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Abu-Rustum NR, Yashar CM, Arend R, Barber E, Bradley K, Brooks R, Campos SM, Chino J, Chon HS, Crispens MA, Damast S, Fisher CM, Frederick P, Gaffney DK, Gaillard S, Giuntoli R, Glaser S, Holmes J, Howitt BE, Kendra K, Lea J, Lee N, Mantia-Smaldone G, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Podoll M, Rodabaugh K, Salani R, Schorge J, Siedel J, Sisodia R, Soliman P, Ueda S, Urban R, Wethington SL, Wyse E, Zanotti K, McMillian N, Espinosa S. Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2024; 22:117-135. [PMID: 38503056 DOI: 10.6004/jnccn.2024.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Vulvar cancer is annually diagnosed in an estimated 6,470 individuals and the vast majority are histologically squamous cell carcinomas. Vulvar cancer accounts for 5% to 8% of gynecologic malignancies. Known risk factors for vulvar cancer include increasing age, infection with human papillomavirus, cigarette smoking, inflammatory conditions affecting the vulva, and immunodeficiency. Most vulvar neoplasias are diagnosed at early stages. Rarer histologies exist and include melanoma, extramammary Paget's disease, Bartholin gland adenocarcinoma, verrucous carcinoma, basal cell carcinoma, and sarcoma. This manuscript discusses recommendations outlined in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for treatments, surveillance, systemic therapy options, and gynecologic survivorship.
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Affiliation(s)
| | | | | | - Emma Barber
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jordan Holmes
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | - Kari Kendra
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Jayanthi Lea
- UT Southwestern Simmons Comprehensive Cancer Center
| | - Nita Lee
- The UChicago Medicine Comprehensive Cancer Center
| | | | | | - David Mutch
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Christa Nagel
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | | | - John Schorge
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | | | - Stefanie Ueda
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | - Kristine Zanotti
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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Kvale E, Phillips F, Ghosh S, Lea J, Hoppenot C, Costales A, Sunde J, Badr H, Nwogu-Onyemkpa E, Saleem N, Ward R, Balasubramanian B. Survivorship Care for Women Living With Ovarian Cancer: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e48069. [PMID: 38335019 PMCID: PMC10891493 DOI: 10.2196/48069] [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: 05/26/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Ovarian cancer ranks 12th in cancer incidence among women in the United States and 5th among causes of cancer-related death. The typical treatment of ovarian cancer focuses on disease management, with little attention given to the survivorship needs of the patient. Qualitative work alludes to a gap in survivorship care; yet, evidence is lacking to support the delivery of survivorship care for individuals living with ovarian cancer. We developed the POSTCare survivorship platform with input from survivors of ovarian cancer and care partners as a means of delivering patient-centered survivorship care. This process is framed by the chronic care model and relevant behavioral theory. OBJECTIVE The overall goal of this study is to test processes of care that support quality of life (QOL) in survivorship. The specific aims are threefold: first, to test the efficacy of the POSTCare platform in supporting QOL, reducing depressive symptom burden, and reducing recurrence worry. In our second aim, we will examine factors that mediate the effect of the intervention. Our final aim focuses on understanding aspects of care platform design and delivery that may affect the potential for dissemination. METHODS We will enroll 120 survivors of ovarian cancer in a randomized controlled trial and collect data at 12 and 24 weeks. Each participant will be randomized to either the POSTCare platform or the standard of care process for survivorship. Our population will be derived from 3 clinics in Texas; each participant will have received some combination of treatment modalities; continued maintenance therapy is not exclusionary. RESULTS We will examine the impact of the POSTCare-O platform on QOL at 12 weeks after intervention as the primary end point. We will look at secondary outcomes, including depressive symptom burden, recurrence anxiety, and physical symptom burden. We will identify mediators important to the impact of the intervention to inform revisions of the intervention for subsequent studies. Data collection was initiated in November 2023 and will continue for approximately 2 years. We expect results from this study to be published in early 2026. CONCLUSIONS This study will contribute to the body of survivorship science by testing a flexible platform for survivorship care delivery adapted for the specific survivorship needs of patients with ovarian cancer. The completion of this project will contribute to the growing body of science to guide survivorship care for persons living with cancer. TRIAL REGISTRATION ClinicalTrials.gov NCT05752448; https://clinicaltrials.gov/study/NCT05752448. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48069.
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Affiliation(s)
- Elizabeth Kvale
- Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Farya Phillips
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, United States
| | - Samiran Ghosh
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Houston, TX, United States
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Claire Hoppenot
- Department of Gynecologic Oncology, Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - Anthony Costales
- Department of Gynecologic Oncology, Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - Jan Sunde
- Department of Gynecologic Oncology, Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - Hoda Badr
- Department of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Eberechi Nwogu-Onyemkpa
- Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Nimrah Saleem
- Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Rikki Ward
- University of Texas Health Houston School of Public Health - Dallas Campus, Dallas, TX, United States
| | - Bijal Balasubramanian
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Houston, TX, United States
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Aroche Gutierrez LL, McIntire DD, Lea J, LoCoco S, Miller DS. Social determinants of health in uterine carcinosarcoma. Gynecol Oncol 2024; 184:117-122. [PMID: 38309028 DOI: 10.1016/j.ygyno.2024.01.042] [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: 10/19/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE UCS survival outcome disparities by race have been reported. We aimed to investigate social determinants of health (SDOH) and their relation to survival outcomes in women at two affiliated high-volume institutions serving a racially and economically diverse population. METHODS Women diagnosed with stage I-IV UCS treated at St. Paul University Hospital, University of Texas Southwestern (UTSW) Zale Lipshy Pavilion-William P. Clements Jr. University Hospital, and Parkland Memorial Hospital between 1992 and 2022 were eligible. Patients were identified by the local tumor registries; a retrospective study was conducted. The Pearson chi-square test was utilized for categorical variables. OS and PFS were calculated using Kaplan-Meier estimates and compared with the log-rank test. Multivariate Cox models were used to identify independent prognostic factors. All statistical analyses were performed using SAS, version 9.4. RESULTS Over half of the 218 patients with UCS were NHB. 35% of the patients had stage IV disease. Most HSP and NHB patients had a lower median household income* than Asian/Pacific Islander (API) or NHW (p < 0.001). Stage at diagnosis significantly affected OS (p < 0.001) but not PFS (p = 0.46) in univariate analyses. Accounting for age at diagnosis, insurance, income*, hospital, distance between hospital and home, months from diagnosis to first treatment, stage, and adjuvant therapy, race was significant for OS (p = 0.03) and PFS (p = 0.04). *Median household income by ZIP Code. CONCLUSIONS Racial disparities were seen in median household income. Most SDOH independently analyzed in this study did not affect OS. The complex interaction between race and stage in UCS survival outcomes needs further investigation.
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Affiliation(s)
- Larissa L Aroche Gutierrez
- Department of Obstetrics & Gynecology, Division of General Obstetrics & Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Donald D McIntire
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Jayanthi Lea
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, and Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Salvatore LoCoco
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, and Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - David Scott Miller
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, and Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
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Abu-Rustum NR, Yashar CM, Arend R, Barber E, Bradley K, Brooks R, Campos SM, Chino J, Chon HS, Crispens MA, Damast S, Fisher CM, Frederick P, Gaffney DK, Gaillard S, Giuntoli R, Glaser S, Holmes J, Howitt BE, Lea J, Mantia-Smaldone G, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Podoll M, Rodabaugh K, Salani R, Schorge J, Siedel J, Sisodia R, Soliman P, Ueda S, Urban R, Wyse E, McMillian NR, Aggarwal S, Espinosa S. NCCN Guidelines® Insights: Cervical Cancer, Version 1.2024. J Natl Compr Canc Netw 2023; 21:1224-1233. [PMID: 38081139 DOI: 10.6004/jnccn.2023.0062] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The NCCN Guidelines for Cervical Cancer provide recommendations for all aspects of management for cervical cancer, including the diagnostic workup, staging, pathology, and treatment. The guidelines also include details on histopathologic classification of cervical cancer regarding diagnostic features, molecular profiles, and clinical outcomes. The treatment landscape of advanced cervical cancer is evolving constantly. These NCCN Guidelines Insights provide a summary of recent updates regarding the systemic therapy recommendations for recurrent or metastatic disease.
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Affiliation(s)
| | | | | | - Emma Barber
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | | | | | | | | | | | | | | | | | | | - Scott Glaser
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | | | | | | | - Andrea Mariani
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - David Mutch
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | | | - Ritu Salani
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | | | | | | | - Renata Urban
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
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Yu X, Ye J, Hathaway CA, Tworoger S, Lea J, Li B. Quantifiable TCR repertoire changes in pre-diagnostic blood specimens among high-grade ovarian cancer patients. bioRxiv 2023:2023.10.12.562056. [PMID: 37905034 PMCID: PMC10614767 DOI: 10.1101/2023.10.12.562056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
High grade serous ovarian cancer (HGOC) is a major cause of death in women. Early detection of HGOC usually leads to a cure, yet it remains a clinical challenge with over 90% HGOCs diagnosed at advanced stages. This is mainly because conventional biomarkers are not sensitive to detect the microscopic yet metastatic early HGOC lesions. In this study, we sequenced the blood T cell receptor (TCR) repertoires of 466 ovarian cancer patients and controls, and systematically investigated the immune repertoire signatures in HGOCs. We observed quantifiable changes of selected TCRs in HGOCs that are reproducible in multiple independent cohorts. Importantly, these changes are stronger during stage I. Using pre-diagnostic patient blood samples from the Nurses' Health Study, we confirmed that HGOC signals can be detected in the blood TCR repertoire up to 4 years proceeding conventional diagnosis. Our findings may provide the basis of an immune-based HGOC early detection criterion.
