scholarly journals Assessment of Luminal and Basal Phenotypes in Bladder Cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Charles C. Guo ◽  
Jolanta Bondaruk ◽  
Hui Yao ◽  
Ziqiao Wang ◽  
Li Zhang ◽  
...  

Abstract Genomic profiling studies have demonstrated that bladder cancer can be divided into two molecular subtypes referred to as luminal and basal with distinct clinical behaviors and sensitivities to frontline chemotherapy. We analyzed the mRNA expressions of signature luminal and basal genes in bladder cancer tumor samples from publicly available and MD Anderson Cancer Center cohorts. We developed a quantitative classifier referred to as basal to luminal transition (BLT) score which identified the molecular subtypes of bladder cancer with 80–94% sensitivity and 83–93% specificity. In order to facilitate molecular subtyping of bladder cancer in primary care centers, we analyzed the protein expressions of signature luminal (GATA3) and basal (KRT5/6) markers by immunohistochemistry, which identified molecular subtypes in over 80% of the cases. In conclusion, we provide a tool for assessment of molecular subtypes of bladder cancer in routine clinical practice.

2017 ◽  
Vol 23 (1) ◽  
pp. 136-143 ◽  
Author(s):  
Iñaki Martín-Lesende ◽  
Estibalitz Orruño ◽  
Maider Mateos ◽  
Elizabete Recalde ◽  
José Asua ◽  
...  

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 6525-6525
Author(s):  
Andrew George Robinson ◽  
Xuejiao Wei ◽  
William J. Mackillop ◽  
Christopher M. Booth

2020 ◽  
Vol 38 (2) ◽  
pp. 193-199
Author(s):  
Robyn L. Shepardson ◽  
Mark R. Minnick ◽  
Jennifer S. Funderburk

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 277-277
Author(s):  
Joyce Roquemore ◽  
Leslie Kian

277 Background: Reviewing clinical practice by provider has been an ongoing process for quite some time. The metrics reviewed and how the review was conducted were not clearly defined and, as a result, has varied widely between organizations. Recredentialing or some self-imposed process were the main drivers until The Joint Commission required a more regular review of the clinicians’ practice in a hospital and clinics setting. MD Anderson embraced the requirement as an opportunity to improve its clinical review process and create a more robust infrastructure. Methods: Organizational and technological support was critical for success. The OPPE effort is led by the V.P. for Medical Affairs. A new faculty role, Quality Officer (QO), was established in each clinical department. The Office of Performance Improvement (OPI) was enlisted for data support and provided educational resources to the QOs. The Information Services staff maintains the technology to support the project long term. The Medical Staff Office has administrative responsibility for the program. Results: Two bi-annual OPPE reviews for credentialed providers (physicians and mid-levels) have been completed under the new process. Electronic display and processing has eliminated volumes of paper needed to track OPPE for 1,000+ faculty. External audit requirements are easily supported. Early adopters of the new OPPE tools have been complimentary of the support provided by display of values in control chart versus table formats. The application of statistical process control rules help QOs understand variation in performance among faculty and aid in identifying statistically valid quality issues. Conclusions: MD Anderson leveraged the OPPE requirements to make organizational changes and create processes that enhance review of clinical practice with electronic tools that improve decision making and analytical capabilities. The implementation of clinical quality metrics has made it clearer to see how each practice is doing based on criteria they defined, as well as create a path towards developing oncology performance metrics that can be considered nationally.


2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 57-57 ◽  
Author(s):  
Jamie Cathleen Riches ◽  
Nikolaus Schultz ◽  
Geoffrey Yuyat Ku ◽  
Tooba Imtiaz ◽  
David Paul Kelsen ◽  
...  

57 Background: Esophagogastric (EG) cancer is a phenotypically heterogeneous disease. The Cancer Genome Atlas (TCGA) identified four distinct subsets: 1) Epstein Barr Virus (EBV) tumors with PIK3CA mutations, PD-L1/2 amplification (amp), 2) Tumors with Microsatellite instability (MSI-H), 3) chromosomally unstable (CIN) tumors with frequent amplifications, 4) chromosomally stable/diffuse type tumors with RHOA mutations. We explore the utility/feasibility of genomic profiling of EG tumors in routine clinical practice. Methods: Patients (pts) with metastatic EG adenocarcinoma undergoing treatment at MSKCC were consented for molecular testing under institutional protocol. Archival formalin fixed paraffin embedded (FFPE) samples were analyzed using an on-site 341 cancer-associated gene bait capture, next generation sequencing (NGS) assay. Results: Of 70 analyzed EG tumors, 66 (94%) harbored at least one genomic alteration, the most frequent being TP53 mutations (77%), HER2 amp (30%) and EGFR amp (10%). Alterations in PI3K/AKT/mTOR (9%) and G1-S1 cell cycle regulators (CDK12 (11%), CDKN2A (10%)) were also observed. A comparison with the TCGA results revealed an over-representation of the CIN subtype (65% vs 50% in TCGA). We found very few EBV or MSI tumors (3% each), with the remaining 29% being chromosomally stable. Data is reported in the clinical medical record and maintained in the MSKCC-internal cBioPortal for Cancer Genomics ( http://cbioportal.org ) (Gao, et al.). The portal is a web resource for exploring, visualizing, and analyzing multidimensional cancer genomics data and when available, to link these data to therapeutic interventions and clinical outcomes. Conclusions: CIN tumors with frequent amplifications represent majority of metastatic EG cancer at our institution. Optimal development of target-specific therapy for EG tumors will require genomic characterization. Comprehensive molecular profiling is feasible in routine clinical practice and has created a roadmap for pt stratification and genome-guided trial development.


