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Suwajanakorn D, Lane AM, Go AK, Hartley CD, Oxenreiter M, Wu F, Gragoudas ES, Sullivan RJ, Montazeri K, Kim IK. Impact of gene expression profiling on diagnosis and survival after metastasis in patients with uveal melanoma. Melanoma Res 2024:00008390-990000000-00142. [PMID: 38578293 DOI: 10.1097/cmr.0000000000000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Surveillance frequency for metastasis is guided by gene expression profiling (GEP). This study evaluated the effect of GEP on time to diagnosis of metastasis, subsequent treatment and survival. A retrospective study was conducted of 110 uveal melanoma patients with GEP (DecisionDx-UM, Castle Biosciences, Friendswood, Texas, USA) and 110 American Joint Committee on Cancer-matched controls. Surveillance testing and treatment for metastasis were compared between the two groups and by GEP class. Rates of metastasis, overall survival and melanoma-related mortality were calculated using Kaplan-Meier estimates. Baseline characteristics and follow-up time were balanced in the two groups. Patients' GEP classification was 1A in 41%, 1B in 25.5% and 2 in 33.6%. Metastasis was diagnosed in 26.4% (n = 29) in the GEP group and 23.6% (n = 26) in the no GEP group (P = 0.75). Median time to metastasis was 30.5 and 22.3 months in the GEP and no GEP groups, respectively (P = 0.44). Median months to metastasis were 34.7, 75.8 and 26.1 in class 1A, 1B and 2 patients, respectively (P = 0.28). Disease-specific 5-year survival rates were 89.4% [95% confidence interval (CI): 81.0-94.2%] and 84.1% (95% CI: 74.9-90.1%) in the GEP and no GEP groups respectively (P = 0.49). Median time to death from metastasis was 10.1 months in the GEP group and 8.5 months in the no GEP group (P = 0.40). There were no significant differences in time to metastasis diagnosis and survival outcomes in patients with and without GEP. To realize the full benefit of GEP, more sensitive techniques for detection of metastasis and adjuvant therapies are required.
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Affiliation(s)
- D Suwajanakorn
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Department of Ophthalmology, Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - A M Lane
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - A K Go
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - C D Hartley
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska
| | - M Oxenreiter
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Close Concerns, San Francisco, California, USA
| | - F Wu
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - E S Gragoudas
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - R J Sullivan
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - K Montazeri
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - I K Kim
- Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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Dimitriou F, Namikawa K, Reijers ILM, Buchbinder EI, Soon JA, Zaremba A, Teterycz P, Mooradian MJ, Armstrong E, Nakamura Y, Vitale MG, Tran LE, Bai X, Allayous C, Provent-Roy S, Indini A, Bhave P, Farid M, Kähler KC, Mehmi I, Atkinson V, Klein O, Stonesifer CJ, Zaman F, Haydon A, Carvajal RD, Hamid O, Dummer R, Hauschild A, Carlino MS, Mandala M, Robert C, Lebbe C, Guo J, Johnson DB, Ascierto PA, Shoushtari AN, Sullivan RJ, Cybulska-Stopa B, Rutkowski P, Zimmer L, Sandhu S, Blank CU, Lo SN, Menzies AM, Long GV. Single-agent anti-PD-1 or combined with ipilimumab in patients with mucosal melanoma: an international, retrospective, cohort study. Ann Oncol 2022; 33:968-980. [PMID: 35716907 DOI: 10.1016/j.annonc.2022.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 03/09/2022] [Revised: 05/15/2022] [Accepted: 06/07/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Mucosal melanoma (MM) is a rare melanoma subtype with distinct biology and poor prognosis. Data on the efficacy of immune checkpoint inhibitors (ICIs) is limited. We determined the efficacy of ICIs in MM, analysed by primary site and ethnicity/race. PATIENTS AND METHODS Retrospective cohort study from 25 cancer centres in Australia, Europe, USA and Asia. Patients with histologically confirmed MM were treated with anti-PD1+/-ipilimumab. Primary endpoints were response rate (RR), progression-free survival (PFS), overall survival (OS) by primary site (naso-oral, urogenital, anorectal, other), ethnicity/race (Caucasian, Asian, Other) and treatment. Univariate and multivariate Cox proportional hazard model analyses were conducted. RESULTS In total, 545 patients were included: 331 (63%) Caucasian, 176 (33%) Asian and 20 (4%) Other. Primary sites included 113 (21%) anorectal, 178 (32%) urogenital, 206 (38%) naso-oral and 45 (8%) other. 348 (64%) received anti-PD1 and 197 (36%) anti-PD1/ipilimumab. RR, PFS and OS did not differ by primary site, ethnicity/race or treatment. RR for naso-oral was numerically higher for anti-PD1/ipilimumab (40%, 95% CI 29-54%) compared with anti-PD1 (29%, 95% CI 21-37%). 35% of patients that initially responded progressed. Median duration of response (mDOR) was 26 months (95% CI 18-NR [Not Reached]). Factors associated with short PFS were ECOG PS ≥3 (p<0.01), LDH >ULN (p=0.01), lung metastases (p<0.01) and ≥1 previous treatments (p<0.01). Factors associated with short OS were ECOG PS ≥1 (p<0.01), LDH >ULN (p=0.03), lung metastases (p<0.01) and ≥1 previous treatments (p<0.01). CONCLUSIONS MM has poor prognosis. Treatment efficacy of anti-PD1+/-ipilimumab was similar and did not differ by ethnicity/race. Naso-oral primaries had numerically higher response to anti-PD1/ipilimumab, without difference in survival. The addition of ipilimumab did not show greater benefit over anti-PD1 for other primary sites. In responders, mDOR was short and acquired resistance was common. Other factors, including site and number of metastases were associated with survival.
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Affiliation(s)
- F Dimitriou
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Department of Dermatology, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - I L M Reijers
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E I Buchbinder
- Melanoma Disease Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02481, USA
| | - J A Soon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - A Zaremba
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - P Teterycz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, 49585Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - M J Mooradian
- Division of Oncology and Hematology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - E Armstrong
- Department of Medicine, Melanoma Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Y Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - M G Vitale
- Istituto Nazionale Tumori IRCCS Fondazione 'G. Pascale', Napoli, Italy
| | - L E Tran
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - X Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - C Allayous
- APHP Hôpital Saint-Louis, Dermatology Department, DMU ICARE, Paris, France
| | - S Provent-Roy
- Dermatology Service, Department of Medicine, Gustave Roussy and Paris-Saclay University, Villejuif, France
| | - A Indini
- Unit of Medical Oncology, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | - P Bhave
- Westmead and Blacktown Hospitals, Sydney, New South Wales, Australia
| | - M Farid
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - K C Kähler
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - I Mehmi
- Department of Hematology/Oncology, The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, 11800 Wilshire Blvd Suite 300, Los Angeles, CA, 90025, USA
| | - V Atkinson
- Princess Alexandra Hospital, Greenslopes Private Hospital, University of Queensland, Queensland, Australia
| | - O Klein
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria
| | - C J Stonesifer
- Columbia University Irving Medical Center, New York City, New York, USA
| | - F Zaman
- Alfred Hospital, Melbourne, Victoria, Australia
| | - A Haydon
- Alfred Hospital, Melbourne, Victoria, Australia
| | - R D Carvajal
- Columbia University Irving Medical Center, New York City, New York, USA
| | - O Hamid
- Department of Hematology/Oncology, The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, 11800 Wilshire Blvd Suite 300, Los Angeles, CA, 90025, USA
| | - R Dummer
- Department of Dermatology, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Westmead and Blacktown Hospitals, Sydney, New South Wales, Australia
| | - M Mandala
- Unit of Medical Oncology, University of Perugia, Perugia, Italy
| | - C Robert
- Dermatology Service, Department of Medicine, Gustave Roussy and Paris-Saclay University, Villejuif, France
| | - C Lebbe
- Université de Paris, APHP Hôpital Saint-Louis, Dermatology Department, DMU ICARE, INSERM U-976, Paris, France
| | - J Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - D B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - P A Ascierto
- Istituto Nazionale Tumori IRCCS Fondazione 'G. Pascale', Napoli, Italy
| | - A N Shoushtari
- Department of Medicine, Melanoma Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - R J Sullivan
- Division of Oncology and Hematology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - B Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, 49585Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - S Sandhu
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - C U Blank
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S N Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - G V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia.
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Gong J, Drobni ZD, Zafar A, Quinaglia T, Hartmann SE, Gilman HK, Raghu VK, Gongora C, Alvi R, Zubiri L, Nohria A, Sullivan RJ, Reynolds KL, Zlotoff DA, Neilan TG. Pericardial disease in patients treated with immune checkpoint inhibitors. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are limited data on the occurrence, associations and outcomes of pericardial effusions and pericarditis after treatment with immune checkpoint inhibitors (ICIs).
Purpose
To evaluate incidence of pericardial disease in patients treated with an ICI.
Methods
This was a retrospective study at a single academic center that compared 2842 consecutive patients who received ICIs with 2699 age- and cancer-type matched patients with metastatic disease who did not receive ICI (design 1). A pericardial event was defined as a composite outcome of pericarditis and new or worsening moderate or large pericardial effusion. The endpoints were obtained through chart review and were blindly adjudicated. To identify risk factors associated with a pericardial event, in a second analysis, we also compared patients who developed an event on an ICI to patients treated with an ICI who did not develop a pericardial event (design 2). Cox proportional hazard model and logistical regression analysis were performed to study the association between ICI use and pericardial disease as well as pericardial disease and mortality. An additional 6-week landmark analysis was performed to account for lead-time bias.
Results
There were 42 pericardial events in the patients treated with ICI (n=2842) over 193 days (interquartile range 64 to 411) with an incidence rate of 1.57 events per 100 person-years. There was a 4-fold increase in the risk for pericarditis or a pericardial effusion among patients on an ICI compared to controls not treated with ICI after adjusting for potential confounders (hazard ratio [HR] 4.37, 95% confidence interval [CI] 2.09–9.14, p<0.001). Patients who developed pericardial disease while on an ICI had a trend for increased all-cause mortality (HR 1.53, 95% CI 0.99–2.36, p=0.05) compared to those who did not develop pericardial disease. When comparing those who developed pericardial disease after ICI treatment to those who did not, a higher dose of corticosteroid pre-ICI (>0.7 mg/kg prednisone) was associated with increased risk of pericardial disease (HR 2.56, 95% CI 1.00–6.57, p=0.049).