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Affiliation(s)
- Xuexin Yu
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia
- Department of Pathology, Perelman School of Medicine, University of Pennsylvania
| | - Jianfeng Ye
- Department of Neuroscience, UT Southwestern Medical Center
| | | | | | - Jayanthi Lea
- Department of Gynecology, UT Southwestern Medical Center
| | - Bo Li
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia
- Department of Pathology, Perelman School of Medicine, University of Pennsylvania
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Abu-Rustum N, Yashar C, Arend R, Barber E, Bradley K, Brooks R, Campos SM, Chino J, Chon HS, Chu C, Crispens MA, Damast S, Fisher CM, Frederick P, Gaffney DK, Giuntoli R, Han E, Holmes J, Howitt BE, Lea J, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Podoll M, Salani R, Schorge J, Siedel J, Sisodia R, Soliman P, Ueda S, Urban R, Wethington SL, Wyse E, Zanotti K, McMillian NR, Aggarwal S. Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2023; 21:181-209. [PMID: 36791750 DOI: 10.6004/jnccn.2023.0006] [Citation(s) in RCA: 66] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Adenocarcinoma of the endometrium (also known as endometrial cancer, or more broadly as uterine cancer or carcinoma of the uterine corpus) is the most common malignancy of the female genital tract in the United States. It is estimated that 65,950 new uterine cancer cases will have occurred in 2022, with 12,550 deaths resulting from the disease. Endometrial carcinoma includes pure endometrioid cancer and carcinomas with high-risk endometrial histology (including uterine serous carcinoma, clear cell carcinoma, carcinosarcoma [also known as malignant mixed Müllerian tumor], and undifferentiated/dedifferentiated carcinoma). Stromal or mesenchymal sarcomas are uncommon subtypes accounting for approximately 3% of all uterine cancers. This selection from the NCCN Guidelines for Uterine Neoplasms focuses on the diagnosis, staging, and management of pure endometrioid carcinoma. The complete version of the NCCN Guidelines for Uterine Neoplasms is available online at NCCN.org.
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Affiliation(s)
| | | | | | - Emma Barber
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Susana M Campos
- Dana-Farber/Brigham and Women's Cancer Center
- Massachusetts General Hospital Cancer Center
| | | | | | | | | | | | | | | | | | | | | | - Jordan Holmes
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | - Jayanthi Lea
- UT Southwestern Simmons Comprehensive Cancer Center
| | | | - David Mutch
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Christa Nagel
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Larissa Nekhlyudov
- Dana-Farber/Brigham and Women's Cancer Center
- Massachusetts General Hospital Cancer Center
| | | | | | - John Schorge
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | - Rachel Sisodia
- Dana-Farber/Brigham and Women's Cancer Center
- Massachusetts General Hospital Cancer Center
| | | | - Stefanie Ueda
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | - Kristine Zanotti
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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Spirtos A, Parnell T, Barth J, Huang W, Street A, Lea J. 40 Pre-operative non-narcotic analgesia decreases the use of postoperative narcotics. Gynecol Oncol Rep 2022. [DOI: 10.1016/s2352-5789(22)00252-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Aroche-Gutierrez L, McIntire DD, Lea J, LoCoco S, Carlson M, Miller DS. 45 Disparities in carcinosarcoma: public vs private hospital system. Gynecol Oncol Rep 2022. [DOI: 10.1016/s2352-5789(22)00257-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Spirtos A, Werner B, Barth J, Parnell T, Street A, LoCoco S, Carlson M, Miller DS, Lea J. 17 Pre-operative patient characteristics predict outpatient opioid use. Gynecol Oncol Rep 2022. [DOI: 10.1016/s2352-5789(22)00229-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Yu X, Lin W, Spirtos A, Wang Y, Chen H, Ye J, Parker J, Liu CC, Wang Y, Quinn G, Zhou F, Chambers SK, Lewis C, Lea J, Li B, Zheng W. Dissection of transcriptome dysregulation and immune characterization in women with germline BRCA1 mutation at single-cell resolution. BMC Med 2022; 20:283. [PMID: 36076202 PMCID: PMC9461201 DOI: 10.1186/s12916-022-02489-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND High-grade serous carcinoma (HGSC) is the most frequent and lethal type of ovarian cancer. It has been proposed that tubal secretory cells are the origin of ovarian HGSC in women with familial BRCA1/2 mutations. However, the molecular changes underlying malignant transformation remain unknown. METHOD We performed single-cell RNA and T cell receptor sequencing of tubal fimbriated ends from 3 BRCA1 germline mutation carriers (BRCA1 carriers) and 3 normal controls with no high-risk history (non-BRCA1 carriers). RESULTS Exploring the transcriptomes of 19,008 cells, predominantly from BRCA1+ samples, we identified 5 major cell populations in the fallopian tubal mucosae. The secretory cells of BRCA1+ samples had differentially expressed genes involved in tumor growth and regulation, chemokine signaling, and antigen presentation compared to the wild-type BRCA1 controls. There are several novel findings in this study. First, a subset of the fallopian tubal secretory cells from one BRCA1 carrier exhibited an epithelial-to-mesenchymal transition (EMT) phenotype, which was also present in the mucosal fibroblasts. Second, we identified a previously unreported phenotypic split of the EMT secretory cells with distinct evolutionary endpoints. Third, we observed increased clonal expansion among the CD8+ T cell population from BRCA1+ carriers. Among those clonally expanded CD8+ T cells, PD-1 was significantly increased in tubal mucosae of BRCA1+ patients compared with that of normal controls, indicating that T cell exhaustion may occur before the development of any premalignant or malignant lesions. CONCLUSION These results indicate that EMT and immune evasion in normal-looking tubal mucosae may represent early events leading to the development of HGSC in women with BRCA1 germline mutation. Our findings provide a probable molecular mechanism explaining why some, but not all, women with BRCA1 germline mutation present with early development and rapid dissemination of HGSC.
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Affiliation(s)
- Xuexin Yu
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, USA
| | - Wanrun Lin
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexandra Spirtos
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yan Wang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hao Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jianfeng Ye
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jessica Parker
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Present address: Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, USA
| | - Ci Ci Liu
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Present address: Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Yiying Wang
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Gabriella Quinn
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, USA
| | - Feng Zhou
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Present address: Department of Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Setsuko K Chambers
- Department of Obstetrics and Gynecology, The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Cheryl Lewis
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Present address: Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA.
| | - Bo Li
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, USA. .,Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA. .,Department of Immunology, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Wenxin Zheng
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA.
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Lea J, Sorrels C, Ye J, Li B. Detection of high-grade serous ovarian carcinoma using adaptive immune response and T cell repertoire (201). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Holloway S, Miller D, Lea J. Pembrolizumab in pretreated advanced, metastatic cervical, vulvar, vaginal carcinoma (325). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Holloway S, Mercadel A, Miller D, Lea J. Isolated para-aortic nodal metastasis or recurrence absent after radical hysterectomy for stage IA-IIA cervical carcinoma (401). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01623-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jiang X, Wang J, Zheng X, Liu Z, Zhang X, Li Y, Wilhelm J, Cao J, Huang G, Zhang J, Sumer B, Lea J, Lu Z, Gao J, Luo M. Intratumoral administration of STING-activating nanovaccine enhances T cell immunotherapy. J Immunother Cancer 2022; 10:jitc-2021-003960. [PMID: 35623658 PMCID: PMC9150169 DOI: 10.1136/jitc-2021-003960] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 05/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cancer vaccines are able to achieve tumor-specific immune editing in early-phase clinical trials. However, the infiltration of cytotoxic T cells into immune-deserted tumors is still a major limiting factor. An optimized vaccine approach to induce antigen-specific T cells that can perform robust tumor infiltration is important to accelerate their clinical translation. We previously developed a STING-activating PC7A nanovaccine that produces a strong anti-tumor T cell response on subcutaneous injection. This study systematically investigated the impact of administration methods on the performance of nanovaccines. METHODS Tumor growth inhibition by intratumoral delivery and subcutaneous delivery of nanovaccine was investigated in TC-1 human papillomavirus-induced cancer model and B16-OVA melanoma model. Nanovaccine distribution in vivo was detected by clinical camera imaging, systemic T cell activation and tumor infiltration were tested by in vivo cytotoxicity killing assay and flow cytometry. For mechanism analysis, T cell recruitment was investigated by in vivo migration blocking assay, multiplex chemokine array, flow cytometry, RT-qPCR, chemotaxis assay and gene knockout mice. RESULTS Nanovaccine administration was found to alter T cell production and infiltration in tumors. Intratumoral delivery of nanovaccines displayed superior antitumor effects in multiple tumor models compared with subcutaneous delivery. Mechanistic investigation revealed that intratumoral administration of the nanovaccine significantly increased the infiltration of antigen-specific T cells in TC-1 tumors, despite the lower systemic levels of T cells compared with subcutaneous injection. The inhibition of tumor growth by nanovaccines is primarily dependent on CD8+ cytotoxic T cells. Nanovaccine accumulation in tumors upregulates CXCL9 expression in myeloid cells in a STING dependent manner, leading to increased recruitment of IFNγ-expressing CD8+ T cells from the periphery, and IFNγ reciprocally stimulates CXCL9 expression in myeloid cells, resulting in positive feedback between myeloid-CXCL9 and T cell-IFNγ to promote T cell recruitment. However, the STING agonist alone could not sustain this effect in the presence of a systemic deficiency in antigen-specific T cells. CONCLUSIONS Our results demonstrate that intratumoral administration of PC7A nanovaccine achieved stronger antitumor immunity and efficacy over subcutaneous injection. These data suggest intratumoral administration should be included in the therapeutic design in the clinical use of nanovaccine.
