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Ojo AS, Araoye MO, Ali A, Sarma R. The impact of current therapeutic options on the health-related quality of life of patients with relapse/refractory multiple myeloma: a systematic review of clinical studies. J Cancer Surviv 2024; 18:673-697. [PMID: 36645615 DOI: 10.1007/s11764-023-01332-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/05/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE Patients with relapse and/or refractory multiple myeloma (RRMM) have a high disease burden with poor health-related quality of life (HRQoL) which worsens with each additional relapse. We aimed to review the impact of triplet, doublet, monotherapies, and salvage autologous stem cell transplantation on the HRQoL of RRMM patients. METHODS We performed a comprehensive literature search of Medline/PubMed, Wiley Cochrane Library, EMBASE, Scopus, CINAHL, and Clinicaltrials.gov to identify clinical studies in RRMM patients with HRQoL as an outcome measure. The ISOQoL and CONSORT-PRO extension guidelines were used to assess the quality of HRQoL reporting. We synthesized the result using a qualitative analysis. RESULTS A total of 10,245 RRMM patients enrolled in 28 eligible studies received either a triplet, doublet regimen, monotherapy, or salvage autologous stem cell transplantation. The EORTC QLQ-C30 was the most used questionnaire, and compliance with HRQoL reporting standards is generally poor among studies without an additional HRQoL publication. Most of the current therapeutic options are at best able to maintain HRQoL at baseline but not improve it. The methodological and reporting heterogeneity among the studies complicates generalizations. CONCLUSIONS Many of the current treatment regimens for RRMM have demonstrated clinical effectiveness in trials. Unlike newly diagnosed MM, these regimens are less likely to result in significant improvement in HRQoL in RRMM. This should be communicated to patients before initiating therapies. IMPLICATIONS FOR CANCER SURVIVORS Individualized therapeutic approach for RRMM should be chosen based on a shared decision-making process that aligns clinical efficacy with patients' treatment priorities and HRQoL.
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Affiliation(s)
- Ademola S Ojo
- Department of Internal Medicine, Howard University Hospital, 2041 Georgia Ave. NW, Washington, DC, USA.
| | - Mojisola O Araoye
- Hematology/Oncology Division, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ahmed Ali
- Department of Medicine, Hematology/Oncology Division, Howard University Hospital, Washington, DC, USA
| | - Ravi Sarma
- Department of Medicine, Hematology/Oncology Division, Howard University Hospital, Washington, DC, USA
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Wahba A, Delpassand ES, Nunez R, Esfandiari R, Venkatramani R. Alpha-emitter therapy for pediatric relapsed metastatic pancreatic neuroendocrine tumor. Pediatr Blood Cancer 2024; 71:e30961. [PMID: 38556730 DOI: 10.1002/pbc.30961] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 12/22/2023] [Accepted: 03/05/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Andrew Wahba
- Department of Pediatrics - Section of Hematology/Oncology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, USA
| | | | - Rodolfo Nunez
- Excel Diagnostics and Nuclear Oncology Center, Houston, Texas, USA
| | | | - Rajkumar Venkatramani
- Department of Pediatrics - Section of Hematology/Oncology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, USA
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Sharma J, Deo SVS, Kumar S, Bhoriwal S, Gupta N, Saikia J, Bhatnagar S, Mishra S, Bharti S, Thulkar S, Bakhshi S, Sharma DN. Malignant Chest Wall Tumors: Complex Defects and Their Management-A Review of 181 Cases. Ann Surg Oncol 2024; 31:3675-3683. [PMID: 38153642 DOI: 10.1245/s10434-023-14765-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Chest wall tumors are a heterogeneous group of tumors that are managed by surgeons from diverse specialties. Due to their rarity, there is no consensus on their diagnosis and management. MATERIALS This retrospective, descriptive analysis includes patients with malignant chest wall tumors undergoing chest wall resection. Tumors were classified as primary, secondary, and metastatic tumors. The analysis includes clinicopathological characteristics, resection-reconstruction profile, and relapse patterns. RESULTS A total of 181 patients underwent chest wall resection between 1999 and 2020. In primary tumors (69%), the majority were soft tissue tumors (59%). In secondary tumors, the majority were from the breast (45%) and lung (42%). Twenty-five percent of patients received neoadjuvant chemotherapy, and 98% of patients underwent R0 resection. Soft tissue, skeletal + soft tissue, and extended resections were performed in 45%, 70%, and 28% of patients, respectively. The majority of patients (60%) underwent rib resections, and a median of 3.5 ribs were resected. The mean defect size was 24 cm2. Soft tissue reconstruction was performed in 40% of patients, mostly with latissimus dorsi flaps. Rigid reconstruction was performed in 57% of patients, and 18% underwent mesh-bone cement sandwich technique reconstruction. Adjuvant radiotherapy and chemotherapy were given to 29% and 39% of patients, respectively. CONCLUSIONS This is one of the largest single-institutional experiences on malignant chest wall tumors. The results highlight varied tumor spectra and multimodality approaches for optimal functional and survival outcomes. In limited resource setting, surgery, including reconstructive expertise, is very crucial.
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Affiliation(s)
- Jyoti Sharma
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - S V S Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India.
| | - Sunil Kumar
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Bhoriwal
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Naveen Gupta
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoutishman Saikia
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anesthesia, Pain and Palliative Care, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Mishra
- Department of Onco-Anesthesia, Pain and Palliative Care, All India Institute of Medical Sciences, New Delhi, India
| | - Sachidanand Bharti
- Department of Onco-Anesthesia, Pain and Palliative Care, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Thulkar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - D N Sharma
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
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4
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Shore ND, Moul JW, Pienta KJ, Czernin J, King MT, Freedland SJ. Biochemical recurrence in patients with prostate cancer after primary definitive therapy: treatment based on risk stratification. Prostate Cancer Prostatic Dis 2024; 27:192-201. [PMID: 37679602 PMCID: PMC11096125 DOI: 10.1038/s41391-023-00712-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Nearly one-third of patients with prostate cancer (PCa) experience biochemical recurrence (BCR) after primary definitive treatment. BCR increases the risk of distant metastasis and mortality in patients with prognostically unfavorable features. These patients are best managed with a tailored treatment strategy incorporating risk stratification using clinicopathological factors, next-generation imaging, and genomic testing. OBJECTIVE This narrative review examines the utility of risk stratification for the management of patients with BCR in the context of clinical trial data, referencing the latest recommendations by European and US medical societies. METHODS PubMed was searched for relevant studies published through May 21 2023 on treatment of patients with BCR after radical prostatectomy (RP) or external beam radiotherapy (EBRT). RESULTS European and US guidelines support the risk-stratified management of BCR. Post-RP, salvage EBRT (with or without androgen deprivation therapy [ADT]) is an accepted treatment option for patients with BCR. Post-EBRT, local salvage therapies (RP, cryotherapy, high-intensity focused ultrasound, stereotactic body radiotherapy, and low-dose-rate and high-dose-rate brachytherapy) have demonstrated comparable relapse-free survival rates but differing adverse event profiles, short and long term. Local salvage therapies should be used for local-only relapses while ADT should be considered for regional or distant relapses. In practice, patients often receive ADT, with varying guidance for intermittent ADT vs. continuous ADT, due to consideration of quality-of-life effects. CONCLUSIONS Despite a lack of consensus for BCR treatment among guideline associations and medical societies, risk stratification of patients is essential for personalized treatment approaches, as it allows for an informed selection of therapeutic strategies and estimation of adverse events. In lower-risk disease, observation is recommended while in higher-risk disease, after failed repeat local therapy, ADT and/or clinical trial enrollment may be appropriate. Results from ongoing clinical studies of patients with BCR should provide consensus for management.
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Affiliation(s)
- Neal D Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
| | - Judd W Moul
- Duke Cancer Institute, Duke University, Durham, NC, USA
| | | | - Johannes Czernin
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Martin T King
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
| | - Stephen J Freedland
- Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Veterans Affairs Medical Center, Durham, NC, USA.
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Wei Y, Chen C, Xie YF, Huang JA. [Advances in immunotherapy for pulmonary sarcomatoid carcinoma]. Zhonghua Jie He He Hu Xi Za Zhi 2024; 47:480-484. [PMID: 38706073 DOI: 10.3760/cma.j.cn112147-20231118-00318] [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: 05/07/2024]
Abstract
Pulmonary sarcomatoid carcinoma (PSC) is a rare, poorly differentiated non-small cell lung cancer (NSCLC) that contains sarcomatoid components or sarcomatoid differentiation, and accounts for less than 1% of all lung tumors. Compared to other types of NSCLC, PSC has more invasive biological behavior, is prone to metastasis, and has a higher recurrence rate after early surgery. Its greater resistance to traditional treatments leads to a poorer prognosis compared to other NSCLCs. Immunotherapy offers the possibility of long-term survival for PSC patients.
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Affiliation(s)
- Y Wei
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - C Chen
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Y F Xie
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - J A Huang
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
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Gagelmann N, Dima D, Merz M, Hashmi H, Ahmed N, Tovar N, Oliver-Caldés A, Stölzel F, Rathje K, Fischer L, Born P, Schäfer L, Albici AM, Schub N, Kfir-Erenfeld S, Assayag M, Asherie N, Wulf GG, Kharboutli S, Müller F, Shune L, Davis JA, Anwer F, Vucinic V, Platzbecker U, Ayuk F, Kröger N, Khouri J, Gurnari C, McGuirk J, Stepensky P, Abdallah AO, Fernández de Larrea C. Development and Validation of a Prediction Model of Outcome After B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T-Cell Therapy in Relapsed/Refractory Multiple Myeloma. J Clin Oncol 2024; 42:1665-1675. [PMID: 38358946 PMCID: PMC11095856 DOI: 10.1200/jco.23.02232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/21/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
PURPOSE Although chimeric antigen receptor T therapy (CAR-T) cells are an established therapy for relapsed/refractory multiple myeloma (RRMM), there are no established models predicting outcome to identify patients who may benefit the most from CAR-T. PATIENTS AND METHODS This is an international retrospective observational study including patients with RRMM infused with currently available commercial or academically produced anti-B-cell maturation antigen (BCMA) CAR-T. We describe characteristics and outcomes in Europe (n = 136) and the United States (n = 133). Independent predictors of relapse/progression built a simple prediction model (Myeloma CAR-T Relapse [MyCARe] model) in the training cohort (Europe), which was externally validated (US cohort) and tested within patient- and treatment-specific subgroups. RESULTS The overall response rate was 87% and comparable between both cohorts, and complete responses were seen in 48% (Europe) and 49% (the United States). The median time to relapse was 5 months, and early relapse <5 months from infusion showed poor survival across cohorts, with the 12-month overall survival of 30% (Europe) and 14% (the United States). The presence of extramedullary disease or plasma cell leukemia, lenalidomide-refractoriness, high-risk cytogenetics, and increased ferritin at the time of lymphodepletion were independent predictors of early relapse or progression. Each factor received one point, forming the three-tiered MyCARe model: scores 0-1 (low risk), scores 2-3 (intermediate risk), and a score of 4 (high risk). The MyCARe model was significantly associated with distinct 5-month incidence of relapse/progression (P < .001): 7% for low-risk, 27% for intermediate-risk, and 53% for high-risk groups. The model was validated in the US cohort and maintained prognostic utility for response, survival, and outcomes across subgroups. CONCLUSION Outcomes of patients with RRMM after CAR-T are comparable between Europe and the United States. The MyCARe model may facilitate optimal timing of CAR-T cells in patient-specific subgroups.
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Affiliation(s)
- Nico Gagelmann
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Danai Dima
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
| | - Maximilian Merz
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Hamza Hashmi
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- Medical University of South Carolina, Charleston, SC
| | - Nausheen Ahmed
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
| | - Natalia Tovar
- Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Aina Oliver-Caldés
- Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Friedrich Stölzel
- Division for Stem Cell Transplantation and Cellular Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - Kristin Rathje
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Luise Fischer
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Patrick Born
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Lisa Schäfer
- Department of Hematology and Medical Oncology, Medical Center University of Göttingen, Göttingen, Germany
| | - Anca-Maria Albici
- Division for Stem Cell Transplantation and Cellular Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - Natalie Schub
- Division for Stem Cell Transplantation and Cellular Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - Shlomit Kfir-Erenfeld
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Miri Assayag
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nathalie Asherie
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gerald Georg Wulf
- Department of Hematology and Medical Oncology, Medical Center University of Göttingen, Göttingen, Germany
| | - Soraya Kharboutli
- Department of Internal Medicine, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Fabian Müller
- Department of Internal Medicine, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Leyla Shune
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
| | - James A. Davis
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- Medical University of South Carolina, Charleston, SC
| | - Faiz Anwer
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
| | - Vladan Vucinic
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Uwe Platzbecker
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Francis Ayuk
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jack Khouri
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
| | - Carmelo Gurnari
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
- Department of Biomedicine and Prevention, PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Joseph McGuirk
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
| | - Polina Stepensky
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Al-Ola Abdallah
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
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Pereira R, Bergantim R. An Assessment of the Effectiveness and Safety of Chimeric Antigen Receptor T-Cell Therapy in Multiple Myeloma Patients with Relapsed or Refractory Disease: A Systematic Review and Meta-Analysis. Int J Mol Sci 2024; 25:4996. [PMID: 38732213 PMCID: PMC11084236 DOI: 10.3390/ijms25094996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
Multiple myeloma (MM), the second most common hematologic malignancy, remains incurable, and its incidence is rising. Chimeric Antigen Receptor T-cell (CAR-T cell) therapy has emerged as a novel treatment, with the potential to improve the survival and quality of life of patients with relapsed/refractory multiple myeloma (rrMM). In this systematic review and meta-analysis, conducted in accordance with PRISMA guidelines, we aim to provide a concise overview of the latest developments in CAR-T therapy, assess their potential implications for clinical practice, and evaluate their efficacy and safety outcomes based on the most up-to-date evidence. A literature search conducted from 1 January 2019 to 12 July 2023 on Medline/PubMed, Scopus, and Web of Science identified 2273 articles, of which 29 fulfilled the specified criteria for inclusion. Our results offer robust evidence supporting CAR-T cell therapy's efficacy in rrMM patients, with an encouraging 83.21% overall response rate (ORR). A generally safe profile was observed, with grade ≥ 3 cytokine release syndrome (CRS) at 7.12% and grade ≥ 3 neurotoxicity at 1.37%. A subgroup analysis revealed a significantly increased ORR in patients with fewer antimyeloma regimens, while grade ≥ 3 CRS was more common in those with a higher proportion of high-risk cytogenetics and prior exposure to BCMA therapy.
