Permanent URI for this collection
Browse
Recent Submissions
Publication Plasma Proteome-Based Test for First-Line Treatment Selection in Metastatic Non-Small Cell Lung Cancer(American Society of Clinical Oncology, 2024-03-21) Christopoulos, Petros; Harel, Michal; McGregor, Kimberly; Brody, Yehuda; Puzanov, Igor; Bar, Jair; Elon, Yehonatan; Sela, Itamar; Yellin, Ben; Lahav, Coren; Raveh, Shani; Reiner-Benaim, Anat; Reinmuth, Niels; Nechushtan, Hovav; Farrugia, David; Bustinza-Linares, Ernesto; Lou, Yanyan; Leibowitz, Raya; Kamer, Iris; Zer Kuch, Alona; Moskovitz, Mor; Levy-Barda, Adva; Koch, Ina; Lotem, Michal; Katzenelson, Rivka; Agbarya, Abed; Price, Gillian; Cheley, Helen; Abu-Amna, Mahmoud; Geldart, Tom; Gottfried, Maya; Tepper, Ella; Polychronis, Andreas; Wolf, Ido; Dicker, Adam; Carbone, David; Gandara, David; Farrugia, David; Medical and DentalPurpose: Current guidelines for the management of metastatic non-small cell lung cancer (NSCLC) without driver mutations recommend checkpoint immunotherapy with PD-1/PD-L1 inhibitors, either alone or in combination with chemotherapy. This approach fails to account for individual patient variability and host immune factors and often results in less-than-ideal outcomes. To address the limitations of the current guidelines, we developed and subsequently blindly validated a machine learning algorithm using pretreatment plasma proteomic profiles for personalized treatment decisions. Patients and methods: We conducted a multicenter observational trial (ClinicalTrials.gov identifier: NCT04056247) of patients undergoing PD-1/PD-L1 inhibitor-based therapy (n = 540) and an additional patient cohort receiving chemotherapy (n = 85) who consented to pretreatment plasma and clinical data collection. Plasma proteome profiling was performed using SomaScan Assay v4.1. Results: Our test demonstrates a strong association between model output and clinical benefit (CB) from PD-1/PD-L1 inhibitor-based treatments, evidenced by high concordance between predicted and observed CB (R2 = 0.98, P < .001). The test categorizes patients as either PROphet-positive or PROphet-negative and further stratifies patient outcomes beyond PD-L1 expression levels. The test successfully differentiates between PROphet-negative patients exhibiting high tumor PD-L1 levels (≥50%) who have enhanced overall survival when treated with a combination of immunotherapy and chemotherapy compared with immunotherapy alone (hazard ratio [HR], 0.23 [95% CI, 0.1 to 0.51], P = .0003). By contrast, PROphet-positive patients show comparable outcomes when treated with immunotherapy alone or in combination with chemotherapy (HR, 0.78 [95% CI, 0.42 to 1.44], P = .424). Conclusion: Plasma proteome-based testing of individual patients, in combination with standard PD-L1 testing, distinguishes patient subsets with distinct differences in outcomes from PD-1/PD-L1 inhibitor-based therapies. These data suggest that this approach can improve the precision of first-line treatment for metastatic NSCLC.Publication Phyllodes tumours at gloucestershire hospitals NHS foundation trust breast unit from 2016 to 2023(Elsevier, 2024-05) Humphreys, Alex; Massey, Eleanore; Massey, Eleanore; Medical and DentalNo abstract availablePublication Glioblastoma in the UK post WHO CNS 5: Initial findings from the Histo-Mol GBM Collaborative(Oxford University Press, 2024-10-15) Robinson, Stephen; Ryan, Katherine; Black, Louisa; Forner, Sam; Hatton, Nathaniel Luke; Hatton, Rebecca; Aktar, Nurjahan; Lathangue, Haydn; Conkey, David; Durage, Praveen; MacArthur, Rachel; Teoh, May; Choudhury, Mahbuba; Bowman, Miranda; Cavalli, Camilla; de Luna, Paolo; Christodoulou, Pavlos; Hill, Timothy; Williams, Adenike; Golten, Jennifer; Aghadiuno, Tasia; Yogalingam, Kohgulakuhan; Lau, Sue; Kahan, Jennifer; Dixit, Sanjay; Guglani, Samir; Williams, Matthew; Lewis, Rachel; Moleron, Rafael; Iqbal, Najmus; Wadd, Nick; Lord, Hannah; Bhat, Prashanth; Giamas, Georgios; Lorimer, Cressida; Chandy, Edward; Critchley, Giles; Durage, Praveen; Guglani, Samir; Medical and DentalNo abstract availablePublication Management of the older patient with glioblastoma in the UK: An