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Affiliation(s)
- Xiaoyi Jiang
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Jian Wang
- Department of Pharmacology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Xichen Zheng
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Zhida Liu
- Shanxi Academy of Advanced Research and Innovation, Taiyuan, Shanxi, China
| | - Xinyu Zhang
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Yuwei Li
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Jonathan Wilhelm
- Department of Pharmacology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jun Cao
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Gang Huang
- Department of Pharmacology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jinlan Zhang
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China.,The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Baran Sumer
- Department of Otolaryngology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Zhigang Lu
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China .,The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.,Shanghai Institute of Infectious Diseases and Biosecurity, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jinming Gao
- Department of Pharmacology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA .,Department of Otolaryngology, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Min Luo
- Institute of Pediatrics, Children's Hospital of Fudan University, and Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
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15
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Wang Y, Chang RJ, Luo RZ, Yu J, Zhang X, Yang X, Quddus MR, Li L, Yang W, Liu A, Jiang Q, Zhao R, Zhu H, Zhou F, Wang Y, Sheng X, Liu LL, Wen YL, Banet N, Sung CJ, Qi Y, Bi R, Li M, Wang Y, Li J, Lin W, Wang Y, Rivera G, Chen H, Holloway SB, Fadare O, Liu J, Wang J, Lea J, Kong B, Zheng W. Tumoral Morphologic Features From Cervical Biopsies That Are Predictive of a Negligible Risk for Nodal Metastasis and Tumor Recurrence in Usual-type Cervical Adenocarcinomas: A Multi-institutional Study. Am J Surg Pathol 2022; 46:713-724. [PMID: 34753864 DOI: 10.1097/pas.0000000000001833] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The metastatic or recurrent potential of localized human papillomavirus-associated endocervical adenocarcinoma (HPVA EAC) is difficult to predict, especially based upon biopsy alone. Recent analyses of small cohorts indicate that high tumor nuclear grade (TNG) and the presence of necrotic tumor debris (NTD) from HPVA EACs in cervical biopsy specimens are highly predictive of nodal metastasis (NM). In the present study, we aimed to investigate how reliably tumoral morphologic features from cervical biopsy specimens predict NM or tumor recurrence (TR) and patient outcomes in a large cohort of endocervical adenocarcinoma patients. A cohort comprised of 397 patients with HPVA EAC treated at 18 institutions was identified, and cervical biopsies were paired with their associated complete tumor resections for a total of 794 specimens. A variety of tumoral histologic features were examined for each paired specimen, including TNG (assessed on a 3-tiered scale of increasing abnormalities-TNG1, TNG2, TNG3) and NTD (defined by the presence of necrotic and apoptotic tumor cells within tumor glandular lumens admixed with granular and eosinophilic amorphous material and inflammatory cells), which were correlated with outcomes. The distribution of TNG in biopsies was as follows: 86 (21.7%) TNG1, 223 (56.2%) TNG2, and 88 (22.2%) TNG3. NTD was identified in 176 (44%) of the biopsy specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of a TNG1 assignment in the biopsy being predictive of the same assignment in the full resection were 0.82 (95% confidence interval [CI]: 0.7-0.9), 0.895 (0.86-0.93), 0.593 (0.48-0.696), and 0.96 (0.94-0.98), respectively. Respective values for an NTD-negative status were 0.89 (95% CI: 0.83-0.92), 0.715 (0.64-0.77), 0.72 (0.65-0.77), and 0.89 (0.83-0.93), respectively. Compared with the other cases in each category, both TNG1 and an NTD-negative status were each significantly associated with lower rates of NM (odds ratio for TNG1=0.245, 95% CI: 0.070-0.857, P=0.0277; for NTD=0.199, 95% CI: 0.094-0.421, P<0.0001) and TR (odds ratio for TNG1=0.225, 95% CI: 0.051-0.987, P=0.0479; for NTD=0.367, 95% CI: 0.171-0.786, P=0.0099) independent of depth of stromal invasion, lymphovascular invasion, tumor size, FIGO stage, and Silva pattern. Overall, 73/379 (19%) cases were both TNG1 and NTD-negative on the biopsy, and none of these 73 cases showed NM (0%), but a single case (1.4%) showed TR. In contrast, among the 324 biopsies with TNG2/3 and/or presence of NTD, 62 (19.1%) had NM, and 41 (12.9%) had TR. In summary, 2 variables in combination (ie, TNG1 and NTD-negative) identified a subset of HPVA EAC patients-∼19%-with a 0% frequency of nodal metastases and only 1.4% frequency of recurrence. Biopsies highly but imperfectly predicted these features. Nonetheless, these findings may potentially be of clinical utility in the risk stratification of patients with HPVA EACs. This may allow some patients with a minimal risk of nodal metastases and TR to be identified at the biopsy phase, thereby facilitating more personalized, possibly less aggressive treatment.
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Affiliation(s)
- Yue Wang
- Department of Obstetrics and Gynecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital
| | | | | | - Jing Yu
- Department of Pathology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine
| | - Xiaofei Zhang
- Department of Pathology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang Province
| | - Xianghong Yang
- Department of Pathology, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning Province
| | - M R Quddus
- Department of Pathology, Women & Infants Hospital & Alpert Medical School of Brown University, Providence, RI
| | - Li Li
- Department of Pathology, Shandong University School of Basic Medical Sciences
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai
| | - Aijun Liu
- Department of Pathology, The Seventh Medical Center of Chinese PLA General Hospital
| | - Qingping Jiang
- Department of Pathology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province
| | - Ruijiao Zhao
- Department of Pathology, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, Henan Province
| | - Huiting Zhu
- Department of Pathology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine
| | - Feng Zhou
- Department of Pathology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang Province
| | - Yiying Wang
- Department of Obstetrics and Gynecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital
| | - Xiujie Sheng
- Department of Pathology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province
| | | | | | - Natalie Banet
- Department of Pathology, Women & Infants Hospital & Alpert Medical School of Brown University, Providence, RI
| | - C J Sung
- Department of Pathology, Women & Infants Hospital & Alpert Medical School of Brown University, Providence, RI
| | - Yafei Qi
- Department of Pathology, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning Province
| | - Rui Bi
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai
| | - Ming Li
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai
| | - Yun Wang
- Department of Pathology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jinhang Li
- Department of Pathology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | | | | | | | | | | | - Oluwole Fadare
- Department of Pathology, University of California San Diego, La Jolla, CA
| | - Jihong Liu
- Gynecologic Oncology, Sun Yat-Sen University Cancer Center
| | | | - Jayanthi Lea
- Obstetrics and Gynecology
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
| | - Beihua Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University School of Medicine, Jinan, Shandong Province
| | - Wenxin Zheng
- Departments of Pathology
- Obstetrics and Gynecology
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
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16
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Gosling H, Pratt D, Montgomery H, Lea J. The relationship between minority stress factors and suicidal ideation and behaviours amongst transgender and gender non-conforming adults: A systematic review. J Affect Disord 2022; 303:31-51. [PMID: 34958812 DOI: 10.1016/j.jad.2021.12.091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/10/2021] [Accepted: 12/19/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The impact of Minority Stress (MS) upon suicidal ideation and behaviours amongst Transgender and Gender Non-Conforming (TGNC) adults is not sufficiently understood, hence our intervention efforts on an individual and societal level are limited. This review aims to evaluate recent literature that reports on the association between MS and suicidal ideation and behaviours amongst TGNC adults. METHODS PsycINFO, Web of Science, MEDLINE, CINAHL and EMBASE were systematically searched for relevant articles. Peer reviewed and grey literature were considered. Included papers reported quantitative analyses on associations between MS factors and suicidal ideation and behaviours amongst TGNC adults. The quality of papers was assessed. RESULTS 28 papers were identified as eligible. Findings suggested positive associations between external and internal minority stressors and suicidal ideation and behaviour. Dysfunctional individual coping was associated with a greater likelihood of suicide attempts. Community resilience was negatively associated with suicidal outcomes, but did not consistently buffer the effects of minority stress. LIMITATIONS Overall quality of included papers was 'poor'. Almost all papers were cross-sectional by design, therefore causality cannot be inferred. Many papers measured variables using non-standardised measures undermining the reliability and validity of reported results. CONCLUSIONS Findings offer support to the application of MS theory to the understanding of suicidal ideation and behaviour amongst TGNC. Future research should use standardised measures and longitudinal designs to better support the investigation of directionality and causality. More research is needed to understand the complex interactions between minority stress factors and the role of resilience in this population.