Conclusions
ICI use was associated with an increased risk for development of pericardial disease among cancer patients and a pericardial event on an ICI was associated with a trend towards increased mortality.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): National Institutes of Health/National Heart, Lung, and Blood Institute; a gift from A. Curt Greer and Pamela Kohlberg
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Affiliation(s)
- J Gong
- Brigham and Women'S Hospital, Harvard Medical School, Department of Medicine, Boston, United States of America
| | - Z D Drobni
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - A Zafar
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - T Quinaglia
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - S E Hartmann
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - H K Gilman
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - V K Raghu
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - C Gongora
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - R Alvi
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - L Zubiri
- Massachusetts General Hospital, Division of Oncology and Hematology, Department of Medicine, Boston, United States of America
| | - A Nohria
- Brigham and Women'S Hospital, Harvard Medical School, Cardio-Oncology Program, Division of Cardiovascular Medicine, Boston, United States of America
| | - R J Sullivan
- Massachusetts General Hospital, Division of Oncology and Hematology, Department of Medicine, Boston, United States of America
| | - K L Reynolds
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
| | - D A Zlotoff
- Massachusetts General Hospital - Harvard Medical School, Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Boston, United States of America
| | - T G Neilan
- Massachusetts General Hospital - Harvard Medical School, Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Boston, United States of America
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4
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Affiliation(s)
- A. K. Thiemann
- The Veterinary Department The Donkey Sanctuary Offwell, Honiton Devon UK
| | - J. Buil
- The Veterinary Department The Donkey Sanctuary Offwell, Honiton Devon UK
| | - K. Rickards
- The Veterinary Department The Donkey Sanctuary Offwell, Honiton Devon UK
| | - R. J. Sullivan
- The Veterinary Department The Donkey Sanctuary Offwell, Honiton Devon UK
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Owen CN, Bai X, Quah T, Lo SN, Allayous C, Callaghan S, Martínez-Vila C, Wallace R, Bhave P, Reijers ILM, Thompson N, Vanella V, Gerard CL, Aspeslagh S, Labianca A, Khattak A, Mandala M, Xu W, Neyns B, Michielin O, Blank CU, Welsh SJ, Haydon A, Sandhu S, Mangana J, McQuade JL, Ascierto PA, Zimmer L, Johnson DB, Arance A, Lorigan P, Lebbé C, Carlino MS, Sullivan RJ, Long GV, Menzies AM. Delayed immune-related adverse events with anti-PD-1-based immunotherapy in melanoma. Ann Oncol 2021; 32:917-925. [PMID: 33798657 DOI: 10.1016/j.annonc.2021.03.204] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [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: 11/01/2020] [Revised: 03/09/2021] [Accepted: 03/28/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Immune-related adverse events (irAEs) typically occur within 4 months of starting anti-programmed cell death protein 1 (PD-1)-based therapy [anti-PD-1 ± anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4)], but delayed irAEs (onset >12 months after commencement) can also occur. This study describes the incidence, nature and management of delayed irAEs in patients receiving anti-PD-1-based immunotherapy. PATIENTS AND METHODS Patients with delayed irAEs from 20 centres were studied. The incidence of delayed irAEs was estimated as a proportion of melanoma patients treated with anti-PD-1-based therapy and surviving >1 year. Onset, clinical features, management and outcomes of irAEs were examined. RESULTS One hundred and eighteen patients developed a total of 140 delayed irAEs (20 after initial combination with anti-CTLA4), with an estimated incidence of 5.3% (95% confidence interval 4.0-6.9, 53/999 patients at sites with available data). The median onset of delayed irAE was 16 months (range 12-53 months). Eighty-seven patients (74%) were on anti-PD-1 at irAE onset, 15 patients (12%) were <3 months from the last dose and 16 patients (14%) were >3 months from the last dose of anti-PD-1. The most common delayed irAEs were colitis, rash and pneumonitis; 55 of all irAEs (39%) were ≥grade 3. Steroids were required in 80 patients (68%), as well as an additional immunosuppressive agent in 27 patients (23%). There were two irAE-related deaths: encephalitis with onset during anti-PD-1 and a multiple-organ irAE with onset 11 months after ceasing anti-PD-1. Early irAEs (<12 months) had also occurred in 69 patients (58%), affecting a different organ from the delayed irAE in 59 patients (86%). CONCLUSIONS Delayed irAEs occur in a small but relevant subset of patients. Delayed irAEs are often different from previous irAEs, may be high grade and can lead to death. They mostly occur in patients still receiving anti-PD-1. The risk of delayed irAE should be considered when deciding the duration of treatment in responding patients. However, patients who stop treatment may also rarely develop delayed irAE.
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Affiliation(s)
- C N Owen
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - X Bai
- Massachusetts General Hospital, Boston, USA; Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - T Quah
- Westmead and Blacktown Hospitals, Sydney, Australia
| | - S N Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - C Allayous
- Dermatology Department, Université de Paris, AP-HP Saint-Louis Hospital, INSERM, Paris, France
| | - S Callaghan
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - R Wallace
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - P Bhave
- The Alfred Hospital, Melbourne, Australia
| | - I L M Reijers
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N Thompson
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - V Vanella
- Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - C L Gerard
- Lausanne University Hospital, Lausanne, Switzerland
| | - S Aspeslagh
- University Hospital Brussels, Brussels, Belgium
| | - A Labianca
- Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy
| | - A Khattak
- Fiona Stanley Hospital and Edith Cowan University, Perth, Australia
| | - M Mandala
- University of Perugia, Unit of Medical Oncology, Santa Maria misericordia hospital, Perugia, Italy
| | - W Xu
- Princess Alexandra Hospital and The University of Queensland, Brisbane, Australia
| | - B Neyns
- University Hospital Brussels, Brussels, Belgium
| | - O Michielin
- Lausanne University Hospital, Lausanne, Switzerland
| | - C U Blank
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S J Welsh
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Haydon
- The Alfred Hospital, Melbourne, Australia
| | - S Sandhu
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - J Mangana
- Dermatology, Department of Dermato-Oncology, University Hospital Zurich, Zürich, Switzerland
| | - J L McQuade
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - P A Ascierto
- Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - D B Johnson
- Vanderbilt University Medical Center, Nashville, USA
| | - A Arance
- Hospital Clinic Barcelona, Barcelona, Spain
| | - P Lorigan
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - C Lebbé
- Dermatology Department, Université de Paris, AP-HP Saint-Louis Hospital, INSERM, Paris, France
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Westmead and Blacktown Hospitals, Sydney, Australia
| | | | - G V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Royal North Shore Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia.
| | - A M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Royal North Shore Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia
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Sullivan RJ, Flaherty K. Correction to: MAP kinase signaling and inhibition in melanoma. Oncogene 2021; 40:2482. [PMID: 33658630 DOI: 10.1038/s41388-021-01716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- R J Sullivan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - K Flaherty
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
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7
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Wu J, Liu D, Offin M, Lezcano C, Torrisi JM, Brownstein S, Hyman DM, Gounder MM, Abida W, Drilon A, Harding JJ, Sullivan RJ, Janku F, Welsch D, Varterasian M, Groover A, Li BT, Lacouture ME. Characterization and management of ERK inhibitor associated dermatologic adverse events: analysis from a nonrandomized trial of ulixertinib for advanced cancers. Invest New Drugs 2021; 39:785-795. [PMID: 33389388 DOI: 10.1007/s10637-020-01035-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/22/2020] [Accepted: 11/13/2020] [Indexed: 12/16/2022]
Abstract
Background Ulixertinib is the first-in-class ERK1/2 kinase inhibitor with encouraging clinical activity in BRAF- and NRAS-mutant cancers. Dermatologic adverse events (dAEs) are common with ulixertinib, so management guidelines like those established for epidermal growth factor receptor inhibitor (EGFRi)-associated dAEs are needed. Patients and Methods This was an open-label, multicenter, phase I dose escalation and expansion trial of ulixertinib evaluating data from 135 patients with advanced malignancies enrolled between March 2013 and July 2017. Histopathological features, management, and dAEs in 34 patients are also reported. Twice daily oral ulixertinib was administered at 10 to 900 mg in the dose escalation cohort (n = 27) and at 600 mg in 21-day cycles in the expansion cohort (n = 108). Results The incidence of ulixertinib-induced dAEs and combined rash were 79% (107/135) and 76% (102/135). The most common dAEs included acneiform rash (45/135, 33%), maculopapular rash (36/135, 27%), and pruritus (34/135, 25%). Grade 3 dAEs were observed in 19% (25/135) of patients; no grade 4 or 5 dAEs were seen. The presence of at least 1 dAE was associated with stable disease (SD) or partial response (PR) (OR = 3.64, 95% CI 1.52-8.72; P = .003). Acneiform rash was associated with a PR (OR = 10.19, 95% CI 2.67-38.91; P < .001). Conclusion The clinical spectrum of ulixertinib-induced dAEs was similar to EGFR and MEK inhibitors; dAEs may serve as a surrogate marker of tumor response. We propose treatment algorithms for common ERK inhibitor-induced dAEs to maintain patients' quality of life and dose intensity for maximal clinical benefit. Clinical Trial Registration: NCT01781429.
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Affiliation(s)
- J Wu
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Keelung, Linkou, Taipei, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - D Liu
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - M Offin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA
| | - C Lezcano
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - J M Torrisi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - S Brownstein
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - D M Hyman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA
| | - M M Gounder
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA
| | - W Abida
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA
| | - A Drilon
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA.,Thoracic Oncology and Early Drug Development Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medicine, 530 East 74th Street, New York, NY, 10021, USA
| | - J J Harding
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA
| | - R J Sullivan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, 02114, USA
| | - F Janku
- MD Anderson Cancer Center, The University of Texas, Houston, TX, 77030, USA
| | - D Welsch
- BioMed Valley Discoveries, Kansas City, MO, 64111, USA
| | - M Varterasian
- BioMed Valley Discoveries, Kansas City, MO, 64111, USA
| | - A Groover
- BioMed Valley Discoveries, Kansas City, MO, 64111, USA
| | - B T Li
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA. .,Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA. .,Thoracic Oncology and Early Drug Development Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medicine, 530 East 74th Street, New York, NY, 10021, USA.
| | - M E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA. .,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA. .,Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medicine, 530 East 74th Street, New York, NY, 10021, USA.
