Medical Specialties Commons^™

A Quality Improvement Initiative To Decrease Sugammadex Expenditures, Jordan Austin Gardo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

A Quality Improvement Initiative to Decrease Sugammadex Expenditures

Jordan Gardo

Introduction/Background: The manufacturer’s suggestion in the dosing of the Sugammadex is

generally dosed at 2-4 mg/kg of total body weight (TBW) depending on the extent of

neuromuscular blockade. Evidence suggests that in the morbidly obese population, this

can lead to excessive dosing due to the drug's hydrophilic properties, making it less cost-

effective. Dosing based on adjusted body weight (ABW) leads to dose reductions while

achieving full reversal of neuromuscular blockade as measured by quantitative train-of-

four monitoring, resulting in lower costs from decreased vial usage.

Purpose: The purpose …

Open Repair Of Isolated Internal Iliac Artery Aneurysm In A Young Patient With Loeys-Dietz Syndrome, Ezra Y Koh, Dianna M Milewicz, Thanila A Macedo, Gustavo S Oderich

Faculty, Staff and Students Publications

Introduction: Isolated internal iliac artery aneurysms in the absence of aorto-iliac disease are exceedingly rare. The case of a 41 year old woman who presented after experiencing several weeks of lower abdominal pain is reported. She was diagnosed with a large, isolated right internal iliac artery aneurysm.

Report: Patient medical records were reviewed retrospectively. The patient underwent genetic evaluation, after which she was diagnosed with Loeys-Dietz syndrome type I. Given her age and heritable aortic disease, her aneurysm was treated by open surgical repair via a right retroperitoneal approach with an interposition bypass graft. The patient's hospital course was uneventful, …

Increasing Surgical Healthcare Utilization For Infants With Congenital Anomalies In Texas, Bea B Jeon, Sarah Peiffer, Shannon M Larabee, Kathleen Hosek, Dailen Alonso, Timothy C Lee, Sundeep G Keswani, Alice King

Faculty, Staff and Students Publications

Introduction: Congenital anomalies (CAs) impact 3% of live births and account for disproportionately high healthcare costs. While many CAs require multidisciplinary care and surgical intervention, the overall financial impact of infants diagnosed with CA with surgical needs is unknown. We aim to evaluate and characterize the charges of care in infants with CA and surgical needs in Texas.

Methods: A database study using the Texas Inpatient Public Use Data File was performed to query infants (< 365 days) statewide from 1/2021 to 12/2021 for admissions with CA and involved organ system by ICD-10 codes. Encounters transferred to an outside hospital were excluded to avoid systematic double-counting. Descriptive statistics were performed.

Results: Of 376,215 total admissions, 81,666 had surgical needs with OR charges. While non-CA represent the majority of surgical admissions (63,895/81,666; 78.24%), CA-surgical admissions …

Quality Cancer Survivorship Care: A Modified Delphi Study To Define Nurse Capabilities, Gemma Mcerlean, Heidi Hui, Fiona Crawford-Williams, Nicolas H. Hart, Meinir Krishnasamy, Bogda Koczwara, Thomas Walwyn, Mahesh Iddawela, Rebecca Mcintosh, Raymond J. Chan, Michael Jefford

Research outputs 2022 to 2026

Purpose: To establish capabilities required by nurses to deliver quality cancer survivorship care in Australia. Methods: A two-round online modified Delphi involving Australian cancer nurses. Initial domains and capability statements were based on the Quality of Cancer Survivorship Care Framework and supplemented by national and international nursing frameworks. In Round 1 (R1), experts categorised the applicability of 53 capabilities for cancer nurses, across eight domains, in relation to Australian National Professional Development Framework for Cancer Nursing (EdCaN) groups: ‘All’, ‘Many’, ‘Some’, and ‘Few’ nurses, or not relevant. In Round 2 (R2), experts rated agreement with capabilities allocated to the nurse …