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Affiliation(s)
- Rita Pereira
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Rui Bergantim
- i3S—Instituto de Investigação e Inovação em Saúde, University of Porto, 4200-135 Porto, Portugal
- Cancer Drug Resistance Group, IPATIMUP—Institute of Molecular Pathology and Immunology of the University of Porto, 4200-135 Porto, Portugal
- Clinical Hematology Department, Hospital Center of São João, 4200-319 Porto, Portugal
- Clinical Hematology Department, FMUP—Faculty of Medicine of the University of Porto, 4200-319 Porto, Portugal
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Medioni M, Cervantes B, Huguet F, Bachet JB, Parc Y, André T, Lefèvre JH, Cohen R. [An update on total neoadjuvant treatment of adenocarcinoma of the rectum]. Bull Cancer 2024; 111:483-495. [PMID: 38553289 DOI: 10.1016/j.bulcan.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 05/13/2024]
Abstract
A major advance has been made in the management of rectal cancer, with the emergence in 2021 of total neoadjuvant treatment. The main publications from the RAPIDO and PRODIGE-23 trials reported a significant improvement in progression-free survival and the pathological complete response rate. The aim of this review is to synthesize recent data on neoadjuvant treatment of rectal cancer, to explain the long-term results of the RAPIDO and PRODIGE-23 trials, and to put them into perspective, considering current advances in de-escalation strategies. The update of the 5-year survival data from the RAPIDO trial highlights an increased risk of loco-regional relapse, with 11.7% of relapses in the experimental group and 8.1% in the control group, while the update of the PRODIGE-23 trial confirms the benefits of this treatment regimen, with a significant improvement in overall survival. In addition, the results of the OPRA and PROPSPECT trials confirm the benefit of total neoadjuvant treatment with induction chemotherapy, as well as the possibility of surgical de-escalation in the OPRA trial and radiotherapy in the PROSPECT trial. The challenge for the future is to identify patients who require total neoadjuvant treatment with the aim of curative surgery to obtain a cure without local or distant relapse, and those for whom therapeutic de-escalation can be envisaged.
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Affiliation(s)
- Maroussia Medioni
- Sorbonne université, hôpital Saint-Antoine, AP-HP, service d'oncologie médicale, 75012 Paris, France
| | - Baptiste Cervantes
- Sorbonne université, hôpital Saint-Antoine, AP-HP, service d'oncologie médicale, 75012 Paris, France
| | - Florence Huguet
- Sorbonne université, hôpital Tenon, AP-HP, service d'oncologie radiothérapie, Paris, France
| | - Jean-Baptiste Bachet
- Sorbonne université, hôpital Pitié Salpêtrière, AP-HP, service d'hépato-gastroentérologie, Paris, France
| | - Yann Parc
- Sorbonne université, hôpital Saint-Antoine, AP-HP, service de chirurgie générale et digestive, Paris, France
| | - Thierry André
- Sorbonne université, hôpital Saint-Antoine, AP-HP, service d'oncologie médicale, 75012 Paris, France; INSERM URMS_938, centre de recherche Saint-Antoine, SIRIC CURAMUS, équipe instabilité des microsatellites et cancer, équipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Jérémie H Lefèvre
- Sorbonne université, hôpital Saint-Antoine, AP-HP, service de chirurgie générale et digestive, Paris, France
| | - Romain Cohen
- Sorbonne université, hôpital Saint-Antoine, AP-HP, service d'oncologie médicale, 75012 Paris, France; INSERM URMS_938, centre de recherche Saint-Antoine, SIRIC CURAMUS, équipe instabilité des microsatellites et cancer, équipe labellisée par la Ligue Nationale contre le Cancer, Paris, France.
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9
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Maroufi SF, Assar M, Khorasanizadeh M, Sabet FM, Sabahi M, Dabecco R, Adada B, Zada G, Borghei-Razavi H. Assessment of multimodal treatment options in recurrent and persistent acromegaly: a systematic review and meta-analysis. J Neurooncol 2024; 168:13-25. [PMID: 38587609 DOI: 10.1007/s11060-024-04658-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE In patients with acromegaly, secondary treatment options in cases of hormonal non-remission or tumor progression include repeat transsphenoidal surgery (TSS), radiation-based treatment (RT), or medical therapy (MT). In this study, we aim to evaluate the clinical effectiveness of various second-line treatment options for acromegaly. METHODS Using the PRISMA guideline, a systematic review was performed by searching MEDLINE (PubMed), Web of Science, Scopus, and Cochrane electronic bibliographic databases from conception to the end of 2022. Outcomes of interest included hormonal remission rate, complications, and mortality associated with each treatment modality for refractory acromegaly. RESULTS A total of 79 studies including 3,208 refractory acromegaly patients (44.90% males) were analyzed, with a mean patient age of 43.89 years. There was a statistically significant difference between various therapeutic modalities in terms of remission rate, with MT offering the highest remission rate (62.55%), followed by RT (50.15%) and TSS (37.39%). Subgroup analysis of radiotherapeutic and medical modalities did not show a significant difference in remission rate between different kinds of sub-modalities in each treatment approach. Recurrence following secondary treatment was not different in patients treated with reoperation TSS compared to other modalities. CONCLUSIONS The management of persistent and recurrent acromegaly optimally requires a multimodal approach. In different scenarios of refractory acromegaly based on previous treatment, secondary treatments may vary in terms of remission rate and complications. Medical agents provide considerable effectiveness as a second-line therapy for recurrent or persistent disease. In selected cases, however, reoperation still provides an opportunity for cure or freedom from medications. The findings of this study may help clinicians to prioritize varying options involved in this multifaceted decision-making process.
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Affiliation(s)
- Seyed Farzad Maroufi
- Neurosurgery Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Manijeh Assar
- Department of Surgery, University of Florida, Jacksonville, FL, USA
| | - MirHojjat Khorasanizadeh
- Department of Neurosurgery, Mount Sinai Hospital, Icahn School of Medicine, New York City, NY, USA
| | - Fatemeh Mahdavi Sabet
- Neurosurgery Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammadmahdi Sabahi
- Department of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA
| | - Rocco Dabecco
- Department of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA
| | - Badih Adada
- Department of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA
| | - Gabriel Zada
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hamid Borghei-Razavi
- Department of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA.
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 2950 Cleveland Clinic Blvd., 33331, Weston, FL, USA.
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10
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Liu MA, Li JW, Runcie K. Management of Oligometastatic and Locally Recurrent Urothelial Carcinoma. Curr Oncol Rep 2024; 26:496-503. [PMID: 38602581 DOI: 10.1007/s11912-024-01523-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE OF REVIEW To summarize and evaluate the literature on treatment approaches for oligometastatic and locally recurrent urothelial cancer. RECENT FINDINGS There is no clear definition for oligometastatic urothelial cancers due to limited data. Studies focusing on oligometastatic and locally recurrent urothelial cancer have been primarily retrospective. Treatment options include local therapy with surgery or radiation, and generalized systemic therapy such as chemotherapy or immunotherapy. Oligometastatic and locally recurrent urothelial cancers remain challenging to manage, and treatment requires an interdisciplinary approach. Systemic therapy is nearly always a component of current care in the form of chemotherapy, but the role of immunotherapy has not been explored. Consideration of surgical and radiation options may improve outcomes, and no studies have compared directly between the two localized treatment options. The development of new prognostic and predictive biomarkers may also enhance the treatment landscape in the future.
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Affiliation(s)
- Michael A Liu
- Division of Hematology and Oncology, Columbia University Irving Medical Center, 161 Fort Washington Avenue, New York, NY, 10032, USA
| | - Jennifer W Li
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Karie Runcie
- Division of Hematology and Oncology, Columbia University Irving Medical Center, 161 Fort Washington Avenue, New York, NY, 10032, USA.
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11
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Fong PY, Loh TKS, Shen L, Eu DKC, Lim CM. Patterns of recurrence in HNSCC patients treated definitively with upfront surgery, chemoradiation. Eur Arch Otorhinolaryngol 2024; 281:2645-2653. [PMID: 38498191 DOI: 10.1007/s00405-024-08556-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Locally-advanced oropharynx (LA-OPSCC) and hypopharynx/larynx (LA-HPLSCC) cancers may be treated with surgical or non-surgical modalities. While survival outcomes are comparable, patterns of disease recurrence are not well established. METHODS Retrospective review of 98 consecutive patients with LA-OPSCC or LA-HPLSCC treated by either surgery plus adjuvant therapy (S-POAT, n = 48) or chemoradiation (CRT, n = 50). RESULTS CRT-treated patients had higher recurrence risk (42% vs 14.6%, p = 0.003). This was significant only among LA-OPSCC (p = 0.002) but not LA-HPLSCC patients (p = 0.159). Median time to recurrence in LA-OPSCC was 16.8 vs 11.6 months, and 16.6 vs 15.1 months in LA-HPLSCC, comparing surgically treated and CRT cohorts. Surgically-treated p16-negative LA-OPSCC experienced improved locoregional control than CRT-treated patients (100% vs 12.5%, p = 0.045) and 3-year RFS (83.0% vs 33.3%, p < 0.001). CONCLUSION Locoregional control and RFS benefit was observed in surgically treated p16 negative LA-OPSCC patients. Locoregional recurrence is the main reason of treatment failure in LA-HNSCC, occurring commonly within the first 2 years post-treatment, regardless of treatment option.
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Affiliation(s)
- Pei Yuan Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thomas Kwok Seng Loh
- Department of Otolaryngology- Head and Neck Surgery, National University Health System, 1E Kent Ridge Road, Level 7 NUHS Tower Block, Singapore, 119228, Singapore
- National University Cancer Institute, National University Health System, Singapore, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Donovan Kum Chuen Eu
- Department of Otolaryngology- Head and Neck Surgery, National University Health System, 1E Kent Ridge Road, Level 7 NUHS Tower Block, Singapore, 119228, Singapore.
- National University Cancer Institute, National University Health System, Singapore, Singapore.
| | - Chwee Ming Lim
- Department of Otolaryngology-Head and Neck Surgery, Singapore General Hospital, 20 College Road, Level 5 Academia, Singapore, 169856, Singapore.
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12
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Eigendorff F, Filimonova I, Scholl S, Sayer-Klink A, Rummler S, Kunert C, Pietschmann K, Wittig A, Hochhaus A, Schnetzke U. Effective bridging strategies prior to infusion with tisagenlecleucel results in high response rates and long-term remission in relapsed/refractory large B-cell lymphoma: findings from a German monocentric study. J Cancer Res Clin Oncol 2024; 150:224. [PMID: 38693452 PMCID: PMC11062962 DOI: 10.1007/s00432-024-05765-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/23/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Incorporating chimeric antigen receptor (CAR)-T cell therapy into relapsed or refractory large B-cell lymphoma (rr LBCL) treatment algorithms has yielded remarkable response rates and durable remissions, yet a substantial portion of patients experience progression or relapse. Variations in outcomes across treatment centers may be attributed to different bridging strategies and remission statuses preceding CAR-T cell therapy. PATIENTS Twenty-nine consecutive adult patients receiving tisagenlecleucel (tisa-cel) for rr LBCL from December 2019 to February 2023 at Jena University Hospital were analyzed. RESULTS The median age was 63, with a median of 3 prior treatments. Twenty patients (69%) were refractory to any systemic therapy before CAR-T cell treatment. Following leukapheresis, 25 patients (86%) received bridging therapy with the majority undergoing chemotherapy (52%) or combined modality therapy (32%). Radiotherapy (RT) was part of the bridging strategy in 44%, with moderately hypofractionated involved site RT (30.0 Gy/2.5 Gy) being applied most frequently (64%). Post-CAR-T infusion, the objective response rate at 30 days was 83%, with 55% achieving complete response. Twelve-month progression-free (PFS) and overall survival (OS) were 60% and 74%, respectively, with a median follow up of 11.1 months for PFS and 17.9 months for OS. Factors significantly associated with PFS were chemotherapy sensitivity pre-leukapheresis and response to bridging. CONCLUSION The study underscores the importance of minimal tumor burden at CAR-T initiation, emphasizing the need for suitable bridging regimens. The findings advocate for clinical trials and further real-world analyses to optimize CAR-T cell therapy outcomes by identifying the most effective bridging strategies.
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MESH Headings
- Humans
- Male
- Middle Aged
- Female
- Aged
- Immunotherapy, Adoptive/methods
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Adult
- Remission Induction
- Neoplasm Recurrence, Local/therapy
- Neoplasm Recurrence, Local/pathology
- Germany
- Receptors, Antigen, T-Cell/therapeutic use
- Retrospective Studies
- Combined Modality Therapy
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Affiliation(s)
- Farina Eigendorff
- Klinik Für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Irina Filimonova
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Sebastian Scholl
- Klinik Für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Anne Sayer-Klink
- Institut für Transfusionsmedizin, Universitätsklinikum Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Silke Rummler
- Institut für Transfusionsmedizin, Universitätsklinikum Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Christa Kunert
- Klinik Für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Klaus Pietschmann
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Andrea Wittig
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena, Jena, Germany
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Andreas Hochhaus
- Klinik Für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany
| | - Ulf Schnetzke
- Klinik Für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
- Comprehensive Cancer Center Central Germany (CCCG) Jena/Leipzig, Campus Jena, Jena, Germany.
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13
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Potter S, Avery K, Ahmed R, de Boniface J, Chatterjee S, Dodwell D, Dubsky P, Iwata H, Jiang M, Lee HB, MacKenzie M, Poulakaki F, Richardson AL, Sepulveda K, Spillane A, Thompson AM, Werutsky G, Wright JL, Zdenkowski N, Cowan K, McIntosh S. Protocol for the development of a core outcome set and reporting guidelines for locoregional treatment in neoadjuvant systemic breast cancer treatment trials: the PRECEDENT project. BMJ Open 2024; 14:e084488. [PMID: 38643011 PMCID: PMC11033665 DOI: 10.1136/bmjopen-2024-084488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/03/2024] [Indexed: 04/22/2024] Open
Abstract
INTRODUCTION Neoadjuvant systemic anticancer therapy (neoSACT) is increasingly used in the treatment of early breast cancer. Response to therapy is prognostic and allows locoregional and adjuvant systemic treatments to be tailored to minimise morbidity and optimise oncological outcomes and quality of life. Accurate information about locoregional treatments following neoSACT is vital to allow the translation of downstaging benefits into practice and facilitate meaningful interpretation of oncological outcomes, particularly locoregional recurrence. Reporting of locoregional treatments in neoSACT studies, however, is currently poor. The development of a core outcome set (COS) and reporting guidelines is one strategy by which this may be improved. METHODS AND ANALYSIS A COS for reporting locoregional treatment (surgery and radiotherapy) in neoSACT trials will be developed in accordance with Core Outcome Measures in Effectiveness Trials (COMET) and Core Outcome Set-Standards for Development guidelines. Reporting guidance will be developed concurrently.The project will have three phases: (1) generation of a long list of relevant outcome domains and reporting items from a systematic review of published neoSACT studies and interviews with key stakeholders. Identified items and domains will be categorised and formatted into Delphi consensus questionnaire items. (2) At least two rounds of an international online Delphi survey in which at least 250 key stakeholders (surgeons/oncologists/radiologists/pathologists/trialists/methodologists) will score the importance of reporting each outcome. (3) A consensus meeting with key stakeholders to discuss and agree the final COS and reporting guidance. ETHICS AND DISSEMINATION Ethical approval for the consensus process will be obtained from the Queen's University Belfast Faculty Ethics Committee. The COS/reporting guidelines will be presented at international meetings and published in peer-reviewed journals. Dissemination materials will be produced in collaboration with our steering group and patient advocates so the results can be shared widely. REGISTRATION The study has been prospectively registered on the COMET website (https://www.comet-initiative.org/Studies/Details/2854).