initial report from the HISTO-MOL GBM collaborative(Oxford University Press, 2024-10-15) Robinson, Stephen; Ryan, Katherine; Black, Louisa; Forner, Sam; Hatton, Nathaniel Luke; Hatton, Rebecca; Aktar, Nurjahan; Lathangue, Haydn; Conkey, David; Durage, Praveen; MacArthur, Rachel; Teoh, May; Choudhury, Mahbuba; Bowman, Miranda; Cavalli, Camilla; de Luna, Paolo; Christodoulou, Pavlos; Hill, Timothy; Williams, Adenike; Golten, Jennifer; Aghadiuno, Tasia; Yogalingam, Kohgulakuhan; Lau, Sue; Kahan, Jennifer; Dixit, Sanjay; Guglani, Samir; Williams, Matthew; Lewis, Rachel; Moleron, Rafael; Iqbal, Najmus; Wadd, Nick; Lord, Hannah; Bhat, Prashanth; Giamas, Georgios; Lorimer, Cressida; Chandy, Edward; Critchley, Giles; Durage, Praveen; Guglani, Samir; Medical and DentalNo abstract availablePublication Interprofessional education in cancer care – a scoping review(Springer, 2024-07-16) Sulosaari, Virpi; Dodlek, Nikolina; Brandl, Andreas; De Munter, Johan; Eriksen, Jesper Grau; McInally, Wendy; O'Higgins, Niall; Benstead, Kim; Díez de Los Ríos de la Serna, Celia; Benstead, Kim; Medical and DentalBackground: Comprehensive cancer care requires effective collaboration by interprofessional healthcare teams. The need to develop educational initiatives to improve interprofessional collaboration is increasingly recognised. However, there is no agreement regarding the interprofessional competencies required for effective cancer care leading to much variation on the focus of research, planning and managing change. A scoping review was conducted to identify the current status of IPE in cancer care and to summarise the results of previous research in order to guide the development of interprofessional education in cancer care. Methods: The JBI Scoping Review guidelines were used to guide the process of the review. A search of the available literature was conducted in CINAHL, MEDLINE (Ovid), PubMed, PsycInfo, Scopus databases from January 2012 to March 2023 to investigate IPE for health professional clinicians working in cancer care. Results: Of the 825 initial references and 153 studies imported for screening, a total of 28 studies were included in the final review. From those studies, seven focused on the need for IPE and interprofessional competence for oncology healthcare professionals, four reviewed existing IPE programs and 17 described the development and evaluation of interprofessional education. Findings show variation and lack of concept definitions underpinning research in IPE in cancer care settings. Variation also exists in the range of research activities in IPE, most notably related to communication, teamwork and the development of interprofessional practice. The evaluation of impact of IPE is mainly focused on health care professionals' self-evaluation and general feedback. Impact on patient care was only evaluated in one study. Conclusions: Based on the results, interprofessional education research in the field of cancer care is limited in Europe. Thus, there is a significant increase in publications in the last five years. A more systematic focus on the theoretical framework and definition of concepts would be of value. Research and programme development should be based on a shared understanding on what constitutes the interprofessional competences and IPE. Programmes to develop interprofessional practice should be developed and implemented systematically with inclusion of validated assessment methods, and evaluated and improved regularly.Publication British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: An update on recommendations for practice 2023(Elsevier, 2023-11-15) Morrison, Jo; Baldwin, Peter; Hanna, Louise; Andreou, Adrian; Buckley, Lynn; Durrant, Lisa; Edey, Katharine; Faruqi, Asma; Fotopoulou, Christina; Ganesan, Raji; Hillaby, Kathryn; Taylor, Alexandra; Hillaby, Kathryn; Medical and DentalNo abstract availablePublication UK national observational cohort study investigating Tolerance of Anti-cancer Systemic Therapy in the Elderly: the TOASTIE study(BMJ Group, 