Exercise And Inflammation In Female Survivors Of Breast Cancer: Systematic Review And Meta-Analysis With Secondary Mediation Analysis On Body Composition, Francesco Bettariga, Dennis R. Taaffe, Anita Borsati, Alice Avancini, Sara Pilotto, Stefano G. Lazzarini, Pedro Lopez, Luca Maestroni, Umberto Crainich, Enrico Bandini, John P. Campbell, Timothy D. Clay, Daniel A. Galvão, Robert U. Newton

Research outputs 2022 to 2026

Purpose: Inflammation plays a key role in breast cancer recurrence and mortality by promoting tumor progression. Exercise significantly reduces pro-inflammatory markers such as IL-6, TNF-α, and CRP, potentially reducing mortality risk. However, it is yet to be determined whether exercise-induced changes in body composition can modulate inflammatory biomarker responses in the breast cancer setting. Methods: We conducted a secondary mediation analysis based on the findings from our previously published systematic review with meta-analysis. Randomized controlled trials examining the effects of exercise on IL-1β, IL-6, IL-8, IL-10, TNF-α, and CRP and body composition and anthropometry measures such as lean mass (LM), …

Neoadjuvant Anti-Pd-1 Alone Or In Combination With Anti-Tigit Or An Oncolytic Virus In Resectable Stage Iiib–D Melanoma: A Phase 1/2 Trial, Reinhard Dummer, Caroline Robert, Richard A. Scolyer, Janis M. Taube, Michael T. Tetzlaff, Alexander M. Menzies, Andrew Hill, Jean Jacques Grob, David C. Portnoy, Celeste Lebbe, Muhammad A. Khattak, Jonathan Cohen, Gil Bar-Sela, Inderjit Mehmi, Ronnie Shapira-Frommer, Nicolas Meyer, Andrea L. Webber, Yixin Ren, Mizuho Fukunaga-Kalabis, Clemens Krepler, Georgina V. Long

Research outputs 2022 to 2026

Neoadjuvant immunotherapies have shown antitumor activity in melanoma. Substudy 02C of the global, rolling-arm, phase 1/2, adaptive-design KEYMAKER-U02 trial is evaluating neoadjuvant pembrolizumab (anti-PD-1) alone or in combination, followed by adjuvant pembrolizumab, for stage IIIB–D melanoma. Here we report results from the first three arms: pembrolizumab plus vibostolimab (anti-TIGIT), pembrolizumab plus gebasaxturev (coxsackievirus A21) and pembrolizumab monotherapy. Pathologic complete responses occurred in 10 of 26 patients (38%) with pembrolizumab plus vibostolimab, 7 of 25 (28%) with pembrolizumab plus gebasaxturev and 6 of 15 (40%) with pembrolizumab monotherapy. Major pathologic responses occurred in 13 (50%), 10 (40%) and 7 (47%) patients, …

Effect Of Exercise On Bone-Related Outcomes In Patients With Cancer Affected By Bone Metastases Or Bone Loss: A Systematic Review And Meta-Analysis, Anita Borsati, Gloria Adamoli, Diana Giannarelli, Lorenzo Belluomini, Andrea Trevisan, Piero Schenal, Francesco Bettariga, Anna M. Markarian, Federico Schena, Michele Milella, Robert U. Newton, Sara Pilotto, Alice Avancini

Research outputs 2022 to 2026

Introduction: This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on bone mineral density (BMD), bone mineral content (BMC), and bone turnover markers in patients with cancer and compromised bone health. Materials and Methods: A comprehensive search of four electronic databases was conducted to identify randomized controlled trials evaluating the effect of exercise intervention compared to supplementation or bone-targeted agents only on BMD, BMC and bone turnover markers. Meta-analyses were performed using random-effects models to calculate effect sizes (ES) with 95% confidence intervals (CI). Results: Eighteen studies were included, involving 1,478 patients with mainly breast and …