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Affiliation(s)
- H Gosling
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK
| | - D Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK
| | - H Montgomery
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK
| | - J Lea
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK.
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17
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Kremer K, Lee J, Carlson M, Lea J. Trends in gestational trophoblastic neoplasia for the years 2000–2016: An analysis of the SEER cancer database. Gynecol Oncol 2022. [DOI: 10.1016/j.ygyno.2021.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Yong M, Young E, Lea J, Foggin H, Zaia E, Kozak FK, Westerberg BD. Commentary: Effect of cochlear implantation on vestibular function in children: A scoping review. Front Pediatr 2022; 10:1101540. [PMID: 36619515 PMCID: PMC9811810 DOI: 10.3389/fped.2022.1101540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- M Yong
- Division of Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada
| | - E Young
- Southwest Health, Warrnambool, VIC, Australia
| | - J Lea
- Division of Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada.,Division of Otolaryngology - Head and Neck Surgery, St. Paul's Hospital, Vancouver, BC, Canada
| | - H Foggin
- Division of Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada
| | - E Zaia
- Audio-Vestibular Clinic, Vancouver, BC, Canada
| | - F K Kozak
- Division of Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada.,Division of Otolaryngology - Head and Neck Surgery, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - B D Westerberg
- Division of Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada.,Division of Otolaryngology - Head and Neck Surgery, St. Paul's Hospital, Vancouver, BC, Canada
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19
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Wong T, Carlson M, Lea J, Lococo S, Miller D, Lee J. Is there a need for consultant team for bowel resection? An evaluation of surgical outcomes of bowel resection at time of ovarian cytoreductive surgery. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)01016-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Mercadel A, Saripella M, Holloway S, Lea J. Risk factors for catheter-associated urinary tract infections following radical hysterectomy for cervical cancer. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)01152-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Abu-Rustum NR, Yashar CM, Bradley K, Campos SM, Chino J, Chon HS, Chu C, Cohn D, Crispens MA, Damast S, Diver E, Fisher CM, Frederick P, Gaffney DK, George S, Giuntoli R, Han E, Howitt B, Huh WK, Lea J, Mariani A, Mutch D, Nekhlyudov L, Podoll M, Remmenga SW, Reynolds RK, Salani R, Sisodia R, Soliman P, Tanner E, Ueda S, Urban R, Wethington SL, Wyse E, Zanotti K, McMillian NR, Motter AD. NCCN Guidelines® Insights: Uterine Neoplasms, Version 3.2021. J Natl Compr Canc Netw 2021; 19:888-895. [PMID: 34416706 DOI: 10.6004/jnccn.2021.0038] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The NCCN Guidelines for Uterine Neoplasms provide recommendations for diagnostic workup, clinical staging, and treatment options for patients with endometrial cancer or uterine sarcoma. These NCCN Guidelines Insights focus on the recent addition of molecular profiling information to aid in accurate diagnosis, classification, and treatment of uterine sarcomas.
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Affiliation(s)
| | | | | | | | | | | | | | - David Cohn
- The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute
| | | | | | | | | | | | | | | | | | | | | | | | - Jayanthi Lea
- UT Southwestern Simmons Comprehensive Cancer Center
| | | | - David Mutch
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | | | | | | | | | | | - Edward Tanner
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | - Stefanie Ueda
- UCSF Helen Diller Family Comprehensive Cancer Center
| | - Renata Urban
- Fred Hutchinson Cancer Research CenterSeattle Cancer Care Alliance
| | | | | | - Kristine Zanotti
- Case Comprehensive Cancer CenterUniversity Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute; and
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22
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Wong T, Carlson M, Lea J, Lococo S, Miller D, Lee J. Stoma creation at the time of large bowel resection during ovarian cytoreductive surgery does not improve 30-day postoperative surgical outcomes. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)01180-x] [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]
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23
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Mercadel A, Lococo S, Carlson M, Lea J, Miller D, Lee J. Perioperative risk factors and postoperative outcomes following pelvic exenterations for gynecologic versus non-gynecologic malignancies. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)01095-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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24
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Beshnova D, Ye J, Onabolu O, Moon B, Zheng W, Fu YX, Brugarolas J, Lea J, Li B. De novo prediction of cancer-associated T cell receptors for noninvasive cancer detection. Sci Transl Med 2021; 12:12/557/eaaz3738. [PMID: 32817363 DOI: 10.1126/scitranslmed.aaz3738] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/05/2020] [Accepted: 07/21/2020] [Indexed: 01/21/2023]
Abstract
The adaptive immune system recognizes tumor antigens at an early stage to eradicate cancer cells. This process is accompanied by systemic proliferation of the tumor antigen-specific T lymphocytes. While detection of asymptomatic early-stage cancers is challenging due to small tumor size and limited somatic alterations, tracking peripheral T cell repertoire changes may provide an attractive solution to cancer diagnosis. Here, we developed a deep learning method called DeepCAT to enable de novo prediction of cancer-associated T cell receptors (TCRs). We validated DeepCAT using cancer-specific or non-cancer TCRs obtained from multiple major histocompatibility complex I (MHC-I) multimer-sorting experiments and demonstrated its prediction power for TCRs specific to cancer antigens. We blindly applied DeepCAT to distinguish over 250 patients with cancer from over 600 healthy individuals using blood TCR sequences and observed high prediction accuracy, with area under the curve (AUC) ≥ 0.95 for multiple early-stage cancers. This work sets the stage for using the peripheral blood TCR repertoire for noninvasive cancer detection.
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Affiliation(s)
- Daria Beshnova
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Jianfeng Ye
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Oreoluwa Onabolu
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Benjamin Moon
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Wenxin Zheng
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Yang-Xin Fu
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA.,Department of Immunology, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - James Brugarolas
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Bo Li
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX 75390, USA. .,Department of Immunology, UT Southwestern Medical Center, Dallas, TX 75390, USA
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25
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Rivera-Colon G, Chen H, Molberg K, Niu S, Strickland AL, Castrillon DH, Carrick K, Gwin K, Lea J, Zheng W, Lucas E. PD-L1 Expression in Endocervical Adenocarcinoma: Correlation With Patterns of Tumor Invasion, CD8+ Tumor-infiltrating Lymphocytes, and Clinical Outcomes. Am J Surg Pathol 2021; 45:742-752. [PMID: 33298732 DOI: 10.1097/pas.0000000000001633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Programmed death-1 ligand (PD-L1) expression has been used as a predictive marker for response to immune checkpoint inhibitors and has been reported to have prognostic value. Its prevalence and significance in endocervical adenocarcinoma (ECA) remain underinvestigated. We evaluated PD-L1 expression and CD8+ tumor-infiltrating lymphocyte density in whole tissue sections of 89 ECAs. PD-L1 expression was observed in 68% of ECAs by combined positive score (CPS, cutoff 1) and 29% of ECAs by tumor proportion score (TPS, cutoff 1%). Using CPS, PD-L1 expression was seen in 11%, 78%, and 72% of pattern A, B, and C tumors, respectively, with significantly higher expression in tumors with destructive-type invasion (B and C) (P=0.001 [A vs. B], 0.0006 [A vs. C], 0.0002 [A vs. B+C]). Using TPS, no significant difference in PD-L1 expression was seen between tumors with different invasion patterns (0%, 22%, and 32% in tumors with pattern A, B, and C, respectively; P=0.27 [A vs. B], 0.053 [A vs. C], 0.11 [A vs. B+C]). PD-L1-positive ECAs demonstrated significantly higher CD8+ tumor-infiltrating lymphocyte density (CPS: P=0.028; TPS: P=0.013) and worse progression-free survival when compared with PD-L1-negative ECAs (CPS: hazard ratio [HR]=4.253 vs. 0.235, P=0.025; TPS: HR=4.98 vs. 0.2; P=0.004). When invasion patterns were separately assessed, pattern C tumors similarly showed worse progression-free survival in PD-L1-positive tumors (CPS: HR=6.15 vs. 0.16, P=0.045; TPS: HR=3.78 vs. 0.26, P=0.027). In conclusion, our data show frequent PD-L1 expression in ECA with destructive-type invasion, supporting the role of the PD-1/PD-L1 pathway as a therapeutic target for these tumors. Our data also support PD-L1 as a negative prognostic marker associated with a potentially unfavorable outcome.
