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  • 1
    In: Journal of the National Comprehensive Cancer Network, Harborside Press, LLC, Vol. 19, No. 6 ( 2021-06), p. 733-754
    Abstract: Hodgkin lymphoma (HL) is a highly curable form of cancer, and current treatment regimens are focused on improving treatment efficacy while decreasing the risk of late effects of treatment. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for pediatric HL provide recommendations on the workup, diagnostic evaluation, and treatment of classic HL, including principles of pathology, imaging, staging, systemic therapy, and radiation therapy. This portion of the NCCN Guidelines focuses on the management of pediatric classic HL in the upfront and relapsed/refractory settings.
    Type of Medium: Online Resource
    ISSN: 1540-1405 , 1540-1413
    Language: Unknown
    Publisher: Harborside Press, LLC
    Publication Date: 2021
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  • 2
    In: Journal of the National Comprehensive Cancer Network, Harborside Press, LLC, Vol. 18, No. 8 ( 2020-08), p. 1105-1123
    Abstract: Pediatric aggressive mature B-cell lymphomas are the most common types of non-Hodgkin lymphoma in children, and they include Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). These diseases are highly aggressive but curable, the treatment is complex, and patients may have many complicated supportive care issues. The NCCN Guidelines for Pediatric Aggressive Mature B-Cell Lymphomas provide guidance regarding pathology and diagnosis, staging, initial treatment, disease reassessment, surveillance, therapy for relapsed/refractory disease, and supportive care for clinicians who treat sporadic pediatric BL and DLBCL.
    Type of Medium: Online Resource
    ISSN: 1540-1405 , 1540-1413
    Language: Unknown
    Publisher: Harborside Press, LLC
    Publication Date: 2020
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  • 3
    In: Cancer, Wiley, Vol. 129, No. 12 ( 2023-06-15), p. 1856-1865
    Abstract: KMT2Ar acute myeloid leukemia (AML) is associated with increased major and minor bleeding events, disseminated intravascular coagulopathy (DIC), and early mortality. Early recognition and aggressive management of DIC and coagulopathy could mitigate the risk of death during induction therapy in KMT2Ar AML.
    Type of Medium: Online Resource
    ISSN: 0008-543X , 1097-0142
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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    detail.hit.zdb_id: 2594979-2
    detail.hit.zdb_id: 1429-1
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  • 4
    In: Cancer Gene Therapy, Springer Science and Business Media LLC, Vol. 28, No. 12 ( 2021-12), p. 1325-1338
    Abstract: Osteosarcoma (OS) is a molecularly heterogeneous, aggressive, poorly differentiated pediatric bone cancer that frequently spreads to the lung. Relatively little is known about phenotypic and epigenetic changes that promote lung metastases. To identify key drivers of metastasis, we studied human CCH-OS-D OS cells within a previously described rat acellular lung (ACL) model that preserves the native lung architecture, extracellular matrix, and capillary network. This system identified a subset of cells—termed derived circulating tumor cells (dCTCs)—that can migrate, intravasate, and spread within a bioreactor-perfused capillary network. Remarkably, dCTCs highly expressed epithelial-to-mesenchymal transition (EMT)-associated transcription factors (EMT-TFs), such as ZEB1, TWIST, and SOX9, which suggests that they undergo cellular reprogramming toward a less differentiated state by coopting the same epigenetic machinery used by carcinomas. Since YAP/TAZ and AXL tightly regulate the fate and plasticity of normal mesenchymal cells in response to microenvironmental cues, we explored whether these proteins contributed to OS metastatic potential using an isogenic pair of human OS cell lines that differ in AXL expression. We show that AXL inhibition significantly reduced the number of MG63.2 pulmonary metastases in murine models. Collectively, we present a laboratory-based method to detect and characterize a pure population of dCTCs, which provides a unique opportunity to study how OS cell fate and differentiation contributes to metastatic potential. Though the important step of clinical validation remains, our identification of AXL, ZEB1, and TWIST upregulation raises the tantalizing prospect that EMT-TF-directed therapies might expand the arsenal of therapies used to combat advanced-stage OS.