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8
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Rodriguez-Manfredi JA, de la Torre Juárez M, Alonso A, Apéstigue V, Arruego I, Atienza T, Banfield D, Boland J, Carrera MA, Castañer L, Ceballos J, Chen-Chen H, Cobos A, Conrad PG, Cordoba E, del Río-Gaztelurrutia T, de Vicente-Retortillo A, Domínguez-Pumar M, Espejo S, Fairen AG, Fernández-Palma A, Ferrándiz R, Ferri F, Fischer E, García-Manchado A, García-Villadangos M, Genzer M, Giménez S, Gómez-Elvira J, Gómez F, Guzewich SD, Harri AM, Hernández CD, Hieta M, Hueso R, Jaakonaho I, Jiménez JJ, Jiménez V, Larman A, Leiter R, Lepinette A, Lemmon MT, López G, Madsen SN, Mäkinen T, Marín M, Martín-Soler J, Martínez G, Molina A, Mora-Sotomayor L, Moreno-Álvarez JF, Navarro S, Newman CE, Ortega C, Parrondo MC, Peinado V, Peña A, Pérez-Grande I, Pérez-Hoyos S, Pla-García J, Polkko J, Postigo M, Prieto-Ballesteros O, Rafkin SCR, Ramos M, Richardson MI, Romeral J, Romero C, Runyon KD, Saiz-Lopez A, Sánchez-Lavega A, Sard I, Schofield JT, Sebastian E, Smith MD, Sullivan RJ, Tamppari LK, Thompson AD, Toledo D, Torrero F, Torres J, Urquí R, Velasco T, Viúdez-Moreiras D, Zurita S. The Mars Environmental Dynamics Analyzer, MEDA. A Suite of Environmental Sensors for the Mars 2020 Mission. Space Sci Rev 2021; 217:48. [PMID: 34776548 PMCID: PMC8550605 DOI: 10.1007/s11214-021-00816-9] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 05/16/2023]
Abstract
NASA's Mars 2020 (M2020) rover mission includes a suite of sensors to monitor current environmental conditions near the surface of Mars and to constrain bulk aerosol properties from changes in atmospheric radiation at the surface. The Mars Environmental Dynamics Analyzer (MEDA) consists of a set of meteorological sensors including wind sensor, a barometer, a relative humidity sensor, a set of 5 thermocouples to measure atmospheric temperature at ∼1.5 m and ∼0.5 m above the surface, a set of thermopiles to characterize the thermal IR brightness temperatures of the surface and the lower atmosphere. MEDA adds a radiation and dust sensor to monitor the optical atmospheric properties that can be used to infer bulk aerosol physical properties such as particle size distribution, non-sphericity, and concentration. The MEDA package and its scientific purpose are described in this document as well as how it responded to the calibration tests and how it helps prepare for the human exploration of Mars. A comparison is also presented to previous environmental monitoring payloads landed on Mars on the Viking, Pathfinder, Phoenix, MSL, and InSight spacecraft.
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Affiliation(s)
| | | | | | - V. Apéstigue
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - I. Arruego
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - T. Atienza
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - D. Banfield
- Cornell Center for Astrophysics and Planetary Science, Cornell University, Ithaca, NY USA
| | - J. Boland
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | | | - L. Castañer
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - J. Ceballos
- Instituto de Microelectrónica de Sevilla (US-CSIC), Seville, Spain
| | - H. Chen-Chen
- Universidad del País Vasco (UPV/EHU), Bilbao, Spain
| | - A. Cobos
- CRISA-Airbus, Tres Cantos, Spain
| | | | - E. Cordoba
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | | | | | | | - S. Espejo
- Instituto de Microelectrónica de Sevilla (US-CSIC), Seville, Spain
| | - A. G. Fairen
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - R. Ferrándiz
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - F. Ferri
- Università degli Studi di Padova, Padova, Italy
| | - E. Fischer
- University of Michigan, Ann Arbor, MI USA
| | | | | | - M. Genzer
- Finnish Meteorological Institute, Helsinki, Finland
| | - S. Giménez
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - J. Gómez-Elvira
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - F. Gómez
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - A.-M. Harri
- Finnish Meteorological Institute, Helsinki, Finland
| | - C. D. Hernández
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - M. Hieta
- Finnish Meteorological Institute, Helsinki, Finland
| | - R. Hueso
- Universidad del País Vasco (UPV/EHU), Bilbao, Spain
| | - I. Jaakonaho
- Finnish Meteorological Institute, Helsinki, Finland
| | - J. J. Jiménez
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - V. Jiménez
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - A. Larman
- Added-Value-Solutions, Elgoibar, Spain
| | - R. Leiter
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - A. Lepinette
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - G. López
- Universidad Politécnica de Cataluña, Barcelona, Spain
| | - S. N. Madsen
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - T. Mäkinen
- Finnish Meteorological Institute, Helsinki, Finland
| | - M. Marín
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - G. Martínez
- Lunar and Planetary Institute, Houston, TX USA
| | - A. Molina
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | | | - S. Navarro
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - C. Ortega
- Added-Value-Solutions, Elgoibar, Spain
| | - M. C. Parrondo
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | - V. Peinado
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - A. Peña
- CRISA-Airbus, Tres Cantos, Spain
| | | | | | | | - J. Polkko
- Finnish Meteorological Institute, Helsinki, Finland
| | - M. Postigo
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | | | - M. Ramos
- Universidad de Alcalá, Alcalá de Henares, Spain
| | | | - J. Romeral
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - C. Romero
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | - A. Saiz-Lopez
- Dept. of Atmospheric Chemistry and Climate, Institute of Physical Chemistry Rocasolano, CSIC, Madrid, Spain
| | | | - I. Sard
- Added-Value-Solutions, Elgoibar, Spain
| | - J. T. Schofield
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - E. Sebastian
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - M. D. Smith
- NASA Goddard Space Flight Center, Greenbelt, MD USA
| | - R. J. Sullivan
- Cornell Center for Astrophysics and Planetary Science, Cornell University, Ithaca, NY USA
| | - L. K. Tamppari
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - A. D. Thompson
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA USA
| | - D. Toledo
- Instituto Nacional de Técnica Aeroespacial (INTA), Madrid, Spain
| | | | - J. Torres
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | - R. Urquí
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
| | | | | | - S. Zurita
- Centro de Astrobiología (INTA-CSIC), Madrid, Spain
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Ameri AH, Mooradian MJ, Emerick KS, Park JC, Wirth LJ, Asgari MM, Tsao H, Lawrence D, Sullivan RJ, Demehri S. Immunotherapeutic strategies for cutaneous squamous cell carcinoma prevention in xeroderma pigmentosum. Br J Dermatol 2019; 181:1095-1097. [PMID: 31102460 DOI: 10.1111/bjd.18144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- A H Ameri
- Center for Cancer Immunology and Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A.,Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - M J Mooradian
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - K S Emerick
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, U.S.A
| | - J C Park
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - L J Wirth
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - M M Asgari
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - H Tsao
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - D Lawrence
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - R J Sullivan
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
| | - S Demehri
- Center for Cancer Immunology and Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A.,Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, U.S.A
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Sullivan RJ, Newman SG. Chiral auxiliary recycling in continuous flow: automated recovery and reuse of Oppolzer's sultam. Chem Sci 2018; 9:2130-2134. [PMID: 29719686 PMCID: PMC5896371 DOI: 10.1039/c7sc05192a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 01/17/2018] [Indexed: 11/24/2022] Open
Abstract
The telescoping of a three-stage, chiral auxiliary-mediated transformation in flow is described, including continuous separation of the product and auxiliary, enabling automated auxiliary reuse.
The telescoping of a three-stage, chiral auxiliary-mediated transformation in flow is described, including continuous separation of the product and auxiliary. The auxiliary can either be collected for later reuse, or directly fed back to the beginning of the process for recycling in real time, enabling each molecule of auxiliary to make multiple equivalents of chiral product and thus minimizing the step- and atom-economy issues associated with auxiliary-mediated synthesis. This concept is demonstrated for the asymmetric hydrogenation of olefins using Oppolzer's sultam, shortening the total reaction time >100 fold compared to batch, and demonstrating formal sub-stoichiometric auxiliary loading with respect to the process by automating auxiliary recycling within a closed loop.
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Affiliation(s)
- R J Sullivan
- Centre for Catalysis Research and Innovation , Department of Chemistry and Biomolecular Sciences , University of Ottawa , 10 Marie-Curie , Ottawa , Ontario K1N 6N5A , Canada .
| | - S G Newman
- Centre for Catalysis Research and Innovation , Department of Chemistry and Biomolecular Sciences , University of Ottawa , 10 Marie-Curie , Ottawa , Ontario K1N 6N5A , Canada .
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Menzies AM, Johnson DB, Ramanujam S, Atkinson VG, Wong ANM, Park JJ, McQuade JL, Shoushtari AN, Tsai KK, Eroglu Z, Klein O, Hassel JC, Sosman JA, Guminski A, Sullivan RJ, Ribas A, Carlino MS, Davies MA, Sandhu SK, Long GV. Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab. Ann Oncol 2017; 28:368-376. [PMID: 27687304 DOI: 10.1093/annonc/mdw443] [Citation(s) in RCA: 566] [Impact Index Per Article: 80.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Anti-PD-1 antibodies (anti-PD-1) have clinical activity in a number of malignancies. All clinical trials have excluded patients with significant preexisting autoimmune disorders (ADs) and only one has included patients with immune-related adverse events (irAEs) with ipilimumab. We sought to explore the safety and efficacy of anti-PD-1 in such patients. Patients and methods Patients with advanced melanoma and preexisting ADs and/or major immune-related adverse events (irAEs) with ipilimumab (requiring systemic immunosuppression) that were treated with anti-PD-1 between 1 July 2012 and 30 September 2015 were retrospectively identified. Results One hundred and nineteen patients from 13 academic tertiary referral centers were treated with anti-PD-1. In patients with preexisting AD (N = 52), the response rate was 33%. 20 (38%) patients had a flare of AD requiring immunosuppression, including 7/13 with rheumatoid arthritis, 3/3 with polymyalgia rheumatica, 2/2 with Sjogren's syndrome, 2/2 with immune thrombocytopaenic purpura and 3/8 with psoriasis. No patients with gastrointestinal (N = 6) or neurological disorders (N = 5) flared. Only 2 (4%) patients discontinued treatment due to flare, but 15 (29%) developed other irAEs and 4 (8%) discontinued treatment. In patients with prior ipilimumab irAEs requiring immunosuppression (N = 67) the response rate was 40%. Two (3%) patients had a recurrence of the same ipilimumab irAEs, but 23 (34%) developed new irAEs (14, 21% grade 3-4) and 8 (12%) discontinued treatment. There were no treatment-related deaths. Conclusions In melanoma patients with preexisting ADs or major irAEs with ipilimumab, anti-PD-1 induced relatively frequent immune toxicities, but these were often mild, easily managed and did not necessitate discontinuation of therapy, and a significant proportion of patients achieved clinical responses. The results support that anti-PD-1 can be administered safely and can achieve clinical benefit in patients with preexisting ADs or prior major irAEs with ipilimumab.