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Affiliation(s)
| | - Hao Chen
- Departments of Pathology
- Department of Pathology, Parkland Hospital, Dallas, TX
| | - Kyle Molberg
- Departments of Pathology
- Department of Pathology, Parkland Hospital, Dallas, TX
| | - Shuang Niu
- Departments of Pathology
- Department of Pathology, Parkland Hospital, Dallas, TX
| | - Amanda L Strickland
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Diego H Castrillon
- Departments of Pathology
- Obstetrics and Gynecology
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
- Department of Pathology, Parkland Hospital, Dallas, TX
| | - Kelley Carrick
- Departments of Pathology
- Department of Pathology, Parkland Hospital, Dallas, TX
| | - Katja Gwin
- Departments of Pathology
- Department of Pathology, Parkland Hospital, Dallas, TX
| | - Jayanthi Lea
- Obstetrics and Gynecology
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
| | - Wenxin Zheng
- Departments of Pathology
- Obstetrics and Gynecology
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
- Department of Pathology, Parkland Hospital, Dallas, TX
| | - Elena Lucas
- Departments of Pathology
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center
- Department of Pathology, Parkland Hospital, Dallas, TX
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26
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Aguilar M, Zhang H, Zhang M, Cantarell B, Sahoo SS, Li HD, Cuevas IC, Lea J, Miller DS, Chen H, Zheng W, Gagan J, Lucas E, Castrillon DH. Serial genomic analysis of endometrium supports the existence of histologically indistinct endometrial cancer precursors. J Pathol 2021; 254:20-30. [PMID: 33506979 PMCID: PMC8252414 DOI: 10.1002/path.5628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/12/2021] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
The endometrium is unique as an accessible anatomic location that can be repeatedly biopsied and where diagnostic biopsies do not extirpate neoplastic lesions. We exploited these features to retrospectively characterize serial genomic alterations along the precancer/cancer continuum in individual women. Cases were selected based on (1) endometrial cancer diagnosis/hysterectomy and (2) preceding serial endometrial biopsies including for some patients an early biopsy before a precancer histologic diagnosis. A comprehensive panel was designed for endometrial cancer genes. Formalin‐fixed, paraffin‐embedded specimens for each cancer, preceding biopsies, and matched germline samples were subjected to barcoded high‐throughput sequencing to identify mutations and track their origin and allelic frequency progression. In total, 92 samples from 21 patients were analyzed, providing an opportunity for new insights into early endometrial cancer progression. Definitive invasive endometrial cancers exhibited expected mutational spectra, and canonical driver mutations were detectable in preceding biopsies. Notably, ≥1 cancer mutations were detected prior to the histopathologic diagnosis of an endometrial precancer in the majority of patients. In 18/21 cases, ≥1 mutations were confirmed by abnormal protein levels or subcellular localization by immunohistochemistry, confirming genomic data and providing unique views of histologic correlates. In 19 control endometria, mutation counts were lower, with a lack of canonical endometrial cancer hotspot mutations. Our study documents the existence of endometrial lesions that are histologically indistinct but are bona fide endometrial cancer precursors. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Mitzi Aguilar
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - He Zhang
- Quantitative Biomedical Research Center, Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Musi Zhang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Brandi Cantarell
- Lyda Hill Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Subhransu S Sahoo
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hao-Dong Li
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ileana C Cuevas
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jayanthi Lea
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David S Miller
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hao Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Wenxin Zheng
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey Gagan
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elena Lucas
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Diego H Castrillon
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Tao T, Lin W, Wang Y, Zhang J, Chambers SK, Li B, Lea J, Wang Y, Wang Y, Zheng W. Loss of tubal ciliated cells as a risk for "ovarian" or pelvic serous carcinoma. Am J Cancer Res 2020; 10:3815-3827. [PMID: 33294269 PMCID: PMC7716167] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/06/2020] [Indexed: 06/12/2023] Open
Abstract
Recent advances suggest the fallopian tube as the main anatomic site for high-grade ovarian or pelvic serous carcinoma (O/PSC). Many studies on the biologic role of tubal secretory cells in O/PSC development has been performed in the last decade. However, the role of tubal ciliated cells in this regard has rarely been explored. The purpose of this study was to determine if the change of the tubal ciliated cells is associated with serous neoplasia within the female pelvis. This study included 3 groups (low-risk or benign control, high-risk, and O/PSC) of patients and they were age-matched. Age of patients ranged from 20 to 85 and the age-associated data was stratified by 10-year intervals. The number of tubal ciliated cells was determined by microscopy and by tubulin immunohistochemical staining. The data was then professionally analyzed. The results showed that the absolute number of tubal ciliated cells decreased significantly with age within each age group. A reduction in ciliated cell counts within the tubal segments remained a significant risk factor for the development of serous cancers within the female pelvis after age adjustment. A dramatic decrease of tubal ciliated cells was identified in patients with high-risk and with O/PSC compared to those in the benign control or low-risk group (P < 0.001). Further, within the tubal fimbria, the number of ciliated cells reduction was more prominent in the high-risk group when compared to those of O/PSC patients. Our findings suggest that a decreased number of ciliated cells within women's fallopian tubes represents another histologic hallmark for early serous carcinogenesis. There is a relationship between loss of tubal ciliated cells and aging, the presence of high-risk factors for tubal-ovarian cancer, and co-existing O/PSCs. This represents an initial study identifying the role of tubal ciliated cells in the development of high-grade serous carcinoma in women's pelvis.
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Affiliation(s)
- Tao Tao
- Department of Obstetrics and Gynecology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s HospitalZhengzhou, Henan, China
| | - Wanrun Lin
- Department of Pathology, University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Yan Wang
- Department of Pathology, University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Jing Zhang
- Department of Pediatrics, University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Setsuko K Chambers
- Department of Obstetrics and Gynecology, University of ArizonaTucson, AZ, USA
- Arizona Cancer Center, University of ArizonaTucson, AZ, USA
| | - Bo Li
- Lyda Hill Department of Bioinformatics and Department of Immunology, University of Texas Southwestern Medical CenterDallas, TX, USA
- Harold C Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Jayanthi Lea
- Harold C Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical CenterDallas, TX, USA
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Yiying Wang
- Department of Obstetrics and Gynecology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s HospitalZhengzhou, Henan, China
| | - Yue Wang
- Department of Obstetrics and Gynecology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s HospitalZhengzhou, Henan, China
| | - Wenxin Zheng
- Department of Pathology, University of Texas Southwestern Medical CenterDallas, TX, USA
- Harold C Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical CenterDallas, TX, USA
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical CenterDallas, TX, USA
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Khulpateea BR, Paulson A, Carlson M, Miller DS, Lea J. Stage IVA cervical cancer: outcomes of disease related complications and treatment. Int J Gynecol Cancer 2020; 31:518-523. [PMID: 32920534 DOI: 10.1136/ijgc-2019-000386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/15/2019] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Stage IVA cervical cancer is an uncommon diagnosis. The course of the disease and the complications of treatment are not well characterized. The goal of this study was to report treatment outcomes of patients with stage IVA cervical cancer. METHODS A single institution retrospective review was carried out of all patients treated for stage IVA cervical cancer from January 2008 to July 2017. Patients were clinically staged using the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging criteria for cervical cancer. Inclusion criteria were patients with stage IVA cervical cancer of any histologic subtype, including patients with evidence of para-aortic lymph node involvement, treated at the institution during this time period. Overall survival and progression free survival were calculated using the Kaplan-Meyer method. Comparisons between survival were done using the Cox proportional hazards regression model and the log rank test. RESULTS We identified 25 patients with stage IVA cervical cancer. Mean age at diagnosis was 54 years (range 27-77). Squamous cell carcinoma was the histologic diagnosis in 24 of 25 patients (96%), with 1 case of small cell carcinoma (4%). 21 patients completed a full course of radiation. The median overall survival for patients who completed their treatment was 60 months (range 3-136), with a 2 year overall survival of 63%. The median progression free survival was 27 months (range 0-125), with a 2 year progression free survival of 40%. 11 of 25 patients (44%) developed fistulas during the course of their disease, and 55% of these were complex fistulas. 19 of 25 (76%) patients had a percutaneous nephrostomy for either hydronephrosis or diversion of vesicovaginal fistula. 111 unplanned admissions occurred among the 25 patients, and infections of the urinary tract was implicated in 46 (41%) of these. The cohort had a total of 92 emergency department visits, with pain control (36%) and medication refills (15%) being the most common presentations. DISCUSSION Patients with stage IVA cervical cancer may have substantial long term survival, although the sequelae of disease and treatment is associated with significant morbidity. Symptoms of fistula, percutaneous nephrostomy complications, and chronic pain present unique issues that require extensive supportive care.