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Affiliation(s)
- Shelley Potter
- Bristol Surgical and Perioperative Care Complex Intervention Collaboration, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Breast Care Centre, North Bristol NHS Trust, Bristol, UK
| | - Kerry Avery
- Bristol Surgical and Perioperative Care Complex Intervention Collaboration, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Rosina Ahmed
- Tata Medical Center, Kolkata, West Bengal, India
| | - Jana de Boniface
- Breast Unit, Capio St. Göran's Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Instituet, Stockholm, Sweden
| | | | | | - Peter Dubsky
- Hirslanden Klinik St Anna, Lucerne, Switzerland
- University of Lucerne, Luzern, Switzerland
| | | | - Michael Jiang
- Bristol Surgical and Perioperative Care Complex Intervention Collaboration, Bristol Medical School, University of Bristol, Bristol, UK
| | - Han-Byoel Lee
- Breast Care Centre, Dept. of Surgery, Seoul National University Hospital, Seoul, South Korea
- Cancer Research Institute, Seoul National University, Seoul, South Korea
| | | | - Fiorita Poulakaki
- Breast Surgery Department, Athens Medical Centre, Athens, Greece
- Europa Donna The European Breast Cancer Coalition, Milan, Italy
| | | | | | | | - Alastair M Thompson
- Department of Surgical Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | | | | | | | | | - Stuart McIntosh
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
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14
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Liu W, Liu W, Zou H, Chen L, Huang W, Lv R, Xu Y, Liu H, Shi Y, Wang K, Wang Y, Xiong W, Deng S, Yi S, Sui W, Peng G, Ma Y, Wang H, Lv L, Wang J, Wei J, Qiu L, Zheng W, Zou D. Combinational therapy of CAR T-cell and HDT/ASCT demonstrates impressive clinical efficacy and improved CAR T-cell behavior in relapsed/refractory large B-cell lymphoma. J Immunother Cancer 2024; 12:e008857. [PMID: 38631712 PMCID: PMC11029269 DOI: 10.1136/jitc-2024-008857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Approximately two-thirds of patients with relapsed or refractory large B-cell lymphoma (R/R LBCL) do not respond to or relapse after anti-CD19 chimeric antigen receptor T (CAR T)-cell therapy, leading to poor outcomes. Previous studies have suggested that intensified lymphodepletion and hematological stem cell infusion can promote adoptively transferred T-cell expansion, enhancing antitumor effects. Therefore, we conducted a phase I/II clinical trial in which CNCT19 (an anti-CD19 CAR T-cell) was administered after myeloablative high-dose chemotherapy and autologous stem cell transplantation (HDT/ASCT) in patients with R/R LBCL. METHODS Transplant-eligible patients with LBCL who were refractory to first-line immunochemotherapy or experiencing R/R status after salvage chemotherapy were enrolled. The study aimed to evaluate the safety and efficacy of this combinational therapy. Additionally, frozen peripheral blood mononuclear cell samples from this trial and CNCT19 monotherapy studies for R/R LBCL were used to evaluate the impact of the combination therapy on the in vivo behavior of CNCT19 cells. RESULTS A total of 25 patients with R/R LBCL were enrolled in this study. The overall response and complete response rates were 92.0% and 72.0%, respectively. The 2-year progression-free survival rate was 62.3%, and the overall survival was 68.5% after a median follow-up of 27.0 months. No unexpected toxicities were observed. All cases of cytokine release syndrome were of low grade. Two cases (8%) experienced grade 3 or higher CAR T-cell-related encephalopathy syndrome. The comparison of CNCT19 in vivo behavior showed that patients in the combinational therapy group exhibited enhanced in vivo expansion of CNCT19 cells and reduced long-term exhaustion formation, as opposed to those receiving CNCT19 monotherapy. CONCLUSIONS The combinational therapy of HDT/ASCT and CNCT19 demonstrates impressive efficacy, improved CNCT19 behavior, and a favorable safety profile. TRIAL REGISTRATION NUMBERS ChiCTR1900025419 and NCT04690192.
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Affiliation(s)
- Wei Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
- Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Tianjin, China
| | - Wei Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Hesong Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Lianting Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Wenyang Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Rui Lv
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Yan Xu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Huimin Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Yin Shi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Kefei Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yi Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Wenjie Xiong
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Shuhui Deng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Shuhua Yi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Weiwei Sui
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Guangxin Peng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Yueshen Ma
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Huijun Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Lulu Lv
- Juventas Cell Therapy Ltd, Tianjin, China
| | - Jianxiang Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
- Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Tianjin, China
| | - Jun Wei
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Lugui Qiu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Wenting Zheng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Dehui Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
- Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Tianjin, China
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15
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Choi BD, Gerstner ER, Frigault MJ, Leick MB, Mount CW, Balaj L, Nikiforow S, Carter BS, Curry WT, Gallagher K, Maus MV. Intraventricular CARv3-TEAM-E T Cells in Recurrent Glioblastoma. N Engl J Med 2024; 390:1290-1298. [PMID: 38477966 DOI: 10.1056/nejmoa2314390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
In this first-in-human, investigator-initiated, open-label study, three participants with recurrent glioblastoma were treated with CARv3-TEAM-E T cells, which are chimeric antigen receptor (CAR) T cells engineered to target the epidermal growth factor receptor (EGFR) variant III tumor-specific antigen, as well as the wild-type EGFR protein, through secretion of a T-cell-engaging antibody molecule (TEAM). Treatment with CARv3-TEAM-E T cells did not result in adverse events greater than grade 3 or dose-limiting toxic effects. Radiographic tumor regression was dramatic and rapid, occurring within days after receipt of a single intraventricular infusion, but the responses were transient in two of the three participants. (Funded by Gateway for Cancer Research and others; INCIPIENT ClinicalTrials.gov number, NCT05660369.).
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Affiliation(s)
- Bryan D Choi
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Elizabeth R Gerstner
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Matthew J Frigault
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Mark B Leick
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Christopher W Mount
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Leonora Balaj
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Sarah Nikiforow
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Bob S Carter
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - William T Curry
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Kathleen Gallagher
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
| | - Marcela V Maus
- From the Cellular Immunotherapy Program (B.D.C., M.J.F., M.B.L., C.W.M., K.G., M.V.M.) and Krantz Family Center for Cancer Research (M.B.L., K.G., M.V.M.), Mass General Cancer Center, and the Departments of Neurology (E.R.G.), Pathology (C.W.M., K.G.), Neurosurgery (B.D.C., L.B., B.S.C., W.T.C.), and Medicine (M.J.F., M.B.L., M.V.M.), Massachusetts General Hospital and Harvard Medical School, and Connell and O'Reilly Families Cell Manipulation Core Facility, Dana-Farber/Harvard Cancer Center (S.N.) - both in Boston
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Otani K, Konieczkowski DJ, Rodden DJ, Wu S, Davicioni E, Saylor PJ, Dahl DM, Wu CL, Kamran SC, Efstathiou JA, Miyamoto DT. CGE24-096: Impact of Somatic Mutations on Outcomes of Salvage Radiation and Hormonal Therapy for Prostate Cancer Recurrence After Prostatectomy. J Natl Compr Canc Netw 2024; 22:CGE24-096. [PMID: 38579754 DOI: 10.6004/jnccn.2023.7238] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
| | | | | | - Shulin Wu
- 1Massachusetts General Hospital, Boston, MA
| | | | - Philip J Saylor
- 1Massachusetts General Hospital, Boston, MA
- 4Harvard Medical School, Boston, MA
| | - Douglas M Dahl
- 1Massachusetts General Hospital, Boston, MA
- 4Harvard Medical School, Boston, MA
| | - Chin-Lee Wu
- 1Massachusetts General Hospital, Boston, MA
- 4Harvard Medical School, Boston, MA
| | - Sophia C Kamran
- 1Massachusetts General Hospital, Boston, MA
- 4Harvard Medical School, Boston, MA
- 5Broad Institute of Harvard and MIT, Cambridge, MA
| | - Jason A Efstathiou
- 1Massachusetts General Hospital, Boston, MA
- 4Harvard Medical School, Boston, MA
| | - David T Miyamoto
- 1Massachusetts General Hospital, Boston, MA
- 4Harvard Medical School, Boston, MA
- 5Broad Institute of Harvard and MIT, Cambridge, MA
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17
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Sundram S, Nandi S, Arora A, Saini S. To study the survival analysis and recurrence pattern in women treated for breast cancer: Retrospective study, a tertiary cancer center experience from Sub-Himalayan Region of India. J Surg Oncol 2024; 129:843-849. [PMID: 38221665 DOI: 10.1002/jso.27588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Breast cancer is a leading health concern in India, comprising 25% of female cancers with significant mortality. This study was conducted at the Cancer Research Institute in the Northern Sub-Himalayan region of India from 2016 to 2021, evaluated 674 breast cancer cases to analyze factors that influence recurrence. METHODOLOGY Retrospective clinical audit assessing patients' survival outcomes using Kaplan-Meier curves and Cox proportional hazard regression. Factors including age, molecular subtype, TNM staging, and treatment modalities were evaluated. RESULTS Notable findings include a high occurrence of breast cancer in young patients (24.48% ≤ 40 years) and varying recurrence rates among molecular subtypes with human epidermal growth factor receptor 2 neu-enriched (25.24%) and triple‑negative breast cancer (22.58%) being the most common. Advanced T and N stages, neoadjuvant chemotherapy, and the number of nodes dissected showed significant associations with higher recurrence rates. CONCLUSION This study sheds light on survival and recurrence patterns in Northern Sub-Himalayan breast cancer patients, emphasizing the need for tailored treatment strategies, comprehensive follow-up care, with improved understanding of regional outcomes. These findings contribute valuable insights for optimizing patient care and improving survival rates in this region.
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Affiliation(s)
- Shivangi Sundram
- Department of Surgical Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Sourabh Nandi
- Department of Surgical Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Anshika Arora
- Department of Surgical Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Sunil Saini
- Department of Surgical Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
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18
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Barkley A, Butler E, Park C, Friedman A, Landi D, Ashley DM, Bigner D, Bernstock JD, Friedman GK, Johnston JM, Thompson EM. The safety and accuracy of intratumoral catheter placement to infuse viral immunotherapies in children with malignant brain tumors: a multi-institutional study. J Neurosurg Pediatr 2024; 33:359-366. [PMID: 38215438 PMCID: PMC10810678 DOI: 10.3171/2023.12.peds23404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE Relatively little is known about the safety and accuracy of catheter placement for oncolytic viral therapy in children with malignant brain tumors. Accordingly, this study combines data from two phase I clinical trials that employed viral immunotherapy across two institutions to describe the adverse event profile, safety, and accuracy associated with the stereotactic placement and subsequent removal of intratumoral catheters. METHODS Children with progressive/recurrent supratentorial malignant tumors were enrolled in two clinical trials (NCT03043391 and NCT02457845) and treated with either the recombinant polio:rhinovirus (lerapolturev) or the genetically modified oncolytic herpesvirus (G207). Age, sex, race, tumor diagnosis, and tumor location were analyzed. Events related to the catheter placement or removal were categorized. A catheter that was either pulled back or could not be used was defined as "misplaced." Neuronavigation software was used to analyze the accuracy of catheter placement for NCT03043391. Descriptive statistics were performed. RESULTS Nineteen patients were treated across the two completed trials with a total of 49 catheters. The mean ± SD (range) age was 14.1 ± 3.6 (7-19) years. All tumors were grade 3 or 4 gliomas. Nonlobar catheter tip placement included the corpus callosum, thalamus, insula, and cingulate gyrus. Six of 19 patients (31.6%) had minor hemorrhage noted on CT; however, no patients were symptomatic and/or required intervention related to these findings. One of 19 patients had a delayed CSF leak after catheter removal that required oversewing of the surgical site. No patients developed infection or a neurological deficit. In 7 patients with accuracy data, the mean ± SD distance of the planned trajectory (PT) to the catheter tip was 1.57 ± 1.6 mm, the mean angle of the PT to the catheter was 2.43° ± 2.1°, and the greatest distance of PT to the catheter in the parallel plane was 1.54 ± 1.5 mm. Three of 49 (6.1%) catheters were considered misplaced. CONCLUSIONS Although instances of minor hemorrhage were encountered, they were clinically asymptomatic. One of 49 catheters required intervention for a CSF leak. Congruent with previous studies in the literature, the stereotactic placement of catheters in these pediatric tumor patients was accurate with approximately 95% of catheters having been adequately placed.
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Affiliation(s)
- Ariana Barkley
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico
- Departments of Neurosurgery and
| | | | - Christine Park
- School of Medicine, Duke University, Durham, North Carolina
| | | | - Daniel Landi
- Pediatrics, Duke University, Durham, North Carolina
| | | | | | - Joshua D. Bernstock
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gregory K. Friedman
- Pediatrics, University of Alabama at Birmingham, Alabama
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas; and
| | | | - Eric M. Thompson
- Departments of Neurosurgery and
- Department of Neurosurgery, University of Chicago, Illinois
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19
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Brinkman M, Green H, Crofts S, Jones B, Walsh S, Smith M. Personalized dietary management of advanced prostate cancer using nutrigenomics: a case report. Eur J Clin Nutr 2024; 78:356-359. [PMID: 38071236 PMCID: PMC11003864 DOI: 10.1038/s41430-023-01377-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 04/11/2024]
Abstract
While there are emerging reports in the scientific literature on potential associations between cholesterol/lipids and prostate cancer, information on the dietary management of these cancer patients is currently lacking. We report on a 57-year-old white Australian male diagnosed with advanced prostate cancer who had personalized dietary management in preparation for and following his medical treatment: radiation and radical prostatectomy. Dietary recommendations were based on his blood results and nutrigenomic tests which showed a history of and genetic predisposition to dyslipidemia. Nutritional analysis also confirmed the need for dietary modification of his fat intake. Eighteen months post medical and dietary intervention his PSA level was reported at 0.1 ug/L and all blood lipid levels were within reference ranges. At two years there was no detectable disease recurrence and androgen deprivation therapy (ADT) was not required. Personalized dietary recommendations could be a clinically beneficial addition to the multidisciplinary management of prostate cancer patients.