Author(s):  
Ю.А. Лушпаева

Целью исследования было выявление возможных проблем диагностики, междисциплинарного взаимодействия и причины дефектов терапии пациентов с остеоартритом на амбулаторном приеме, а также оценка эффективности и безопасности применения в рутинной клинической практике у пациентов с остеоартритом коленных суставов препарата, основой которого является биоактивный концентрат мелких морских рыб. Проанализированы результаты амбулаторного приема ревматолога и истории болезни 2312 пациентов с направительным диагнозом «остеоартрит» различной локализации. Оказалось, что из всех обратившихся к ревматологу пациентов с направительным диагнозом «остеоартрит» 47% направлений можно расценить как безосновательные. Было обнаружено, что 45% пациентов даже при установленном достоверном диагнозе «остеоартрит» на амбулаторном приеме терапия назначалась не в полном объеме и не соответствовала рекомендациям по ведению данной категории больных. После двух курсов (в течение года) лечения препаратом на основе биоактивного концентрата мелких морских рыб эффектом от терапии были удовлетворены 67% пациентов с остеоартритом коленных суставов, отметившие снижение интенсивности боли, улучшение функции суставов и качества жизни. В группе наблюдения не было зарегистрировано нежелательных явлений. Несмотря на то, что в настоящее время проблема остеоартрита хорошо освещена, в реальной клинической практике на этапе первичного звена врачи нередко сталкиваются со сложностями решения как диагностических, так и терапевтических задач. В связи с этим возникает острая необходимость в пересмотре и адаптации к рутинной амбулаторной практике междисциплинарных алгоритмов ведения больных остеоартритом, с определением порога вмешательства врача первичного звена и специалиста. Существует также необходимость в разработке и внедрении в рутинную клиническую практику оптимизированных шкал/опросников для динамической оценки качества жизни пациентов с остеоартритом коленных суставов. Проведенное исследование демонстрирует достаточно высокую эффективность, безопасность и доступность препарата на основе биоактивного концентрата мелких морских рыб, а лечение данным препаратом может широко применяться в комплексной терапии остеоартрита коленных суставов. The purpose of the study was to identify the problems of diagnosis, interdisciplinary interaction and the causes of defects in the treatment of patients with osteoarthritis on an outpatient basis, as well as to assess the efficacy and safety of using the medicine from bioactive concentrate of small marine fish, in routine clinical practice in patients with knee osteoarthritis. The results of an out-patient reception hours with a rheumatologist and case histories of 2312 patients with a referral diagnosis of osteoarthritis of various localization were analyzed. It turned out that 47% of all referrals to a rheumatologist with a referral diagnosis of osteoarthritis can be regarded as unfounded. It was found that 45% of patients, even with an established reliable diagnosis of osteoarthritis, on an outpatient basis, therapy was not prescribed in full and did not comply with the recommendations for the management of this category of patients. After 2 courses (within a year) of treatment with a drug based on a bioactive concentrate of small marine fish, 67% of patients with osteoarthritis of the knee joints were satisfied with the effect of therapy, noting a decrease in pain intensity, an improvement in knee joint function and quality of life. No adverse events were reported in the observation group. Despite the fact that at present the problem of osteoarthritis is well covered, in real clinical practice at the stage of primary care physicians often face difficulties in solving both diagnostic and therapeutic problems. In this regard, there is an urgent need to revise and adapt to the routine outpatient practice of interdisciplinary algorithms for managing patients with osteoarthritis, with the determination of the intervention threshold of a primary care physician and a specialist physician. However, there is a need to develop and introduce into routine clinical practice optimized scales/questionnaires for dynamic assessment of the quality of life of patients with knee osteoarthritis. The study demonstrates a fairly high efficacy, safety and availability of a drug based on a bioactive concentrate of small marine fish, and treatment with this drug can be widely used in the complex therapy of osteoarthritis of the knee joints.


BMC Cancer ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Talal Hilal ◽  
Mary Nakazawa ◽  
Jacob Hodskins ◽  
John L. Villano ◽  
Aju Mathew ◽  
...  

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