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Affiliation(s)
- Beman Roy Khulpateea
- Gynecologic Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Annette Paulson
- Gynecologic Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Matthew Carlson
- Gynecologic Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - David Scott Miller
- Gynecologic Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Jayanthi Lea
- Gynecologic Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
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29
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Ostmeyer J, Lucas E, Christley S, Lea J, Monson N, Tiro J, Cowell LG. Biophysicochemical motifs in T cell receptor sequences as a potential biomarker for high-grade serous ovarian carcinoma. PLoS One 2020; 15:e0229569. [PMID: 32134923 PMCID: PMC7058380 DOI: 10.1371/journal.pone.0229569] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 11/19/2019] [Accepted: 02/09/2020] [Indexed: 11/18/2022] Open
Abstract
We previously showed, in a pilot study with publicly available data, that T cell receptor (TCR) repertoires from tumor infiltrating lymphocytes (TILs) could be distinguished from adjacent healthy tissue repertoires by the presence of TCRs bearing specific, biophysicochemical motifs in their antigen binding regions. We hypothesized that such motifs might allow development of a novel approach to cancer detection. The motifs were cancer specific and achieved high classification accuracy: we found distinct motifs for breast versus colorectal cancer-associated repertoires, and the colorectal cancer motif achieved 93% accuracy, while the breast cancer motif achieved 94% accuracy. In the current study, we sought to determine whether such motifs exist for ovarian cancer, a cancer type for which detection methods are urgently needed. We made two significant advances over the prior work. First, the prior study used patient-matched TILs and healthy repertoires, collecting healthy tissue adjacent to the tumors. The current study collected TILs from patients with high-grade serous ovarian carcinoma (HGSOC) and healthy ovary repertoires from cancer-free women undergoing hysterectomy/salpingo-oophorectomy for benign disease. Thus, the classification task is distinguishing women with cancer from women without cancer. Second, in the prior study, classification accuracy was measured by patient-hold-out cross-validation on the training data. In the current study, classification accuracy was additionally assessed on an independent cohort not used during model development to establish the generalizability of the motif to unseen data. Classification accuracy was 95% by patient-hold-out cross-validation on the training set and 80% when the model was applied to the blinded test set. The results on the blinded test set demonstrate a biophysicochemical TCR motif found overwhelmingly in women with HGSOC but rarely in women with healthy ovaries, strengthening the proposal that cancer detection approaches might benefit from incorporation of TCR motif-based biomarkers. Furthermore, these results call for studies on large cohorts to establish higher classification accuracies, as well as for studies in other cancer types.
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Affiliation(s)
- Jared Ostmeyer
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Elena Lucas
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Scott Christley
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Nancy Monson
- Department of Neurology and Neurotherapeutics, Department of Immunology, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Jasmin Tiro
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Lindsay G. Cowell
- Department of Population and Data Sciences, Department of Immunology, UT Southwestern Medical Center, Dallas, TX, United States of America
- * E-mail:
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30
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Albuquerque K, Tumati V, Lea J, Ahn C, Richardson D, Miller D, Timmerman R. A Phase II Trial of Stereotactic Ablative Radiation Therapy as a Boost for Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2020; 106:464-471. [DOI: 10.1016/j.ijrobp.2019.10.042] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/19/2019] [Accepted: 10/23/2019] [Indexed: 01/01/2023]
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Perkins V, Moore K, Vesely S, Matsuo K, Mostofizadeh S, Sims TT, Lea J, Barnes D, Chen S, Carlson M, Roman L, Monk BJ, Holman LL. Incorporation of whole pelvic radiation into treatment of stage IVB cervical cancer: A novel treatment strategy. Gynecol Oncol 2019; 156:100-106. [PMID: 31810653 DOI: 10.1016/j.ygyno.2019.10.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 06/27/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Chemotherapy is the standard treatment in stage IVB cervical cancer (CC). However, given that many women have a significant pelvic disease burden, whole pelvic radiation (WPR) in addition to chemotherapy for primary treatment may have utility. The aim of this study was to compare the overall survival (OS) and complication rates between women who received both WPR and chemotherapy (CT) versus CT alone in the management of stage IVB CC. METHODS A multi-institutional, IRB-approved, retrospective review of patients (pts) with stage IVB CC, diagnosed between 2005 and 2015, was performed. Descriptive statistics of the demographic, oncologic, and treatment characteristics were performed. OS was estimated using the Kaplan Meier method. RESULTS A total of 126 pts met inclusion criteria. Thirty one patients elected for hospice care at diagnosis and were excluded from further analysis. In the remaining population, median age was 53 yrs. The majority (72%) had squamous cell carcinoma and 82% had FIGO grade 2 or 3 tumors. Thirty four patients (35.8%) received WPR in addition to CT as a part of planned primary therapy and 64.2% (n = 61) received CT alone, with 88.2% and 80.3% receiving a cisplatin-based chemotherapy regimen, respectively. The OS was significantly longer in the WPR with CT group (41.6 vs 17.6 mo, p < 0.01). The rates of ureteral obstruction, vaginal bleeding, pelvic infection, pelvic pain, and fistula were not significantly different between the 2 groups (all p > 0.05). CONCLUSION This study found WPR in addition to CT gives a significant OS benefit. Further study is warranted to determine which subgroups may benefit the most from this novel treatment strategy.
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Affiliation(s)
- Victoria Perkins
- Section of Gynecologic Oncology, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Kathleen Moore
- Section of Gynecologic Oncology, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sara Vesely
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, The University of Southern California, Los Angeles, CA, USA
| | - Sayedamin Mostofizadeh
- Division of Gynecologic Oncology, The University of Southern California, Los Angeles, CA, USA
| | - Travis T Sims
- Division of Gynecologic Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jayanthi Lea
- Division of Gynecologic Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Dominique Barnes
- Arizona Oncology (US Oncology Network), Division of Gynecologic Oncology, University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Matthew Carlson
- Division of Gynecologic Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lynda Roman
- Division of Gynecologic Oncology, The University of Southern California, Los Angeles, CA, USA
| | - Bradley J Monk
- Arizona Oncology (US Oncology Network), Division of Gynecologic Oncology, University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Laura L Holman
- Section of Gynecologic Oncology, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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32
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Small A, Lea J, Niemeyer D, Hughes J, McLean D, McLean J, Ralph J. Development of a microwave stunning system for cattle 2: Preliminary observations on behavioural responses and EEG. Res Vet Sci 2019; 122:72-80. [DOI: 10.1016/j.rvsc.2018.11.010] [Citation(s) in RCA: 8] [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: 10/11/2018] [Revised: 11/01/2018] [Accepted: 11/11/2018] [Indexed: 11/28/2022]
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33
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Wahner Hendrickson A, Costello B, Jewell A, Kennedy V, Fleming G, Corr B, Taylor S, Lea J, Reid J, Swisher E, Satele D, Allred J, Lensing J, Ivy S, Erlichman C, Adjei A, Kaufmann S. A phase II clinical trial of veliparib and topotecan in patients with platinum resistant ovarian cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.208] [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: 11/12/2022] Open
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34
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Manders DB, Kishore HA, Gazdar AF, Keller PW, Tsunezumi J, Yanagisawa H, Lea J, Word RA. Dysregulation of fibulin-5 and matrix metalloproteases in epithelial ovarian cancer. Oncotarget 2018; 9:14251-14267. [PMID: 29581841 PMCID: PMC5865667 DOI: 10.18632/oncotarget.24484] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 07/20/2017] [Accepted: 02/01/2018] [Indexed: 12/20/2022] Open
Abstract
Fibulin 5 (FBLN5) is an extracellular matrix glycoprotein that suppresses matrix metalloprotease 9 (MMP-9), angiogenesis and epithelial cell motility. Here, we investigated the regulation and function of FBLN5 in epithelial ovarian cancer (EOC). FBLN5 mRNA was down-regulated 5-fold in EOC relative to benign ovary. Not surprisingly, MMP9 mRNA and enzyme activity were increased significantly, and inversely correlated with FBLN5 gene expression. FBLN5 degradation products of 52.8 and 41.3 kDa were increased substantially in EOC. We identified two candidate proteases (serine elastase and MMP-7, but not MMP-9) that cleave FBLN5. MMP-7, but not neutrophil elastase, gene expression was increased dramatically in EOC. Recombinant FBLN5 significantly inhibited adhesion of EOC cells to both laminin and collagen I. Finally, using immunohistochemistry, we found immunoreactive FBLN5 within tumor macrophages throughout human EOC tumors. This work indicates that FBLN5 is degraded in EOC most likely by proteases enriched in macrophages of the tumor microenvironment. Proteolysis of FBLN5 serves as a mechanism to promote cell adhesion and local metastasis of ovarian cancer cells. Promotion of a stable ECM with intact FBLN5 in the tumor matrix may serve as a novel therapeutic adjunct to prevent spread of ovarian cancer.