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Affiliation(s)
- Maree Brinkman
- Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, South Melbourne, VIC, Australia.
| | - Hayden Green
- Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, South Melbourne, VIC, Australia
| | - Sam Crofts
- Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, South Melbourne, VIC, Australia
| | - Bridget Jones
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Simone Walsh
- MHTP Translation Research Facility, SmartDNA Pty Ltd, Clayton, VIC, Australia
| | - Margaret Smith
- MHTP Translation Research Facility, SmartDNA Pty Ltd, Clayton, VIC, Australia
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20
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Gehrke-Beck S, Holzinger F. [The cough just does not go away! Wait and watch, treat, or refer?]. MMW Fortschr Med 2024; 166:34-37. [PMID: 38581513 DOI: 10.1007/s15006-024-3693-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Affiliation(s)
- Sabine Gehrke-Beck
- Institut für Allgemeinmedizin, Charité Univ.-Medizin Berlin - CCM, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Felix Holzinger
- Institut für Allgemeinmedizin, Charité Univ.-Medizin Berlin - CCM, Charitéplatz 1, 10117, Berlin, Deutschland
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21
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Zhao X, Wen Q, Wang J, Dou W, Zhang G, Shi H. Is intravoxel incoherent motion magnetic resonance imaging useful for predicting hepatocellular cancer recurrence and invasion of the peritumoral zone after transarterial chemoembolization? J Cancer Res Ther 2024; 20:584-591. [PMID: 38687928 DOI: 10.4103/jcrt.jcrt_1582_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/25/2023] [Indexed: 05/02/2024]
Abstract
PURPOSE We evaluated the potential role of intravoxel incoherent motion (IVIM) in predicting the therapeutic response and peritumoral invasion in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). MATERIALS AND METHODS We enrolled 47 patients previously treated with TACE between January 2018 and December 2021. We evaluated the IVIM-derived metrics [apparent diffusion coefficient (ADC), D, D*, f] in the TACE-treated, peritumoral, and parenchymal areas of the liver. RESULTS The ADCtace and Dtace values (1.13 ± 0.22 × 10-3 m2/s vs 0.95 ± 0.13 × 10-3 mm2/s, 1.28 ± 0.27 × 10-3 mm2/s vs 1.07 ± 0.3 × 10-3 mm2/s, P < 0.05) were higher in the non-progressing groups than in the progressing groups in the TACE-treated areas. Dpt represented the D values in the peritumoral area, which can distinguish between the progressive and non-progressive groups with an AUC of 0.73. The Dstd values, which represent the D values in the peritumoral area normalized by the D values in the liver parenchyma in the non-progressing groups (1.10 ± 0.14 × 10-3 mm2/s), were higher than those of the progressing groups (0.93 ± 0.17 × 10-3 mm2/s). CONCLUSION The ADCtace, Dtace, Dpt, and Dstd values reflect the changes in the microstructure of the progressive and non-progressive groups after TACE treatment, showing robust diagnostic performances in predicting the therapeutic response and peritumoral invasion.
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Affiliation(s)
- Xinyao Zhao
- Shandong Provincial Qianfoshan Hospital, Shandong University, Yantai, Shandong, China
- Yantaishan Hospital, Yantai, Shandong, China
| | - Qingqing Wen
- The First Affiliated Hospital of Shandong First Medical University, Beijing, China
| | - Junying Wang
- GE Healthcare, MR Research China, Beijing, China
| | - Weiqiang Dou
- The First Affiliated Hospital of Shandong First Medical University, Beijing, China
| | | | - Hao Shi
- Shandong Provincial Qianfoshan Hospital, Shandong University, Yantai, Shandong, China
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22
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Kaye EC, Smith J, Zhou Y, Bagatell R, Baker JN, Cohn SL, Diller LR, Glade Bender JL, Granger MM, Marachelian A, Park JR, Rosenberg AR, Shusterman S, Twist CJ, Mack JW. Factors influencing parents' choice of palliative treatment goals for children with relapsed or refractory neuroblastoma: A multi-site longitudinal survey study. Cancer 2024; 130:1101-1111. [PMID: 38100619 PMCID: PMC10939929 DOI: 10.1002/cncr.35149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Many parents of children with advanced cancer report curative goals and continue intensive therapies that can compound symptoms and suffering. Factors that influence parents to choose palliation as the primary treatment goal are not well understood. The objective of this study was to examine experiences impacting parents' report of palliative goals adjusted for time. The authors hypothesized that awareness of poor prognosis, recall of oncologists' prognostic disclosure, intensive treatments, and burdensome symptoms and suffering would influence palliative goal-setting. METHODS The authors collected prospective, longitudinal surveys from parents of children with relapsed/refractory neuroblastoma at nine pediatric cancer centers across the United States, beginning at relapse and continuing every 3 months for 18 months or until death. Hypothesized covariates were examined for possible associations with parental report of palliative goals. Generalized linear mixed models were used to evaluate factors associated with parents' report of palliative goals at different time points. RESULTS A total of 96 parents completed surveys. Parents were more likely to report a primary goal of palliation when they recalled communication about prognosis by their child's oncologist (odds ratio [OR], 52.48; p = .010). Treatment intensity and previous ineffective therapeutic regimens were not associated with parents' report of palliative goals adjusted for time. A parent who reported new suffering for their child was less likely to report palliative goals (OR, 0.13; p = .008). CONCLUSIONS Parents of children with poor prognosis cancer may not report palliative goals spontaneously in the setting of treatment-related suffering. Prognostic communication, however, does influence palliative goal-setting. Evidence-based interventions are needed to encourage timely, person-centered prognostic disclosure in the setting of advanced pediatric cancer. PLAIN LANGUAGE SUMMARY Many parents of children with poor-prognosis cancer continue to pursue curative treatments that may worsen symptoms and suffering. Little is known about which factors influence parents to choose palliative care as their child's main treatment goal. To explore this question, we asked parents of children with advanced neuroblastoma across the United States to complete multiple surveys over time. We found that the intensity of treatment, number of treatments, and suffering from treatment did not influence parents to choose palliative goals. However, when parents remembered their child's oncologist talking about prognosis, they were more likely to choose palliative goals of care.
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Affiliation(s)
- Erica C. Kaye
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Jesse Smith
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, TN
| | - Yiwang Zhou
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, TN
| | - Rochelle Bagatell
- Division of Oncology, Department of Pediatrics, The Children’s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Justin N. Baker
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN
| | - Susan L. Cohn
- Department of Pediatrics, Comer Children’s Hospital, University of Chicago, Chicago, IL
| | - Lisa R. Diller
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
- Division of Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
| | - Julia L. Glade Bender
- Department of Pediatric Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. Meaghan Granger
- Hematology and Oncology Center, Cook Children’s Hospital, Fort Worth, TX
| | - Araz Marachelian
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Julie R. Park
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, University of Washington School of Medicine, Seattle, WA
- Department of Pediatric Hematology/Oncology, Seattle Children’s Hospital, Seattle, WA, USA
| | - Abby R. Rosenberg
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, University of Washington School of Medicine, Seattle, WA
- Department of Pediatric Hematology/Oncology, Seattle Children’s Hospital, Seattle, WA, USA
- Department of Psychosocial Oncology and Palliative Care, Division of Pediatric Palliative Care; Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pediatrics, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Suzanne Shusterman
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
- Division of Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
| | - Clare J. Twist
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jennifer W. Mack
- Department of Pediatrics, Comer Children’s Hospital, University of Chicago, Chicago, IL
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
- Division of Population Sciences’ Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, MA, USA
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Morgan TM, Boorjian SA, Buyyounouski MK, Chapin BF, Chen DYT, Cheng HH, Chou R, Jacene HA, Kamran SC, Kim SK, Kirkby E, Luckenbaugh AN, Nathanson BJ, Nyame YA, Posadas EM, Tran PT, Chen RC. Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline Part III: Salvage Therapy After Radiotherapy or Focal Therapy, Pelvic Nodal Recurrence and Oligometastasis, and Future Directions. J Urol 2024; 211:526-532. [PMID: 38421252 DOI: 10.1097/ju.0000000000003890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE The summary presented herein covers recommendations on salvage therapy for recurrent prostate cancer intended to facilitate care decisions and aid clinicians in caring for patients who have experienced a recurrence following prior treatment with curative intent. This is Part III of a three-part series focusing on evaluation and management of suspected non-metastatic recurrence after radiotherapy (RT) and focal therapy, evaluation and management of regional recurrence, management for molecular imaging metastatic recurrence, and future directions. Please refer to Part I for discussion of treatment decision-making and Part II for discussion of treatment delivery for non-metastatic biochemical recurrence (BCR) after radical prostatectomy (RP). MATERIALS AND METHODS The systematic review that informs this Guideline was based on searches in Ovid MEDLINE (1946 to July 21, 2022), Cochrane Central Register of Controlled Trials (through August 2022), and Cochrane Database of Systematic Reviews (through August 2022). Update searches were conducted on July 26, 2023. Searches were supplemented by reviewing electronic database reference lists of relevant articles. RESULTS In a collaborative effort between AUA, ASTRO, and SUO, the Salvage Therapy for Prostate Cancer Guideline Panel developed evidence- and consensus-based guideline statements to provide guidance for the care of patients who experience BCR after initial definitive local therapy for clinically localized disease. CONCLUSIONS Continuous and deliberate efforts for multidisciplinary care in prostate cancer will be required to optimize and improve the oncologic and functional outcomes of patients treated with salvage therapies in the future.
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Affiliation(s)
- Todd M Morgan
- Urology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Brian F Chapin
- Urology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Y T Chen
- Urology, Fox Chase Cancer Center-Temple Health, Rockledge, Pennsylvania
| | - Heather H Cheng
- Division of Hematology and Oncology Medicine, University of Washington, Seattle, Washington
| | - Roger Chou
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
| | | | - Sophia C Kamran
- Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sennett K Kim
- American Urological Association, Linthicum, Maryland
| | - Erin Kirkby
- American Urological Association, Linthicum, Maryland
| | | | | | - Yaw A Nyame
- Urology, University of Washington, Seattle, Washington
| | | | - Phuoc T Tran
- Radiation Oncology, University of Maryland, Baltimore, Maryland
| | - Ronald C Chen
- Radiation Oncology, University of Kansas, Kansas City, Kansas
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24
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Feferman Y, Rosen R, Gebran S, Yuval JB, Kerioui M, Gonen M, Wei IH, Widmar M, Nash GM, Weiser MR, Paty PB, Hajj C, O’Brien DR, Romesser PB, Crane C, Smith JJ, Aguilar JG, Pappou EP. Anal Adenocarcinoma Treated in the Era of Total Neoadjuvant Therapy and Nonoperative Management. Dis Colon Rectum 2024; 67:496-504. [PMID: 38127627 PMCID: PMC10922541 DOI: 10.1097/dcr.0000000000003113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Anal adenocarcinoma bears a treatment strategy unique to other anal cancers. OBJECTIVE This study aimed to describe oncologic outcomes of total neoadjuvant therapy followed by watch-and-wait approach for anal adenocarcinoma. DESIGN Retrospective analysis. SETTINGS This study was conducted at a comprehensive cancer center. PATIENTS Patients with anal adenocarcinoma treated between 2004 and 2019 were selected. INTERVENTIONS Fifty-four patients received neoadjuvant therapy and were divided into 2 groups according to their treatment strategy: total neoadjuvant therapy versus single neoadjuvant modality therapy. MAIN OUTCOME MEASURES Organ preservation, tumor regrowth, local failure, distant metastasis rates, recurrence-free survival, and overall survival. RESULTS This study included 70 patients with anal adenocarcinoma. Fifty-four patients (77%) received neoadjuvant therapy, of whom 30 (42%) received total neoadjuvant therapy and 24 (34%) received single neoadjuvant modality. Twenty-three (33%) patients achieved complete clinical response and were managed by watch-and-wait approach. The proportion of patients able to continue to watch-and-wait approach was higher after receiving total neoadjuvant therapy (60%) compared with single neoadjuvant modality therapy (20%; p = 0.004). A tumor regrowth rate of 22% was observed in the total neoadjuvant therapy group. The 5-year overall survival rate was 70% (95% CI, 59%-83%), including 61% (95% CI, 42%-88%) for the total neoadjuvant therapy and 65% (95% CI, 48%-88%) for the single neoadjuvant modality groups. Colostomy was avoided in 50% of patients who received total neoadjuvant therapy and 83% of watch-and-wait patients. Five-year recurrence-free survival rates of 55% (95% CI, 39%-79%) and 30% (95% CI, 15%-58%) were observed in the total neoadjuvant therapy and single neoadjuvant modality groups. LIMITATIONS Retrospective nature. CONCLUSIONS This is the first report in the literature describing the safety and feasibility of nonoperative management for anal adenocarcinoma. Anal adenocarcinoma treated with total neoadjuvant therapy and nonoperative management achieve regrowth rates comparable to those observed in rectal cancer, with oncologic outcomes similar to those of traditional treatment strategies. See Video Abstract . ADENOCARCINOMA ANAL TRATADO EN LA ERA DE LA TERAPIA NEOADYUVANTE TOTAL Y EL TRATAMIENTO NO QUIRRGICO ANTECEDENTES:El adenocarcinoma anal conlleva una estrategia de tratamiento único para otros cánceres anales.OBJETIVO:Describir los resultados oncológicos de la terapia neoadyuvante total seguida de observar y esperar en adenocarcinoma anal.DISEÑO:Análisis retrospectivo.AJUSTE:Este estudio se llevó a cabo en un centro oncológico integral.PACIENTES:Se seleccionaron pacientes con adenocarcinoma anal tratados entre 2004-2019.INTERVENCIONES:Cincuenta y cuatro pacientes recibieron terapia neoadyuvante y se dividieron en dos grupos según su estrategia de tratamiento: terapia neoadyuvante total versus terapia de modalidad neoadyuvante única.PRINCIPALES MEDIDAS DE RESULTADO:Preservación de órganos, recurrencia tumoral, falla local, tasas de metástasis a distancia, libre de recurrencia y supervivencia general.RESULTADOS:El estudio incluyó a 70 pacientes con adenocarcinoma anal. Cincuenta y cuatro pacientes (77%) recibieron terapia neoadyuvante, de los cuales 30 (42%) recibieron terapia neoadyuvante total y 24 (34%) recibieron modalidad neoadyuvante única. Veintitrés (33%) pacientes presentaron una respuesta clínica completa y fueron tratados con vigilancia y espera. La proporción de pacientes capaces de continuar en observar y esperar fue mayor después de recibir terapia neoadyuvante total (60%) en comparación con la terapia de modalidad neoadyuvante única (20%) ( p = 0,004). Se observó una tasa de recurrencia tumoral del 22% en el grupo de terapia neoadyuvante total. La tasa de supervivencia general a 5 años fue del 70% (IC95% 59%-83 %), incluido el 61% (IC95% 42%-88%) para la terapia neoadyuvante total y el 65% (IC95% 48%-88%) para grupos de modalidad neoadyuvante única. Se evitó la colostomía en el 50% de los pacientes que recibieron terapia neoadyuvante total y el 83% de los pacientes en observar y esperar. Se observaron tasas de supervivencia libre de recurrencia a cinco años del 55% (IC95% 39%-79%) y del 30% (IC95% 15%-58%) en los grupos de terapia neoadyuvante total y modalidad neoadyuvante única, respectivamente.LIMITACIONES:Diseño retrospectivo.CONCLUSIONES:Este es el primer informe en la literatura que describe la seguridad y viabilidad del tratamiento no quirúrgico del adenocarcinoma anal. El adenocarcinoma anal tratado con terapia neoadyuvante total y manejo no quirúrgico logra tasas de recurrencia comparables a las observadas en el cáncer de recto, con resultados oncológicos similares a las estrategias de tratamientos tradicionales. (Traducción-Dr. Fidel Ruiz Healy ).