    Type of Medium: Online Resource
    ISSN: 0929-1903 , 1476-5500
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 5
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 80, No. 14_Supplement ( 2020-07-15), p. B44-B44
    Abstract: Objective: The main culprit for mortality in osteosarcoma (OS) is metastatic pulmonary disease, which originates from a highly selected group of tumor cells that acquire a heightened ability to migrate from the primary tumor, intravasate, and survive in the bloodstream while circulating to remote sites. The early steps of this process are thought to be regulated by epithelial-to-mesenchymal translation (EMT)-related transcription factors (EMT-TFs), which can surprisingly occur in nonepithelial malignancies such as glioma, leukemia, and sarcoma. To determine how EMT-TFs and other mediators of stemness contribute to the early steps of tumor metastasis, drug resistance, and ultimately to the shedding of circulating tumor cells (CTC), we explored the presence and role of these EMT-TFs such as SNAIL, ZEB1, TWIST, and AXL in OS. Methods: The acellularized rat lung (ACL) model used in our research provided a unique ability to isolate and characterize thousands of lab-derived circulating tumor cells (dCTCs) and compare them to the primary tumors formed in rat lung by injecting OS-D OS cell line. Expression of EMT-TFs (SNAIL, ZEB1, TWIST, AXL) in cells cultured in 2D monolayer, primary tumors (PT) formed in acellularized lung, and the derived CTCs were evaluated by immune-fluorescence (IF) staining using confocal microscopy and quantified by IMARIS software. We also compared the level of expression of EMT-TFs in parental OS cell line MG63, and its derivative metastatic cell lines MG63.2 and MG63.3 by IF and Western blotting. Circulating tumor cells were also isolated from OS patients for IF analysis of EMT-TFs and compared with their paired primary tumor. Results: The dCTCs collected from ACL OS model showed substantially higher expression of SNAIL, TWIST, and AXL, as well as considerably higher expression of ZEB1 compared with cells from 2D culture and PTs. AXL showed significantly increased expression in metastatic cell lines MG63.2 and MG63.3 compared with the parental cell line MG63. ZEB1, TWIST, or SNAIL did not replicate this difference in expression, likely due to the phenotypic changes that cells undergo when grown on the 2D monolayer. Results from the ACL experiments were validated by comparing the expression of AXL, TWIST, and ZEB1 in CTCs collected from patients with a limited set of paired primary patient tumors. Conclusion: An ACL model of the lung microenvironment yielded an opportunity to characterize lab-derived CTCs, using techniques that cannot readily be achieved from clinical specimens. Surprisingly, EMT-TFs were enriched in dCTCs, an important finding that suggests a small subset of OS cells—which are already high grade—can become even more stem-like as they navigate the initial steps required of early metastasis. Though we have just begun to validate this result using paired tumor/CTC clinical samples, early evidence confirms our lab findings. The identification of EMT-TF in OS CTCs suggests that antagonists of AXL, ZEB, or TWIST might impede the earliest steps in the metastatic cascade. Citation Format: Sana Mohiuddin, Salah-Eddine Lamhamedi-Cherradi, Dhruva K. Mishra, Kristi Pence, Sandhya Krishnan, Brian A. Mnegaz, Alejandra Ruiz Velasco, Danh Dinh Troung, Branko Cuglievan, Amelia Vetter, Eric R. Molina, Min P. Kim, Joseph A. Ludwig. Role of EMT transcription factors in the metastatic potential of osteosarcoma [abstract] . In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr B44.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
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    detail.hit.zdb_id: 410466-3
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  • 6
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Pediatric Drugs Vol. 23, No. 5 ( 2021-09), p. 457-463
    In: Pediatric Drugs, Springer Science and Business Media LLC, Vol. 23, No. 5 ( 2021-09), p. 457-463
    Type of Medium: Online Resource
    ISSN: 1174-5878 , 1179-2019
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2043681-6
    SSG: 15,3
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  • 7
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2014
    In:  Cancer Research Vol. 74, No. 19_Supplement ( 2014-10-01), p. 5497-5497
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 74, No. 19_Supplement ( 2014-10-01), p. 5497-5497
