalmology, Bascom Palmer
Eye Institute, Miller School of Medicine, Miami, FL, USA
- Department of Ophthalmology, Havener Eye
Institute, Ohio State University, Columbus, OH, USA
| | - Noy Ashkenazy
- Department of Ophthalmology, Bascom Palmer
Eye Institute, Miller School of Medicine, Miami, FL, USA
| | - Dhariana Acon Ramirez
- Department of Ophthalmology, Bascom Palmer
Eye Institute, Miller School of Medicine, Miami, FL, USA
- Department of Ophthalmology, Hospital
Calderon Guardia, San Jose, Costa Rica, USA
| | - Audina Berrocal
- Department of Ophthalmology, Bascom Palmer
Eye Institute, Miller School of Medicine, Miami, FL, USA
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Marquez-Rodas I, Berciano Guerrero M, Muñoz Couselo E, Soria A, Cerezuela-Fuentes P, Manzano Mozo J, Gutierrez Sanz L, Crespo G, Puértolas T, Garcia Castano A, Aguado de la Rosa C, Espinosa E, Majem Tarruella M, López Castro R, Ayala de Miguel P, Medina Martinez J, Fernández Morales L, Bellido Hernández L, Berrocal A, Martín Algarra S. 848P Second-line systemic treatment for patients with advanced melanoma: Results from the prospective real-world study GEM1801. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.974] [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: 11/26/2022] Open
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8
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Chiang MF, Quinn GE, Fielder AR, Ostmo SR, Paul Chan RV, Berrocal A, Binenbaum G, Blair M, Peter Campbell J, Capone A, Chen Y, Dai S, Ells A, Fleck BW, Good WV, Elizabeth Hartnett M, Holmstrom G, Kusaka S, Kychenthal A, Lepore D, Lorenz B, Martinez-Castellanos MA, Özdek Ş, Ademola-Popoola D, Reynolds JD, Shah PK, Shapiro M, Stahl A, Toth C, Vinekar A, Visser L, Wallace DK, Wu WC, Zhao P, Zin A. International Classification of Retinopathy of Prematurity, Third Edition. Ophthalmology 2021; 128:e51-e68. [PMID: 34247850 PMCID: PMC10979521 DOI: 10.1016/j.ophtha.2021.05.031] [Citation(s) in RCA: 216] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), which is now required because of challenges such as: (1) concerns about subjectivity in critical elements of disease classification; (2) innovations in ophthalmic imaging; (3) novel pharmacologic therapies (e.g., anti-vascular endothelial growth factor agents) with unique regression and reactivation features after treatment compared with ablative therapies; and (4) recognition that patterns of ROP in some regions of the world do not fit neatly into the current classification system. DESIGN Review of evidence-based literature, along with expert consensus opinion. PARTICIPANTS International ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men. METHODS The committee was initially divided into 3 subcommittees-acute phase, regression or reactivation, and imaging-each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification. MAIN OUTCOME MEASURES Consensus statement. RESULTS The ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular-vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II, notch, subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae. CONCLUSIONS These principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care.
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Affiliation(s)
- Michael F Chiang
- National Eye Institute, National Institutes of Health, Bethesda, Maryland.
| | - Graham E Quinn
- Division of Ophthalmology, Children's Hospital of Philadelphia, Scheie Eye Institute, Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alistair R Fielder
- Department of Optometry and Visual Science, University of London, London, United Kingdom
| | - Susan R Ostmo
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - R V Paul Chan
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
| | - Audina Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Gil Binenbaum
- Division of Ophthalmology, Children's Hospital of Philadelphia, Scheie Eye Institute, Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael Blair
- Retina Consultants, Ltd., Des Plaines, Illinois; Department of Ophthalmology, University of Chicago, Chicago, Illinois
| | - J Peter Campbell
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Antonio Capone
- Associated Retinal Consultants, PC, Royal Oak, Michigan, and Department of Ophthalmology, Oakland University, William Beaumont Hospital School of Medicine, Auburn Hills, Michigan
| | - Yi Chen
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China
| | - Shuan Dai
- Ophthalmology Department, Queensland Children's Hospital, Brisbane, Australia
| | - Anna Ells
- Calgary Retina Consultants, Calgary, Canada
| | - Brian W Fleck
- Department of Ophthalmology, University of Edinburgh, Edinburgh, United Kingdom
| | - William V Good
- Smith-Kettlewell Eye Research Institute, San Francisco, California
| | - M Elizabeth Hartnett
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Gerd Holmstrom
- Department Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Shunji Kusaka
- Department of Ophthalmology, Kindai University, Osakasayama, Japan
| | | | - Domenico Lepore
- A. Gemelli Foundation IRCSS, Department of Ageing and Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | - Birgit Lorenz
- Department of Ophthalmology, Justus-Liebig-University Giessen, Giessen, Germany; Department of Ophthalmology, Universitaetsklinikum Bonn, Bonn, Germany
| | | | - Şengül Özdek
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | | | - James D Reynolds
- Ross Eye Institute, Department of Ophthalmology, University at Buffalo, Buffalo, New York
| | - Parag K Shah
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | | | - Andreas Stahl
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Cynthia Toth
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Anand Vinekar
- Department of Pediatric Retina, Narayana Nethralaya Eye Institute, Bangalore, Karnataka, India
| | - Linda Visser
- Department of Ophthalmology, University of KwaZulu-Natal, Durban, South Africa
| | - David K Wallace
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, and Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Andrea Zin
- Clinical Research Unit, Fernandes Figueira Institute, FIOCRUZ, Rio de Janeiro, Brazil
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9
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Tanenbaum R, Acon D, Rodriguez A, Negron C, Berrocal A. Macular Retinal Pigment Epithelial Clumping Leading to a Diagnosis of FEVR. Ophthalmic Surg Lasers Imaging Retina 2021; 52:505-508. [PMID: 34505810 DOI: 10.3928/23258160-20210819-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Familial exudative vitreoretinopathy (FEVR) is a rare hereditary disorder characterized by abnormal or incomplete retinal angiogenesis. The peripheral avascularity, irregular neovascularization, and vascular leakage seen in FEVR are similar to changes that may be seen in retinopathy of prematurity (ROP). The authors report a case of atypical macular pigment clumping leading to the diagnosis of ROPER (ie, ROP vs FEVR) in a premature infant born at 23 weeks of gestation with a birth weight of 451 grams, who presented with atypical aggressive posterior ROP and a heterozygous variant in the LRP5 gene. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:505-508.].
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10
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Marquez-Rodas I, Arance A, Berciano Guerrero M, Díaz Beveridge R, Alamo M, Garcia Castaño A, Gonzalez Cao M, Vidal J, Puertolas Hernandez T, Soria A, Aguado de la Rosa C, Sánchez Mauriño P, Valduvieco I, Delgado Rico R, Conde A, Foro P, Prada P, Puertas E, Alvarez Gonzalez A, Berrocal A. 1038MO Intracranial activity of encorafenib and binimetinib followed by radiotherapy in patients with BRAF mutated melanoma and brain metastasis: Preliminary results of the GEM1802/EBRAIN-MEL phase II clinical trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Salama A, Cheshuk V, Siveke J, Berrocal A, Abdullah S, Lockwood S, McCully M, Kee D. 1014P Characterization of cytokine release syndrome (CRS) following treatment with tebentafusp in previously untreated patients with metastatic uveal melanoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Majem M, Manzano JL, Marquez-Rodas I, Mujika K, Muñoz-Couselo E, Pérez-Ruiz E, de la Cruz-Merino L, Espinosa E, Gonzalez-Cao M, Berrocal A. SEOM clinical guideline for the management of cutaneous melanoma (2020). Clin Transl Oncol 2021; 23:948-960. [PMID: 33651321 PMCID: PMC8057998 DOI: 10.1007/s12094-020-02539-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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] [Accepted: 12/02/2020] [Indexed: 12/15/2022]
Abstract
Melanoma affects about 6000 patients a year in Spain. A group of medical oncologists from Spanish Society of Medical Oncology (SEOM) and Spanish Multidisciplinary Melanoma Group (GEM) has designed these guidelines to homogenize the management of these patients. The diagnosis must be histological and determination of BRAF status has to be performed in patients with stage ≥ III. Stage I–III resectable melanomas will be treated surgically. In patients with stage III melanoma, adjuvant treatment with immunotherapy or targeted therapy is also recommended. Patients with unresectable or metastatic melanoma will receive treatment with immunotherapy or targeted therapy, the optimal sequence of these treatments remains unclear. Brain metastases require a separate consideration, since, in addition to systemic treatment, they may require local treatment. Patients must be followed up closely to receive or change treatment as soon as their previous clinical condition changes, since multiple therapeutic options are available.