Prognostic And Predictive Value Of Gastric Acid Suppressants In The Eortc 1325/Keynote-054 Randomized Phase Iii Trial Of Pembrolizumab Vs Placebo In Resected Stage Iii Melanoma, Emanuel Bührer, Nina Glassee, Michal Kicinski, Oliver J. Kennedy, Christian U. Blank, Georgina V. Long, Victoria G. Atkinson, Stéphane Dalle, Andrew M. Haydon, Andrey Meshcheryakov, Adnan Khattak, Matteo S. Carlino, Shahneen Sandhu, James Larkin, Susana Puig, Paolo A. Ascierto, Piotr Rutkowski, Dirk Schadendorf, Marye Boers-Sonderen, Anna Maria Di Giacomo, Alfonsus J.M. Van Den Eertwegh, Jean Jacques Grob, Ralf Gutzmer, Rahima Jamal, Alexander C.J. Van Akkooi, Sara Gandini

Research outputs 2022 to 2026

Background: The gut microbiome plays a pivotal role in regulating immunity. Gastric acid suppressants (GAS) are known to alter the gut microbiome and might therefore modify response to immunotherapy in cancer patients. We estimated associations of GAS with recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in the EORTC 1325/KEYNOTE-054 trial. Methods: Patients with resected stage III melanoma were randomized to receive 200 mg of pembrolizumab or placebo. Pembrolizumab prolonged RFS and DMFS (reported elsewhere). We used Cox models to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the association between GAS at baseline, and RFS and …

Relationship Between Nontraditional Lipid Parameters And The Risk Of Type 2 Diabetes In Individuals Recovered From Dyslipidemia: A Cohort Study, Yuxian Wang, Zekai Chen, Zhen He, Hailun Qin, Kuangyi Wu, Huancong Zheng, Peng Fu, Zefeng Cai, Weiqiang Wu, Yulong Lan, Dan Wu, Shouling Wu, Youren Chen

Research outputs 2022 to 2026

Aims/Introduction: Lipid profiles are essential for assessing type 2 diabetes (T2D) risk, but individuals who recover from dyslipidemia are often overlooked, leaving their residual risk unclear. This study aimed to evaluate T2D risk in individuals with varying lipid change patterns and investigate the associations between traditional and novel lipid parameters with T2D risk among those recovered from dyslipidemia. Materials and Methods: In this prospective cohort study of the Kailuan Study, 39,283 non-diabetic participants were followed to evaluate T2D risk across lipid change patterns using the Cox proportional hazards models. A subset of 3,850 individuals recovered from dyslipidemia was analyzed to …

Survival After Cessation Of Immunotherapies In Melanoma: A Systematic Review And Meta-Analysis, Kristine E. Mayer, Lydia Warburton, Anne Zaremba, Sarah Preis, Yannick Foerster, Tilo Biedermann, Oana Diana Persa

Research outputs 2022 to 2026

Background: Immune-checkpoint inhibitor (ICI) therapy elicits durable responses in a subset of patients with advanced melanoma. However, the appropriate timing for treatment cessation remains an unresolved issue. Moreover, some patients are required to discontinue therapy due to the occurrence of severe adverse events. Upon treatment cessation, a subset of patients maintains a durable response, while some patients relapse and require rechallenge with ICI. Criteria for a safe stop of ICI have not been established. Objectives: The aim of this systematic review and meta-analysis was to evaluate the durability of response in melanoma patients who discontinued ICI therapy. Furthermore, the outcome …

Accounting For Unmet Needs Resulting From Cancer-Related Cognitive Impairment, Darren Haywood, Alexandre Chan, Raymond J. Chan, Evan Dauer, Haryana M. Dhillon, Ashley M. Henneghan, Maryam B. Lustberg, Moira O’Connor, Janette L. Vardy, Susan L. Rossell, Nicolas H. Hart

Research outputs 2022 to 2026

Purpose: Cancer-related cognitive impairment (CRCI) causes a wide range of unmet needs for cancer survivors. It is unknown which clinical, demographic, cognitive, and psychological factors underpin and account for these various unmet needs. This study aimed to (a) identify factors associated with CRCI-related unmet needs, and (b) establish the most pertinent factors that account for CRCI-related unmet needs. Methods: Four hundred and fifty-six (n = 456) cancer survivors responded to a range of demographic and clinical questions, as well as measures of CRCI-related unmet needs (MASCC COG-IMPACT), perceived cognitive impairment (PROMIS-COG), and psychological distress (DASS-21). Descriptive statistics, bivariate correlations, and …