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Affiliation(s)
- A M Menzies
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia.,Royal North Shore and Mater Hospitals, Sydney, Australia
| | - D B Johnson
- Vanderbilt University Medical Center, Nashville, USA
| | - S Ramanujam
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia
| | - V G Atkinson
- Princess Alexandra Hospital, Greenslopes Hospital and University of Queensland, Brisbane, Australia
| | - A N M Wong
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J J Park
- Crown Princess Mary Cancer Centre Westmead, Sydney, Australia
| | - J L McQuade
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - K K Tsai
- Department of Medical Oncology, University of California San Francisco, San Francisco, USA
| | - Z Eroglu
- Department of Medical Oncology, Moffitt Cancer Centre, Tampa, USA
| | - O Klein
- Department of Medical Oncology, Olivia Newton-John Cancer Centre & Cancer Research Institute, Austin Health, Melbourne, Australia
| | - J C Hassel
- Department of Dermatology, Heidelberg University, Heidelberg, Germany
| | - J A Sosman
- Vanderbilt University Medical Center, Nashville, USA
| | - A Guminski
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia.,Royal North Shore and Mater Hospitals, Sydney, Australia
| | - R J Sullivan
- Massachusetts General Hospital Cancer Center, Boston, USA
| | - A Ribas
- Division of Hematology-Oncology, University of California Los Angeles, Los Angeles, USA
| | - M S Carlino
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia.,Crown Princess Mary Cancer Centre Westmead, Sydney, Australia
| | - M A Davies
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S K Sandhu
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - G V Long
- Melanoma Institute Australia and The University of Sydney, Sydney, Australia.,Royal North Shore and Mater Hospitals, Sydney, Australia
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Abstract
Malignant melanoma is rising in incidence. The treatment options have been very limited but advances in molecular biology and immunology have led to a greater understanding of the pathogenesis of the disease. Four drugs have been approved for the treatment of advanced melanoma in the past 2 years and two new classes of agents have recently been shown to lead to durable responses in a substantial minority of patients. The identification of biomarkers has helped clinicians and researchers segregate patients into molecular subgroups, which facilitates the selection of therapy. Preliminary work has begun on determining the ideal sequences of the various therapies. Investigations have been carried out on why these treatments work and what the mechanisms of resistance are to these therapies. It is hoped that combinations of therapies will emerge that lead to a high percentage of durable responses.
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Affiliation(s)
- R J Sullivan
- Massachusetts General Hospital Cancer Center, 55 Fruit Street, Yawkey 9E, Boston, MA, 02114, U.S.A
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Abstract
The mitogen-activated protein kinase (MAPK) pathway is critical to oncogenic signaling in the majority of patients with malignant melanoma. Driver mutations in both NRAS and BRAF have important implications for prognosis and treatment. The development of inhibitors to mediators of the MAPK pathway, including those to CRAF, BRAF, and MEK, has led to major advances in the treatment of patients with melanoma. In particular, the selective BRAF inhibitor vemurafenib has been shown to improve overall survival in patients with tumors harboring BRAF mutations. However, the duration of benefit is limited in many patients and highlights the need for understanding the limitations of therapy in order to devise more effective strategies. MEK inhibitors have proven to particularly active in BRAF mutant melanomas also. Emerging knowledge about mechanisms of resistance as well as a more complete understanding of the biology of MAPK pathway signaling provides insight into rational combination regimens and sequences of molecularly targeted therapies.
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Affiliation(s)
- R J Sullivan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA 02114, USA
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14
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Deeken JF, Rudek MA, Aboulafia DM, Sullivan RJ, Gerecitano JF, Cianfrocca ME, Henry DH, Ratner L, Dezube BJ, Mosby K, Tibbals M, Little RF, Ivy SP, Moore PC, Mitsuyasu RT. AIDS malignancy consortium (AMC) study 061: A phase I/PK study of sunitinib (S) with highly active antiretroviral therapy (HAART) in HIV+ patients with solid tumors. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2591] [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: 11/20/2022] Open
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15
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Joseph RW, Hwu P, Davies MA, Atkins MB, Sullivan RJ. Clinical benefit of ipilimumab in patients with metastatic melanoma who progress on high-dose IL-2. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Arvidson RE, Ashley JW, Bell JF, Chojnacki M, Cohen J, Economou TE, Farrand WH, Fergason R, Fleischer I, Geissler P, Gellert R, Golombek MP, Grotzinger JP, Guinness EA, Haberle RM, Herkenhoff KE, Herman JA, Iagnemma KD, Jolliff BL, Johnson JR, Klingelhöfer G, Knoll AH, Knudson AT, Li R, McLennan SM, Mittlefehldt DW, Morris RV, Parker TJ, Rice MS, Schröder C, Soderblom LA, Squyres SW, Sullivan RJ, Wolff MJ. Opportunity Mars Rover mission: Overview and selected results from Purgatory ripple to traverses to Endeavour crater. ACTA ACUST UNITED AC 2011. [DOI: 10.1029/2010je003746] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Arvidson RE, Bell JF, Bellutta P, Cabrol NA, Catalano JG, Cohen J, Crumpler LS, Des Marais DJ, Estlin TA, Farrand WH, Gellert R, Grant JA, Greenberger RN, Guinness EA, Herkenhoff KE, Herman JA, Iagnemma KD, Johnson JR, Klingelhöfer G, Li R, Lichtenberg KA, Maxwell SA, Ming DW, Morris RV, Rice MS, Ruff SW, Shaw A, Siebach KL, de Souza PA, Stroupe AW, Squyres SW, Sullivan RJ, Talley KP, Townsend JA, Wang A, Wright JR, Yen AS. Spirit Mars Rover Mission: Overview and selected results from the northern Home Plate Winter Haven to the side of Scamander crater. ACTA ACUST UNITED AC 2010. [DOI: 10.1029/2010je003633] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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18
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Joseph RW, Sullivan RJ, Panka D, Manoukian G, Percy A, Harrell R, Bassett RL, Atkins MB, Hwu P, Davies MA. Effect of mutational status on response, PFS, or OS after treatment with IL-2 for metastatic melanoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Sullivan RJ, Frankenthaler A, Wang W, Seery VJ, Lee M, Koon HB, Atkins MB. A retrospective comparison of 12 weeks versus 52 weeks of adjuvant interferon for patients with stage IIB, IIC, and IIIA (IIB-IIIA) melanoma (Mel). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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DeRose ER, Pleet A, Seery VJ, Lee M, Renzi S, Sullivan RJ, Atkins MB. Utility of 3-year torso CT and head imaging in asymptomatic patients with high-risk melanoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Squyres SW, Knoll AH, Arvidson RE, Ashley JW, Bell JF, Calvin WM, Christensen PR, Clark BC, Cohen BA, de Souza PA, Edgar L, Farrand WH, Fleischer I, Gellert R, Golombek MP, Grant J, Grotzinger J, Hayes A, Herkenhoff KE, Johnson JR, Jolliff B, Klingelhöfer G, Knudson A, Li R, McCoy TJ, McLennan SM, Ming DW, Mittlefehldt DW, Morris RV, Rice JW, Schröder C, Sullivan RJ, Yen A, Yingst RA. Exploration of Victoria Crater by the Mars Rover Opportunity. Science 2009; 324:1058-61. [DOI: 10.1126/science.1170355] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- S. W. Squyres
- Department of Astronomy, Space Sciences Building, Cornell University, Ithaca, NY 14853, USA
| | - A. H. Knoll
- Botanical Museum, Harvard University, Cambridge, MA 02138, USA
| | - R. E. Arvidson
- Department of Earth and Planetary Sciences, Washington University, St. Louis, MO 63031, USA
| | - J. W. Ashley
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - J. F. Bell
- Department of Astronomy, Space Sciences Building, Cornell University, Ithaca, NY 14853, USA
| | - W. M. Calvin
- University of Nevada, Reno, Geological Sciences, Reno, NV 89557, USA
| | - P. R. Christensen
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - B. C. Clark
- Lockheed Martin Corporation, Littleton, CO 80127, USA
| | - B. A. Cohen
- National Aeronautics and Space Administration, Marshall Space Flight Center, Huntsville, AL 35812, USA
| | - P. A. de Souza
- Tasmanian Information and Communication Technologies Centre, Commonwealth Scientific and Industrial Research Organisation, Castray Esplanade, Hobart TAS 7000, Australia
| | - L. Edgar
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | | | - I. Fleischer
- Institut für Anorganische und Analytische Chemie, Johannes Gutenberg-Universität, Mainz, Germany
| | - R. Gellert
- Department of Physics, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - M. P. Golombek
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - J. Grant
- Center for Earth and Planetary Studies, Smithsonian Institution, Washington, DC 20560, USA
| | - J. Grotzinger
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - A. Hayes
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | | | | | - B. Jolliff
- Department of Earth and Planetary Sciences, Washington University, St. Louis, MO 63031, USA
| | - G. Klingelhöfer
- Institut für Anorganische und Analytische Chemie, Johannes Gutenberg-Universität, Mainz, Germany
| | - A. Knudson
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - R. Li
- Department of Civil and Environmental Engineering and Geodetic Science, Ohio State University, Columbus, OH 43210, USA
| | - T. J. McCoy
- Department of Mineral Sciences, National Museum of Natural History, Smithsonian Institution, Washington, DC 20560, USA
| | - S. M. McLennan
- Department of Geosciences, State University of New York, Stony Brook, NY 11794, USA
| | - D. W. Ming
- Astromaterials Research and Exploration Science, NASA Johnson Space Center, Houston, TX 77058, USA
| | - D. W. Mittlefehldt
- Astromaterials Research and Exploration Science, NASA Johnson Space Center, Houston, TX 77058, USA
| | - R. V. Morris
- Astromaterials Research and Exploration Science, NASA Johnson Space Center, Houston, TX 77058, USA
| | - J. W. Rice
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - C. Schröder
- Institut für Anorganische und Analytische Chemie, Johannes Gutenberg-Universität, Mainz, Germany
| | - R. J. Sullivan
- Department of Astronomy, Space Sciences Building, Cornell University, Ithaca, NY 14853, USA
| | - A. Yen
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - R. A. Yingst
- Natural and Applied Sciences, University of Wisconsin Green Bay, Green Bay, WI 54311, USA