    Abstract: Introduction. Glioblastoma multiforme (GBM) is the most common and aggressive form of primary brain cancer affecting 3 to 4 per 100,000 people annually in the United States. Despite aggressive therapy including surgical resection followed by both radiation and chemotherapy, overall survival remains dismal at approximately 14 months. Recent studies have determined that GBM's contain a small population of stem cells (GSCs), which promote tumor growth through unlimited self-renewal. Since GSCs are chemo- and radio-resistant and drive tumor regrowth following therapy, successful treatment depends on the elimination of these cells. Withaferin A (WA) is a bioactive compound derived from the plant Withonia somnifera which possesses anti-inflammatory and anti-cancer properties. Here we evaluated the effects of WA on patient derived GSCs. Methods. With IRB approval, GSC lines were generated. GSCs were propagated in neurosphere media and examined for the stem cell markers CD133, nestin, musashi and BMi1 by immunocytochemistry and western blot analysis. Effect of WA on cell viability was determined using MTS assay. The effect of WA on cell survival and stress pathways was evaluated by western blot analysis. Results. WA induced a significant decrease in cell viability at low micromolar concentrations. The IC50 for 3 patient derived GSC lines ranged between 0.96-1.78μM. WA induced ER stress and apoptosis in the GSCs as indicated by increased expression of ER stress markers grp78 and CHOP and increased levels of cleaved PARP. Furthermore, WA decreased survivin but increased phospho-ERK levels. However, inhibition of ERK activity with U0126 did not potentiate the effect of WA on cell death. Conclusion. Ashwagandha has been used safely for medicinal purposes for centuries and pharmacokinetic studies in mice indicate that micromolar plasma concentrations of WA are obtainable. Our studies indicate that very low concentrations of WA induce ER stress and cell death in GSC lines. Targeting GSC with WA may increase patient survival by hindering GSC mediated tumor regrowth following surgery. Our data demonstrates the efficacy of WA and supports additional studies toward the use of WA as an adjuvant GBM therapy. Citation Format: Baoyu Zhang, Branko Cuglievan, Nadia G. Myrthil, Steven Vanni, Ricardo J. Komotar, Regina M. Graham. Targeting glioblastoma stem cells with withaferin A. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5497. doi:10.1158/1538-7445.AM2014-5497
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2014
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  • 8
    In: Blood, American Society of Hematology, Vol. 138, No. Supplement 1 ( 2021-11-05), p. 2465-2465
    Abstract: Background: Although the prognosis for children with Hodgkin lymphoma (HL) is excellent, up to 25% of patients experience relapse and require salvage therapy. Event-free survival (EFS) for patients with relapsed or refractory disease (R/R) who require high-dose therapy with autologous stem cell transplantation (ASCT) is between 31-67% (Daw, 2011), and efforts to improve these outcomes are an area of urgent clinical need. Brentuximab vedotin (BV) is an anti-CD30 antibody-drug conjugate combined with monomethyl auristatin E. The phase III AETHERA study (NCT01100502) was a randomized, placebo-controlled trial that demonstrated consolidation with BV following ASCT for adults with R/R HL improved progression-free survival (PFS) in comparison to placebo (5-year PFS 59% vs. 41%) in patients identified as having a high-risk of post-ASCT progression (Moskowitz, 2015, 2018). However, there is limited data on post-ASCT BV consolidation in pediatric patients. Here, we report a retrospective multi-center study of BV as consolidation post-ASCT in pediatric patients with R/R HL. Patients and Methods: We performed a retrospective analysis of pediatric patients aged ≤ 21 years who received BV as consolidative therapy following ASCT for the treatment of relapsed/refractory HL. Data was collected on disease risk factors (refractory disease or relapse ≤ 12 months after frontline therapy, best response of partial remission or stable disease to salvage therapy, presence of extranodal involvement, presence of B symptoms, and number of systemic treatments pre-ASCT ≥ 2), treatment history, BV-related toxicity, and response to therapy. The primary endpoint was 3-year EFS. Events were defined as relapse, progression of disease, or death from any cause. Results: Seventy patients were identified from 14 academic centers. Eighteen received BV & gt;90 days after ASCT and were excluded due to significant delay in initiation of BV. Of the remaining 52 patients, the median age at diagnosis was 15 years (range 4-21), and the median age at diagnosis of R/R disease was 16 years (range 8-22). Twenty-eight patients (54%) were male, 13 (25%) had B symptoms, 19 (37%) had extranodal disease. Six patients (12%) had primary refractory disease and 24 patients (47%) relapsed & lt;12 months after frontline therapy. The median number of salvage regimens received pre-ASCT was 2 (range 1-7). Forty-two patients (81%) received BV as part of a pre-ASCT salvage regimen, 4 (8%) of whom did not receive BV in the regimen