Activity Behaviours And Quality Of Life In Patients With Malignant Pleural Effusion, Bianca M. Iacopetta, David C.L. Lam, Jenny C.L. Ngai, Johnny W.M. Chan, Fifian Chiang, Macy M.S. Lui, W. L. Law, Ken K.P. Chan, Joanne Mcveigh, Carolyn J. Peddle-Mcintyre, Y. C.Gary Lee

Research outputs 2022 to 2026

Background and objective Accelerometery is used to measure activity behaviours in patients with malignant pleural effusion (MPE). This study aimed to evaluate physical activity and sedentary behaviour profiles of patients with MPE in Hong Kong, and to explore relationships between activity behaviours and quality of life (QoL). We also compared clinician-recorded performance status measures with objective measures of activity levels. Methods Participants wore an Actigraph GT3X+ accelerometer continuously for 7 consecutive days. The EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) was used to assess five dimensions of QoL and correlate with activity behaviours. The Eastern Cooperative Oncology Group (ECOG) performance status …

An Expert Opinion On The Management Of Frailty In Heart Failure From The Australian Cardiovascular Alliance National Taskforce, Julee Mcdonagh, Caleb Ferguson, Sarah N. Hilmer, Ruth E. Hubbard, Richard I. Lindley, Andrea Driscoll, Andrew Maiorana, Lindsay Wu, John J. Atherton, Beata V. Bajorek, Bridie Carr, Kim Delbaere, Elsa Dent, Mai Duong, Louise Hickman, Ingrid Hopper, Quan Huynh, Sunita Jha, Anthony Keech, Marc Sim, Gursharan Singh, Anthony Villani, Catherine Shang, Meng Hsu, Jamie Vandenberg, Patricia Davidson

Research outputs 2022 to 2026

Approximately 50% of all adults with heart failure (HF) are classified as frail. Frailty is a clinical state of 'accelerated ageing' that complicates management and results in adverse health outcomes. Despite recommendations for frailty assessment in HF guidelines, its implementation into routine clinical practice has been slow. Further, evidence to inform models of care and pharmacological treatment for individuals with HF who are classified as frail is lacking. The complexity of management underscores the importance of tailoring models of care that can improve the focus on frailty through multidisciplinary care teams. Frailty can be reduced in some cases through the …

Bone Mineral Density In Childhood Cancer Survivors During And After Oncological Treatment: A Systematic Review And Meta-Analysis, Anna Maria Markarian, Dennis R. Taaffe, Francesco Bettariga, Hao Luo, Daniel A. Galvão, Jodie Cochrane Wilkie, Carolyn J. Peddle-Mcintyre, Robert U. Newton

Research outputs 2022 to 2026

Osteoporosis poses a significant concern for childhood cancer survivors (CCS). While recommendations for surveillance and management of bone mineral density (BMD) exist, no systematic review and meta-analysis has been undertaken to quantify BMD Z-scores in childhood cancer patients undergoing cancer treatment and survivors who have completed treatments. Accordingly, we conducted a systematic review with a 3-level mixed-effects meta-analysis to examine the course of BMD Z-scores in childhood cancer patients and survivors and identified possible moderators using meta-regression models. A systematic search was conducted in CINAHL, Embase, PubMed, SPORTDiscus, and Web of Science databases from inception to November 2023. We included …

Exercise In Cancer Care For People With Lung Cancer: A Narrative Synthesis, Kellie Toohey, David Mizrahi, Nicolas H. Hart, Ben Singh, Pedro Lopez, Maddison Hunter, Robert U. Newton, Kathryn H. Schmitz, Diana Adams, Lara Edbrooke, Sandi Hayes

Research outputs 2022 to 2026

Objectives: Lung cancer is the second most common cancer diagnosed worldwide, resulting in significant physical and psychological consequences. In this narrative review, we explore the role of exercise as an adjunct therapy to counteract health issues experienced by people before, during and after treatment for lung cancer, and offer recommendations for exercise prescription and future research. Design: Narrative cornerstone review. Methods: A narrative review was conducted to explore the role of exercise in cancer care for people diagnosed with lung cancer. Results: Improvements in fitness, strength and quality of life have been demonstrated in people with lung cancer following participation …