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Affiliation(s)
- Yael Feferman
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Roni Rosen
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Selim Gebran
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jonathan B. Yuval
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marion Kerioui
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mithat Gonen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Iris H. Wei
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Maria Widmar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Garrett M. Nash
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin R. Weiser
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Philip B. Paty
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Carla Hajj
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Diana Roth O’Brien
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul B. Romesser
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christopher Crane
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - J. Joshua Smith
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Julio Garcia Aguilar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Emmanouil P. Pappou
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Morgan TM, Boorjian SA, Buyyounouski MK, Chapin BF, Chen DYT, Cheng HH, Chou R, Jacene HA, Kamran SC, Kim SK, Kirkby E, Luckenbaugh AN, Nathanson BJ, Nyame YA, Posadas EM, Tran PT, Chen RC. Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline Part I: Introduction and Treatment Decision-Making at the Time of Suspected Biochemical Recurrence after Radical Prostatectomy. J Urol 2024; 211:509-517. [PMID: 38421253 DOI: 10.1097/ju.0000000000003892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE The summary presented herein covers recommendations on salvage therapy for recurrent prostate cancer intended to facilitate care decisions and aid clinicians in caring for patients who have experienced a recurrence following prior treatment with curative intent. This is Part I of a three-part series focusing on treatment decision-making at the time of suspected biochemical recurrence (BCR) after radical prostatectomy (RP). Please refer to Part II for discussion of treatment delivery for non-metastatic BCR after RP and Part III for discussion of evaluation and management of recurrence after radiotherapy (RT) and focal therapy, regional recurrence, and oligometastasis. MATERIALS AND METHODS The systematic review that informs this Guideline was based on searches in Ovid MEDLINE (1946 to July 21, 2022), Cochrane Central Register of Controlled Trials (through August 2022), and Cochrane Database of Systematic Reviews (through August 2022). Update searches were conducted on July 26, 2023. Searches were supplemented by reviewing electronic database reference lists of relevant articles. RESULTS In a collaborative effort between AUA, ASTRO, and SUO, the Salvage Therapy for Prostate Cancer Panel developed evidence- and consensus-based statements to provide guidance for the care of patients who experience BCR after initial definitive local therapy for clinically localized disease. CONCLUSIONS Advancing work in the area of diagnostic tools (particularly imaging), biomarkers, radiation delivery, and biological manipulation with the evolving armamentarium of therapeutic agents will undoubtedly present new opportunities for patients to experience long-term control of their cancer while minimizing toxicity.
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Affiliation(s)
- Todd M Morgan
- Urology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Brian F Chapin
- Urology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Y T Chen
- Urology, Fox Chase Cancer Center-Temple Health, Rockledge, Pennsylvania
| | - Heather H Cheng
- Division of Hematology and Oncology Medicine, University of Washington, Seattle, Washington
| | - Roger Chou
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
| | | | - Sophia C Kamran
- Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sennett K Kim
- American Urological Association, Linthicum, Maryland
| | - Erin Kirkby
- American Urological Association, Linthicum, Maryland
| | | | | | - Yaw A Nyame
- Urology, University of Washington, Seattle, Washington
| | | | - Phuoc T Tran
- Radiation Oncology, University of Maryland, Baltimore, Maryland
| | - Ronald C Chen
- Radiation Oncology, University of Kansas, Kansas City, Kansas
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26
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Leonardi R, Ambrosini F, Cafarelli A, Calarco A, Colombo R, Tuzzolo D, De Marco F, Ferrari G, Ludovico G, Pecoraro S, De Cobelli O, Terrone C, Mantica G. Office-based management of Non-Muscle Invasive Bladder Cancer (NMIBC): A position paper on current state of the art and future perspectives. Arch Ital Urol Androl 2024; 96:12404. [PMID: 38502027 DOI: 10.4081/aiua.2024.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 03/20/2024] Open
Abstract
To the Editor, Bladder cancer is one of the most common cancers in humans, representing the 7th and 17th type of neoplasm in both genders. Its incidence and mortality are quite heterogeneous in different countries and are due to different risk factors, quality and prevalence of healthcare and the possibility of early diagnosis and treatment of the tumor and its potential recurrences [...].
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Affiliation(s)
- Rosario Leonardi
- Casa di Cura Musumeci GECAS, Gravina di Catania; Urologi Ospedalità Gestione Privata (UrOP).
| | | | - Angelo Cafarelli
- Urology Unit, Villa Igea, Ancona; Urologi Ospedalità Gestione Privata (UrOP).
| | | | - Renzo Colombo
- Department of Urology, Vita e Salute San Raffaele University, Milan; Urologi Ospedalità Gestione Privata (UrOP).
| | | | | | - Giovanni Ferrari
- Hesperia Hospital, Modena; Urologi Ospedalità Gestione Privata (UrOP).
| | - Giuseppe Ludovico
- Ospedale Miulli, Acquaviva delle Fonti, Bari; Urologi Ospedalità Gestione Privata (UrOP).
| | | | - Ottavio De Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan; Urologi Ospedalità Gestione Privata (UrOP).
| | - Carlo Terrone
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova.
| | - Guglielmo Mantica
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova.
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27
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Zou H, Liu W, Wang X, Wang Y, Wang C, Qiu C, Liu H, Shan D, Xie T, Huang W, Sui W, Yi S, An G, Xu Y, Ma T, Wang J, Qiu L, Zou D. Dynamic monitoring of circulating tumor DNA reveals outcomes and genomic alterations in patients with relapsed or refractory large B-cell lymphoma undergoing CAR T-cell therapy. J Immunother Cancer 2024; 12:e008450. [PMID: 38443094 DOI: 10.1136/jitc-2023-008450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Over 50% of patients with relapsed or refractory large B-cell lymphoma (r/r LBCL) receiving CD19-targeted chimeric antigen receptor (CAR19) T-cell therapy fail to achieve durable remission. Early identification of relapse or progression remains a significant challenge. In this study, we prospectively investigate the prognostic value of dynamic circulating tumor DNA (ctDNA) and track genetic evolution non-invasively, for the first time in an Asian population of r/r patients undergoing CAR19 T-cell therapy. METHODS Longitudinal plasma samples were prospectively collected both before lymphodepletion and at multiple timepoints after CAR19 T-cell infusion. ctDNA was detected using a capture-based next-generation sequencing which has been validated in untreated LBCL. RESULTS The study enrolled 23 patients with r/r LBCL and collected a total of 101 ctDNA samples. Higher pretreatment ctDNA levels were associated with inferior progression-free survival (PFS) (p=0.031) and overall survival (OS) (p=0.023). Patients with undetectable ctDNA negative (ctDNA-) at day 14 (D14) achieved an impressive 3-month complete response rate of 77.8% vs 22.2% (p=0.015) in patients with detectable ctDNA positive (ctDNA+), similar results observed for D28. CtDNA- at D28 predicted significantly longer 1-year PFS (90.9% vs 27.3%; p=0.004) and OS (90.9% vs 49.1%; p=0.003) compared with patients who remained ctDNA+. Notably, it is the first time to report that shorter ctDNA fragments (<170 base pairs) were significantly associated with poorer PFS (p=0.031 for D14; p=0.002 for D28) and OS (p=0.013 for D14; p=0.008 for D28) in patients with LBCL receiving CAR T-cell therapy. Multiple mutated genes exhibited an elevated prevalence among patients with progressive disease, including TP53, IGLL5, PIM1, BTG1, CD79B, GNA13, and P2RY8. Notably, we observed a significant correlation between IGLL5 mutation and inferior PFS (p=0.008) and OS (p=0.014). CONCLUSIONS Our study highlights that dynamic ctDNA monitoring during CAR T-cell therapy can be a promising non-invasive method for early predicting treatment response and survival outcomes. Additionally, the ctDNA mutational profile provides novel insights into the mechanisms of tumor-intrinsic resistance to CAR19 T-cell therapy.
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Affiliation(s)
- Hesong Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Wei Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
- Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Xiaojuan Wang
- Jichen Biotechnology Co, Ltd, Hangzhou, Zhejiang, China
- Genecn-Biotech Co, Ltd, Hangzhou, Zhejiang, China
| | - Yi Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Chunyang Wang
- Jichen Biotechnology Co, Ltd, Hangzhou, Zhejiang, China
- Genecn-Biotech Co, Ltd, Hangzhou, Zhejiang, China
| | - Chen Qiu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Huimin Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Dandan Shan
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Ting Xie
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Wenyang Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Weiwei Sui
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Shuhua Yi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Gang An
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Yan Xu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Tonghui Ma
- Jichen Biotechnology Co, Ltd, Hangzhou, Zhejiang, China
- Genecn-Biotech Co, Ltd, Hangzhou, Zhejiang, China
| | - Jianxiang Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
- Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Lugui Qiu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Dehui Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
- Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
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28
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Pampeno C, Opp S, Hurtado A, Meruelo D. Sindbis Virus Vaccine Platform: A Promising Oncolytic Virus-Mediated Approach for Ovarian Cancer Treatment. Int J Mol Sci 2024; 25:2925. [PMID: 38474178 PMCID: PMC10932354 DOI: 10.3390/ijms25052925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/30/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
This review article provides a comprehensive overview of a novel Sindbis virus vaccine platform as potential immunotherapy for ovarian cancer patients. Ovarian cancer is the most lethal of all gynecological malignancies. The majority of high-grade serous ovarian cancer (HGSOC) patients are diagnosed with advanced disease. Current treatment options are very aggressive and limited, resulting in tumor recurrences and 50-60% patient mortality within 5 years. The unique properties of armed oncolytic Sindbis virus vectors (SV) in vivo have garnered significant interest in recent years to potently target and treat ovarian cancer. We discuss the molecular biology of Sindbis virus, its mechanisms of action against ovarian cancer cells, preclinical in vivo studies, and future perspectives. The potential of Sindbis virus-based therapies for ovarian cancer treatment holds great promise and warrants further investigation. Investigations using other oncolytic viruses in preclinical studies and clinical trials are also presented.
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Affiliation(s)
- Christine Pampeno
- Department of Pathology, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | | | - Alicia Hurtado
- Department of Pathology, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Daniel Meruelo
- Department of Pathology, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
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29
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Damron EP, McDonald J, Rooney MK, Das P, Ludmir EB, Minsky BD, Messick C, Chang GJ, Morris VK, Holliday EB. Salvage Treatment of Recurrent or Persistent Anal Squamous Cell Carcinoma: The Role of Multi-modality Therapy. Clin Colorectal Cancer 2024; 23:85-94. [PMID: 38216367 DOI: 10.1016/j.clcc.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND The standard treatment for recurrent or persistent anal squamous cell carcinoma is surgical salvage, but disease control and survival are suboptimal. PATIENTS/METHODS Patients treated for recurrent or persistent anal squamous cell carcinoma at our institution from 2002 to 2022 were included. Patients were classified by type of salvage treatment received: surgery alone vs. reirradiation followed by surgery and by whether they received intraoperative radiation at the time of surgery. Clinical and pathologic variables were collected and assessed for association with risk of second local recurrence and death from any cause. RESULTS Sixty four patients were included; 55(85.9%) were treated with surgery alone and 9 (14.1%) were treated with reirradiation followed by surgery. Median (IQR) follow up from the time of salvage treatment was 40.0 (20.3-68.0) months. The 3-year cumulative incidence of second local recurrence (95% CI) after salvage surgery was 36% (24%-48%); 39% (26%-52%) for patients treated with surgery alone and 15% (0.46%-51%) for patients treated with reirradiation followed by surgery. Factors associated with increased second local recurrence after salvage surgery included a locoregional recurrence, lymphovascular space invasion and positive surgical margins. The 3-year overall survival (95% CI) after salvage surgery was 70% (59%-83%); 68% (7%-56%) after surgery alone and 89% (10.5%-70.6%) after reirradiation followed by surgery. Factors associated with worse overall survival included male sex, a larger recurrent tumor and positive surgical margins. CONCLUSIONS Approximately 60% of patients achieved pelvic control after salvage therapy for recurrent or persistent anal squamous cell carcinoma. Although receipt of reirradiation and intraoperative radiation were not associated with improved second local recurrence or overall survival in our cohort, patients with positive surgical margins and lymphovascular space invasion on surgical pathology had higher rates of pelvic recurrence after salvage surgery and may benefit from escalated salvage therapy.
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Affiliation(s)
- Ethan P Damron
- University of Texas McGovern Medical School, Houston, TX
| | - Jordan McDonald
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Prajnan Das
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ethan B Ludmir
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bruce D Minsky
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Craig Messick
- Department of Colorectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - George J Chang
- Department of Colorectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Van K Morris
- Deparment of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Emma B Holliday
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
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30
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Kato K, Sugio T, Ikeda T, Yoshitsugu K, Miyazaki K, Suzumiya J, Yamamoto G, Kim SW, Ikegame K, Uehara Y, Mori Y, Ishikawa J, Hiramoto N, Eto T, Nakazawa H, Kobayashi H, Serizawa K, Onizuka M, Fukuda T, Atsuta Y, Suzuki R. Outcomes of allogeneic hematopoietic stem cell transplantation for relapsed or refractory diffuse large B-cell lymphoma. Bone Marrow Transplant 2024; 59:306-314. [PMID: 38102209 DOI: 10.1038/s41409-023-02156-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/06/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a currative treatment modality for diffuse large B-cell lymphoma (DLBCL) because of the intrinsic graft-versus-lymphoma effect. However, limited information is available regarding which patients with relapsed or refractory DLBCL are likely to benefit from allo-HSCT. We retrospectively analyzed data from 1268 DLBCL patients who received allo-HSCT. The overall survival and progression-free survival (PFS) rates were 30.3% and 21.6% at 3 years, respectively. Multivariate analysis revealed that stable or progressive disease at transplantation, male patient, poorer performance status at transplantation, and shorter intervals from previous transplantation were associated independently with a lower PFS. Four prognostic factors were used to construct a prognostic index for PFS, predicting 3-year PFS of 55.4%, 43.7%, 20.4% and 6.6%, respectively. The prognostic model predicted relapse rates following allo-HSCT accordingly (P < 0.0001), whereas did not predict transplantation-related mortality (P = 0.249). The prognostic index can identify a subgroup of DLBCL patients who benefit from allo-HSCT and it is worthwhile to evaluate whether this model is also applicable to patients undergoing allo-HSCT in cases of relapse after chimeric antigen receptor engineered T-cell therapy, although the application of allo-HSCT has been declining with the increase of novel immunotherapies.