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Affiliation(s)
- M Majem
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, c/Sant Antoni Maria Claret 167, 08025, Barcelona, Spain.
| | - J L Manzano
- Department of Medical Oncology, H. Germans Trias i Pujol, Catalan Institute of Oncology, ICO-Badalona, Badalona, Spain
| | - I Marquez-Rodas
- Department of Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid, Spain
| | - K Mujika
- Department of Medical Oncology, UGC de Oncología de Gipuzkoa, OSI Donostialdea-Onkologikoa, Guipúzcoa, Spain
| | - E Muñoz-Couselo
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Hospital Vall d'Hebron Barcelona, Barcelona, Spain
| | - E Pérez-Ruiz
- Department of Medical Oncology, Hospital Costa del Sol and UGC Oncol, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Regional Virgen Victoria, Málaga, Spain
| | - L de la Cruz-Merino
- Department of Medical Oncology, Hospital Universitario Virgen Macarena, Seville, Spain.,Medicine Department, Universidad de Sevilla, Seville, Spain
| | - E Espinosa
- Department of Medical Oncology, Hospital Universitario La Paz, CIBERONC, Madrid, Spain
| | - M Gonzalez-Cao
- Oncology Department (IOR), Hospital Dexeus, Barcelona, Spain
| | - A Berrocal
- Department of Medical Oncology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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Venkateswaran N, Tonk RS, Berrocal A. Corneal Edema in a Gardener. JAMA Ophthalmol 2021; 138:998-999. [PMID: 32722773 DOI: 10.1001/jamaophthalmol.2020.1325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Rahul S Tonk
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida
| | - Audina Berrocal
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida
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14
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Sridhar J, Kuriyan AE, Yonekawa Y, Berrocal A, Khan MA, Chan RP, Haller JA. Representation of Women in Vitreoretinal Meeting Faculty Roles from 2015 through 2019. Am J Ophthalmol 2021; 221:131-136. [PMID: 32918901 DOI: 10.1016/j.ajo.2020.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To describe the proportion of female faculty presenting or moderating at vitreoretinal meetings from 2015 through 2019. DESIGN Retrospective trend study. SUBJECTS 6 highly attended annual national vitreoretinal meetings from 2015 to 2019 (30 total meetings) METHODS: Conference programs were acquired either through online search or directly from meeting organizers and were reviewed and analyzed. Genders of program committee members, first author main podium presenters of papers and nonpaper presenters, main podium panelists, and main podium moderators were recorded. A χ2 analysis was performed to compare the proportion of women with podium roles in 2015 and those in each subsequent year until 2019. MAIN OUTCOME MEASUREMENTS change in proportion of women filling faculty roles in 2015 versus those in 2019. RESULTS A total of 4,521 faculty roles were included for analysis. Women filled 22.1% of those roles and were more likely to be included as invited moderators or panelists (25.0%) than as paper (21.4%) or non-paper (19.8%) presenters. Meetings with at least one female program committee member were significantly more likely to include female non-paper presenters (P = .02), moderators or panelists (P = .02), and total women faculty (P < .001). Although there were no significant changes in the proportion of women when comparing consecutive years, the overall trend was for an increased proportion of women faculty, with a significant increase from 19.6% in 2015 to 25.5% in 2019 (P = .002). When the types of faculty roles filled by women were examined, there was a statistically significant increase from 2015 to 2019 in the proportion of abstract presentations (19.7% vs. 25.2%, respectively; P = .045) but a nonstatistically significant increase in invited presentations and moderator or panelist roles. CONCLUSIONS AND RELEVANCE Women filled less than one-fourth of the main podium faculty roles at vitreoretinal meetings included for analysis over a 5-year period, although there was a significant increase in female representation when 2015 and 2019 participation were compared. Meetings with at least 1 female program committee member filled non-paper podium faculty roles with a significantly greater proportion of women.
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15
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Wang YE, Ramirez DA, Chang TC, Berrocal A. Peters plus syndrome and Chorioretinal findings associated with B3GLCT gene mutation - a case report. BMC Ophthalmol 2020; 20:118. [PMID: 32204707 PMCID: PMC7092513 DOI: 10.1186/s12886-020-01380-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 03/10/2020] [Indexed: 12/04/2022] Open
Abstract
Background Peters plus syndrome (PPS) is a combination of congenital Peters anomaly and systemic abnormalities. It is inherited most commonly in an autosomal recessive pattern with homozygous B3GLCT mutations. Ocular findings consist predominantly anterior segment abnormalities without posterior segment involvement. Case presentation In this presentation, we report a case of PPS with homozygous pathogenic variant in B3GLCT who presented with classic anterior segment findings, systemic abnormalities, as well as atypical bilateral chorioretinal atrophy. The chorioretinal findings were characterized with spectral-domain optical coherence tomography. Conclusions Our report expands the phenotypic descriptions of PPS by characterizing posterior segment findings.
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Rodriguez JP, Patel S, Espinosa E, Pelster M, Merino LDLC, Khoja L, Joshua A, Tebe C, Berrocal A. 1143P Nivolumab and ipilimumab (N+I) is active in patients (pts) with metastatic uveal melanoma (mUM) with extra-hepatic only involvement: Pooled analysis from 2 phase II trials. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1266] [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: 12/01/2022] Open
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17
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Fernandez AA, O'Day S, Merino LDLC, Petrella T, Jamal R, Ny L, Carneiro A, Berrocal A, Márquez-Rodas I, Spreafico A, Victoria Atkinson V, Costa Svedman F, Smith A, Chen K, Diede S, Krepler C, Long G. LBA44 Lenvatinib (len) plus pembrolizumab (pembro) for advanced melanoma (MEL) that progressed on a PD-1 or PD-L1 inhibitor: Initial results of LEAP-004. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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18
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Acón D, Hamichi SE, Berrocal A, Murray TG. Leukocoria in a 2-Year-Old Patient With Atypical Optic Nerve Fiber Layer Myelination. J Pediatr Ophthalmol Strabismus 2020; 57:e56-e58. [PMID: 32816043 DOI: 10.3928/01913913-20200527-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/27/2020] [Indexed: 11/20/2022]
Abstract
Myelinated retinal nerve fiber layer is a benign retinal condition that is usually an incidental finding in a healthy patient. Visual acuity is typically not compromised, but some cases have other associated ocular conditions that can affect vision. Diagnosis in challenging atypical cases requires imaging studies to rule out other pathologies. The authors describe the case of a 2-year-old girl who presented with atypical optic nerve fiber myelination. [J Pediatr Ophthalmol Strabismus. 2020;57:e56-e58.].
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Westhovens R, Yoo D, Wiland P, Zawadzki M, Ivanova D, Berrocal A, Chalouhi E, Balázs É, Shevchuk S, Lee SJ, Kim SH, Suh J, Hwang C, Choi DS. THU0186 CLINICAL EVALUATION OF THE IMMUNOGENICITY TO CT-P13 FOR SUBCUTANEOUS USE IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: 1-YEAR CLINICAL RESULTS FROM A MULTICENTER, RANDOMIZED CONTROLLED PIVOTAL TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Background:Novel subcutaneous infliximab (CT-P13 SC) was developed to augment the flexibility in therapeutic use of infliximab and noninferiority (NI) of CT-P13 SC versus CT-P13 intravenous (IV) was demonstrated for efficacy in patients with rheumatoid arthritis (RA) [1]. CT-P13 SC 120mg biweekly showed consistent higher therapeutic trough levels during the treatment period, which helps in maintaining efficacy over time. Since immunogenicity has clinical importance in patients using anti-TNF alpha agents and there is a general presumption that SC route is more immunogenic than IV route, this needs careful assessment.Objectives:Immunogenicity assessment of CT-P13 SC with further impact analysis has been performed on the pivotal data set [1] to determine whether there was any correlation between the magnitude of anti-drug antibody (ADA) positivity and clinical outcomes in RA patients.Methods:The immune response against CT-P13 in human serum was detected using an electrochemiluminescence (ECL) platform with an Affinity Capture Elution (ACE) step. An ADA ECL ACE assay showed ability to detect ADA at low levels in all samples regardless of residual drug in serum (25 ng/mL ADA in the presence of 80 μg/mL of CT-P13 in RA serum). To investigate the impact of ADA titer on PK, efficacy and safety, key clinical parameters were assessed by visit based ADA titer quartile. All patients who had ‘Positive’ ADA status result at each visit were included in the analysis and categorized into 4 groups using the 25th, 50th, 75th percentiles of ADA titer result, respectively.Results:The four subgroups categorized by quartiles at each visit from week 22 to week 54 were: 1st (ADA titer ≤ 3), 2nd (3 < ADA titer ≤ 9), 3rd (9 < ADA titer ≤ 27) and 4th (27 < ADA titer). There was a trend for pre-dose concentration to decrease as ADA titer increases for both CT-P13 SC and CT-P13 IV arms as expected (Figure 1). Patients in the 1st and 2nd subgroup maintained the sufficient therapeutic drug concentration level. Figure 2 shows the correlation between ADA titer and efficacy outcomes where the change from baseline of DAS28 (CRP) and the proportion of patients achieving ACR20 were lower in the 3rd and 4th subgroups. The ADA impact was especially apparent in the 4th subgroup where the mean pre-dose concentration of the patients was below the therapeutic drug concentration level (1 μg/mL), which led to worse efficacy outcomes in both arms, IV as well as SC. Nevertheless, no impact of ADA on safety profile in both arms was observed. A neutralizing antibody (NAb) method with enhanced drug tolerance but limited performance was also