immediately prior to ASCT. Radiation therapy was used pre or post-ASCT in 16 patients (31%). Prior to ASCT, 40 patients (77%) were PET-negative (Deauville 1-3), 11 (21%) were PET-positive (Deauville 4-5), and response in 1 (2%) was unknown. The median time from ASCT to the start of BV consolidation was 52 days (range 30-90 days). The most frequent adverse events were peripheral neuropathy of any grade (sensory 19/52 [37%]; motor (14/52 [27%] ), and cytopenias (grade 3 or 4: (25/52 [48%]), including neutropenia (13/52 [25%] ), thrombocytopenia (7/52 [14%]), and anemia (5/52 [10%] ). Three patients (6%) experienced infusion-related reactions. The median number of BV cycles completed post-ASCT was 12 (range 1-17), and 16 patients (31%) completed the full 16 cycles of BV. The most common reason for premature termination was adverse effects (22/36 [61%]). Additional reasons included: physician plan for shorter duration (4/36 [11%] ), patient/family decision (3/36 [8%]), and progression (1/36 [3%] ). Treatment was still ongoing in 3 patients and reason for premature termination was not reported for 17/36 patients (47%). With a median follow of 2.8 years (range 0.1 to 6.25 years) the three-year EFS was 92% [95%CI: 83-100]. Patients with 0-1 risk factors (15/52 [29%] ) and ≥ 2 risk factors (37/52 [71%]), had a 3-year EFS of 100% and 90% [95%CI: 79-100] , respectively. Fifty patients (96%) are alive with no evidence of disease, while 2 (4%) patients are alive with disease. No deaths have occurred. Conclusion: The use of post-ASCT BV consolidation for pediatric patients with R/R HL is associated with a favorable safety and tolerability profile. In this cohort, the combination of salvage therapy, HD-chemotherapy/ASCT, and BV consolidation resulted in extremely promising outcomes and warrants further investigation in a prospective pediatric trial. Figure 1 Figure 1. Disclosures Leger: Jazz Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Abbott Diagnostics: Research Funding. Roth: Merck: Consultancy; Janssen: Consultancy.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2021
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  • 9
    Online Resource
    Online Resource
    American Society of Hematology ; 2017
    In:  Blood Vol. 129, No. 7 ( 2017-02-16), p. 917-917
    In: Blood, American Society of Hematology, Vol. 129, No. 7 ( 2017-02-16), p. 917-917
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2017
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 10
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e13632-e13632
    Abstract: e13632 Background: Every year more than 140,000 patients receiving anticancer therapy for malignancies in the US experience febrile neutropenia. Early detection of severe neutropenia could enable preventive strategies to reduce the incidence of febrile episodes. PointCheck is a novel portable optical device that can noninvasively monitor for severe neutropenia at home using microscopy and artificial intelligence. Preliminary clinical results of this device including usability (Lamaj et al., 2022), and sensitivity, and specificity (Pablo-Trinidad et al., 2019) for detection of severe neutropenia have already been reported. Here, we describe an exploratory clinical utility subanalysis. Methods: We conducted an international multicenter study with a primary endpoint of usability including mainly patients with hematological or breast cancer receiving therapy with intermediate/high risk for severe neutropenia, tested at two time points (baseline and nadir tests). Data included demographic information, cancer type, and a differential cell count within 120 minutes of the optical testing. The treating physician also completed an exploratory survey with 11 questions about the device´s potential clinical utility. A mixed-methods approach (descriptive statistics & “Likert” analyses with R 4.2.2) was used to evaluate the results. Results: 79 patients were included in this exploratory subanalysis. The median age was 49.5 (IQR 10.5-78.5) years, and 64 (81%) patients were female. The most common diagnoses were breast cancer (63%) and lymphoma (20%). Preliminary utility results were favorable with attending physicians agreeing that PointCheck could have helped evaluate 85% of the patients. In 82% of the patients, physicians felt that the device could avoid preparation of chemotherapy infusions in the setting of neutropenia. In 73% of the patients, physicians would consider administration of G-CSF or prophylactic antibiotics when sustained grade IV neutropenia was detected. Conclusions: This novel technology is able to non-invasively monitor for severe neutropenia and can add clinical utility as assessed by treating oncologists. Further studies are needed to validate these results.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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