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Affiliation(s)
- Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
| | - Takeshi Sugio
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takashi Ikeda
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kanako Yoshitsugu
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Junji Suzumiya
- Department of Hematology, Koga Community Hospital, Yaizu, Japan
| | - Go Yamamoto
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Sung-Won Kim
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhiro Ikegame
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Yasufumi Uehara
- Department of Hematology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Jun Ishikawa
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hideyuki Nakazawa
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hikaru Kobayashi
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Kentaro Serizawa
- Division of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Hospital, Osaka, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ritsuro Suzuki
- Department of Hematology and Oncology, Shimane University School of Medicine, Izumo, Japan
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Azadeh P, Gholizadeh Pasha S, Yaghobi Joybari A, Abiar Z, Alahyari S, Taghizadeh-Hesary F. Survival Benefit of Induction Chemotherapy with Paclitaxel and Carboplatin Followed by Chemoradiation Versus Postoperative Treatment in Locally Advanced Gastric Cancer: A Retrospective Cohort Study. J Gastrointest Cancer 2024; 55:457-466. [PMID: 38010493 DOI: 10.1007/s12029-023-00991-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Gastric cancer remains a prevalent worldwide illness that lacks a definitive cure. Recently, induction chemotherapy followed by concurrent chemoradiation has shown promising results in achieving a significant pathological response in locally advanced gastric cancer and improving survival rates. However, the optimal regimen for this approach continues to be a subject of discussion. METHODS This retrospective cohort study was conducted on treatment-naïve patients with locally advanced gastric cancer who were referred to Imam Hossain General Hospital in Tehran, Iran, between April 2016 and March 2019. Eligible patients met the criteria of clinical T3-4 or nodal-positive stage, or both, and had non-metastatic resectable tumors. The patients were categorized into two groups: (a) the neoadjuvant group, which received induction chemotherapy (carboplatin AUC 2 and paclitaxel 50 mg/m2 weekly for 12 cycles) followed by concurrent neoadjuvant chemoradiation (radiotherapy 45-50 Gy/1.8 Gy per fraction concurrent with capecitabine 500 mg/m2 BID and oxaliplatin 40 mg/m2 weekly), and (b) the adjuvant group, which was treated with standard chemoradiation or chemotherapy regimens. The two groups were compared regarding the 3-year recurrence rate and 3-year overall survival. RESULTS A total of 102 patients were included in the study (63.7% male, mean age ± standard deviation 56 ± 13 years). Among these, 45 patients received neoadjuvant treatment, and 57 received adjuvant treatment. The neoadjuvant group had a higher proportion of patients with advanced disease (stage III: 91.1% vs. 57.9%, P = 0.001). In the neoadjuvant group, 20 patients (44.4%) achieved a complete pathologic response, and all underwent curative surgery. The neoadjuvant group exhibited a lower 3-year recurrence rate (13 [28.9%] vs. 33 [57.9%], P = 0.003) and a higher 3-year overall survival rate (36 [80%] vs. 32 [56.1%], P = 0.003). CONCLUSIONS Patients receiving induction chemotherapy with paclitaxel and carboplatin followed by chemoradiation demonstrated enhanced disease control and survival compared to standard adjuvant regimens. In addition, patients treated with the applied preoperative regimen in this study showed higher pathologic response and overall survival rates than in previous studies.
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Affiliation(s)
- Payam Azadeh
- Department of Radiation Oncology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Gholizadeh Pasha
- Department of Radiation Oncology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Yaghobi Joybari
- Department of Radiation Oncology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Abiar
- Radiation Oncologist, Imam sajad hospital, Iran university of medical science, Shahryar, Tehran, Iran
| | - Sam Alahyari
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Taghizadeh-Hesary
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, University of Medical Sciences, Tehran, Iran.
- Department of Radiation Oncology, Iran University of Medical Sciences, Tehran, Iran.
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Akturk Esen S, Uncu D. Is the watch-and-wait strategy suitable for every patient who has achieved a complete clinical response with neoadjuvant treatment in locally advanced rectum cancer? J Surg Oncol 2024; 129:459-460. [PMID: 38031877 DOI: 10.1002/jso.27537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Selin Akturk Esen
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Dogan Uncu
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
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Zhong JH. Adjuvant therapy for hepatocellular carcinoma: Dilemmas at the start of a new era. World J Gastroenterol 2024; 30:806-810. [PMID: 38516235 PMCID: PMC10950644 DOI: 10.3748/wjg.v30.i8.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/27/2023] [Accepted: 01/31/2024] [Indexed: 02/26/2024] Open
Abstract
Approximately 50%-70% of patients with hepatocellular carcinoma experience recurrence within five years after curative hepatic resection or ablation. As a result, many patients receive adjuvant therapy after curative resection or ablation in order to prolong recurrence-free survival. The therapy recommended by national guidelines can differ, and guidelines do not specify when to initiate adjuvant therapy or how long to continue it. These and other unanswered questions around adjuvant therapies make it difficult to optimize them and determine which may be more appropriate for a given type of patient. These questions need to be addressed by clinicians and researchers.
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Affiliation(s)
- Jian-Hong Zhong
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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Men B, Cui H, Han Z, Jin X, Xu Q, Jin Y, Piao Z, Zhang S. Evaluation of the efficacy of transarterial chemoembolization combined with microwave ablation followed by adjuvant therapy in patients with hepatocellular carcinoma. Front Immunol 2024; 15:1337396. [PMID: 38380330 PMCID: PMC10876829 DOI: 10.3389/fimmu.2024.1337396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
Objective This study aimed to explore the efficacy of transarterial chemoembolization (TACE) combined with microwave ablation (MWA) adjuvant to lenvatinib and anti-PD-1 antibodies for patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis of 67 patients with HCC treated at our hospital between October 2018 and May 2022 was conducted. All patients underwent a combination of TACE and MWA. Among them, 29 received postoperative treatment with molecular-targeted agents, like lenvatinib, along with anti-PD-1 antibodies such as sindilizumab, karelizumab, or tirilizumab. The remaining 38 patients did not receive postoperative systemic therapies, like targeted or immunotherapy. The survival and prognosis of all patients were analyzed. Results Nine patients in the observation group and 29 patients in the control group experienced recurrence, and the median progression-free survival 1 (PFS1) was not reached 'Not Applicable'(NA) and 17.05 months (P=0.035), respectively. Failure to combine adjuvant therapy was identified as an independent risk factor for tumor recurrence, and the observation group had a 0.245 times lower risk of recurrence compared to that in the control group (P=0.005). Multivariable Cox regression analysis confirmed that the maximum tumor size, and tumor number were risk factors for tumor recurrence. Patients with a large maximum tumor size had a 1.519 times higher risk of recurrence compared to those with a small maximum tumor size (P=0.006), and patients with a large number of tumors had a 5.978 times higher risk of recurrence compared to those with a small number of tumors (P=0.02). The median PFS2 of the two groups was 11.795 and 21.257 months, respectively, though not statistically significant (P=0.955). However, there was a disparity in the percentage of BCLC stages associated with recurrence between the two groups. In the observation group approximately 22.22% of patients progressed to stage C, while in the control group, this proportion was 34.48%. The observation group exhibited a lower risk of distant metastasis compared to the control group. Conclusion Adjuvant treatment of HCC following TACE combined with MWA improved PFS and achieved better clinical outcomes compared to that with TACE combined with MWA alone.
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Affiliation(s)
- Bowen Men
- Department of Oncology, Yanbian University Hospital, Yanji, China
| | - Huzhe Cui
- Department of Radiology, Yanbian University Hospital, Yanji, China
| | - Zhezhu Han
- Department of Oncology, Yanbian University Hospital, Yanji, China
| | - Xiuying Jin
- Department of Oncology, Yanbian University Hospital, Yanji, China
| | - Qiang Xu
- Department of Oncology, Yanbian University Hospital, Yanji, China
| | - Yongmin Jin
- Department of Oncology, Yanbian University Hospital, Yanji, China
| | - Zhengri Piao
- Department of Radiation Oncology, Yanbian University Hospital, Yanji, China
| | - Songnan Zhang
- Department of Oncology, Yanbian University Hospital, Yanji, China
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Victorio CBL, Novera W, Ganasarajah A, Ong J, Thomas M, Wu J, Toh HSY, Sun AX, Ooi EE, Chacko AM. Repurposing of Zika virus live-attenuated vaccine (ZIKV-LAV) strains as oncolytic viruses targeting human glioblastoma multiforme cells. J Transl Med 2024; 22:126. [PMID: 38308299 PMCID: PMC10835997 DOI: 10.1186/s12967-024-04930-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/24/2024] [Indexed: 02/04/2024] Open
Abstract
Glioblastoma multiforme (GBM) is the most common malignant primary brain cancer affecting the adult population. Median overall survival for GBM patients is poor (15 months), primarily due to high rates of tumour recurrence and the paucity of treatment options. Oncolytic virotherapy is a promising treatment alternative for GBM patients, where engineered viruses selectively infect and eradicate cancer cells by inducing cell lysis and eliciting robust anti-tumour immune response. In this study, we evaluated the oncolytic potency of live-attenuated vaccine strains of Zika virus (ZIKV-LAV) against human GBM cells in vitro. Our findings revealed that Axl and integrin αvβ5 function as cellular receptors mediating ZIKV-LAV infection in GBM cells. ZIKV-LAV strains productively infected and lysed human GBM cells but not primary endothelia and terminally differentiated neurons. Upon infection, ZIKV-LAV mediated GBM cell death via apoptosis and pyroptosis. This is the first in-depth molecular dissection of how oncolytic ZIKV infects and induces death in tumour cells.
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Affiliation(s)
- Carla Bianca Luena Victorio
- Laboratory for Translational and Molecular Imaging, Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore, 169857.
| | - Wisna Novera
- Laboratory for Translational and Molecular Imaging, Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Arun Ganasarajah
- Laboratory for Translational and Molecular Imaging, Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Joanne Ong
- Laboratory for Translational and Molecular Imaging, Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Melisyaa Thomas
- Laboratory for Translational and Molecular Imaging, Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Jonas Wu
- Laboratory for Translational and Molecular Imaging, Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Hilary Si Yin Toh
- Laboratory of Human Neural Models, Neuroscience and Behavioural Disorders Programme, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Alfred Xuyang Sun
- Laboratory of Human Neural Models, Neuroscience and Behavioural Disorders Programme, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Eng Eong Ooi
- Programme in Emerging Infectious Disease, Duke-NUS Medical School, Singapore, Singapore, 169857
| | - Ann-Marie Chacko
- Laboratory for Translational and Molecular Imaging, Cancer and Stem Cell Biology Programme, Duke-NUS Medical School, Singapore, Singapore, 169857.
- Division of Cellular and Molecular Research, National Cancer Centre, Singapore, Singapore, 169610.
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Honing J, Koch AD, Siersema PD, Spaander M. Endoscopic resection for residual oesophageal neoplasia after definitive chemoradiotherapy. Best Pract Res Clin Gastroenterol 2024; 68:101885. [PMID: 38522883 DOI: 10.1016/j.bpg.2024.101885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/22/2024] [Indexed: 03/26/2024]
Abstract
Definitive chemoradiation is the recommended treatment for locally advanced, irresectable oesophageal cancer and a valid alternative to neoadjuvant chemoradiotherapy (CRT) with surgery in oesophageal squamous cell cancer (OSCC) patients. In case of locoregional recurrence, salvage treatment can be considered in fit and resectable patients. Salvage surgery is a valid option but associated with significant morbidity. Therefore, for tumors confined to the mucosa or submucosal layers endoscopic resection is a good and less-invasive alternative. Over the last decade several case-series have demonstrated a high technical success rate of endoscopic treatment after definitive CRT. In this review we summarize the clinical outcomes and challenges of endoscopic treatment of early recurrence after definitive CRT in oesophageal cancer.
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Affiliation(s)
- Judith Honing
- Department of Gastroenterology and Hepatology, Rotterdam MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Arjun D Koch
- Department of Gastroenterology and Hepatology, Rotterdam MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, Rotterdam MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Manon Spaander
- Department of Gastroenterology and Hepatology, Rotterdam MC Cancer Institute, University Medical Center Rotterdam, the Netherlands.
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Protocol for a national audit of the watch-and-wait approach in patients with rectal cancer in Aotearoa New Zealand: The ACCORD study. Colorectal Dis 2024; 26:371-379. [PMID: 38124235 DOI: 10.1111/codi.16822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 12/23/2023]
Abstract
AIM The watch-and-wait approach is increasingly being used in the management of rectal cancer as many patients achieve a clinical complete response after neoadjuvant treatment This national, multicentre, retrospective cohort study aims to understand the use of the watch-and-wait approach in the management of rectal cancer in Aotearoa New Zealand and its associated outcomes. METHOD This retrospective cohort study will include patients aged 18 years and over with biopsy proven rectal adenocarcinoma diagnosed between January 2015 and December 2022 who have a clinical complete response following neoadjuvant treatment (including short-course radiotherapy, long-course chemoradiotherapy or total neoadjuvant treatment) and have been managed with a watch-and-wait approach. Data will be collected from centres that manage rectal cancer in Aotearoa New Zealand with the eligible population being identified using data linkage with the National Cancer Registry. CONCLUSION This multicentre, national cohort study will investigate the use of the watch-and-wait strategy for rectal cancer in Aotearoa New Zealand. Through novel data linkage approaches, these data and methods will lay the foundation for a future prospective registry and outcome-tracking initiative.
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38
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Pepper NB, Eich HT, Müther M, Oertel M, Rehn S, Spille DC, Stummer W. ALA-RDT in GBM: protocol of the phase I/II dose escalation trial of radiodynamic therapy with 5-Aminolevulinic acid in patients with recurrent glioblastoma. Radiat Oncol 2024; 19:11. [PMID: 38254201 PMCID: PMC10804590 DOI: 10.1186/s13014-024-02408-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Despite improvements in surgical as well as adjuvant therapies over the last decades, the prognosis for patients with glioblastoma remains poor. Five-Aminolevulinic acid (5-ALA) induced porphyrins are already used for fluorescence-guided resection and as photosensitizer for photodynamic therapy. New findings reveal their potential use as sensitizing agents in combination with ionizing radiation. METHODS We initiated a phase I/II dose escalation study, treating patients with recurrence of glioblastoma with oral 5-ALA concurrent to radiotherapy (RT). This prospective single-center study based in the University Hospital Münster aims to recruit 30 patients over 18 years of age with histologically verified recurrence of supratentorial glioblastoma in good performance status (KPS ≥ 60). Following a 3 + 3 dose-escalation design, patients having undergone re-resection will receive a 36 Gy RT including radiodynamic therapy fractions (RDT). RDT constitutes of oral administration of 5-ALA before the irradiation session. Two cohorts will additionally receive two fractions of neoadjuvant treatment three and two days before surgery. To determine the maximum tolerated dose of repeated 5-ALA-administration, the number of RDT-fractions will increase, starting with one to a maximum of eight fractions, while closely monitoring for safety and toxicity. Follow-up will be performed at two and five months after treatment. Primary endpoint will be the maximum tolerated dose (MTD) of repeated ALA-administration, secondary endpoints are event-free-, progression-free-, and overall-survival. Additionally, 5-ALA metabolites and radiobiological markers will be analysed throughout the course of therapy and tissue effects after neoadjuvant treatment will be determined in resected tissue. This protocol is in accordance with the SPIRIT guidelines for clinical trial protocols. DISCUSSION This is the protocol of the ALA-RDT in GBM-study, the first-in-man evaluation of repeated administration of 5-ALA as a radiosensitizer for treatment of recurrent glioblastoma. TRIAL REGISTRATION This study was approved by the local ethics committee of the Medical Association of Westphalia-Lippe and the University of Münster on 12.10.2022, the German federal institute for Drugs and medical devices on 13.10.2022 and the federal office for radiation protection on 29.08.2022. This trial was registered on the public European EudraCT database (EudraCT-No.: 2021-004631-92) and is registered under www.cliniclatrials.gov (Identifier: NCT05590689).