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Sullivan RJ, Hoshida Y, Brunet J, Tahan S, Aldridge J, Kwabi C, Gardiner E, McDermott D, Golub T, Atkins MB. A single center experience with high-dose (HD) IL-2 treatment for patients with advanced melanoma and pilot investigation of a novel gene expression signature as a predictor of response. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9003 Background: HD IL-2 remains one of two FDA-approved therapies for the treatment of patients (pts) with advanced melanoma. Initial studies conducted 15–20 years ago reported 16% response rate with 8% of pts achieving durable responses. The toxicity of HD IL-2 limits its application to pts treated in specialized centers. We present the clinical outcome of pts treated over a recent 2 year period with HD IL-2 at a single institution and an associated retrospective pilot study evaluating the predictive value of a novel tumor gene expression signature. Methods: Clinical and radiological data were collected and analyzed on 49 consecutive pts treated with HD IL-2 at Beth Israel Deaconess Medical Center from 10/05 - 10/07. Response was evaluated via RECIST. Formalin-fixed paraffin embedded tumor was obtained on consenting pts and classified as either Class 1, defined by melanocyte-specific genes including MITF, or Class 2, represented by immune genes, using the DNA-mediated Annealing, Selection, and Ligation (DASL) technique. Two-sided Fisher's Exact test was used to compare the proportion of responses for pts in the two classes. Results: Clinical response occurred in 16 of the 49 pts (32.6%), with 5 pts (10.2%) having a CR. Two other pts had stable disease > 12 mos; 3 pts who progressed after response had resection to NED. 10 pts remain disease/progression free at a minimum of 16 mos following treatment. 28 pts (including 13 of 16 responders) had sufficient tumor for DASL analysis. Among the 21 categorized as Class 1, 7 (33%) were responders. Of the 7 classified as Class 2, 6 (86%) were responders. This difference in response was statistically significant (p = 0.0286). Conclusions: The overall and CR rates in a contemporary series of pts with metastatic melanoma treated with HD IL-2 are twice that reported in initial studies suggesting some treatment selection on clinical grounds since the 1990s. Pts with tumors expressing an immune signature by DASL appeared more likely to respond. This finding requires prospective validation, but suggests immune-related gene expression might contribute to IL-2 responsiveness. [Table: see text]
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Affiliation(s)
- R. J. Sullivan
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - Y. Hoshida
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - J. Brunet
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - S. Tahan
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - J. Aldridge
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - C. Kwabi
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - E. Gardiner
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - D. McDermott
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - T. Golub
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - M. B. Atkins
- Beth Israel Deaconess Medical Center, Boston, MA; Broad Institute, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
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24
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Arvidson RE, Ruff SW, Morris RV, Ming DW, Crumpler LS, Yen AS, Squyres SW, Sullivan RJ, Bell JF, Cabrol NA, Clark BC, Farrand WH, Gellert R, Greenberger R, Grant JA, Guinness EA, Herkenhoff KE, Hurowitz JA, Johnson JR, Klingelhöfer G, Lewis KW, Li R, McCoy TJ, Moersch J, McSween HY, Murchie SL, Schmidt M, Schröder C, Wang A, Wiseman S, Madsen MB, Goetz W, McLennan SM. Spirit Mars Rover Mission to the Columbia Hills, Gusev Crater: Mission overview and selected results from the Cumberland Ridge to Home Plate. ACTA ACUST UNITED AC 2008. [DOI: 10.1029/2008je003183] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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25
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Arvidson RE, Poulet F, Morris RV, Bibring JP, Bell JF, Squyres SW, Christensen PR, Bellucci G, Gondet B, Ehlmann BL, Farrand WH, Fergason RL, Golombek M, Griffes JL, Grotzinger J, Guinness EA, Herkenhoff KE, Johnson JR, Klingelhöfer G, Langevin Y, Ming D, Seelos K, Sullivan RJ, Ward JG, Wiseman SM, Wolff M. Nature and origin of the hematite-bearing plains of Terra Meridiani based on analyses of orbital and Mars Exploration rover data sets. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2006je002728] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- R. E. Arvidson
- Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | - F. Poulet
- Institut d'Astrophysique Spatiale; Université Paris-Sud; Orsay France
| | | | - J.-P. Bibring
- Institut d'Astrophysique Spatiale; Université Paris-Sud; Orsay France
| | - J. F. Bell
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - S. W. Squyres
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - P. R. Christensen
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
| | - G. Bellucci
- Istituto di Fisica dello Spazio Interplanetario; Istituto Nazionale di Astrofisica; Rome Italy
| | - B. Gondet
- Institut d'Astrophysique Spatiale; Université Paris-Sud; Orsay France
| | - B. L. Ehlmann
- School of Geography and Environment; University of Oxford; Oxford UK
| | | | - R. L. Fergason
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
| | - M. Golombek
- Jet Propulsion Laboratory; Pasadena California USA
| | - J. L. Griffes
- Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | - J. Grotzinger
- Geological and Planetary Sciences; California Institute of Technology; Pasadena California USA
| | - E. A. Guinness
- Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | | | | | - G. Klingelhöfer
- Institut für Anorganische und Analytische Chemie; Johannes Gutenberg-Universität; Mainz Germany
| | - Y. Langevin
- Institut d'Astrophysique Spatiale; Université Paris-Sud; Orsay France
| | - D. Ming
- NASA Johnson Space Center; Houston Texas USA
| | - K. Seelos
- Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | - R. J. Sullivan
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - J. G. Ward
- Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | - S. M. Wiseman
- Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | - M. Wolff
- Space Science Institute; Boulder Colorado USA
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26
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Weitz CM, Anderson RC, Bell JF, Farrand WH, Herkenhoff KE, Johnson JR, Jolliff BL, Morris RV, Squyres SW, Sullivan RJ. Soil grain analyses at Meridiani Planum, Mars. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2005je002541] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- C. M. Weitz
- Planetary Science Institute; Tucson Arizona USA
| | | | - J. F. Bell
- Department of Astronomy; Cornell University; Ithaca New York USA
| | | | | | | | - B. L. Jolliff
- Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | | | - S. W. Squyres
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - R. J. Sullivan
- Department of Astronomy; Cornell University; Ithaca New York USA
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27
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Greeley R, Arvidson RE, Barlett PW, Blaney D, Cabrol NA, Christensen PR, Fergason RL, Golombek MP, Landis GA, Lemmon MT, McLennan SM, Maki JN, Michaels T, Moersch JE, Neakrase LDV, Rafkin SCR, Richter L, Squyres SW, de Souza PA, Sullivan RJ, Thompson SD, Whelley PL. Gusev crater: Wind-related features and processes observed by the Mars Exploration Rover Spirit. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2005je002491] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ronald Greeley
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
| | - R. E. Arvidson
- Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | | | - Diana Blaney
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - N. A. Cabrol
- NASA Ames Research Center; Moffett Field California USA
| | - P. R. Christensen
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
| | - R. L. Fergason
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
| | - M. P. Golombek
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | | | - M. T. Lemmon
- Department of Atmospheric Sciences; Texas A&M University; College Station Texas USA
| | - S. M. McLennan
- Department of Geosciences; State University of New York at Stony Brook; Stony Brook New York USA
| | - J. N. Maki
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | | | - J. E. Moersch
- Department of Earth and Planetary Sciences; University of Tennessee; Knoxville Tennessee USA
| | - L. D. V. Neakrase
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
| | | | - Lutz Richter
- Institut für Raumsimulation; Deutschen Zentrum für Luft- und Raumfahrt; Cologne Germany
| | - S. W. Squyres
- Department of Astronomy; Cornell University; Ithaca New York USA
| | | | - R. J. Sullivan
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - S. D. Thompson
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
| | - P. L. Whelley
- Department of Geological Sciences; Arizona State University; Tempe Arizona USA
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28
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Arvidson RE, Anderson RC, Bartlett P, Bell JF, Christensen PR, Chu P, Davis K, Ehlmann BL, Golombek MP, Gorevan S, Guinness EA, Haldemann AFC, Herkenhoff KE, Landis G, Li R, Lindemann R, Ming DW, Myrick T, Parker T, Richter L, Seelos FP, Soderblom LA, Squyres SW, Sullivan RJ, Wilson J. Localization and physical property experiments conducted by Opportunity at Meridiani Planum. Science 2004; 306:1730-3. [PMID: 15576608 DOI: 10.1126/science.1104211] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.9] [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: 11/02/2022]
Abstract
The location of the Opportunity landing site was determined to better than 10-m absolute accuracy from analyses of radio tracking data. We determined Rover locations during traverses with an error as small as several centimeters using engineering telemetry and overlapping images. Topographic profiles generated from rover data show that the plains are very smooth from meter- to centimeter-length scales, consistent with analyses of orbital observations. Solar cell output decreased because of the deposition of airborne dust on the panels. The lack of dust-covered surfaces on Meridiani Planum indicates that high velocity winds must remove this material on a continuing basis. The low mechanical strength of the evaporitic rocks as determined from grinding experiments, and the abundance of coarse-grained surface particles argue for differential erosion of Meridiani Planum.
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Affiliation(s)
- R E Arvidson
- Department of Earth and Planetary Sciences, Washington University, St. Louis, MO 63130, USA.