developed and clinical consequences of NAb titer in terms of PK, efficacy and safety were not different from the results with ADA.Conclusion:The analysis of both ADA positivity and titer is clinically meaningful in the prediction of PK profile and clinical response. CT-P13 SC administration did not result in a greater incidence of ADA compared to the CT-P13 IV and there were no clinical differences depending on the formulation.References:[1]Westhovens R, et al. Annals of the Rheumatic Diseases 2019;78:1158-1159.Disclosure of Interests:Rene Westhovens Grant/research support from: Celltrion Inc, Galapagos, Gilead, Consultant of: Celltrion Inc, Galapagos, Gilead, Speakers bureau: Celltrion Inc, Galapagos, Gilead, DaeHyun Yoo Grant/research support from: Celltrion, Inc, Consultant of: Celltrion, Inc, Speakers bureau: Celltrion Healthcare, Inc, Piotr Wiland Grant/research support from: Celltrion, Inc, Speakers bureau: Novartis, Pfizer, Abbvie, Gedeon-Richter, Lilly, Roche, Sandoz, Marek Zawadzki Grant/research support from: Celltrion, Inc, Delina Ivanova Grant/research support from: Celltrion, Inc, Alfredo Berrocal Grant/research support from: Celltrion, Inc, Speakers bureau: Pfizer, Elias Chalouhi Grant/research support from: Celltrion, Inc, Éva Balázs Grant/research support from: Celltrion, Inc, Consultant of: Amgen, Sergii Shevchuk Grant/research support from: Celltrion, Inc, Sang Joon Lee Shareholder of: Celltrion, Inc, Employee of: Celltrion, Inc, Sung Hyun Kim Shareholder of: Celltrion, Inc, Employee of: Celltrion, Inc, JeeHye Suh Employee of: Celltrion, Inc, Chankyoung Hwang Employee of: Celltrion, Inc, Dae Seok Choi Shareholder of: Celltrion, Inc, Employee of: Celltrion, Inc
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20
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Lin J, Garcia A, Chen Y, Dubovy S, Lee W, Kopplin LJ, Berrocal A. Pathological Findings of Synchysis Scintillans Secondary to Familial Exudative Vitreoretinopathy With Chronic Exudative Retinal Detachment. Journal of VitreoRetinal Diseases 2020; 4:163-166. [PMID: 37008376 PMCID: PMC9976252 DOI: 10.1177/2474126419880385] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: We describe a unique case of synchysis scintillans in a 23-year-old woman with a history of chronic exudative retinal detachment in the setting of familial exudative vitreoretinopathy. Methods: Fundus and slit-lamp photographs were obtained at presentation, and pathological studies were performed on the enucleated specimen to confirm the diagnosis. Results: Synchysis scintillans is a degenerative condition of cholesterol deposition that affects severely damaged eyes, often as a result of chronic vitreous hemorrhage or retinal detachment. In this case, synchysis scintillans presented as crystals in the anterior chamber in the setting of a chronic retinal detachment. After enucleation, there were noted to be cholesterol slits on pathological correlation, confirming the diagnosis. Conclusions: This case demonstrates the importance of clinical pathological correlation in the diagnosis of synchysis scintillans migrating into the anterior chamber.
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Affiliation(s)
- James Lin
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Armando Garcia
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ying Chen
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Sander Dubovy
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Wendy Lee
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Laura J. Kopplin
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Audina Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
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21
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Osigian CJ, Gologorsky D, Cavuoto KM, Berrocal A, Villegas V. Oral acetazolamide as a medical adjuvant to retinal surgery in optic disc pit maculopathy in a pediatric patient. Am J Ophthalmol Case Rep 2020; 17:100599. [PMID: 31993534 PMCID: PMC6974735 DOI: 10.1016/j.ajoc.2020.100599] [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: 04/16/2018] [Revised: 10/01/2019] [Accepted: 01/10/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose To describe a novel combination of surgical and medical management for the treatment of optic disc pit maculopathy. Observations A 12-year-old obese girl with bilateral optic disc pits presented with decreased vision in the left eye (20/400). On dilated fundus examination, she was found to have a macula-involving serous retinal detachment. Pars plana vitrectomy, posterior hyaloid peel, internal limiting membrane peel, fluid-air exchange, temporal juxtapapillary endolaser, and C3F8 tamponade were performed. Postoperatively, there was persistence of subretinal fluid, so oral acetazolamide and a weight loss regimen were started. After 3 months of medical treatment, the subretinal fluid decreased significantly and visual acuity improved to 20/60. Conclusion and Importance Currently, the mechanisms leading to optic disc pit maculopathy remain a topic of debate. As optic disc pits may provide a conduit between the subarachnoid and subretinal spaces, the reduction of intracranial pressure with the use of systemic carbonic anhydrase inhibitors may play a role in decreasing the subretinal fluid associated with select cases of optic disc pit maculopathy.
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Affiliation(s)
- Carla J Osigian
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel Gologorsky
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kara M Cavuoto
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Audina Berrocal
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Victor Villegas
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
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22
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Majem M, García-Martínez E, Martinez M, Muñoz-Couselo E, Rodriguez-Abreu D, Alvarez R, Arance A, Berrocal A, de la Cruz-Merino L, Lopez-Martin JA. SEOM clinical guideline for the management of immune-related adverse events in patients treated with immune checkpoint inhibitors (2019). Clin Transl Oncol 2020; 22:213-222. [PMID: 31993963 DOI: 10.1007/s12094-019-02273-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 12/16/2019] [Accepted: 12/16/2019] [Indexed: 12/17/2022]
Abstract
The use of immune checkpoint inhibitors has emerged as an effective treatment option for patients with several tumor types. By increasing the activity of the immune system, they can induce inflammatory side effects, which are often termed immune-related adverse events. These are pathophysiologically unique toxicities, compared with those from other anticancer therapies. In addition, the spectrum of the target organs is very broad. Immune-inflammatory adverse events can be life threatening. Prompt diagnosis and pharmacological intervention are instrumental to avoid progression to severe manifestations. Consequently, clinicians require new skills to successfully diagnose and manage these events. These SEOM guidelines have been developed with the consensus of ten medical oncologists. Relevant studies published in peer-review journals were used for the guideline elaboration. The Infectious Diseases Society of America grading system was used to assign levels of evidence and grades of recommendation.
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Affiliation(s)
- M Majem
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, c/Sant Antoni Maria Claret 167, 08025, Barcelona, Spain.
- Spanish Group for Cancer Immuno-Biotherapy, GÉTICA, Madrid, Spain.
| | - E García-Martínez
- Department of Medical Oncology and Hematology, Hospital Universitario Morales Meseguer, Murcia, Spain
- Spanish Group for Cancer Immuno-Biotherapy, GÉTICA, Madrid, Spain
| | - M Martinez
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - E Muñoz-Couselo
- Department of Medical Oncology, Melanoma and Other Skin Tumors Unit, Vall d'Hebron Hospita, Vall d'Hebron Institute of Oncology VHIO, Barcelona, Spain
| | - D Rodriguez-Abreu
- Department of Medical Oncology, C.H.U. Insular-Materno Infantil de Gran Canaria, Las Palmas, Spain
- Spanish Group for Cancer Immuno-Biotherapy, GÉTICA, Madrid, Spain
| | - R Alvarez
- Department of Medical Oncology, Hospital Virgen de la Salud, Toledo, Spain
| | - A Arance
- Department of Medical Oncology, Hospital Clínic, Barcelona, Spain
- Spanish Group for Cancer Immuno-Biotherapy, GÉTICA, Madrid, Spain
| | - A Berrocal
- Department of Medical Oncology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - L de la Cruz-Merino
- Clinical Oncology Department, Hospital Universitario Virgen Macarena, Seville, Spain
- Medicine Department, Universidad de Sevilla, Sevilla, Spain
- Spanish Group for Cancer Immuno-Biotherapy, GÉTICA, Madrid, Spain
| | - J A Lopez-Martin
- Department of Medical Oncology, Hospital Universitario, 12 de Octubre, Madrid, Spain
- Clinical and Translational Oncology, Instituto de Investigación Sanitaria Hospital, 12 de Octubre, Madrid, Spain
- Spanish Group for Cancer Immuno-Biotherapy, GÉTICA, Madrid, Spain
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Kothari N, Read SP, Baumal CR, Capone A, Chang E, Drenser KA, Ferrone PJ, Nudleman E, Rao P, Sisk RA, Smiddy WE, Yonekawa Y, Berrocal A. A Multicenter Study of Pediatric Macular Holes: Surgical Outcomes With Microincisional Vitrectomy Surgery. Journal of VitreoRetinal Diseases 2020; 4:22-27. [PMID: 37009567 PMCID: PMC9976082 DOI: 10.1177/2474126419887555] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: Pediatric macular holes occur often related to trauma and rarely require surgical intervention. The purpose of the present study was to evaluate outcomes of microincisional vitrectomy surgery. Methods: A multicenter retrospective consecutive case series was conducted of pediatric patients undergoing surgery for macular hole repair. Results: A total of 31 eyes from 8 centers were included in this study. The mechanism of macular hole development was blunt trauma in 30 eyes (97%) and industrial laser in 1 eye (3%). The rate of anatomic closure after primary vitrectomy was 81% (25 eyes); the final anatomic closure rate after a secondary vitrectomy was 94% (29 eyes). There was a statistically significant improvement in visual acuity from initial presentation (20/164) to final follow-up (20/100) ( P = .009). Conclusions: Microincisional vitrectomy surgery for pediatric macular holes results in substantial anatomic success and modest improvement in visual acuity.