Proximity To Cancer Rehabilitation And Exercise Oncology By Geography, Race, And Socioeconomic Status, Kathryn H. Schmitz, Kathryn Demanelis, Mary E. Crisafio, Mary A. Kennedy, Anna L. Schwartz, Anna Campbell, Jessica Gorzelitz, Kelley C. Wood, Christopher M. Wilson, Raymond L. Scalise, Alex Vincent

Research outputs 2022 to 2026

Background: Cancer rehabilitation and exercise oncology (CR/EO) have documented benefits for people living with and beyond cancer. The authors examined proximity to CR/EO programs across the United States with respect to population density, race and ethnicity, socioeconomic status, and cancer incidence and mortality rates.

Methods: This cross-sectional study was conducted in 2022–2023. Online searches were initiated to identify CR/EO programs. Geocoding was used to obtain latitudinal and longitudinal geospatial coordinates. Demographic data were abstracted from the 2020 5-year American Community Survey. Cancer incidence and mortality data were obtained from the Centers for Disease Control and Prevention. US 2013 Rural-Urban Continuum …

Feasibility And Psychometric Quality Of Smartphone Administered Cognitive Ecological Momentary Assessments In Women With Metastatic Breast Cancer, Ashley M. Henneghan, Emily W. Paolillo, Kathleen M. Van Dyk, Oscar Y. Franco-Rocha, Soyeong Bang, Rebecca Tasker, Tara Kaufmann, Darren Haywood, Nicolas H. Hart, Raeanne C. Moore

Research outputs 2022 to 2026

Objective: Metastatic breast cancer (MBC) is associated with burdensome side effects, including cognitive changes that require ongoing monitoring. Cognitive ecological momentary assessments (EMAs) allow for assessment of individual cognitive functioning in natural environments and can be administered via smartphones. Accordingly, we sought to establish the feasibility, reliability, and validity of a commercially available cognitive EMA platform. Methods: Using a prospective design, clinical cognitive and psychosocial assessments (cognitive batteries; patient reported outcomes) were collected at baseline, followed by a 28-day daily EMA protocol that included self-ratings for symptoms and mobile cognitive tests (memory, executive functioning, working memory, processing speed). Satisfaction and …

Treatment Refusal By Cancer Patients: A Qualitative Study Of Oncology Health Professionals’ Views And Experiences In Australia, Moira O’Connor, Ashleigh Pantaleo, Tracey Williams, Mary Theophilus, Jordan Joseph, Nicolas H. Hart, Darren Haywood

Research outputs 2022 to 2026

In some cases, against medical advice, a person with cancer decides not to undergo any conventional, evidence-based cancer treatments including chemotherapy, radiotherapy hormone therapy and others. Estimates for treatment refusal range from 2.6% to 14.55%. Refusing evidence-based conventional cancer treatments is linked to rapid deterioration, poor prognosis and a higher risk of premature death. This study aimed to explore oncology health professionals’ experiences and views on why patients refuse standard cancer treatments. We employed an in-depth qualitative research design, adopting a social constructionist framework. Fourteen health professionals in Western Australia (WA) with experience working in oncology were interviewed. Four themes …

Faculty Of Radiation Oncology 2022 Workforce Census, Hon Trinh, Nathan Stevens, Gerard Adams, Raphael Chee, Tuan Ha, Marcel Knesl, Jack Mitchell, Sakshi Nagpal, Edward Sia, Daniel Xing

Research outputs 2022 to 2026

Introduction: This paper reports the key findings of the Faculty of Radiation Oncology 2022 workforce census. This is the first census since the COVID-19 pandemic and questions have been updated to assess the impact on RANZCR trainees and fellows. This report focuses on the analysis of respondents from Australia, New Zealand and overseas members, with a separate paper to follow focusing exclusively on New Zealand respondents. Method: The census was conducted in mid-late 2022 with many questions repeated from previous censuses. New questions were asked about theranostics, working remotely, hypofractionation and the impact of COVID-19 on work practices. Results: The …