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Affiliation(s)
- Niklas Benedikt Pepper
- Department of Radiation Oncology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
| | - Michael Müther
- Department of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
| | - Michael Oertel
- Department of Radiation Oncology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
| | - Stephan Rehn
- Department of Radiation Oncology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
| | - Dorothee Cäcilia Spille
- Department of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
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Galanis E, Dooley KE, Keith Anderson S, Kurokawa CB, Carrero XW, Uhm JH, Federspiel MJ, Leontovich AA, Aderca I, Viker KB, Hammack JE, Marks RS, Robinson SI, Johnson DR, Kaufmann TJ, Buckner JC, Lachance DH, Burns TC, Giannini C, Raghunathan A, Iankov ID, Parney IF. Carcinoembryonic antigen-expressing oncolytic measles virus derivative in recurrent glioblastoma: a phase 1 trial. Nat Commun 2024; 15:493. [PMID: 38216554 PMCID: PMC10786937 DOI: 10.1038/s41467-023-43076-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 10/31/2023] [Indexed: 01/14/2024] Open
Abstract
Measles virus (MV) vaccine strains have shown significant preclinical antitumor activity against glioblastoma (GBM), the most lethal glioma histology. In this first in human trial (NCT00390299), a carcinoembryonic antigen-expressing oncolytic measles virus derivative (MV-CEA), was administered in recurrent GBM patients either at the resection cavity (Group A), or, intratumorally on day 1, followed by a second dose administered in the resection cavity after tumor resection on day 5 (Group B). A total of 22 patients received study treatment, 9 in Group A and 13 in Group B. Primary endpoint was safety and toxicity: treatment was well tolerated with no dose-limiting toxicity being observed up to the maximum feasible dose (2×107 TCID50). Median OS, a secondary endpoint, was 11.6 mo and one year survival was 45.5% comparing favorably with contemporary controls. Other secondary endpoints included assessment of viremia, MV replication and shedding, humoral and cellular immune response to the injected virus. A 22 interferon stimulated gene (ISG) diagonal linear discriminate analysis (DLDA) classification algorithm in a post-hoc analysis was found to be inversely (R = -0.6, p = 0.04) correlated with viral replication and tumor microenvironment remodeling including proinflammatory changes and CD8 + T cell infiltration in post treatment samples. This data supports that oncolytic MV derivatives warrant further clinical investigation and that an ISG-based DLDA algorithm can provide the basis for treatment personalization.
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Affiliation(s)
- Evanthia Galanis
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA.
| | | | | | | | | | - Joon H Uhm
- Department of Neurology, Division of Neuro-Oncology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Ileana Aderca
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kimberly B Viker
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Julie E Hammack
- Department of Neurology, Division of Neuro-Oncology, Mayo Clinic, Rochester, MN, USA
| | - Randolph S Marks
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Steven I Robinson
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jan C Buckner
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Daniel H Lachance
- Department of Neurology, Division of Neuro-Oncology, Mayo Clinic, Rochester, MN, USA
| | - Terry C Burns
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Caterina Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Aditya Raghunathan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ianko D Iankov
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ian F Parney
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
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Xian F, Song XW, Bie J, Zhao CX, Zhang GJ, Xu GH. Efficacy and safety of camrelizumab combined with TACE for hepatocellular carcinoma: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2024; 28:687-701. [PMID: 38305611 DOI: 10.26355/eurrev_202401_35066] [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: 02/03/2024]
Abstract
OBJECTIVE Hepatocellular carcinoma (HCC) represents a highly lethal and recurrent neoplasm, with limited effective treatment regimens available. Camrelizumab, as a novel PD1 inhibitor combined with transcatheter arterial chemoembolization (TACE), has been widely used in the treatment of HCC. However, there remains a contentious debate regarding the clinical value of the TACE and camrelizumab combination. This study seeks to investigate the efficacy and safety of this combination treatment regimen in patients with HCC. MATERIALS AND METHODS The related studies were retrieved from four online databases, including Pubmed, Cochrane Library, EMBASE, and Web of Science, up to June 1, 2023. The selection of studies was based on screening of titles, abstracts, and full-texts. The primary efficacy outcomes included complete response (CR), objective response rate (ORR), and disease control rate (DCR), while safety outcomes evaluated all treatment-related adverse events (AEs). Additionally, secondary outcomes such as overall (OS) and progression-free survival (PFS) were extracted for further survival analysis. The quality of the included trials was assessed using the MINORS tool. Publication bias was evaluated through funnel plot and Egger's test. RESULTS A total of 17 publications involving 1,377 cases were included. The pooled CR rate, ORR, and DCR of the patients treated with TACE plus camrelizumab had a pooled CR rate of 8% (95% CI: 0.01-0.15, p=0.03), ORR of 47% (95% CI: 0.42-0.52, p<0.00001) and DCR of 82% (95% CI: 0.77-0.88, p<0.00001), respectively. Compared with a control group that did not receive TACE or camrelizumab, the pooled RR of CR rate, ORR, and DCR were 1.61 (95% CI: 1.27-2.04, p<0.0001), 1.56 (95% CI: 1.19-2.05, p=0.001) and 1.55 (95% CI: 1.19-2.03, p=0.001), respectively. Besides, the combination regimen can prolong the OS (HR=2.60, 95% CI: 2.25-3.02, p<0.00001) and PFS (HR=4.90, 95% CI: 1.94-12.38, p=0.0008). However, the incidence of treatment-related AEs was relatively high (77%), with 29% for grade 3 AEs. The most common AEs observed were pain (47%), fever (46%), hepatic function abnormalities (44%), hypoalbuminemia (39%), and hypertension (37%). The combination treatment did not increase the incidence of AEs compared to the control group, except for the hand-foot skin reaction (RR=0.85, 0.74-0.97, p=0.01), hepatic encephalopathy (RR=4.29, 2.51-7.35, p<0.00001) and nausea (RR=1.35, 1.13-1.61, p=0.001). CONCLUSIONS Combination therapy of TACE plus camrelizumab has shown notable clinical benefits, improved survival, and a manageable safety profile in patients with HCC, but it is essential to monitor and manage the specific toxicities, especially for the camrelizumab-related AEs.
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Affiliation(s)
- F Xian
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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Deuning-Smit E, Custers JAE, Braam CIW, Hermens RPMG, Prins JB. Toward implementation of an evidence-based intervention for fear of cancer recurrence: Feasibility in real-world psycho-oncology practice. Psychooncology 2024; 33:e6297. [PMID: 38282226 DOI: 10.1002/pon.6297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Few evidence-based interventions addressing high levels of fear of cancer recurrence (FCR) have been implemented. Understanding how these might be implemented is crucial to bridge the research-practice gap. This study investigated the feasibility of implementing the blended Survivors' Worries of Recurrent Disease (SWORD) intervention in real-world psycho-oncology practice. METHODS SWORD was offered for 15 months (2021-2022) as the standard care for clinical FCR in a university hospital, a general hospital, and psycho-oncological center. We evaluated using a mixed-methods design six feasibility outcomes based on Bowen's framework: demand, limited effectiveness, degree of execution, acceptability, practicality, and integration. Anonymous data were collected for all oncology patients on referral. Study participants completed questionnaires before and after treatment, including the Cancer Worry Scale (CWS-6) as the primary measure of effectiveness. Qualitative data included interviews with patients and psychologists, and field notes. RESULTS Regarding demand, 81 of 644 patients referred (13%) were eligible for SWORD. The uptake of SWORD was 79% (n = 63/80) and the completion rate 73% (n = 46/63). SWORD was effective in reducing FCR (p < 0.001, ηp2 = 0.694). Regarding execution, a variability in the length, planning and number of treatment sessions was found between different settings. Adherence to the treatment manual's content was high (89%). Regarding acceptability, most patients were satisfied with SWORD (average 8.2/10) and psychologists valued the blended format. Psychologists reported SWORD was practical to deliver given their knowledge and skills. Although differences between settings were found, SWORD integrated well into practice. Referral for FCR and a reluctance to contract new eHealth providers were barriers for implementation. CONCLUSIONS Despite differences between healthcare settings, the implementation of SWORD was evaluated well. The feasibility of SWORD in different settings should inform a national implementation strategy.
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Affiliation(s)
- Esther Deuning-Smit
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cheyenne I W Braam
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosella P M G Hermens
- Department of IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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Zhang X, Wang P, Chai Y, Zhou X, Li P, Wang X. Real-world data of immunotherapy from China in recurrent or metastatic head and neck squamous cell carcinoma. Am J Otolaryngol 2024; 45:104065. [PMID: 37879241 DOI: 10.1016/j.amjoto.2023.104065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/16/2023] [Accepted: 09/24/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Immune checkpoint inhibitors (ICIs) have become a standard therapy for recurrent or metastatic head and neck squamous cell carcinoma (R/MHNSCC), however, there are still unanswered questions about immunotherapy. Furthermore, immunotherapy for R/MHNSCC of the mainland Chinese population are lacking. The aim of this study is to evaluate the efficacy and safety of ICIs in real-world settings in China. MATERIALS AND METHODS We retrospectively reviewed 59 patients with R/MHNSCC who received immunotherapy between May 2019 and December 2021. We assessed demographics, efficacy, survival and safety. RESULTS Fifty-nine patients were included in the study, all of whom had R/MHNSCC affecting the oral cavity, oropharynx, hypopharynx, larynx, nasal cavity, paranasal sinuses and metastatic cancer in the neck with an unknown primary. The objective response rate (ORR) for all patients was found to be 40.6 %. Out of these patients, 11 patients achieved a complete response and 13 achieved a partial response. The median progression-free survival (PFS) was calculated to be 10.64 months (range: 1.15-29.24 months), while the median overall survival (OS) was 21.75 months (range 2.0-37.55 months). The addition of local radiotherapy resulted in higher ORR and PFS compared to previous reports. Notably, patients with R/MHNSCC in the paranasal sinuses and nasal cavity also showed benefits from immunotherapy. Additionally, patients who achieved stable disease (SD) had similar survival rates to those who achieved partial response (PR), indicating that SD is also an indicator of clinical benefit from immunotherapy. The overall incidence of immune-related adverse reactions in this study was low, with fatigue and rash being the most common side effects. CONCLUSION These findings highlight the effectiveness and safety of immunotherapy for R/MHNSCC in a real-world setting in China. Further investigation is warranted to explore the potential benefits of incorporating local radiotherapy into the treatment of R/MHNSCC.
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Affiliation(s)
- Ximei Zhang
- Department of Radiation Oncology, Cancer Institute and Hospital, Tianjin Medical University, Tianjin, PR China.
| | - Peiguo Wang
- Department of Radiation Oncology, Cancer Institute and Hospital, Tianjin Medical University, Tianjin, PR China
| | - Yanlan Chai
- Department of Radiation Oncology, Cancer Institute and Hospital, Tianjin Medical University, Tianjin, PR China
| | - Xuan Zhou
- Department of Maxillofacial and Otorhinolaryngology Oncology, Tianjin's Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Ping Li
- Department of Maxillofacial and Otorhinolaryngology Oncology, Tianjin's Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Xudong Wang
- Department of Maxillofacial and Otorhinolaryngology Oncology, Tianjin's Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
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Narayanan G, Kamala LH, Nair SG, Purushothaman PN, Kumar A, Kattoor J. Ewing's sarcoma in adolescents and adults - 10-year experience from a tertiary cancer center in India. J Cancer Res Ther 2024; 20:79-84. [PMID: 38554302 DOI: 10.4103/jcrt.jcrt_775_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/01/2022] [Indexed: 04/01/2024]
Abstract
BACKGROUND Ewing's sarcoma (EWS) is an aggressive small round cell tumor, affecting bone and soft tissues and is mostly seen in childhood and second decade of life. EWS accounts for 10-12% of bone tumors in more than 15 years age group and is even rarer after 40 years of age. MATERIALS AND METHODS This retrospective analysis was conducted among patients aged more than 15 years with histologically proven EWS. RESULTS Among 240 cases of EWS treated at our center during 2001-2010, 130 (54%) were more than 15 years of age. The median age was 20 years with a male: female ratio of 2.4:1. Ninety percent had skeletal EWS, 10% had extra skeletal EWS, and 37% patients were metastatic at presentation. Eighty-two received curative treatment with chemotherapy (vincristine, doxorubicin, cyclophosphamide, ifosfamide, etoposide (VAC/IE)) along with local treatment, radiotherapy (RT) in 61, surgery alone in seven, and RT plus surgery in 14. Two- and 5-year overall survival (OS) was 43.3% and 25.5%, respectively, for the entire series. The OS for the non-metastatic group was 63.2% at 2 years and 36.5% at 5 years, and the progression free survival was 53.7% at 2 years and 37.8% at 5 years. High lactate dehydrogenase was found to be a significant poor prognostic factor (P = 0.001). Median OS for localized central EWS was 49.2 months and that for peripheral EWS was 24 months. Patients more than 20 years of age with non-metastatic disease had better OS compared to those with 15-20 years of age. CONCLUSION Treatment of EWS requires a multidisciplinary approach with radical surgery and/or radiation to control local disease and multiagent chemotherapy to control systemic disease. Long-term follow-up is essential because of disease relapse and treatment-related complications.