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Affiliation(s)
- Dustin B Manders
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hari Annavarapu Kishore
- Department of Obstetrics and Gynecology, Green Center for Reproductive Biology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Adi F Gazdar
- Hamon Center for Therapeutic Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Patrick W Keller
- Department of Obstetrics and Gynecology, Green Center for Reproductive Biology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jun Tsunezumi
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hiromi Yanagisawa
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Current address: Life Science Center, Tsukuba Advanced Research Alliance, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, Green Center for Reproductive Biology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ruth Ann Word
- Department of Obstetrics and Gynecology, Green Center for Reproductive Biology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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35
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Ogundipe LO, Jorsh M, Wain B, Lea J. Onset of clinical improvement of depressive illness following electroconvulsive therapy. Psychiatr bull 2018. [DOI: 10.1192/pb.23.8.474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodTo examine the onset and course of clinically observable improvement in patients receiving electroconvulsive therapy (ECT). A prospective design was used In which 19 consecutive patients receiving ECT were followed up from commencement to termination of ECT. The Clinical Global Improvement Scale was administered at every ECT session to monitor their Improvement.ResultsEleven of the 19 subjects Improved minimally and another subject Improved substantially after the first two ECT treatments.Clinical implicationsECT produces clinically observable improvement in depression within a few days of starting treatment perhaps earlier than is generally acknowledged.
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36
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Grubman J, Lea J. Specimen Fragmentation and Outcomes of Loop Electrosurgical Excision Procedures (LEEP) and Cold Knife Cone Biopsies (CKC) for Cervical Dysplasia. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.07.076] [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]
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37
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Moore K, Cadoo K, Chambers S, Ghamande S, Konecny G, Oza A, Chen LM, Konstantinopoulos P, Lea J, Spitz D, Uyar D, Mugundu G, Laing N, Strickland D, Jones S, Burris H, Spigel D, Hamilton E. A multicentre phase II study of AZD1775 plus chemotherapy in patients with platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.061] [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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38
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Naranjo EN, Cleworth TW, Allum JHJ, Inglis JT, Lea J, Westerberg BD, Carpenter MG. Threat effects on human oculo-motor function. Neuroscience 2017; 359:289-298. [PMID: 28733210 DOI: 10.1016/j.neuroscience.2017.07.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 09/24/2016] [Revised: 06/11/2017] [Accepted: 07/11/2017] [Indexed: 11/27/2022]
Abstract
Neuro-anatomical evidence supports the potential for threat-related factors, such as fear, anxiety and vigilance, to influence brainstem motor nuclei controlling eye movements, as well as the vestibular nuclei. However, little is known about how threat influences human ocular responses, such as eye saccades (ES), smooth pursuit eye tracking (SP), and optokinetic nystagmus (OKN), and whether these responses can be facilitated above normal baseline levels with a natural source of threat. This study was designed to examine the effects of height-induced postural threat on the gain of ES, SP and OKN responses in humans. Twenty participants stood at two different surface heights while performing ES (ranging from 8° to 45° from center), SP (15, 20, 30°/s) and OKN (15, 30, 60°/s) responses in the horizontal plane. Height did not significantly increase the slope of the relationship between ES peak velocity and initial amplitude, or the gain of ES amplitude. In contrast height significantly increased SP and OKN gain. Significant correlations were found between changes in physiological arousal and OKN gain. Observations of changes with height in OKN and SP support neuro-anatomical evidence of threat-related mechanisms influencing both oculo-motor nuclei and vestibular reflex pathways. Although further study is warranted, the findings suggest that potential influences of fear, anxiety and arousal/alertness should be accounted for, or controlled, during clinical vestibular and oculo-motor testing.
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Affiliation(s)
- E N Naranjo
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - T W Cleworth
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - J H J Allum
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada; Department of ORL, University of Basel Hospital, Basel, Switzerland
| | - J T Inglis
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - J Lea
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - B D Westerberg
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - M G Carpenter
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
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Luo M, Wang H, Wang Z, Cai H, Lu Z, Li Y, Du M, Huang G, Wang C, Chen X, Porembka MR, Lea J, Frankel AE, Fu YX, Chen ZJ, Gao J. A STING-activating nanovaccine for cancer immunotherapy. Nat Nanotechnol 2017; 12:648-654. [PMID: 28436963 PMCID: PMC5500418 DOI: 10.1038/nnano.2017.52] [Citation(s) in RCA: 538] [Impact Index Per Article: 76.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 03/03/2017] [Indexed: 05/17/2023]
Abstract
The generation of tumour-specific T cells is critically important for cancer immunotherapy. A major challenge in achieving a robust T-cell response is the spatiotemporal orchestration of antigen cross-presentation in antigen-presenting cells with innate stimulation. Here, we report a minimalist nanovaccine, comprising a simple physical mixture of an antigen and a synthetic polymeric nanoparticle, PC7A NP, which generates a strong cytotoxic T-cell response with low systemic cytokine expression. Mechanistically, the PC7A NP achieves efficient cytosolic delivery of tumour antigens to antigen-presenting cells in draining lymph nodes, leading to increased surface presentation while simultaneously activating type I interferon-stimulated genes. This effect is dependent on stimulator of interferon genes (STING), but not the Toll-like receptor or the mitochondrial antiviral-signalling protein (MAVS) pathway. The nanovaccine led to potent tumour growth inhibition in melanoma, colon cancer and human papilloma virus-E6/E7 tumour models. The combination of the PC7A nanovaccine and an anti-PD-1 antibody showed great synergy, with 100% survival over 60 days in a TC-1 tumour model. Rechallenging of these tumour-free animals with TC-1 cells led to complete inhibition of tumour growth, suggesting the generation of long-term antitumour memory. The STING-activating nanovaccine offers a simple, safe and robust strategy in boosting anti-tumour immunity for cancer immunotherapy.
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Affiliation(s)
- Min Luo
- Department of Pharmacology, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Hua Wang
- Department of Molecular Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Zhaohui Wang
- Department of Pharmacology, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Haocheng Cai
- Department of Molecular Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Zhigang Lu
- Department of Developmental Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Yang Li
- Department of Pharmacology, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Mingjian Du
- Department of Molecular Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Gang Huang
- Department of Pharmacology, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Chensu Wang
- Department of Pharmacology, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Xiang Chen
- Department of Molecular Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Matthew R. Porembka
- Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Arthur E. Frankel
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Yang-Xin Fu
- Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
| | - Zhijian J. Chen
- Department of Molecular Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
- Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
- Correspondence and requests for materials should be addressed to Z.J.C () or J.G. ()
| | - Jinming Gao
- Department of Pharmacology, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390, USA
- Correspondence and requests for materials should be addressed to Z.J.C () or J.G. ()
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Bedell S, Manders D, Miller D, Lea J, Kehoe S, Richardson D, Carlson M. Response to “Towards implementation of sexual healthcare”. Gynecol Oncol Rep 2017; 20:139. [PMID: 29892679 PMCID: PMC5993518 DOI: 10.1016/j.gore.2017.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 11/26/2022] Open
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Bedell S, Manders D, Kehoe S, Lea J, Miller D, Richardson D, Carlson M. The opinions and practices of providers toward the sexual issues of cervical cancer patients undergoing treatment. Gynecol Oncol 2017; 144:586-591. [PMID: 28081881 DOI: 10.1016/j.ygyno.2016.12.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/22/2016] [Accepted: 12/23/2016] [Indexed: 01/05/2023]
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Bedell S, Manders D, Miller D, Lea J, Kehoe S, Richardson D, Carlson M. The Opinions and Practices of Providers Toward the Sexual Issues of Cervical Cancer Patients Undergoing Treatment. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.284] [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: 10/21/2022]
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Perkins V, Carlson M, Sims T, Lea J, Chen S, Monk B, Moore K, Holman LL. The Potential Role of Pelvic Radiation in Stage IVB Cervical Carcinoma. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.310] [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: 10/21/2022]
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Mayadev J, Elshaikh M, Christie A, Nagel C, Khan N, Kennedy V, Lea J, Ghanem A, Miller D, Xie X, Folkert M, Albuquerque K. Prognostic Significance of Nodal Location in Stage IIIC Endometrial Carcinoma: Implications for Optimal Adjuvant Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1386] [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: 11/16/2022]
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Thu KL, Papari-Zareei M, Stastny V, Song K, Peyton M, Martinez VD, Zhang YA, Castro IB, Varella-Garcia M, Liang H, Xing C, Kittler R, Milchgrub S, Castrillon DH, Davidson HL, Reynolds CP, Lam WL, Lea J, Gazdar AF. A comprehensively characterized cell line panel highly representative of clinical ovarian high-grade serous carcinomas. Oncotarget 2016; 8:50489-50499. [PMID: 28881577 PMCID: PMC5584155 DOI: 10.18632/oncotarget.9929] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 11/14/2015] [Accepted: 05/22/2016] [Indexed: 12/26/2022] Open
Abstract
Recent literature suggests that most widely used ovarian cancer (OVCA) cell models do not recapitulate the molecular features of clinical tumors. To address this limitation, we generated 18 cell lines and 3 corresponding patient-derived xenografts predominantly from high-grade serous carcinoma (HGSOC) peritoneal effusions. Comprehensive genomic characterization and comparison of each model to its parental tumor demonstrated a high degree of molecular similarity. Our characterization included whole exome-sequencing and copy number profiling for cell lines, xenografts, and matched non-malignant tissues, and DNA methylation, gene expression, and spectral karyotyping for a subset of specimens. Compared to the Cancer Genome Atlas (TCGA), our models more closely resembled HGSOC than any other tumor type, justifying their validity as OVCA models. Our meticulously characterized models provide a crucial resource for the OVCA research community that will advance translational findings and ultimately lead to clinical applications.