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29
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Bell JF, Squyres SW, Arvidson RE, Arneson HM, Bass D, Calvin W, Farrand WH, Goetz W, Golombek M, Greeley R, Grotzinger J, Guinness E, Hayes AG, Hubbard MYH, Herkenhoff KE, Johnson MJ, Johnson JR, Joseph J, Kinch KM, Lemmon MT, Li R, Madsen MB, Maki JN, Malin M, McCartney E, McLennan S, McSween HY, Ming DW, Morris RV, Dobrea EZN, Parker TJ, Proton J, Rice JW, Seelos F, Soderblom JM, Soderblom LA, Sohl-Dickstein JN, Sullivan RJ, Weitz CM, Wolff MJ. Pancam multispectral imaging results from the Opportunity Rover at Meridiani Planum. Science 2004; 306:1703-9. [PMID: 15576603 DOI: 10.1126/science.1105245] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [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: 11/02/2022]
Abstract
Panoramic Camera (Pancam) images from Meridiani Planum reveal a low-albedo, generally flat, and relatively rock-free surface. Within and around impact craters and fractures, laminated outcrop rocks with higher albedo are observed. Fine-grained materials include dark sand, bright ferric iron-rich dust, angular rock clasts, and millimeter-size spheroidal granules that are eroding out of the laminated rocks. Spectra of sand, clasts, and one dark plains rock are consistent with mafic silicates such as pyroxene and olivine. Spectra of both the spherules and the laminated outcrop materials indicate the presence of crystalline ferric oxides or oxyhydroxides. Atmospheric observations show a steady decline in dust opacity during the mission. Astronomical observations captured solar transits by Phobos and Deimos and time-lapse observations of sunsets.
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Affiliation(s)
- J F Bell
- Department of Astronomy, Cornell University, Ithaca NY 14853, USA.
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30
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Arvidson RE, Anderson RC, Bartlett P, Bell JF, Blaney D, Christensen PR, Chu P, Crumpler L, Davis K, Ehlmann BL, Fergason R, Golombek MP, Gorevan S, Grant JA, Greeley R, Guinness EA, Haldemann AFC, Herkenhoff K, Johnson J, Landis G, Li R, Lindemann R, McSween H, Ming DW, Myrick T, Richter L, Seelos FP, Squyres SW, Sullivan RJ, Wang A, Wilson J. Localization and physical properties experiments conducted by Spirit at Gusev Crater. Science 2004; 305:821-4. [PMID: 15297662 DOI: 10.1126/science.1099922] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.2] [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: 11/02/2022]
Abstract
The precise location and relative elevation of Spirit during its traverses from the Columbia Memorial station to Bonneville crater were determined with bundle-adjusted retrievals from rover wheel turns, suspension and tilt angles, and overlapping images. Physical properties experiments show a decrease of 0.2% per Mars solar day in solar cell output resulting from deposition of airborne dust, cohesive soil-like deposits in plains and hollows, bright and dark rock coatings, and relatively weak volcanic rocks of basaltic composition. Volcanic, impact, aeolian, and water-related processes produced the encountered landforms and materials.
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Affiliation(s)
- R E Arvidson
- Department of Earth and Planetary Sciences, Washington University, St. Louis, MO 63130, USA
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31
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Bell JF, Squyres SW, Arvidson RE, Arneson HM, Bass D, Blaney D, Cabrol N, Calvin W, Farmer J, Farrand WH, Goetz W, Golombek M, Grant JA, Greeley R, Guinness E, Hayes AG, Hubbard MYH, Herkenhoff KE, Johnson MJ, Johnson JR, Joseph J, Kinch KM, Lemmon MT, Li R, Madsen MB, Maki JN, Malin M, McCartney E, McLennan S, McSween HY, Ming DW, Moersch JE, Morris RV, Dobrea EZN, Parker TJ, Proton J, Rice JW, Seelos F, Soderblom J, Soderblom LA, Sohl-Dickstein JN, Sullivan RJ, Wolff MJ, Wang A. Pancam multispectral imaging results from the Spirit Rover at Gusev Crater. Science 2004; 305:800-6. [PMID: 15297658 DOI: 10.1126/science.1100175] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.5] [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: 11/02/2022]
Abstract
Panoramic Camera images at Gusev crater reveal a rock-strewn surface interspersed with high- to moderate-albedo fine-grained deposits occurring in part as drifts or in small circular swales or hollows. Optically thick coatings of fine-grained ferric iron-rich dust dominate most bright soil and rock surfaces. Spectra of some darker rock surfaces and rock regions exposed by brushing or grinding show near-infrared spectral signatures consistent with the presence of mafic silicates such as pyroxene or olivine. Atmospheric observations show a steady decline in dust opacity during the mission, and astronomical observations captured solar transits by the martian moons, Phobos and Deimos, as well as a view of Earth from the martian surface.
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Affiliation(s)
- J F Bell
- Cornell University, Ithaca, NY 14853-6801, USA.
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32
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Greeley R, Squyres SW, Arvidson RE, Bartlett P, Bell JF, Blaney D, Cabrol NA, Farmer J, Farrand B, Golombek MP, Gorevan SP, Grant JA, Haldemann AFC, Herkenhoff KE, Johnson J, Landis G, Madsen MB, McLennan SM, Moersch J, Rice JW, Richter L, Ruff S, Sullivan RJ, Thompson SD, Wang A, Weitz CM, Whelley P. Wind-related processes detected by the Spirit Rover at Gusev Crater, Mars. Science 2004; 305:810-3. [PMID: 15297660 DOI: 10.1126/science.1100108] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.3] [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: 11/02/2022]
Abstract
Wind-abraded rocks, ripples, drifts, and other deposits of windblown sediments are seen at the Columbia Memorial Station where the Spirit rover landed. Orientations of these features suggest formative winds from the north-northwest, consistent with predictions from atmospheric models of afternoon winds in Gusev Crater. Cuttings from the rover Rock Abrasion Tool are asymmetrically distributed toward the south-southeast, suggesting active winds from the north-northwest at the time (midday) of the abrasion operations. Characteristics of some rocks, such as a two-toned appearance, suggest that they were possibly buried and exhumed on the order of 5 to 60 centimeters by wind deflation, depending on location.
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Affiliation(s)
- R Greeley
- Department of Geological Sciences, Arizona State University, Box 871404, Tempe, AZ 85287-1404, USA.
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33
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Bell JF, Squyres SW, Arvidson RE, Arneson HM, Bass D, Blaney D, Cabrol N, Calvin W, Farmer J, Farrand WH, Goetz W, Golombek M, Grant JA, Greeley R, Guinness E, Hayes AG, Hubbard MYH, Herkenhoff KE, Johnson MJ, Johnson JR, Joseph J, Kinch KM, Lemmon MT, Li R, Madsen MB, Maki JN, Malin M, McCartney E, McLennan S, McSween HY, Ming DW, Moersch JE, Morris RV, Dobrea EZN, Parker TJ, Proton J, Rice JW, Seelos F, Soderblom J, Soderblom LA, Sohl-Dickstein JN, Sullivan RJ, Wolff MJ, Wang A. Pancam multispectral imaging results from the Spirit Rover at Gusev Crater. Science 2004. [PMID: 15297658 DOI: 10.1126/science.1100175,2004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Panoramic Camera images at Gusev crater reveal a rock-strewn surface interspersed with high- to moderate-albedo fine-grained deposits occurring in part as drifts or in small circular swales or hollows. Optically thick coatings of fine-grained ferric iron-rich dust dominate most bright soil and rock surfaces. Spectra of some darker rock surfaces and rock regions exposed by brushing or grinding show near-infrared spectral signatures consistent with the presence of mafic silicates such as pyroxene or olivine. Atmospheric observations show a steady decline in dust opacity during the mission, and astronomical observations captured solar transits by the martian moons, Phobos and Deimos, as well as a view of Earth from the martian surface.
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Affiliation(s)
- J F Bell
- Cornell University, Ithaca, NY 14853-6801, USA.
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34
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Bell JF, Squyres SW, Herkenhoff KE, Maki JN, Arneson HM, Brown D, Collins SA, Dingizian A, Elliot ST, Hagerott EC, Hayes AG, Johnson MJ, Johnson JR, Joseph J, Kinch K, Lemmon MT, Morris RV, Scherr L, Schwochert M, Shepard MK, Smith GH, Sohl-Dickstein JN, Sullivan RJ, Sullivan WT, Wadsworth M. Mars Exploration Rover Athena Panoramic Camera (Pancam) investigation. ACTA ACUST UNITED AC 2003. [DOI: 10.1029/2003je002070] [Citation(s) in RCA: 209] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- J. F. Bell
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - S. W. Squyres
- Department of Astronomy; Cornell University; Ithaca New York USA
| | | | - J. N. Maki
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - H. M. Arneson
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - D. Brown
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - S. A. Collins
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - A. Dingizian
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - S. T. Elliot
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - E. C. Hagerott
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - A. G. Hayes
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - M. J. Johnson
- Department of Astronomy; Cornell University; Ithaca New York USA
| | | | - J. Joseph
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - K. Kinch
- Neils Bohr Institute; University of Copenhagen; Copenhagen Denmark
| | - M. T. Lemmon
- Department of Atmospheric Science; Texas A&M University; College Station Texas USA
| | | | - L. Scherr
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - M. Schwochert
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
| | - M. K. Shepard
- Department of Geography and Geosciences; Bloomsburg University; Bloomsburg Pennsylvania USA
| | | | | | - R. J. Sullivan
- Department of Astronomy; Cornell University; Ithaca New York USA
| | - W. T. Sullivan
- Department of Astronomy; University of Washington; Seattle Washington USA
| | - M. Wadsworth
- Jet Propulsion Laboratory; California Institute of Technology; Pasadena California USA
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Arvidson RE, Anderson RC, Haldemann AFC, Landis GA, Li R, Lindemann RA, Matijevic JR, Morris RV, Richter L, Squyres SW, Sullivan RJ, Snider NO. Physical properties and localization investigations associated with the 2003 Mars Exploration rovers. ACTA ACUST UNITED AC 2003. [DOI: 10.1029/2002je002041] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- R. E. Arvidson
- McDonnell Center for the Space Sciences, Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
| | | | | | | | - R. Li
- Department of Civil and Environmental Engineering and Geodetic Science; Ohio State University; Columbus Ohio USA
| | | | | | | | - L. Richter
- DLR Institut für Raumsimulation; Köln Germany
| | - S. W. Squyres
- Center for Radiophysics and Space Research; Cornell University; Ithaca New York USA
| | - R. J. Sullivan
- Center for Radiophysics and Space Research; Cornell University; Ithaca New York USA
| | - N. O. Snider
- McDonnell Center for the Space Sciences, Department of Earth and Planetary Sciences; Washington University; St. Louis Missouri USA
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Abstract
According to a conventional evolutionary perspective, the human propensity for substance use is the product of a 'mismatch' between emotional mechanisms that evolved in a past without pure drugs or direct routes of drug administration, and the occurrence of these phenomena in the contemporary environment. The primary purpose of this review is to assert that, contrary to the conventional view, humans have shared a coevolutionary relationship with psychotropic plant substances that is millions of years old. We argue that this 'deep time' relationship is self-evident both in the extant chemical-ecological adaptations that have evolved in mammals to metabolize psychotropic plant substances and in the structure of plant defensive chemicals that have evolved to mimic the structure, and interfere with the function, of mammalian neurotransmitters. Given this evidence, we question how emotional mechanisms easily triggered by plant toxins can have evolved. Our argument is also supported with archeological and historical evidence of substance use in antiquity suggesting that, for people in the past, psychotropic plant substances were as much a mundane everyday item as they are for many people today. Our second, and more speculative objective is to suggest provisional hypotheses of human substance-using phenomena that can incorporate the evolutionary implications of a deep time relationship between psychotropic substances and people. We discuss hypotheses of selective benefits of substance use, including the idea that neurotransmitter-analog plant chemicals were exploited as substitutes for costly, nutritionally constrained endogenous neurotransmitters. However, even if substance seeking was adaptive in the environment of our hominid ancestors, it may not still be so in the contemporary environment. Thus, the implications of our argument are not that the mismatch concept does not apply to human substance-using phenomena, but that it must be reconsidered and extended to incorporate the implications of a substance-rich, rather than substance-free, evolutionary past.