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Affiliation(s)
- Nikisha Kothari
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Sarah P. Read
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | | | - Antonio Capone
- Associated Retinal Consultants of Michigan, Royal Oak, MI, USA
- William Beaumont School of Medicine, Oakland University, Auburn Hills, MI, USA
| | | | - Kimberly A. Drenser
- Associated Retinal Consultants of Michigan, Royal Oak, MI, USA
- William Beaumont School of Medicine, Oakland University, Auburn Hills, MI, USA
| | - Philip J. Ferrone
- Long Island Vitreoretinal Consultants, North Shore-Long Island Jewish Medical Center, Great Neck, NY, USA
| | - Eric Nudleman
- Department of Ophthalmology, School of Medicine, Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Prethy Rao
- Associated Retinal Consultants of Michigan, Royal Oak, MI, USA
- William Beaumont School of Medicine, Oakland University, Auburn Hills, MI, USA
| | - Robert A. Sisk
- Cincinnati Eye Institute, University of Cincinnati, Cincinnati, OH, USA
- Department of Ophthalmology, Abrahamson Pediatric Eye Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | | | - Yoshihiro Yonekawa
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Audina Berrocal
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
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Manrique JA, Lopez-Reyes G, Cousin A, Rull F, Maurice S, Wiens RC, Madsen MB, Madariaga JM, Gasnault O, Aramendia J, Arana G, Beck P, Bernard S, Bernardi P, Bernt MH, Berrocal A, Beyssac O, Caïs P, Castro C, Castro K, Clegg SM, Cloutis E, Dromart G, Drouet C, Dubois B, Escribano D, Fabre C, Fernandez A, Forni O, Garcia-Baonza V, Gontijo I, Johnson J, Laserna J, Lasue J, Madsen S, Mateo-Marti E, Medina J, Meslin PY, Montagnac G, Moral A, Moros J, Ollila AM, Ortega C, Prieto-Ballesteros O, Reess JM, Robinson S, Rodriguez J, Saiz J, Sanz-Arranz JA, Sard I, Sautter V, Sobron P, Toplis M, Veneranda M. SuperCam Calibration Targets: Design and Development. Space Sci Rev 2020; 216:138. [PMID: 33281235 PMCID: PMC7691312 DOI: 10.1007/s11214-020-00764-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/09/2020] [Indexed: 05/09/2023]
Abstract
SuperCam is a highly integrated remote-sensing instrumental suite for NASA's Mars 2020 mission. It consists of a co-aligned combination of Laser-Induced Breakdown Spectroscopy (LIBS), Time-Resolved Raman and Luminescence (TRR/L), Visible and Infrared Spectroscopy (VISIR), together with sound recording (MIC) and high-magnification imaging techniques (RMI). They provide information on the mineralogy, geochemistry and mineral context around the Perseverance Rover. The calibration of this complex suite is a major challenge. Not only does each technique require its own standards or references, their combination also introduces new requirements to obtain optimal scientific output. Elemental composition, molecular vibrational features, fluorescence, morphology and texture provide a full picture of the sample with spectral information that needs to be co-aligned, correlated, and individually calibrated. The resulting hardware includes different kinds of targets, each one covering different needs of the instrument. Standards for imaging calibration, geological samples for mineral identification and chemometric calculations or spectral references to calibrate and evaluate the health of the instrument, are all included in the SuperCam Calibration Target (SCCT). The system also includes a specifically designed assembly in which the samples are mounted. This hardware allows the targets to survive the harsh environmental conditions of the launch, cruise, landing and operation on Mars during the whole mission. Here we summarize the design, development, integration, verification and functional testing of the SCCT. This work includes some key results obtained to verify the scientific outcome of the SuperCam system.
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Affiliation(s)
- J. A. Manrique
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - G. Lopez-Reyes
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - A. Cousin
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - F. Rull
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - S. Maurice
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - R. C. Wiens
- Los Alamos National Laboratory, Los Alamos, NM USA
| | - M. B. Madsen
- Niels Bohr Institute (NBI), University of Copenhagen, Copenhagen, Denmark
| | | | - O. Gasnault
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - J. Aramendia
- University of the Basque Country (UPV/EHU), Leioa, Spain
| | - G. Arana
- University of the Basque Country (UPV/EHU), Leioa, Spain
| | - P. Beck
- CNRS, Institut de Planetologie et d’Astrophysique de Grenoble (IPAG), Universite Grenoble Alpes, Saint-Martin d’Heres, France
| | - S. Bernard
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie (IMPMC), CNRS, MNHN, Sorbonne Université, Paris, France
| | - P. Bernardi
- Laboratoire d’Etudes Spatiales et d’Instrumentation en Astrophysique, Observatoire de Paris-PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - M. H. Bernt
- Niels Bohr Institute (NBI), University of Copenhagen, Copenhagen, Denmark
| | - A. Berrocal
- Ingeniería de Sistemas para la Defensa de España S.A. (ISDEFE), Madrid, Spain
| | - O. Beyssac
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie (IMPMC), CNRS, MNHN, Sorbonne Université, Paris, France
| | - P. Caïs
- Laboratoire d’astrophysique de Bordeaux, CNRS, Univ. Bordeaux, Bordeaux, France
| | - C. Castro
- Added Value Solutions (AVS), Elgóibar, Spain
| | - K. Castro
- University of the Basque Country (UPV/EHU), Leioa, Spain
| | - S. M. Clegg
- Los Alamos National Laboratory, Los Alamos, NM USA
| | | | - G. Dromart
- Univ Lyon, ENSL, CNRS, LGL-TPE, Univ Lyon 1, 69007 Lyon, France
| | - C. Drouet
- CIRIMAT, Université de Toulouse, CNRS/UT3/INP, Ensiacet, Toulouse, France
| | - B. Dubois
- Observatoire Midi-Pyrénées, Toulouse, France
| | - D. Escribano
- Instituto Nacional de Técnica Aeroespacial, Torrejón de Ardoz, Spain
| | - C. Fabre
- GeoRessources, Vandoeuvre les Nancy, France
| | | | - O. Forni
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - V. Garcia-Baonza
- Instituto de Geociencias CSIC, Universidad Complutense de Madrid, Madrid, Spain
| | - I. Gontijo
- Jet Propulsion Laboratory, Pasadena, CA USA
| | - J. Johnson
- Applied Physics Laboratory, Johns Hopkins University, Laurel, MD USA
| | - J. Laserna
- University of Malaga (UMA), Málaga, Spain
| | - J. Lasue
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - S. Madsen
- Jet Propulsion Laboratory, Pasadena, CA USA
| | - E. Mateo-Marti
- Centro de Astrobiología-CSIC-INTA, Torrejón de Ardoz, Spain
| | - J. Medina
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - P.-Y. Meslin
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - G. Montagnac
- Univ Lyon, ENSL, CNRS, LGL-TPE, Univ Lyon 1, 69007 Lyon, France
| | - A. Moral
- Instituto Nacional de Técnica Aeroespacial, Torrejón de Ardoz, Spain
| | - J. Moros
- University of Malaga (UMA), Málaga, Spain
| | - A. M. Ollila
- Los Alamos National Laboratory, Los Alamos, NM USA
| | - C. Ortega
- Added Value Solutions (AVS), Elgóibar, Spain
| | | | - J. M. Reess
- Laboratoire d’Etudes Spatiales et d’Instrumentation en Astrophysique, Observatoire de Paris-PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - S. Robinson
- Los Alamos National Laboratory, Los Alamos, NM USA
| | - J. Rodriguez
- Ingeniería de Sistemas para la Defensa de España S.A. (ISDEFE), Madrid, Spain
| | - J. Saiz
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - J. A. Sanz-Arranz
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - I. Sard
- Added Value Solutions (AVS), Elgóibar, Spain
| | - V. Sautter
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie (IMPMC), CNRS, MNHN, Sorbonne Université, Paris, France
| | - P. Sobron
- SETI Institute, Mountain View, CA USA
| | - M. Toplis
- Observatoire Midi-Pyrénées, Toulouse, France
| | - M. Veneranda
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
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Balana C, Sepulveda J, Pineda E, Vaz M, Mesia C, Fuster J, Girones R, Muñoz-Langa J, Navarro M, Alonso M, Gil Gil M, Herrero A, Estival A, Gallego O, Peralta S, Olier C, Pérez-Segura P, Covela M, Martinez García M, Domenech M, Carrato C, Sanz C, Velarde J, Berrocal A, Luque R, De las Peñas R, Del Barco S. P14.58 Extending adjuvant temozolomide longer than six cycles doesn’t add any benefit to glioblastoma patients according to the randomized GEINO-014 TRIAL. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.293] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Standard treatment of glioblastoma (GBM) is focal radiation with concomitant and adjuvant temozolomide (TMZ) for 6 cycles. The GEINO-14-01 trial (NCT02209948) investigated the role of extending adjuvant TMZ to 12 cycles in a randomized multicenter study.