Nuclear Destabilisation – A Possible Genesis Of Cancer?, Daniel D. Scott, Francesco Bettariga, Marco Ventin, Chris Bishop, Britta Stordal

Research outputs 2022 to 2026

This review examines the increasingly prominent role of mechanics within cancer formation and progression. The extremely varied and contradictory genetic landscape of cancer is in stark contrast to the seemingly universal mechanical characteristics of cancer cells and their tumour microenvironment, and mechanics may be a principal unifying trait of this disease. The tight regulation of innate cell mechanical properties raises the possibility that destabilisation of the cell drives tumour formation in an attempt to restore cell mechanical homeostasis. With losses in cell stiffness more pronounced at the cell nucleus, we hypothesise that destabilisation occurs within the nucleus, likely within the …

Advancing Person-Centred Care Through Palliative Care Wa’S Acp Workshops: The Longer-Term Impact, Gertrude G. Phiri, Emma Gunner, Philip Bafile, Davina Porock

Research outputs 2022 to 2026

Planning for end-of-life and associated decision-making is one of global significance as it impacts the quality of care in palliative care settings, including ensuring that personal preferences are honoured. It is a priority for the Australian health system to use Advance Care Planning (ACP) as it is an effective tool for individuals and their families to make their personal preferences known and implemented. The aim of this project was to evaluate the longer-term impact of the Palliative Care Western Australia (PCWA) ACP workshops. Semi-structured, open-ended questions were used to collect data from 21 participants. Reflexive thematic analysis was used to …

Elevated Inflammation Supra-Additively Promotes The Progression From Prediabetes To Diabetes: A Prospective Cohort Study, Yulong Lan, Dan Wu, Huancong Zheng, Xiong Ding, Hui Zhou, Kuangyi Wu, Weiqiang Wu, Zegui Huang, Xianxuan Wang, Wei Wang, Shouling Wu, Youren Chen

Research outputs 2022 to 2026

Background Factors impacting on the conversion of prediabetes to diabetes or normoglycemia remain unclear. This study aimed to investigate the role of subclinical inflammation, assessed by high-sensitivity C-reactive protein (hsCRP), in the progression to diabetes from prediabetes, assessed by impaired fasting glucose (IFG). Methods Time-to-event survival analyses were conducted among 82 475 participants without diabetes from Kailuan Study (a real-life prospective cohort in China) to access the isolated and joint effect of hsCRP and IFG on diabetes risk, and quantify their relative contribution to incident diabetes. Results Over a median 11-year follow-up, 14 215 diabetes cases were recorded. IFG and …

Prognostic Value Of Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, And Lactate Dehydrogenase Level In Melanoma Patients Treated With Immune Checkpoint Inhibitors, Wynne Wijaya, Muhammad Adnan Khattak, Afaf Abed, Tarek Meniawy, Michael Millward, Elin Gray, Oliver Oey

Research outputs 2022 to 2026

Introduction: Metastatic melanoma carries a poor prognosis. Immune checkpoint inhibitors (ICIs) have improved outcomes, but responses remain variable, highlighting the need for simple prognostic biomarkers. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) reflect tumour burden and inflammation, though their clinical utility is unstandardised. Methods: We retrospectively analysed 103 metastatic melanoma patients treated with anti-PD-1 monotherapy at two centres in Western Australia (2014–2020). Baseline NLR, PLR, and LDH were assessed within 30 days pre-treatment. Outcomes included clinical benefit, progression-free survival (PFS), and overall survival (OS). Results: Poor ECOG performance status (PS ≥2) (RR 2.39, …

Molecular Testing Of Lung Cancer In Australia: Consensus Best Practice Recommendations From The Royal College Of Pathologists Of Australasia In Collaboration With The Thoracic Oncology Group Of Australasia, Wendy A. Cooper, Benhur Amanuel, Caroline Cooper, Stephen B. Fox, Jon W.A. Graftdyk, Peter Jessup, Sonja Klebe, Wei Sen Lam, Trishe Y.M. Leong, Zarnie Lwin, Rachel Roberts-Thomson, Benjamin J. Solomon, Rebecca Y. Tay, Rebecca Trowman, Janney L. Wale, Nick Pavlakis