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Affiliation(s)
- R J Sullivan
- Department of Anthropology, The University of Auckland, New Zealand.
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Abstract
STUDY DESIGN Randomized, experimental design using a 1-way ANCOVA to determine the influence of various forms of feedback on jump landing forces. OBJECTIVE To investigate the effects of augmented feedback versus sensory feedback on the reduction of jump landing forces. BACKGROUND Several investigators have reported an increased risk of lower extremity injury associated with landing from a jump. METHODS AND MEASURES Nonimpaired college students (N=63) were randomly assigned to 1 of 4 feedback groups. Subjects were instructed to perform maximal vertical jumps onto a force plate for 3 testing sessions (baseline, 2-minute post-test, and 1-week post-test). Three feedback groups (augmented, sensory, and control I) were tested during all 3 testing sessions, while a fourth feedback group (control II) was evaluated at only 2 sessions (baseline and 1-week post-test). Subjects in the augmented feedback condition were provided information via video and verbal analysis of how to land softer. Subjects in the sensory feedback condition were asked to use the experience of their baseline jumps to document how they could land softer. Subjects in each of the control groups were not provided any extraneous feedback. Peak vertical ground reaction force data were collected for analysis. RESULTS The subjects in the augmented feedback group significantly reduced their peak vertical ground reaction force in both post-test conditions (2-minute post-test reduction, 0.85+/-0.62; 1-week post-test reduction, 0.74+/-0.58) as compared to the sensory, control I, and control II feedback groups. CONCLUSIONS High impact landing forces may be reduced by the implementation of augmented feedback information instructing individuals about how to land properly. The reduction of jump landing forces with the use of augmented feedback may prove beneficial in the creation of instructional landing programs.
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Affiliation(s)
- J A Onate
- Department of Exercise and Sport Science, Human Movement Science Program, University of North Carolina at Chapel Hill, 27599-8700, USA.
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Deary NS, Sullivan RJ, Hamolsky MW, Aronson SM. Physicians newly licensed in Rhode Island during 1999-2000. Med Health R I 2001; 84:269-73. [PMID: 11517714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- N S Deary
- Rhode Island Department of Health, Three Capitol Hill, Providence, RI 02908-5097, USA
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Abstract
How do physicians handle informing patients of their diagnoses and how much information do patients really want? How do registered nurses view both sides of this question? Three questionnaires were constructed and administered in a mid-size hospital in New York state. Physicians and nurses underestimate the number of patients who want detailed information. Patients who earn more than average, have a college education, and who are under age 60 are more likely to want information, and state that their physician should give it to them. Only 42% of physicians state that patients want a detailed description of their diagnosis and treatment options. Physicians educated outside the USA appeared to be more likely to change their criteria for informing patients and, along with American-educated nurses, were more willing to participate in formal discussions of the issue. Physicians should comply with the wishes of patients for information and include them in the team deciding on diagnosis and treatment.
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Abstract
Flat-top talus has been described as a pathologic change secondary to idiopathic clubfoot condition and/or as a direct result of nonoperative manipulation involving forced dorsiflexion and molding of the cartilaginous talus. No definitive study, however, on the etiology and the timing of the flat-top talus deformity has been performed to date. The authors evaluated the magnetic resonance images of eleven patients with idiopathic clubfoot deformities treated with 2 to 3 months of casting to assess if flattening of the talar dome occurred at this age with this amount of casting. All children were 3 months of age, were casted for a maximum of 2 to 3 months, and sedated before MRI examination. The images were evaluated for maximum talar head height, maximum talar body height, and deviation of the talar body from a perfect circle. Maximum talar head height ranged from 4 to 9 mm, maximum talar body height ranged from 6 to 10 mm. Eight of the eleven had maximum talar body measurements 3 to 5mm greater than maximum talar head height. Three of the eleven patients had head and body size of equal proportion. Two of the eleven had a talar body that was within 1 mm of a perfect circle. The remaining nine patients had perfectly round talar bodies. In the senior author's (RSD) experience with treating clubfeet, a substantial increase has been seen at operation in flat-top tali among children that were casted for more than 1 year before surgical correction, compared to children casted for 3 months before surgical correction. The current investigation indicated that although tali of children with clubfeet are abnormally shaped, the talar body remains larger than the talar head and maintains its roundness after two to three months of corrective casting. Maintenance of cast treatment for more than three months may lead to the flat-top talus deformity. The authors recommend surgical intervention following three months of failed manipulation and casting to prevent this deformity.
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Affiliation(s)
- R J Sullivan
- Orthopaedic Associates of Hartford, CT 06106, USA.
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Sullivan RJ, Masters J, Cantore R, Roberson A, Petrou I, Stranick M, Goldman H, Guggenheim B, Gaffar A. Development of an enhanced anticaries efficacy dual component dentifrice containing sodium fluoride and dicalcium phosphate dihydrate. Am J Dent 2001; 14 Spec No:3A-11A. [PMID: 11481928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
A dual-chamber dentifrice, which contains sodium fluoride (NaF) in one component and dicalcium phosphate dihydrate (dical) in the other, has been developed. The dentifrice is packaged in a dual-chamber tube and is formulated to deliver 1100 ppm F. A series of studies consisting of in vitro fluoride uptake, in vivo calcium labeling, intraoral remineralization-demineralization, and animal caries studies were performed to support the improved anticaries efficacy of this product in comparison to a sodium fluoride/silica dentifrice (NaF/silica). An in vitro fluoride uptake study comparing 1100 ppm F NaF/dical dentifrice to 1100 ppm F NaF/silica showed that NaF/dical delivered significantly more fluoride than NaF/silica, 3.72 +/- 0.36 micrograms/cm2 versus 2.41 +/- 0.10 micrograms/cm2. A 6-day in vivo brushing study with a 44Ca labeled NaF/dical dentifrice showed that calcium from dical penetrated demineralized enamel and was present in plaque up to 18 hrs since the last brushing. An intra-oral remineralization-demineralization study was performed to evaluate NaF/dical's ability to promote remineralization in comparison to three silica-based dentifrices containing 0, 250, and 1100 ppm F as NaF. The percent mineral changes after treatment were +20.44 +/- 17.14 for NaF/dical, +9.27 +/- 19.53 for 1100 ppm NaF/silica, -1.43 +/- 20.57 for 250 ppm NaF/silica, and -12.36 +/- 32.76 for 0 ppm F/silica. A statistical analysis showed that the dual-chamber NaF/dical dentifrice was significantly more effective than the 1100 ppm NaF/silica dentifrice at promoting remineralization. A rat caries study was performed to evaluate NaF/dical ability to prevent caries in comparison to 1100 ppm F NaF/silica, 250 ppm F NaF/silica, silica, and dical dentifrices. The mean smooth surface caries scores were 1.6 +/- 2.8 for NaF/dical, 5.5 +/- 6.2 for 1100 ppm F NaF/silica, 10.6 +/- 6.2 for 250 ppm F NaF/silica, 13.7 +/- 4.7 for 0 ppm F/silica, and 9.5 +/- 7.8 0 ppm F/dical. A statistical analysis showed that the the dual-chamber NaF/dical dentifrice was superior to all other treatments tested in preventing caries in rats. The dical dentifrice was significantly superior to the silica dentifrice in preventing caries, which indicates that dical alone exhibits anticaries efficacy. In conclusion, individual and cumulative results from the fluoride uptake, intra-oral remineralization-demineralization, and rat caries studies from the dual chamber NaF/dical dentifrice support the improved anticaries efficacy of this product.
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Affiliation(s)
- R J Sullivan
- Oral Care Advanced Technology Department, Colgate-Palmolive Company, Piscataway, New Jersey, USA.
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Kimball HL, Aronow MS, Sullivan RJ, Tarinelli DJ, Nowak MD. Biomechanical evaluation of calcaneocuboid distraction arthrodesis: a cadaver study of two different fixation methods. Foot Ankle Int 2000; 21:845-8. [PMID: 11128015 DOI: 10.1177/107110070002101008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Calcaneocuboid distraction arthrodesis can be used to treat stage 2 posterior tibial tendon dysfunction. Nonunion, graft resorption, and implant failure have been reported after this procedure. This study compared two of the most commonly used methods for fixation of calcaneocuboid distraction arthrodesis. Twelve pairs of cadaver feet underwent simulated calcaneocuboid distraction arthrodesis. One specimen in each pair was fixed with two crossed 3.5 mm cortical lag screws. The contralateral specimen was fixed with a cervical H-plate. The calcaneus was fixed and a load was applied to the plantar aspect of the cuboid at a rate of 5 mm/minute until joint separation of 3 mm or fracture occurred. The average applied load to failure at 1.0 mm of joint separation was 30.5 +/- 11.6 N for the crossed screws and 77.7 +/- 36.4 N for the cervical H-plate (p = 0.001). The average stiffness at 1.0 mm of joint separation was 27.5 +/- 10.9 N/mm for the crossed screws and 43 +/- 21.2 N/mm for the cervical H-plate (p = 0.036). The higher stiffness and load to failure may account for the decreased nonunion rate noted anecdotally by some surgeons with H-plate fixation over crossed screw fixation for calcaneocuboid distraction arthrodesis.