MATERIAL AND METHODS
Between Aug/2014 and Nov/2018, 166 patients (p) were screened and 159 randomized to extend (80p) or not (79p) TMZ treatment to 12 cycles after proving stable disease in the MRI performed before inclusion. The trial was stratified by MGMT status and presence or absence of residual disease (defined as a residual enhancement larger than 1cm on the MRI). The primary endpoint was differences in 6monthsPFS, secondary endpoints were differences in PFS, OS, toxicity, between arms and per stratification factors.
RESULTS
Median age was 60.4 (range 29–83), 97p (61%) were methylated and 83 p (52.2%) were reported with residual disease. Median (m) PFS was 7.9 months (95%CI: 6.1–9.8) and mOS: 20.9 (95%CI: 17.6–24.1). A methylated status was a factor of better PFS (HR=0.29, 95% CI 0.46–0.95; p=0.029) and better OS (HR= 0.43: 95% CI 0.28–0.66; p=0.000) as well as the absence of residual disease (PFS: HR = 0.84: 95% CI =0.71–1.01; p=0.068; OS: HR=0.77, 95%CI 0.63–0.96; p=0.019). We didn’t find any difference in PFS (HR=1.02, 95%CI 0.85–1.21; p=0.82), or OS (HR=0.90; 0.73–1.11; p=0.34) on extending treatment with temozolomide longer than 6 cycles.
CONCLUSION
There is no benefit of continuing TMZ treatment for more than 6 cycles in the adjuvant treatment of glioblastoma. Final data will be presented at the congress. Supported by a Grant of the ISCIII: PI13/01751
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Affiliation(s)
- C Balana
- Institut Catala Oncologia Badalona, Badalona, Spain
| | - J Sepulveda
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - E Pineda
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - M Vaz
- Hospital Ramon y Cajal, Madrid, Spain
| | - C Mesia
- Institut Catala Oncologia Hospital Duran y Reynalds, Hospitalet de Llobregat, Spain
| | - J Fuster
- Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - R Girones
- Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - J Muñoz-Langa
- Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - M Navarro
- Hospital Universitario de Salamanca, Salamanca, Spain
| | - M Alonso
- Hospital Universitario la Virgen del Rocio, Sevilla, Spain
| | - M Gil Gil
- Institut Catala Oncologia Hospital Duran y Reynalds, Hospitalet de Llobregat, Spain
| | - A Herrero
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - A Estival
- Institut Catala Oncologia Badalona, Badalona, Spain
| | - O Gallego
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - S Peralta
- Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - C Olier
- Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain
| | | | - M Covela
- Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | - M Domenech
- Institut Catala Oncologia Badalona, Badalona, Spain
| | - C Carrato
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - C Sanz
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - J Velarde
- Institut Catala Oncologia Badalona, Badalona, Spain
| | - A Berrocal
- Hospital General Universitari de Valencia, Valencia, Spain
| | - R Luque
- HospitalUniversitario Virgen de las Nieves, Granada, Spain
| | | | - S Del Barco
- Institut Catala Oncologia Hospital Universitari Josep Trueta, Girona, Spain
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26
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Márquez-Rodas I, Arance A, Berrocal A, Larios CL, Curto-García J, Campos-Tapias IX, Blanca AB, Martin-Algarra S. A retrospective chart review study describing metastatic melanoma patients profile and treatment patterns in Spain. Clin Transl Oncol 2019; 21:1754-1762. [PMID: 31435877 DOI: 10.1007/s12094-019-02201-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/09/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE To describe patient characteristics by disease stage, resectability status and current treatment management after first diagnosis of IIIB to IV1c advanced (AM)/metastatic melanoma (MM). METHODS/PATIENTS Multicentre, retrospective study based on data from medical charts of patients > 18 years at MM first diagnosis, visited by oncologists at 4 reference centres in Spain: Hospital Universitario Gregorio Marañón (Madrid), Hospital General de Valencia (Valencia), Clínica Universidad de Navarra (Pamplona), and Hospital Clínic (Barcelona). RESULTS Metastatic non-visceral melanoma (IIIB, IIIC, IV M1a) was reported in 139 (48.6%) patients and 40.9% (n = 117) were diagnosed with IV-M1c disease. 160 (55.9%) metastases were resectable. Available therapies under clinical practice were used in 210 patients; 74 were treated under clinical trials (CT). Intention-to-cure surgery (47.6%) was the most common treatment at time of MM diagnosis. Systemic (45.1% overall) therapy included chemo-, targeted- and immunotherapy (19.6%, 14.3%, 8.4%, respectively). At time of data collection, 26 patients were still alive and 120 had progressed to IV-M1c. Median overall survival (OS) was significantly larger in IIIB patients, 28.9 m (25.2-32.7); the shortest for IV-M1c patients, 11.0 m (8.7-13.3). CONCLUSIONS Novel treatments are undoubtedly a major step forward in AM/MM, however these are often only available in the CT setting because early stages of development or country-specific regulations. Further prospective studies and multifactorial analysis should be performed to clearly identify possible clinical associations for outcome in Spanish patients with AM/MM.
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Affiliation(s)
- I Márquez-Rodas
- Medical Oncology, Hospital General Universitario Gregorio Marañón, Calle Dr. Esquerdo 46, 28007, Madrid, Spain.
- CIBERONC, Madrid, Spain.
| | - A Arance
- Medical Oncology, Hospital Clínic Barcelona, Barcelona, Spain
| | - A Berrocal
- Medical Oncology, Hospital General Universitario de Valencia, Valencia, Spain
| | - C L Larios
- Clinical Research Department, MFAR S.L, Barcelona, Spain
| | - J Curto-García
- Clinical Research Department, MFAR S.L, Barcelona, Spain
| | | | | | - S Martin-Algarra
- Medical Oncology, Clínica Universidad de Navarra, Pamplona, Spain
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27
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Venincasa MJ, Hubschman S, Kuriyan AE, Berrocal A, Sivalingam A, Albini TA, Sridhar J. Perceptions of Vitreoretinal Surgical Fellowship Training in the United States. Ophthalmol Retina 2019; 3:802-804. [PMID: 31253472 DOI: 10.1016/j.oret.2019.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Michael J Venincasa
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Sasha Hubschman
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Ajay E Kuriyan
- Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York
| | - Audina Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Arunan Sivalingam
- Mid Atlantic Retina, Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Thomas A Albini
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
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28
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Khine KT, Berrocal A, Chang TC. Funnel-Shaped Finding on Echography. J Pediatr Ophthalmol Strabismus 2019; 56:64. [PMID: 30673105 DOI: 10.3928/01913913-20181003-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/25/2018] [Indexed: 11/20/2022]
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29
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Balaña C, Estival A, Teruel I, Hardy-Werbin M, Sepulveda J, Pineda E, Martinez-García M, Gallego O, Luque R, Gil-Gil M, Mesia C, Del Barco S, Herrero A, Berrocal A, Perez-Segura P, De Las Penas R, Marruecos J, Fuentes R, Reynes G, Velarde JM, Cardona A, Verger E, Panciroli C, Villà S. Delay in starting radiotherapy due to neoadjuvant therapy does not worsen survival in unresected glioblastoma patients. Clin Transl Oncol 2018; 20:1529-1537. [PMID: 29737461 DOI: 10.1007/s12094-018-1883-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE We retrospectively examined the potential effect on overall survival (OS) of delaying radiotherapy to administer neoadjuvant therapy in unresected glioblastoma patients. PATIENTS AND METHODS We compared OS in 119 patients receiving neoadjuvant therapy followed by standard treatment (NA group) and 96 patients receiving standard treatment without neoadjuvant therapy (NoNA group). The MaxStat package of R identified the optimal cut-off point for waiting time to radiotherapy. RESULTS OS was similar in the NA and NoNA groups. Median waiting time to radiotherapy after surgery was 13 weeks for the NA group and 4.2 weeks for the NoNA group. The longest OS was attained by patients who started radiotherapy after 12 weeks and the shortest by patients who started radiotherapy within 4 weeks (12.3 vs 6.6 months) (P = 0.05). OS was 6.6 months for patients who started radiotherapy before the optimal cutoff of 6.43 weeks and 19.1 months for those who started after this time (P = 0.005). Patients who completed radiotherapy had longer OS than those who did not, in all 215 patients and in the NA and NoNA groups (P = 0.000). In several multivariate analyses, completing radiotherapy was a universally favorable prognostic factor, while neoadjuvant therapy was never identified as a negative prognostic factor. CONCLUSION In our series of unresected patients receiving neoadjuvant treatment, in spite of the delay in starting radiotherapy, OS was not inferior to that of a similar group of patients with no delay in starting radiotherapy.