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Affiliation(s)
- Kelsie L Thu
- British Columbia Cancer Agency Research Centre and University of British Columbia, Vancouver, BC, Canada
| | - Mahboubeh Papari-Zareei
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Victor Stastny
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Kai Song
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA.,School of Chemical Engineering and Technology, Tianjin University, Tianjin, P.R. China
| | - Michael Peyton
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Victor D Martinez
- British Columbia Cancer Agency Research Centre and University of British Columbia, Vancouver, BC, Canada
| | - Yu-An Zhang
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Isabel B Castro
- Division of Medical Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | | | - Hanquan Liang
- Eugene McDermott Center for Human Growth & Development, UT Southwestern Medical Center, Dallas, TX, USA
| | - Chao Xing
- Eugene McDermott Center for Human Growth & Development, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ralf Kittler
- Eugene McDermott Center for Human Growth & Development, UT Southwestern Medical Center, Dallas, TX, USA.,Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Sara Milchgrub
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Diego H Castrillon
- Department of Pathology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Heather L Davidson
- Cell Biology & Biochemistry, Internal Medicine, and Pediatrics, School of Medicine Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - C Patrick Reynolds
- Cell Biology & Biochemistry, Internal Medicine, and Pediatrics, School of Medicine Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Wan L Lam
- British Columbia Cancer Agency Research Centre and University of British Columbia, Vancouver, BC, Canada
| | - Jayanthi Lea
- Obstetrics & Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Adi F Gazdar
- Hamon Center for Therapeutic Oncology Research, Department of Pathology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
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Shields BB, Pecot CV, Gao H, McMillan E, Potts M, Nagel C, Purinton S, Wang Y, Ivan C, Kim HS, Borkowski RJ, Khan S, Rodriguez-Aguayo C, Lopez-Berestein G, Lea J, Gazdar A, Baggerly KA, Sood AK, White MA. A genome-scale screen reveals context-dependent ovarian cancer sensitivity to miRNA overexpression. Mol Syst Biol 2015; 11:842. [PMID: 26655797 PMCID: PMC4704493 DOI: 10.15252/msb.20156308] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Large‐scale molecular annotation of epithelial ovarian cancer (EOC) indicates remarkable heterogeneity in the etiology of that disease. This diversity presents a significant obstacle against intervention target discovery. However, inactivation of miRNA biogenesis is commonly associated with advanced disease. Thus, restoration of miRNA activity may represent a common vulnerability among diverse EOC oncogenotypes. To test this, we employed genome‐scale, gain‐of‐function, miRNA mimic toxicity screens in a large, diverse spectrum of EOC cell lines. We found that all cell lines responded to at least some miRNA mimics, but that the nature of the miRNA mimics provoking a response was highly selective within the panel. These selective toxicity profiles were leveraged to define modes of action and molecular response indicators for miRNA mimics with tumor‐suppressive characteristics in vivo. A mechanistic principle emerging from this analysis was sensitivity of EOC to miRNA‐mediated release of cell fate specification programs, loss of which may be a prerequisite for development of this disease.
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Affiliation(s)
- Benjamin B Shields
- Departments of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Chad V Pecot
- Center for RNA interference and Non-Coding RNA, MD Anderson Cancer Center, Houston, TX, USA
| | - Hua Gao
- Departments of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elizabeth McMillan
- Departments of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Malia Potts
- Departments of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Christa Nagel
- Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Scott Purinton
- Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ying Wang
- Department of Bioinformatics and Computational Biology, MD Anderson Cancer Center, Houston, TX, USA
| | - Cristina Ivan
- Department of Bioinformatics and Computational Biology, MD Anderson Cancer Center, Houston, TX, USA
| | - Hyun Seok Kim
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Robert J Borkowski
- Departments of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shaheen Khan
- Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | - Jayanthi Lea
- Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Adi Gazdar
- Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Keith A Baggerly
- Department of Bioinformatics and Computational Biology, MD Anderson Cancer Center, Houston, TX, USA
| | - Anil K Sood
- Center for RNA interference and Non-Coding RNA, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A White
- Departments of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Naranjo EN, Cleworth TW, Allum JHJ, Inglis JT, Lea J, Westerberg BD, Carpenter MG. Vestibulo-spinal and vestibulo-ocular reflexes are modulated when standing with increased postural threat. J Neurophysiol 2015; 115:833-42. [PMID: 26631147 DOI: 10.1152/jn.00626.2015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/27/2015] [Indexed: 01/30/2023] Open
Abstract
We investigated how vestibulo-spinal reflexes (VSRs) and vestibulo-ocular reflexes (VORs) measured through vestibular evoked myogenic potentials (VEMPs) and video head impulse test (vHIT) outcomes, respectively, are modulated during standing under conditions of increased postural threat. Twenty-five healthy young adults stood quietly at low (0.8 m from the ground) and high (3.2 m) surface height conditions in two experiments. For the first experiment (n = 25) VEMPs were recorded with surface EMG from inferior oblique (IO), sternocleidomastoid (SCM), trapezius (TRP), and soleus (SOL) muscles in response to 256 air-conducted short tone bursts (125 dB SPL, 500 Hz, 4 ms) delivered via headphones. A subset of subjects (n = 19) also received horizontal and vertical head thrusts (∼150°/s) at each height in a separate session, comparing eye and head velocities by using a vHIT system for calculating the functional VOR gains. VEMP amplitudes (IO, TRP, SOL) and horizontal and vertical vHIT gains all increased with high surface height conditions (P < 0.05). Changes in IO and SCM VEMP amplitudes as well as horizontal vHIT gains were correlated with changes in electrodermal activity (ρ = 0.44-0.59, P < 0.05). VEMP amplitude for the IO also positively correlated with fear (ρ = 0.43, P = 0.03). Threat-induced anxiety, fear, and arousal have significant effects on VSR and VOR gains that can be observed in both physiological and functional outcome measures. These findings provide support for a potential central modulation of the vestibular nucleus complex through excitatory inputs from neural centers involved in processing fear, anxiety, arousal, and vigilance.
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Affiliation(s)
- E N Naranjo
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - T W Cleworth
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - J H J Allum
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Otolaryngology, University Hospital, Basel, Switzerland
| | - J T Inglis
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; and
| | - J Lea
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - B D Westerberg
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - M G Carpenter
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; and
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Rosene JM, Matthews TD, Mcbride KJ, Galla A, Haun M, Mcdonald K, Gagne N, Lea J, Kasen J, Farias C. The effects of creatine supplementation on thermoregulation and isokinetic muscular performance following acute (3-day) supplementation. J Sports Med Phys Fitness 2015; 55:1488-1496. [PMID: 25781214] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The purpose of this investigation was to determine the effects of 3 d of creatine supplementation on thermoregulation and isokinetic muscular performance. METHODS Fourteen males performed two exercise bouts following 3 d of creatine supplementation and placebo. Subjects exercised for 60 min at 60-65% of VO2max in the heat followed by isokinetic muscular performance at 60, 180, and 300°·s(-1). Dependent variables for pre- and postexercise included nude body weight, urine specific gravity, and serum creatinine levels. Total body water, extracellular water and intracellular water were measured pre-exercise. Core temperature was assessed every 5 min during exercise. Peak torque and Fatigue Index were used to assess isokinetic muscular performance. RESULTS Core temperature increased during the run for both conditions. Total body water and extracellular water were significantly greater (P<0.05) following creatine supplementation. No significant difference (P>0.05) was found between conditions for intracellular water, nude body weight, urine specific gravity, and serum creatinine. Pre-exercise scores for urine specific gravity and serum creatinine were significantly less (P<0.05) versus post-exercise. No significant differences (P>0.05) were found in peak torque values or Fatigue Index between conditions for each velocity. A significant (P<0.05) overall velocity effect was found for both flexion and extension. As velocity increased, mean peak torque values decreased. CONCLUSION Three d of creatine supplementation does not affect thermoregulation during submaximal exercise in the heat and is not enough to elicit an ergogenic effect for isokinetic muscle performance following endurance activity.
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Affiliation(s)
- J M Rosene
- Health and Human Performance Department, Plymouth State University, Plymouth, NH, USA -
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Albuquerque K, Folkert M, Mayadev J, Liotta M, Nagel C, Sevak P, Harkenrider M, Lea J, Hanna R, Small W, Miller D, Potkul R, Elshaikh M. Adjuvant External Radiation is Essential in the Management of Pelvis-Limited Stage III Endometrial Carcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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Manders D, Moron A, Miller D, Kehoe S, Richardson D, Lea J. Locally advanced cervical cancer: Effect of radiation dosage and treatment duration on outcomes. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.07.024] [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: 10/22/2022]
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