Research outputs 2022 to 2026

Molecular testing plays a critical role in guiding optimal treatment decisions for lung cancer patients across a variety of clinical settings. While guidelines for biomarker testing exist in other jurisdictions, to date no best practice guidelines have been developed for the Australian setting. To address this need, the Royal College of Pathologists of Australasia collaborated with the Thoracic Oncology Group of Australasia to identify state-based pathologists, oncologists and consumer representatives to develop consensus best practice recommendations. Sixteen recommendations were established encompassing appropriate biomarkers, lung cancer subtype, tumour stage, specimen types, assay selection and quality assurance protocols that can inform and …

Nivolumab Plus Chemotherapy Or Ipilimumab In Gastroesophageal Cancer: Exploratory Biomarker Analyses Of A Randomized Phase 3 Trial, Kohei Shitara, Yelena Y. Janjigian, Jaffer Ajani, Markus Moehler, Jin Yao, Xuya Wang, Aparna Chhibber, Dimple Pandya, Lin Shen, Marcelo Garrido, Carlos Gallardo, Lucjan Wyrwicz, Kensei Yamaguchi, Tomasz Skoczylas, Arinilda Bragagnoli, Tianshu Liu, Michael Schenker, Patricio Yañez, Ruben Kowalyszyn, Michalis Karamouzis, Thomas Zander, Kynan Feeney, Elena Elimova, Parul Doshi, Mingshun Li, Ming Lei

Research outputs 2022 to 2026

First-line nivolumab-plus-chemotherapy demonstrated superior overall survival (OS) and progression-free survival versus chemotherapy for advanced gastroesophageal adenocarcinoma with programmed death ligand 1 combined positive score ≥ 5, meeting both primary end points of the randomized phase 3 CheckMate 649 trial. Nivolumab-plus-ipilimumab provided durable responses and higher survival rates versus chemotherapy; however, the prespecified OS significance boundary was not met. To identify biomarkers predictive of differential efficacy outcomes, post hoc exploratory analyses were performed using whole-exome sequencing and RNA sequencing. Nivolumab-based therapies demonstrated improved efficacy versus chemotherapy in hypermutated and, to a lesser degree, Epstein–Barr virus-positive tumors compared with chromosomally unstable and …

A Turning Point In Cardiac Remodelling In Obesity: Obesity, Mariella R. Huaman, Carlos J. Toro-Huamanchumo

Research outputs 2022 to 2026

Cardiac remodelling in obesity has received growing attention in the past two decades, particularly as the prevalence of obesity continues to rise globally. In 2013, Aurigemma and colleagues published a seminal study that provided crucial insights into the structural changes in the heart associated with obesity. This study summarized advances in understanding how the disproportionate growth of adipose tissue affects cardiac function, and challenged and reshaped previously established paradigms. Before the publication of this report, the standard paradigm held that obesity-induced haemodynamic stress primarily drove eccentric left ventricular hypertrophy. However, this study instead demonstrated that in individuals with obesity, concentric …

Clinical Impact Of Sub-Clonal Ras/Braf Alterations In Liquid Biopsies From Patients With Advanced Or Metastatic Crc, Peter Gibbs, Khalid Abubaker, Danyi Wang, Zheng Feng, Jawad Hamad, Jiemin Liao, Christopher Stroh, Soetkin Vlassak, Kathrin Heinrich, Adnan Khattak, Juergen Scheuenpflug

Research outputs 2022 to 2026

Introduction: Colorectal cancer (CRC), a global health concern, requires effective treatments. Anti-epidermal growth factor receptor (anti-EGFR) monoclonal antibodies are used for RAS wild-type and BRAFV600 mutation-negative metastatic CRC (mCRC) but are not indicated for RAS mutant CRC. Evidence suggests CRC patients with sub-clonal RAS/BRAF mutations in tumor tissue may benefit from anti-EGFRs. We assessed the outcomes of patients with sub-clonal RAS/BRAF mutated advanced/mCRC receiving anti-EGFRs using liquid-based GuardantINFORM real-world clinical-genomic analysis. Patients and Methods: GuardantINFORM analyzed US patients with advanced CRC with BRAFV600/KRAS/NRAS mutations who received anti-EGFR therapies within 90 days after a Guardant360 test. Primary endpoints were time-to-next treatment …