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Affiliation(s)
- C Balaña
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona (Barcelona), Spain.
| | - A Estival
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona (Barcelona), Spain
| | - I Teruel
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona (Barcelona), Spain
| | - M Hardy-Werbin
- Cancer Research Programm, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J Sepulveda
- Medical Oncology Service, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - E Pineda
- Medical Oncology Service, Hospital Clinic Provincial, Barcelona, Spain
| | | | - O Gallego
- Medical Oncology Service, Hospital de Sant Pau, Barcelona, Spain
| | - R Luque
- Medical Oncology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M Gil-Gil
- Medical Oncology Service, Institut Català d'Oncologia-IDIBELL, Hospitalet de Llobregat, Spain
| | - C Mesia
- Medical Oncology Service, Institut Català d'Oncologia-IDIBELL, Hospitalet de Llobregat, Spain
| | - S Del Barco
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | - A Herrero
- Medical Oncology Service, Hospital Miguel Servet, Saragossa, Spain
| | - A Berrocal
- Medical Oncology Service, Hospital General Universitario de Valencia, Valencia, Spain
| | - P Perez-Segura
- Medical Oncology Service, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - R De Las Penas
- Medical Oncology Service, Hospital Provincial de Castellón, Castellón, Spain
| | - J Marruecos
- Radiation Oncology Service, Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | - R Fuentes
- Radiation Oncology Service, Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | - G Reynes
- Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - J M Velarde
- Institut Investigació Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Badalona, Spain
| | - A Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, FICMAC, Bogotá, Colombia.,Biology Systems Department, Universidad el Bosque, Bogotá, Colombia
| | - E Verger
- Radiation Oncology Service, Hospital Clinic Provincial, Barcelona, Spain
| | - C Panciroli
- Institut Investigació Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Badalona, Spain
| | - S Villà
- Radiation Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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30
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Berrocal A, Arance A, Castellon VE, de la Cruz L, Espinosa E, Cao MG, Larriba JLG, Márquez-Rodas I, Soria A, Algarra SM. SEOM clinical guideline for the management of malignant melanoma (2017). Clin Transl Oncol 2018; 20:69-74. [PMID: 29116432 PMCID: PMC5785602 DOI: 10.1007/s12094-017-1768-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/10/2017] [Indexed: 12/22/2022]
Abstract
All melanoma suspected patients must be confirmed histologically and resected. Sentinel node biopsy must be done when tumor is over 1 mm or if less with high-risk factors. Adjuvant therapy with interferon could be offered for patients with high-risk melanoma and in selected cases radiotherapy can be added. Metastatic melanoma treatment is guided by mutational BRAF status. BRAF wild type patients must receive anti-PD1 containing therapy and BRAF mutated patients BRAF/MEK inhibitors or anti-PD1 containing therapy. Up to 10 years follow up is reasonable for melanoma patients with dermatologic examinations and physical exams.
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Affiliation(s)
- A. Berrocal
- Servicio de Oncología Médica, Consorcio Hospital General Universitario de Valencia, Avda. Tres Cruces 2, 46014 Valencia, Spain
| | - A. Arance
- Hospital Clinic I Provincial de Barcelona, Barcelona, Spain
| | | | - L. de la Cruz
- Complejo Hospitalario Regional Virgen Macaren, Seville, Spain
| | - E. Espinosa
- Hospital Universitario la Paz, Madrid, Spain
| | - M. G. Cao
- Hospital Universitario Quirón Dexeus, Barcelona, Spain
| | | | | | - A. Soria
- Hospital Universitario Ramón y Cajal, Madrid, Spain
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Cunquero Tomas A, Avila Andrade C, Fernandez Diaz A, Meri Abad M, Shaheen I, Condori Farfan L, Rodriguez Huaman A, Sforza V, Aparisi Aparisi F, Safont Aguilera M, Blasco Cordellat A, Gil Raga M, Caballero Diaz C, Berrocal A, Godes Sanz de Bremond M, Pérez A, Iranzo Gonzalez-Cruz V, Camps Herrero C. 70-gene signature, an encouraging prognostic tool to guide adjuvant therapy in early breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx655.029] [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: 11/13/2022] Open
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32
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Meri Abad M, Avila Andrade C, Cunquero Tomas A, Rodriguez Huaman A, Fernandez Diaz A, Condori Farfan L, Shaheen I, Safont Aguilera M, Caballero Diaz C, Iranzo Gonzalez-Cruz V, Blasco Cordellat A, Godes Sanz de Bremond M, Berrocal A, Sforza V, Gil Raga M, Camps Herrero C. Impact on survival of pulmonary metastasectomy in colorectal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx659.015] [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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33
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Patel SN, Klufas MA, Douglas CE, Jonas KE, Ostmo S, Berrocal A, Capone A, Martinez-Castellanos MA, Chau F, Drenser K, Ferrone P, Orlin A, Tsui I, Wu WC, Gupta MP, Chiang MF, Chan RVP. Influence of Computer-Generated Mosaic Photographs on Retinopathy of Prematurity Diagnosis and Management. JAMA Ophthalmol 2017; 134:1283-1289. [PMID: 27685535 DOI: 10.1001/jamaophthalmol.2016.3625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Telemedicine is becoming an increasingly important component of clinical care for retinopathy of prematurity (ROP), but little information exists regarding the role of mosaic photography for ROP telemedicine diagnosis. Objective To examine the potential effect of computer-generated mosaic photographs on the diagnosis and management of ROP. Design, Setting, and Participants In this prospective cohort study performed from July 12, 2011, through September 21, 2015, images were acquired from ROP screening at 8 academic institutions, and ROP experts interpreted 40 sets (20 sets with individual fundus photographs with ≥3 fields and 20 computer-generated mosaic photographs) of wide-angle retinal images from infants with ROP. All experts independently reviewed the 40 sets and provided a diagnosis and management plan for each set presented. Main Outcomes and Measures The primary outcome measure was the sensitivity and specificity of the ROP diagnosis by experts that was calculated using a consensus reference standard diagnosis, determined from the diagnosis of fundus photographs by 3 experienced readers in combination with the clinical diagnosis based on ophthalmoscopic examination. Mean unweighted κ statistics were used to analyze the mean intergrader agreement among experts for diagnosis of zone, stage, plus disease, and category. Results Nine ROP experts (4 women and 5 men) who have been practicing ophthalmology for a mean of 10.8 years (range, 3-24 years) consented to participate. Diagnosis by the mosaic photographs compared with diagnosis by multiple individual photographs resulted in improvements in sensitivity for diagnosis of stage 2 disease or worse (95.9% vs 88.9%; difference, 7.0; 95% CI, 3.5 to 10.5; P = .02), plus disease (85.7% vs 63.5%; difference, 22.2; 95% CI, 7.6 to 36.9; P = .02), and treatment-requiring ROP (84.4% vs 68.5%; difference, 15.9; 95% CI, 0.8 to 31.7; P = .047). With use of the κ statistic, mosaic photographs, compared with multiple individual photographs, resulted in improvements in intergrader agreement for diagnosis of plus disease or not (0.54 vs 0.40; mean κ difference, 0.14; 95% CI, 0.07 to 0.21; P = .004), stage 3 disease or worse or not (0.60 vs 0.52; mean κ difference, 0.06; 95% CI, -0.06 to 0.18; P = .04), and type 2 ROP or not (0.58 vs 0.51; mean κ difference, 0.07; 95% CI, 0.03 to 0.11; P = .04). After viewing the mosaic photographs, experts altered their choice of management in 42 of 180 responses (23.3%; 95% CI, 17.1%-29.5%). Conclusions and Relevance Compared with multiple individual photographs, computer-generated mosaic photographs were associated with improved accuracy of image-based diagnosis for certain categories (eg, plus disease, stage 2 disease or worse, and treatment-requiring ROP) of ROP by experts. It is unclear, however, whether these findings are generalizable, and the results of this study may not be relevant to mosaic grading of other retinal vascular conditions.