2024-08-29) Baxter, Mark; Rowe, Michael; Zucker, Kieran; Peters, Adam; Rohan, Maria; Marsh, Alexander; Gee, Abigail; Quesne, Gemma; Heseltine, Jonny; Prichard, Rachel; Scott, Deborah; O'Neill, Conor; Brunner, Clair; Howells, Joni; Conteh, Veronica; Aujayeb, Avinash; Yan, Xiangfei; Rodgers, Lisa; Martin, Sally; Dearden, Helen; Rohan, Maria; Medical and DentalObjective: The Cancer and Aging Research Group (CARG) score was developed to predict severe chemotherapy-induced toxicity risk in older adults; validation study results have varied. The Tolerance of Anti-cancer Systemic Therapy in the Elderly study sought to evaluate the CARG score prospectively in a chemotherapy-naïve UK population. Methods and analysis: This multicentre, prospective, observational study recruited patients aged ≥65 years commencing first-line chemotherapy for any solid organ malignancy or setting. Baseline demographics and established frailty measures were recorded. Follow-up data including toxicity and hospital admissions were collected retrospectively. Baseline CARG score predictive ability was assessed. Results: 339 patients were recruited from 19 centres; median age 73 years (range 65-92), 51.9% male and 54.9% gastrointestinal primary. At baseline, 85% of patients were of Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1, with median Rockwood Clinical Frailty Scale (CFS) 3 (range 0-8).314 (92.6%) patients had follow-up data; 69 (22.3%) patients experienced Common Terminology for Cancer Adverse Events grade ≥3 toxicity and 84 (27%) required hospital admission during treatment.Increasing CARG risk groups had increased grade ≥3 toxicity (low 19.6%, medium 22.2%, high 28.2%); however, this was non-significant with no evidence of robust predictive performance. Predictive performance of CFS and ECOG PS was superior to CARG. Importantly, patient and clinician perceptions of toxicity risk differed significantly. Conclusions: In older UK patients with cancer commencing chemotherapy, baseline frailty was prevalent. CARG score did not robustly discriminate or predict high-grade toxicity risk. ECOG and CFS showed superior, although limited, ability to predict and discriminate. This study highlights the need for the development of tools that better predict toxicity in this population.Publication "Absolutely No One Else, Other Than Yourself": Experiences of Adolescents and Young Adults with Cancer During the COVID-19 Pandemic(Mary Ann Liebert, 2024-04) Holderness, Ayesha; Magrath, Cameron; Hatcher, Helen; Critoph, Deborah; Magrath, Cameron; Medical and DentalIntroduction: The COVID-19 pandemic caused widespread disruption to the provision of health care in the United Kingdom. It posed two risks to AYACs: disruption of care and long-term adverse consequences compounding late effects. This study sought to better understand the experiences of AYACs receiving care during the pandemic and identify areas where greater support is needed. Methods: In-depth semistructured interviews with AYACs (n = 6), 16-22 years at diagnosis. Interviews were transcribed verbatim and analyzed using the principles of Giorgi's phenomenological analysis. Results: Four major themes and an interconnected theme were identified. Changes to health care meant AYACs were isolated and loss of in-person follow-up caused anxiety (theme 1). AYACs had to adapt to life with COVID-19 restrictions (theme 2). Support during the pandemic came from a variety of sources (theme 3). AYACs reported poor mental health due to a fear of relapse and contracting COVID-19 (theme 4). An additional burden for AYACs was the loss of the third person (e.g., parent) in consultations (interconnected theme). Conclusion: This study has wider implications for delivery of AYAC care, despite being set during the COVID-19 pandemic. The mental health implications will impact long-term care of these patients, and health care professionals must be aware of these to meet AYACs' holistic care needs.Publication 25 The Gloucestershire Early Lung Cancer Pathway - time for a radical approach?(Elsevier, 2024-04-17) Haggie, Rebecca; Leadbetter, Aimee; Steer, Henry; West, Doug; Gugliani, Samir; Brown, Sean; Haggie, Rebecca; Leadbetter, Aimee; Steer, Henry; Guglani, Samir; Brown, Sean; Medical and DentalNo abstract available