Towards Equitable Cancer Outcomes For Rural And Remote Communities: Reflections, Lessons And Recommendations, Anna Ugalde, Hannah Jongebloed, Charlene Wright, Helena Rodi, Anna Chapman, Skye Marshall, Drew Aras, Rebecca J. Bergin, Sophie Boffa, Anna Boltong, Michele Conlin, Fiona Crawford–Williams, Carl De Wet, Wasek Faisal, Lan Gao, Harry Gasper, Kate Gunn, Nicolas H. Hart, Theresa Hayes, Florian Honeyball, Elizabeth A. Johnston, Deme Karikios, Nicole Kiss, Lucy Leigh, Patricia M. Livingston, Carmel O'Kane

Research outputs 2022 to 2026

People living in rural and remote areas continue to face significant inequities in cancer outcomes compared to their metropolitan counterparts. Despite advances in cancer control, these disparities persist across the cancer trajectory. This personal view consolidates findings from our Equitable Cancer Outcomes for Rural and Remote Communities series, highlighting survival disadvantages, challenges in measuring and reporting rurality, barriers to implementing evidence-based interventions, and shortcomings in historical policy. We argue for place-based, system-level reform that genuinely partners with rural communities, leverages local strengths, and embeds rural voices in research, policy, and service delivery. Key recommendations include adopting a formal partnership position …

Intake Of Total, Classes, And Subclasses Of (Poly)Phenols And Risk Of Lymphoid Neoplasms: A Prospective Analysis In The Epic Cohort, Enrique Almanza-Aguilera, David Guananga-Álvarez, Yolanda Benavente, Alexandra Nieters, Caroline Besson, Fatemeh Saberi Hosnijeh, Cecilie Kyrø, Nicola P. Bondonno, Christina C. Dahm, Elisabete Weiderpass, Therese Truong, Mariem Louati-Hajji, Xuan Ren, Verena Katzke, Matthias B. Schulze, Fabrizio Pasanisi, Claudia Vener, Giovanna Masala, Maria Teresa Giraudo, Rosario Tumino, Amaia Aizpurua, Maria Jose Sánchez, José María Huerta, Marcela Guevara, Cristina Lasheras, Paolo Vineis

Research outputs 2022 to 2026

Background: Existing epidemiological evidence regarding the potential role of (poly)phenol intake in lymphoma development is limited. Methods: We investigated the associations between the intake of total and individual classes and subclasses of (poly)phenols and the risk of lymphoma, including main frequent subtypes in the EPIC cohort using multivariable-adjusted Cox proportional hazards models. Results: During a mean 14-year follow-up (time frame: from 1990–1994 to 2008–2013), 2394 incident lymphoma cases were diagnosed from a total of 367,463 individuals. No significant associations were observed between total intakes of (poly)phenols, flavonoids, and phenolic acids and overall lymphoma risk. Total (poly)phenols, phenolic acid and hydroxycinnamic …

The Impact Of Asymmetry In Lower Limb Muscle Strength And Power On Straight-Line Running Speed In Female Soccer Players, Dariusz Skalski, Magdalena Prończuk, Kinga Łosińska, Michał Spieszny, Maciej Kostrzewa, Piotr Aschenbrenner, Adam Maszczyk

Baltic Journal of Health and Physical Activity

The aim of this study was to investigate and determine the impact of asymmetries in muscle strength and power between the right and left lower limbs on straight-line running speed in female soccer players.30 right-footed female soccer players playing in the Ekstraliga participated in the study. The Modulus. Number formula was used to avoid negative results and to assess only the difference in relative strength and power between the lower limbs, not the dominance of one of them. A result equal to or below the threshold defined group G1 "with lower asymmetry," and a result above the threshold defined group …