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Affiliation(s)
- Samir N Patel
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York
| | | | | | - Karyn E Jonas
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York4Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Audina Berrocal
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida
| | - Antonio Capone
- Associated Retinal Consultants, Oakland University, Royal Oak, Michigan
| | | | - Felix Chau
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago
| | - Kimberly Drenser
- Associated Retinal Consultants, Oakland University, Royal Oak, Michigan
| | - Philip Ferrone
- Long Island Vitreoretinal Consultants, Long Island, New York
| | - Anton Orlin
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York
| | - Irena Tsui
- Stein Eye Institute, University of California, Los Angeles
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan11Department of Ophthalmology, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Mrinali P Gupta
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York
| | - Michael F Chiang
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - R V Paul Chan
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York4Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago12Center for Global Health, University of Illinois at Chicago, Chicago
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Dev Borman A, Rachitskaya A, Suzani M, Sisk RA, Ahmed ZM, Holder GE, Cipriani V, Arno G, Webster AR, Hufnagel RB, Berrocal A, Moore AT. Benign Yellow Dot Maculopathy: A New Macular Phenotype. Ophthalmology 2017; 124:1004-1013. [PMID: 28366503 DOI: 10.1016/j.ophtha.2017.02.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 02/21/2017] [Accepted: 02/21/2017] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To describe a novel macular phenotype that is associated with normal visual function. DESIGN Retrospective, observational case series. PARTICIPANTS Thirty-six affected individuals from 23 unrelated families. METHODS This was a retrospective study of patients who had a characteristic macular phenotype. Subjects underwent a full ocular examination, electrophysiologic studies, spectral-domain optical coherence tomography (OCT), and fundus autofluorescence imaging. Genomic analyses were performed using haplotype sharing analysis and whole-exome sequencing. MAIN OUTCOME MEASURES Visual acuity, retinal features, electroretinography, and whole-exome sequencing. RESULTS Twenty-six of 36 subjects were female. The median age of subjects at presentation was 15 years (range, 5-59 years). The majority of subjects were asymptomatic and presented after a routine eye examination (22/36 subjects) or after screening because of a positive family history (13/36 subjects) or by another ophthalmologist (1/36 subjects). Of the 3 symptomatic subjects, 2 had reduced visual acuity secondary to nonorganic visual loss and bilateral ametropic amblyopia with strabismus. Visual acuity was 0.18 logarithm of the minimum angle of resolution (logMAR) or better in 30 of 33 subjects. Color vision was normal in all subjects tested, except for the subject with nonorganic visual loss. All subjects had bilateral symmetric multiple yellow dots at the macula. In the majority of subjects, these were evenly distributed throughout the fovea, but in 9 subjects they were concentrated in the nasal parafoveal area. The dots were hyperautofluorescent on fundus autofluorescence imaging. The OCT imaging was generally normal, but in 6 subjects subtle irregularities at the inner segment ellipsoid band were seen. Electrophysiologic studies identified normal macular function in 17 of 19 subjects and normal full-field retinal function in all subjects. Whole-exome analysis across 3 unrelated families found no pathogenic variants in known macular dystrophy genes. Haplotype sharing analysis in 1 family excluded linkage with the North Carolina macular dystrophy (MCDR1) locus. CONCLUSIONS A new retinal phenotype is described, which is characterized by bilateral multiple early-onset yellow dots at the macula. Visual function is normal, and the condition is nonprogressive. In familial cases, the phenotype seems to be inherited in an autosomal dominant manner, but a causative gene is yet to be ascertained.
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Affiliation(s)
- Arundhati Dev Borman
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom.
| | - Aleksandra Rachitskaya
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Martina Suzani
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Robert A Sisk
- Cincinnati Eye Institute, University of Cincinnati Department of Ophthalmology, Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Zubair M Ahmed
- Otorhinolaryngology Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Graham E Holder
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Valentina Cipriani
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom; UCL Genetics Institute, London, United Kingdom
| | - Gavin Arno
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom
| | - Andrew R Webster
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom
| | - Robert B Hufnagel
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Audina Berrocal
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Anthony T Moore
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom; Ophthalmology Department, University of California San Francisco, San Francisco, California
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González-Cao M, Arance A, Piulats JM, Marquez-Rodas I, Manzano JL, Berrocal A, Crespo G, Rodriguez D, Perez-Ruiz E, Berciano M, Soria A, Castano AG, Espinosa E, Montagut C, Alonso L, Puertolas T, Aguado C, Royo MA, Blanco R, Rodríguez JF, Muñoz E, Mut P, Barron F, Martin-Algarra S. Pembrolizumab for advanced melanoma: experience from the Spanish Expanded Access Program. Clin Transl Oncol 2017; 19:761-768. [DOI: 10.1007/s12094-016-1602-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/16/2016] [Indexed: 11/28/2022]
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Iriarte AR, Martín-Algarra S, Merino LC, Abreu DR, Espinosa E, Berrocal A, Castro RL, Curiel T, Luna P, Lorenzo A, Piulats J. Phase II multi-centre, non randomized, open label study of nivolumab in combination with ipilimumab as first line in adults patients with metastatic uveal melanoma. GEM 14-02. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.54] [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: 11/12/2022] Open
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Martin JL, Merino LC, Fernandez AA, Illescas A, Ruiz IV, Berrocal A, Lopez-Torrecilla J, Rodas IM, Teruel MS, Gonzalez AA, Vicente MC, Abreu DR, Cabrera R, Sanchez MP, Curiel T, Couselo EM, Aristu J, Gomez-Caamano A, Martinez JM, Martin-Algarra S. GRAY-B: An open label multicenter phase-2 GEM study on ipilimumab and radiation in patients with melanoma and brain metastases. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.13] [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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Arance AM, Berrocal A, Lopez-Martin JA, de la Cruz-Merino L, Soriano V, Martín Algarra S, Alonso L, Cerezuela P, La Orden B, Espinosa E. Safety of vemurafenib in patients with BRAF V600 mutated metastatic melanoma: the Spanish experience. Clin Transl Oncol 2016; 18:1147-1157. [DOI: 10.1007/s12094-016-1498-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
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Berrocal A, Arance A, Espinosa E, Castaño AG, Cao MG, Larriba JLG, Martín JAL, Márquez I, Soria A, Algarra SM. SEOM guidelines for the management of Malignant Melanoma 2015. Clin Transl Oncol 2015; 17:1030-5. [PMID: 26669314 PMCID: PMC4689745 DOI: 10.1007/s12094-015-1450-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 11/27/2022]
Abstract
All melanoma patients must be confirmed histologically and resected according to Breslow. Sentinel node biopsy must be done when tumor is over 1 mm or if less with high-risk factors. Adjuvant therapy with interferon must be offered for patients with high-risk melanoma and in selected cases radiotherapy can be added. Metastatic melanoma treatment is guided by mutational BRAF status. BRAF wild type patients must receive anti-PD1 therapy and BRAF mutated patients BRAF/MEK inhibitors or anti-PD1 therapy. Up to 10 years follow up is recommended for melanoma patients with dermatologic examinations and physical exams.
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Affiliation(s)
- A Berrocal
- Servicio de Oncología Médica, Consorcio Hospital General Universitario de Valencia, Avda. Tres Cruces 2, 46014, Valencia, Spain.
| | - A Arance
- Hospital Clinic I Provincial de Barcelona, Barcelona, Spain
| | - E Espinosa
- Hospital Universitario la Paz, Madrid, Spain
| | - A G Castaño
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M G Cao
- Hospital Universitario Quirón Dexeus, Barcelona, Spain
| | - J L G Larriba
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - J A L Martín
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Márquez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Soria
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - S M Algarra
- Clínica Universitaria de Navarra, Pamplona, Spain
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40
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Del Barco Morillo E, Mesia R, Adansa Klain J, Fernández SV, Galan JM, Borgoñnon MP, Rivas CG, Caballero Daroqui J, Berrocal A, Trufero JM, Cruz Hernández J, Vera R. 2802 Phase II study of first-line paclitaxel (PTX) with panitumumab (P) in patients with metastatic or recurrent head and neck cancer: TTCC-2009-03 study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31546-5] [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: 11/28/2022]
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Abstract
Despite that basal cell carcinoma (BCC) is curative in the vast majority of cases, some patients are at high risk of recurrence and, in a few patients, lesions can progress to a point unsuitable for local therapy and prognosis is quite poor. The aim of the present work is to review clinical and pathologic characteristics as well as classical and new treatment options for high-risk, metastatic and locally advanced BCC. Surgery and radiotherapy remain the selected treatments for the majority of high-risk lesions. However, some patients are located on a blurry clinical boundary between high-risk and locally advanced BCC. Treatment of these patients is challenging and need an individualized and highly specialized approach. The treatment of locally advanced BCC, in which surgery or radiotherapy is unfeasible, inappropriate or contraindicated, and metastatic BCC has changed with new Hedgehog pathway inhibitors of which vismodegib is the first drug approved by FDA and EMA.
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Affiliation(s)
- S Puig
- Melanoma Unit, Dermatology Department, Hospital Clínic Barcelona, IDIBAPS, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain,
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Ryan MC, Ostmo S, Jonas K, Berrocal A, Drenser K, Horowitz J, Lee TC, Simmons C, Martinez-Castellanos MA, Chan RP, Chiang MF. Development and Evaluation of Reference Standards for Image-based Telemedicine Diagnosis and Clinical Research Studies in Ophthalmology. AMIA Annu Symp Proc 2014; 2014:1902-1910. [PMID: 25954463 PMCID: PMC4419970] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Information systems managing image-based data for telemedicine or clinical research applications require a reference standard representing the correct diagnosis. Accurate reference standards are difficult to establish because of imperfect agreement among physicians, and discrepancies between clinical vs. image-based diagnosis. This study is designed to describe the development and evaluation of reference standards for image-based diagnosis, which combine diagnostic impressions of multiple image readers with the actual clinical diagnoses. We show that agreement between image reading and clinical examinations was imperfect (689 [32%] discrepancies in 2148 image readings), as was inter-reader agreement (kappa 0.490-0.652). This was improved by establishing an image-based reference standard defined as the majority diagnosis given by three readers (13% discrepancies with image readers). It was further improved by establishing an overall reference standard that incorporated the clinical diagnosis (10% discrepancies with image readers). These principles of establishing reference standards may be applied to improve robustness of real-world systems supporting image-based diagnosis.