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Affiliation(s)
- Geetha Narayanan
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Lakshmi H Kamala
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Sreejith G Nair
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | | | - Aswin Kumar
- Department of Radiation Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Jayasree Kattoor
- Department of Pathology, Regional Cancer Centre, Trivandrum, Kerala, India
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Escolà H, Llombart B, Escolà-Rodríguez A, Barchino-Ortiz L, Marcoval J, Alcaraz I, Beà-Ardébol S, Toll A, Miñano-Medrano R, Rodríguez-Jiménez P, López-Nuñez M, Ferrándiz-Pulido C, Jaka A, Masferrer E, Aguayo-Ortiz RS, Yébenes M, Arandes-Marcocci J, Ruiz-Salas V, Turrión-Merino L, Just M, Sánchez-Schmidt J, Leal L, Mayo-Martínez F, Haya-Martínez L, Sandoval-Clavijo A, Dradi GG, Delgado Y, Verdaguer-Faja J, López-Castillo D, Pujol RM, Deza G. Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients. J Am Acad Dermatol 2024; 90:66-73. [PMID: 37704106 DOI: 10.1016/j.jaad.2023.08.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Evidence regarding long-term therapeutic outcomes and disease-specific survival (DSS) in Extramammary Paget's disease (EMPD) is limited. OBJECTIVES To assess the DSS and outcomes of surgical and nonsurgical therapeutic modalities in a large cohort of EMPD patients. METHODS Retrospective chart review of EMPD patients from 20 Spanish tertiary care hospitals. RESULTS Data on 249 patients with a median follow-up of 60 months were analyzed. The estimated 5-, 10-, and 15-year DSS was 95.9%, 92.9%, and 88.5%, respectively. A significantly lower DSS was observed in patients showing deep dermal invasion (≥1 mm) or metastatic disease (P < .05). A ≥50% reduction in EMPD lesion size was achieved in 100% and 75.3% of patients treated with surgery and topical therapies, respectively. Tumor-free resection margins were obtained in 42.4% of the patients after wide local excision (WLE). The 5-year recurrence-free survival after Mohs micrographic surgery (MMS), WLE with tumor-free margins, WLE with positive margins, radiotherapy, and topical treatments was 63.0%, 51.4%, 20.4%, 30.1%, and 20.8%, respectively. LIMITATIONS Retrospective design. CONCLUSIONS EMPD is usually a chronic condition with favorable prognosis. MMS represents the therapeutic alternative with the greatest efficacy for the disease. Recurrence rates in patients with positive margins after WLE are similar to the ones observed in patients treated with topical agents.
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Affiliation(s)
- Helena Escolà
- Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Barcelona, Spain; Department of Medicine, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain.
| | - Beatriz Llombart
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Alba Escolà-Rodríguez
- Pharmacy Service, Division of Medicines, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | - Joaquim Marcoval
- Department of Dermatology, Hospital de Bellvitge, Barcelona, Spain
| | | | | | - Agustí Toll
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | | | | | - Carla Ferrándiz-Pulido
- Department of Dermatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ane Jaka
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, IGTP, Badalona, Spain
| | - Emili Masferrer
- Department of Dermatology, Hospital Universitari Mútua Terrassa, Barcelona, Spain
| | - Rafael S Aguayo-Ortiz
- Department of Dermatology, Hospital Universitari Arnau de Vilanova - Institut de Recerca Biomèdica de Lleida, Lleida, Spain
| | - Mireia Yébenes
- Department of Dermatology, Hospital Parc Taulí, Barcelona, Spain
| | | | - Verónica Ruiz-Salas
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Miquel Just
- Department of Dermatology, Hospital Joan XXIII, Tarragona, Spain
| | | | - Lorena Leal
- Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Barcelona, Spain
| | | | | | | | | | - Yolanda Delgado
- Department of Dermatology, Hospital de la Princesa, Madrid, Spain
| | - Júlia Verdaguer-Faja
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, IGTP, Badalona, Spain
| | | | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Barcelona, Spain; Department of Medicine, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - Gustavo Deza
- Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Barcelona, Spain; Department of Medicine, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
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Sonoda D, Kondo Y, Maruyama R, Naito M, Mikubo M, Shiomi K, Satoh Y. Prognosis of patients with recurrent nonsmall cell lung cancer who received the best supportive care alone. Curr Probl Surg 2024; 61:101429. [PMID: 38161060 DOI: 10.1016/j.cpsurg.2023.101429] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Dai Sonoda
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan; Department of Thoracic Surgery, Kitasato University Medical Center, Kitamoto, Saitama 364-08501, Japan
| | - Yasuto Kondo
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Raito Maruyama
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Masahito Naito
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Masashi Mikubo
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Kazu Shiomi
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan
| | - Yukitoshi Satoh
- Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan; Department of Thoracic Surgery, Kitasato University Medical Center, Kitamoto, Saitama 364-08501, Japan.
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Morello A, Bianconi A, Rizzo F, Bellomo J, Meyer AC, Garbossa D, Regli L, Cofano F. Laser Interstitial Thermotherapy (LITT) in Recurrent Glioblastoma: What Window of Opportunity for This Treatment? Technol Cancer Res Treat 2024; 23:15330338241249026. [PMID: 38693845 PMCID: PMC11067676 DOI: 10.1177/15330338241249026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/22/2024] [Accepted: 04/05/2024] [Indexed: 05/03/2024] Open
Abstract
Laser Interstitial Thermotherapy is a minimally invasive treatment option in neurosurgery for intracranial tumors, including recurrent gliomas. The technique employs the thermal ablation of target tissue to achieve tumor control with real-time monitoring of the extent by magnetic resonance thermometry, allowing targeted thermal injury to the lesion. Laser Interstitial Thermotherapy has gained interest as a treatment option for recurrent gliomas due to its minimally invasive nature, shorter recovery times, ability to be used even in patients with numerous comorbidities, and potential to provide local tumor control. It can be used as a standalone treatment or combined with other therapies, such as chemotherapy or radiation therapy. We describe the most recent updates regarding several studies and case reports that have evaluated the efficacy and safety of Laser Interstitial Thermotherapy for recurrent gliomas. These studies have reported different outcomes, with some demonstrating promising results in terms of tumor control and patient survival, while others have shown mixed outcomes. The success of Laser Interstitial Thermotherapy depends on various factors, including tumor characteristics, patient selection, and the experience of the surgical team, but the future direction of treatment of recurrent gliomas will include a combined approach, comprising Laser Interstitial Thermotherapy, particularly in deep-seated brain regions. Well-designed prospective studies will be needed to establish with certainty the role of Laser Interstitial Thermotherapy in the treatment of recurrent glioma.
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Affiliation(s)
- Alberto Morello
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, “Città della Salute e della Scienza” University Hospital, University of Turin, Turin, Italy
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andrea Bianconi
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, “Città della Salute e della Scienza” University Hospital, University of Turin, Turin, Italy
| | - Francesca Rizzo
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, “Città della Salute e della Scienza” University Hospital, University of Turin, Turin, Italy
| | - Jacopo Bellomo
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Diego Garbossa
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, “Città della Salute e della Scienza” University Hospital, University of Turin, Turin, Italy
| | - Luca Regli
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Fabio Cofano
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, “Città della Salute e della Scienza” University Hospital, University of Turin, Turin, Italy
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Nitta M, Tazawa M, Naruse J, Takeda K, Oda K, Uchida T, Kano T, Umemoto T, Nakajima N, Hasegawa M, Shoji S, Miyajima A. Two Cases of Intractable Radiation-Induced Hemorrhagic Cystitis Treated with Transcatheter Embolization. Tokai J Exp Clin Med 2023; 48:114-116. [PMID: 37981845] [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] [Received: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 11/21/2023]
Abstract
Radiation-induced hemorrhagic cystitis is a late complication of radiotherapy, and in rare cases, refractory. Refractory bleeding may not be resolved by transurethral electrocoagulation (TUEC) or hyperbaric oxygen (HBO) therapy and requires transcatheter arterial embolization (TAE) or urinary diversion. Here, we report two cases of radiation-induced hemorrhagic cystitis successfully treated with TAE. Case 1 was a 61-yearold man who underwent total prostatectomy for prostate cancer followed by salvage radiation therapy. The patient developed radiation-induced hemorrhagic cystitis 2 years and 3 months after radiotherapy. After no improvement with TUEC and HBO, TAE was performed. Case 2 was a 78-year-old man who underwent total prostatectomy followed by salvage radiation therapy and developed radiation-induced hemorrhagic cystitis 12 years later. TAE was performed after no improvement with HBO. TAE proved successful in both patients, and there was no relapse. TAE is a potential treatment option for refractory radiation-induced hemorrhagic cystitis.
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Affiliation(s)
- Masahiro Nitta
- Department of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Kushner BH, LaQuaglia MP, Cardenas FI, Basu EM, Gerstle JT, Kramer K, Roberts SS, Wolden SL, Cheung NKV, Modak S. Stage 4N neuroblastoma before and during the era of anti-G D2 immunotherapy. Int J Cancer 2023; 153:2019-2031. [PMID: 37602920 DOI: 10.1002/ijc.34693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
Patients with stage 4N neuroblastoma (distant metastases limited to lymph nodes) stand out as virtually the only survivors of high-risk neuroblastoma (HR-NB) before myeloablative therapy (MAT) and immunotherapy with anti-GD2 monoclonal antibodies (mAbs) became standard. Because no report presents more recent results with 4N, we analyzed our large 4N experience. All 51 pediatric 4N patients (<18 years old) diagnosed 1985 to 2021 were reviewed. HR-NB included MYCN-nonamplified 4N diagnosed at age ≥18 months and MYCN-amplified 4N. Among 34 MYCN-nonamplified high-risk patients, 20 are relapse-free 1.5+ to 37.5+ (median 12.5+) years post-diagnosis, including 13 without prior MAT and 5 treated with little (1 cycle; n = 2) or no mAb (n = 3), while 14 patients (7 post-MAT, 8 post-mAbs) relapsed (all soft tissue). Of 15 MYCN-amplified 4N patients, 7 are relapse-free 2.1+ to 26.4+ (median 11.6+) years from the start of chemotherapy (all received mAbs; 3 underwent MAT) and 4 are in second remission 4.2+ to 21.8+ years postrelapse (all soft tissue). Statistical analyses showed no significant association of survival with either MAT or mAbs for MYCN-nonamplified HR-NB; small numbers prevented these analyses for MYCN-amplified patients. The two patients with intermediate-risk 4N (14-months-old) are relapse-free 7+ years postresection of primary tumors; distant disease spontaneously regressed. The natural history of 4N is marked by NB confined to soft tissue without early relapse in bones or bone marrow, where mAbs have proven efficacy. These findings plus curability without MAT, as seen elsewhere and at our center, support consideration of treatment reduction for MYCN-nonamplified 4N.
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Affiliation(s)
- Brian H Kushner
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Michael P LaQuaglia
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Ellen M Basu
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Justin T Gerstle
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kim Kramer
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephen S Roberts
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Suzanne L Wolden
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nai-Kong V Cheung
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Shakeel Modak
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Zhang J, Cai D, Gao R, Miao Y, Cui Y, Liu Z, Zhang H, Yan X, Su N. Case Report: CD19 CAR T-cell therapy following autologous stem cell transplantation: a successful treatment for R/R CD20-negative transformed follicular lymphoma with TP53 mutation. Front Immunol 2023; 14:1307242. [PMID: 38143763 PMCID: PMC10739420 DOI: 10.3389/fimmu.2023.1307242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
Background Follicular lymphoma (FL), a common indolent B-cell lymphoma, has the potential to transform into an aggressive lymphoma, such as diffuse large B-cell lymphoma (DLBCL). The outcome of patients with transformed follicular lymphoma (tFL) is poor, especially in patients with transformed lymphoma after chemotherapy and patients with progression within 24 months (POD24). Chimeric antigen receptor (CAR) T-cell therapy combined with autologous stem cell transplantation (ASCT) has promising antitumor efficacy. Case presentation Here, we described a 39-year-old male patient who was initially diagnosed with FL that transformed into DLBCL with POD24, CD20 negativity, TP53 mutation, and a bulky mass after 3 lines of therapy, all of which were adverse prognostic factors. We applied a combination approach: CD19 CAR T-cell infusion following ASCT. Ibrutinib was administered continuously to enhance efficacy, DHAP was administered as a salvage chemotherapy, and ICE was administered as a bridging regimen. The patient underwent BEAM conditioning on days -7~ -1, a total of 3.8 × 106/kg CD34+ stem cells were infused on days 01~02, and a total of 108 CAR T cells (relmacabtagene autoleucel, relma-cel, JWCAR029) were infused on day 03. The patient experienced grade 2 cytokine release syndrome (CRS), manifesting as fever and hypotension according to institutional standards. There was no immune effector cell-associated neurotoxicity syndrome (ICANS) after CAR T-cell infusion. Finally, the patient achieved CMR at +1 month, which has been maintained without any other adverse effects. Conclusion This case highlights the amazing efficacy of CD19 CAR T-cell therapy following ASCT for R/R tFL, thus providing new insight on therapeutic strategies for the future.
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MESH Headings
- Adult
- Humans
- Male
- Hematopoietic Stem Cell Transplantation
- Immunotherapy, Adoptive/adverse effects
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Non-Hodgkin/etiology
- Neoplasm Recurrence, Local/therapy
- Transplantation, Autologous
- Tumor Suppressor Protein p53
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Affiliation(s)
- Jinjing Zhang
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Dali Cai
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ran Gao
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yuan Miao
- Department of Pathology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yan Cui
- Department of Nuclear Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhenghua Liu
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Heyang Zhang
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaojing Yan
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Nan Su
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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Grou-Boileau F, Tankel J, Nevo Y, Najmeh S, Spicer J, Cools-Lartigue J, Mueller C, Ferri L. Locoregional Recurrence of Esophageal Cancer Treated with Curative Intent Local Salvage Therapy: A Single Center Experience. J Gastrointest Cancer 2023; 54:1292-1299. [PMID: 36988820 DOI: 10.1007/s12029-023-00929-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE Locoregional recurrence of esophageal carcinoma after neoadjuvant therapy and en bloc esophagectomy, although uncommon, is challenging to manage. Currently, there are no standard treatment approaches prompting many health care providers to adopt a palliative approach. We describe our experience and outcomes of treating this specific group of patients with a focus on salvage curative intent local therapy. METHODS All patients undergoing en bloc esophagectomy following neoadjuvant therapy between 2007 and 2017 at the McGill University Health Centre, a tertiary referral center for esophageal cancer, were identified. Patient follow-up included a structured surveillance protocol with serial endoscopic and cross-sectional imaging studies. Local recurrence was defined as histologically confirmed recurrences at the anastomosis. Regional recurrence was defined as radiological evidence of celiac, mediastinal, or para-esophageal/conduit lymphadenopathy. Demographic, pathologic, therapeutic variables were extracted as well as disease free and overall survival. RESULTS Of 755 patients identified, locoregional recurrences occurred in 27 patients (3.6%) of whom 18 were included in the analysis. The median disease-free survival post index operation was 15 months (IQR 10-23). The sites of recurrence were local (6/18, 33.3%); regional (8/18, 44.4%); and locoregional (4, 22.2%). Chemoradiation was the most common modality used to treat recurrence (10/18, 55.6%) whilst 4 (22.2%) underwent surgery. Following treatment for locoregional recurrence, 1-year overall survival was 61.1% and at 5 years was 22.2%. CONCLUSION Consolidative salvage local therapy for locoregional recurrence after en bloc esophagectomy is feasible and can entail prolonged survival in a subset of patients.
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Affiliation(s)
- Frédéric Grou-Boileau
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada
| | - James Tankel
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada
| | - Yehonatan Nevo
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada
| | - Sara Najmeh
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada
| | - Jonathan Spicer
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada
| | - Jonathan Cools-Lartigue
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada
| | - Carmen Mueller
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada
| | - Lorenzo Ferri
- Division of Thoracic and Upper Gastrointestinal Surgery, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada.
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