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Affiliation(s)
- H L Kimball
- The University of Connecticut Health Center, Department of Orthopaedic Surgery, Farmington 06034-4037, USA
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Deary NS, Sullivan RJ, Hamolsky MW, Aronson SM. The practicing physicians of Rhode Island: medical schools attended. Med Health R I 2000; 83:245-8. [PMID: 10974811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- N S Deary
- RI Department of Health, Providence 02908-5097, USA
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Sullivan RJ, Allen JS, Otto C, Tiobech J, Nero K. Effects of chewing betel nut (Areca catechu) on the symptoms of people with schizophrenia in Palau, Micronesia. Br J Psychiatry 2000; 177:174-8. [PMID: 11026959 DOI: 10.1192/bjp.177.2.174] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although millions of people with schizophrenia live in betel chewing regions, the effects of betel chewing on their symptoms are unknown. Betel nut alkaloids include potent muscarinic cholinomimetics: recent research suggests that these agents may be therapeutic in schizophrenia. AIMS To compare the primary and extrapyramidal symptom profiles and substance-using habits of betel chewing v. non-chewing people with schizophrenia. METHOD A cross-sectional study of 70 people with schizophrenia. Symptom ratings measured by the Positive and Negative Syndrome Scale (PANSS) and Extrapyramidal Symptom Rating Scale (ESRS), and demographic and substance-use data, were compared for 40 chewers and 30 non-chewers of betel nut. RESULTS Betel chewers with schizophrenia scored significantly lower on the positive (P = 0.001) and negative (P = 0.002) sub-scales of the PANSS than did non-chewers. There were no significant differences in extrapyramidal symptoms or tardive dyskinesia. CONCLUSIONS Betel chewing is associated with milder symptomatology and avoidance of more harmful recreational drugs. These initial results indicate that longitudinal research is merited.
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Affiliation(s)
- R J Sullivan
- Department of Anthropology, University of Auckland, New Zealand
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45
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Edinger JD, Fins AI, Glenn DM, Sullivan RJ, Bastian LA, Marsh GR, Dailey D, Hope TV, Young M, Shaw E, Vasilas D. Insomnia and the eye of the beholder: are there clinical markers of objective sleep disturbances among adults with and without insomnia complaints? J Consult Clin Psychol 2000; 68:586-93. [PMID: 10965634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Previous findings suggest that some who report insomnia sleep well, whereas some noncomplaining individuals sleep rather poorly. This study was conducted to determine if mood, anxiety, and sleep-related beliefs might relate to perceived sleep disturbance. Thirty-two women and 32 men (aged 40-79 years) with primary insomnia and an aged-matched sample of 61 normal sleepers (31 women, 30 men) completed 6 nocturnal sleep recordings, as well as the Beck Depression Inventory (BDI), the Trait portion of the State-Trait Anxiety Inventory (STAI-2), and the Dysfunctional Beliefs and Attitudes About Sleep Questionnaire. Sleep and interview data were used to subdivide the majority of the sample (n = 108) into objective normal sleepers and subjective insomnia sufferers who seemingly slept well and subjective normal sleepers and objective insomnia sufferers who slept poorly. The 2 subjective subgroups showed the most marked differences on most of the psychometric measures. The findings suggest that the psychological factors scrutinized in this study may mediate sleep satisfaction and/or predict objective sleep difficulties.
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Affiliation(s)
- J D Edinger
- Psychology Service, Veterans Affairs Medical Center (VAMC), Durham, North Carolina 27705, USA
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Abstract
Triangular navicular, dorsal-lateral subluxation of the talo-navicular (TN) joint with a secondary forefoot cavovarus deformity, and degenerative changes of the TN joint are frequent causes of residual clubfoot deformity and pain in the midfoot after surgical correction. This study investigates the usefulness of TN arthrodesis to correct these deformities and to resolve symptoms resulting from these deformities. During the period from 1991-1996, the senior author performed 19 TN fusions (16 patients) for the above residual clubfoot deformities involving a painful TN joint. Eight of the procedures (seven patients) also required a lateral column shortening with a calcaneal wedge osteotomy to allow for a complete correction of the TN joint. The procedure was only performed in cases involving a hindfoot that was adequately aligned during a previous clubfoot correction. The average age of the patients at the time of surgery was 11 years (range: 4-20). One patient (bilateral procedures) was lost to follow-up. Fifteen patients (17 procedures) were followed-up for an average of four years (range: 2-6). All patients reported symptomatic improvement after the TN arthrodesis. Fourteen of the patients (15 procedures) were completely satisfied. The remaining patient (bilateral procedures) was only partially satisfied due to the subsequent development of navicular-cuneiform osteoarthritis in both feet. Two cases (2 patients) developed complications requiring a second procedure for satisfactory results. In addition, the procedure resulted in an improvement of the talus-first metatarsal angle on both antero-posterior and lateral radiographs. TN arthrodesis produced a correction of the residual clubfoot deformities of the midfoot and resulted in satisfactory clinical improvement in all the patients.
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Affiliation(s)
- S Y Wei
- Division of Orthopedic Surgery, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine 19104, USA
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Kennedy JG, Soffe KE, Rogers BW, Kumar S, Griffen DR, Dallo Vedova PA, Sullivan RJ, Sheehan LJ. Deep vein thrombosis prophylaxis in hip fractures: a comparison of the arteriovenous impulse system and aspirin. J Trauma 2000; 48:268-72. [PMID: 10697085 DOI: 10.1097/00005373-200002000-00012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A prospective, randomized controlled trial was used to compare the efficacy of the arteriovenous (AV) impulse system and aspirin in reducing venous thrombosis after fracture to the femoral neck. METHODS A total of 143 patients underwent hemiarthroplasty, after which 70 patients were treated with the AV pump and a second group of 73 patients were commenced on 325 mg of aspirin. Duplex ultrasound was used to assess both proximal and distal venous thrombi on days 7 to 10. Calf and thigh circumferences were also measured. RESULTS Thrombi developed in seven of the patients treated with aspirin and in four patients treated with the AV pump. No statistically significant difference could be established (p = 0.109). There was a significant reduction in both calf (p = 0.003) and thigh (p = 0.002) swelling in the group treated with the AV pump. Neither treatment group was a significant predictor of a poorer outcome by using logistical regression analysis (p = 0.258). CONCLUSIONS Both aspirin and the AV pump are effective in reducing thromboembolic events after hemiarthroplasty of the hip.
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Affiliation(s)
- J G Kennedy
- Department of Orthopaedic Surgery, Mater Misericordiae Hospital, University College of Dublin, Ireland
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48
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Pappalardo RT, Belton MJS, Breneman HH, Carr MH, Chapman CR, Collins GC, Denk T, Fagents S, Geissler PE, Giese B, Greeley R, Greenberg R, Head JW, Helfenstein P, Hoppa G, Kadel SD, Klaasen KP, Klemaszewski JE, Magee K, McEwen AS, Moore JM, Moore WB, Neukum G, Phillips CB, Prockter LM, Schubert G, Senske DA, Sullivan RJ, Tufts BR, Turtle EP, Wagner R, Williams KK. Does Europa have a subsurface ocean? Evaluation of the geological evidence. ACTA ACUST UNITED AC 1999. [DOI: 10.1029/1998je000628] [Citation(s) in RCA: 304] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Rabiner DJ, Branch LG, Sullivan RJ. Patient factors related to the odds of receiving prevention services in Veterans Health Administration medical centers. Am J Manag Care 1999; 5:1153-60. [PMID: 10621081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To examine the association between patient characteristics and the odds of receiving 13 health promotion/disease prevention services recommended by the US Preventive Services Task Force (USPSTF) for average-risk individuals. METHODS A mail survey was sent to a random sample of 68,422 veterans who obtained primary care from any of the 153 Veterans Health Administration facilities in 1996; 44,304 responded (adjusted response rate was 68%). Multivariate logistic regression models were used. RESULTS Demographic factors, health risk behaviors, and self-reported health were associated with the odds of receiving prevention services. Current smokers, heavy alcohol drinkers, and females were less likely to receive many health promotion services, whereas regular exercisers, overweight individuals, males, those reporting poorer health, individuals reporting high or controlled blood pressure, and those reporting high or controlled cholesterol levels were more likely to receive USPSTF-recommended prevention services. CONCLUSION Substantial proportions of veterans were likely to obtain prevention services recommended by the USPSTF for average-risk individuals. Nevertheless, veterans who reported being current smokers, heavy drinkers, or female were less likely to obtain these services. These subgroups may benefit from additional initiatives.
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Affiliation(s)
- D J Rabiner
- Research Triangle Institute, Research Triangle Park, NC, USA
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Abstract
The differential between aneurysmal bone cysts and unicameral bone cysts usually is clear clinically and radiographically. Occasionally there are cases in which the diagnosis is not clear. Because natural history and treatment are different, the ability to distinguish between these two entities before surgery is important. The authors reviewed, in a blinded fashion, the preoperative magnetic resonance images to investigate criteria that could be used to differentiate between the two lesions. All patients had operative or pathologic confirmation of an aneurysmal bone cyst or unicameral bone cyst. The authors analyzed the preoperative magnetic resonance images of 14 patients with diagnostically difficult bone cysts (eight children with unicameral bone cysts and six children with aneurysmal bone cysts) and correlated these findings with diagnosis after biopsy or cyst aspiration and contrast injection. The presence of a double density fluid level within the lesion strongly indicated that the lesion was an aneurysmal bone cyst, rather than a unicameral bone cyst. Other criteria that suggested the lesion was an aneurysmal bone cyst were the presence of septations within the lesion and signal characteristics of low intensity on T1 images and high intensity on T2 images. The authors identified a way of helping to differentiate between aneurysmal bone cysts and unicameral bone cysts on magnetic resonance images. Double density fluid level, septation, and low signal on T1 images and high signal on T2 images strongly suggest the bone cyst in question is an aneurysmal bone cyst, rather than a unicameral bone cyst. This may be helpful before surgery for the child who has a cystic lesion for which radiographic features do not allow a clear differentiation of unicameral bone cyst from aneurysmal bone cyst.
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Affiliation(s)
- R J Sullivan
- University of Connecticut Health Center, Department of Orthopaedic Surgery, Farmington 06034, USA
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