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Affiliation(s)
- Michael C. Ryan
- Departments of Ophthalmology & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Susan Ostmo
- Departments of Ophthalmology & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Karyn Jonas
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY
| | | | - Kimberly Drenser
- Department of Ophthalmology, William Beaumont Hospital, Royal Oak, MI
| | - Jason Horowitz
- Department of Ophthalmology, Columbia University, New York,NY
| | - Thomas C. Lee
- Department of Ophthalmology, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Charles Simmons
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - R.V. Paul Chan
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY
| | - Michael F. Chiang
- Departments of Ophthalmology & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
- Departments of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
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Martin-Algarra S, Soriano V, Malvehy J, Berrocal A, Quindos M, Martinez Del Prado P, Soria A, Márquez-Rodas I, Palacio I, Cerezuela P, Alonso L, López-Vivanco G, Nocea G, Stevinson K, Del Barrio P, Tornamira M, Guillem Porta V, Espinosa E. Treatment Patterns of Adjuvant Interferon Alfa-2B (Ifn-&Agr;2B) for High-Risk Melanoma. a Retrospective Study of the Grupo Español Multidisciplinar De Melanoma (Gem). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu344.39] [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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Balana C, Penas RDL, Sepulveda J, Gil MG, Luque R, Gallego O, Reynes G, Herrero A, Perez-Segura P, Berrocal A. P17.04 * RANO CRITERIA APPLIED TO A PHASE II RANDOMIZED, MULTICENTER TRIAL COMPARING TEMOZOLOMIDE (TMZ) VS TMZ-PLUS-BEVACIZUMAB (BEV) BEFORE STANDARD TREATMENT IN UNRESECTABLE GLIOBLASTOMA (GBM) PATIENTS (P).GENOM 009 STUDY BY THE GEINO GROUP. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.334] [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: 11/13/2022] Open
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Balana C, Sanz C, Ramirez J, Gil J, Sepúlveda J, De Las Penas R, Luque R, Gallego O, Reynes G, Carrato C, Sanchez B, Herrero A, Berrocal A, Perez Segura P, Garcia Castano A, Peralta S, Vazquez S, Fernández Perez I, Martinez-Garcia M. Mgmt Methylation in Tissue and Serum from Unresectable Glioblastoma (Gbm) Patients (P) Included in the Genom 009 Study, a Multicenter Randomized Study By the Geino Group Comparing Temozolomide (Tmz) Versus Tmz-Plus-Bevacizumab (Bev). (Clinicaltrials.Gov Nct01102595). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu330.4] [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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Hitt R, Mesia R, Grau J, Rubió J, Martínez-Trufero J, Del Barco Morillo E, Almodóvar Alvarez C, Taberna-Sanz M, García-Girón C, Vazquez S, Cirauqui B, Pastor Borgoñón M, Galve Calvo E, Juan-Vidal O, Lopez R, Martinez-Galan J, Bastus R, Berrocal A, Adansa Klain J, Cruz Hernandez J. Induction Chemotherapy (Ict) with Docetaxel/Cisplatin/5-Fluorouracil (T/P/F) Followed By Chemoradiotherapy with Cisplatin (Crtp) Vs Bioradiotherapy with Cetuximab (Rtcx) for Unresectable Locally Advanced Head & Neck Cancer (Ulahnc): Preliminary Results on Toxicity a Ttcc Group Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.50] [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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Gallego O, Cuatrecasas M, Benavides M, Segura PP, Berrocal A, Erill N, Colomer A, Quintana MJ, Balaña C, Gil M, Gallardo A, Murata P, Barnadas A. Efficacy of erlotinib in patients with relapsed gliobastoma multiforme who expressed EGFRVIII and PTEN determined by immunohistochemistry. J Neurooncol 2013; 116:413-9. [PMID: 24352766 PMCID: PMC3890043 DOI: 10.1007/s11060-013-1316-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 11/17/2013] [Indexed: 11/26/2022]
Abstract
Epidermal growth factor receptor gene (EGFR) alteration is a common feature in most of glioblastoma multiforme (GBM). Robust response of anti-EGFR treatments has been mostly associated with the EGFR deletion mutant variant III (EGFRvIII) and expression of PTEN. We have performed a prospective trial in order to confirm the efficacy of erlotinib treatment in patients with relapsed GBM who expressed EGFRvIII and PTEN. All patients included in the trial were required to be PTEN (+++), EGFR (+++) and EGFRvIII (+++) positives by immunohistochemistry. This new phase II trial enrolled 40 patients and was design to be stopped in case of fewer than two responses in the first 13 patients. Patient eligibility included histopathology criteria, radiological progression, more than 18 years old, Karnofsky performed status, KPS > 50, and adequate bone marrow and organ function. There was no limit to the number of prior treatments for relapses. No enzyme-inducing antiepileptic drugs were allowed. The primary endpoints were response and progression-free survival at 6 months (PFS6). Thirteen patients (6 men, 7 women) with recurrent GBM received erlotinib 150 mg/day. Median age was 53 years, median KPS was 80, and median prior treatments for relapses were 2. There was one partial response and three stable diseases (one at 18 months). PFS at 6 months was 20 %. Dose reduction for toxicity was not needed in any patient. Dermatitis was the main treatment-related toxicity, grade 1 in 8 patients and grade 2 in 5 patients. No grade 3 toxicity was observed. Median survival was 7 months (95 % IC 1.41–4.7). As conclusion, monotherapy with erlotinib in GBM relapses patients with high protein expression for PTEN (+++), EGFR (+++), and EGFRvlII (+++) showed low toxicity but minimal efficacy and the trial stopped.
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Affiliation(s)
- Oscar Gallego
- Medical Oncology Service, Santa Creu i Sant Pau Hospital, Sant Antoni Mº Claret nº 167, 08025, Barcelona, Spain,
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Hitt R, Grau JJ, López-Pousa A, Berrocal A, García-Girón C, Irigoyen A, Sastre J, Martínez-Trufero J, Brandariz Castelo JA, Verger E, Cruz-Hernández JJ. A randomized phase III trial comparing induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as treatment of unresectable head and neck cancer. Ann Oncol 2013; 25:216-25. [PMID: 24256848 DOI: 10.1093/annonc/mdt461] [Citation(s) in RCA: 223] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Concurrent chemoradiotherapy (CCRT) is the standard treatment for patients with unresectable, nonmetastatic locoregionally advanced squamous-cell carcinoma of the head and neck (LASCCHN). This randomized, open-label, phase III clinical trial compared the efficacy between standard CCRT and two different induction chemotherapy (ICT) regimens followed by CCRT. PATIENTS AND METHODS Patients with untreated LASCCHN were randomly assigned to ICT (three cycles), with either docetaxel (Taxotere), cisplatin and 5-fluorouracil (TPF arm) or cisplatin and 5-fluorouracil (PF arm), followed by CCRT [7 weeks of radiotherapy (RT) with cisplatin 100 mg/m(2) on days 1, 22 and 43]; or 7 weeks of CCRT alone. The primary end points were progression-free survival (PFS) and time-to-treatment failure (TTF). RESULTS In the intention-to-treat (ITT) population (n = 439), the median PFS times were 14.6 (95% CI, 11.6-20.4), 14.3 (95% CI, 11.8-19.3) and 13.8 months (95% CI, 11.0-17.5) at TPF-CCRT, PF-CCRT and CCRT arms, respectively (log-rank P = 0.56). The median TTF were 7.9 (95% CI, 5.9-11.8), 7.9 (95% CI, 6.5-11.8) and 8.2 months (95% CI, 6.7-12.6) for TPF-CCRT, PF-CCRT and CCRT alone, respectively (log-rank P = 0.90). There were no statistically significant differences for overall survival (OS). Toxic effects from ICT-CCRT were manageable. CONCLUSION Overall, this trial failed to show any advantage of ICT-CCRT over CCRT alone in patients with unresectable LASCCHN.
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Affiliation(s)
- R Hitt
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid
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Martín-Algarra S, Fernández-Figueras MT, López-Martín JA, Santos-Briz A, Arance A, Lozano MD, Berrocal A, Ríos-Martín JJ, Espinosa E, Rodríguez-Peralto JL. Guidelines for biomarker testing in metastatic melanoma: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology. Clin Transl Oncol 2013; 16:362-73. [DOI: 10.1007/s12094-013-1090-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 07/16/2013] [Indexed: 12/19/2022]
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Martin JL, Gonzalez Cao M, Sereno M, Mayordomo J, Hidalgo M, Campos B, Cumplido D, Zambrana F, Medina J, Berrocal A. Ipilimumab in Older Patients: Spanish Melanoma Multidisciplinary Group (GEM) Experience in the Expanded Access Programme. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33707-8] [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: 11/29/2022] Open
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