Physical Testing in Cancer Patients: Practical Testing in a Clinical Setting

2021 ◽  
Vol 8 (2) ◽  
pp. 77-88
Author(s):  
Timia van Soom ◽  
◽  
Nick Gebruers ◽  
Wiebren Tjalma ◽  
Goof Schep ◽  
...  
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jessica Garcia ◽  
Nick Kamps-Hughes ◽  
Florence Geiguer ◽  
Sébastien Couraud ◽  
Brice Sarver ◽  
...  

AbstractCirculating cell-free DNA (cfDNA) has the potential to be a specific biomarker for the therapeutic management of lung cancer patients. Here, a new sequencing error-reduction method based on molecular amplification pools (MAPs) was utilized to analyze cfDNA in lung cancer patients. We determined the accuracy of MAPs plasma sequencing with respect to droplet digital polymerase chain reaction assays (ddPCR), and tested whether actionable mutation discovery is improved by next-generation sequencing (NGS) in a clinical setting. This study reports data from 356 lung cancer patients receiving plasma testing as part of routine clinical management. Sequencing of cfDNA via MAPs had a sensitivity of 98.5% and specificity 98.9%. The ddPCR assay was used as the reference, since it is an established, accurate assay that can be performed contemporaneously on the same plasma sample. MAPs sequencing detected somatic variants in 261 of 356 samples (73%). Non-actionable clonal hematopoiesis-associated variants were identified via sequencing in 21% of samples. The accuracy of this cfDNA sequencing approach was similar to that of ddPCR assays in a clinical setting, down to an allele frequency of 0.1%. Due to broader coverage and high sensitivity for insertions and deletions, sequencing via MAPs afforded important detection of additional actionable mutations.


Author(s):  
William Breitbart

This chapter briefly reviews the existential framework and context in which meaning-centered psychotherapy (MCP) for cancer patients was developed. As an introduction to MCP in the cancer setting, readers of this chapter will be exposed to basic existential philosophical and psychotherapeutic constructs that were influential in developing MCP and that will be of benefit to practitioners of MCP in the clinical setting. The contributions of such important existential psychotherapists and philosophers as Irvin Yalom, Viktor Frankl, Kierkegard, Heidegger, Jacques Derrida, and others are distilled for the reader in a manner specifically aimed at elucidating how universal existential concerns are incorporated into MCP.


2020 ◽  
Author(s):  
Yueqiong Ni ◽  
Zoltan Lohinai ◽  
Yoshitaro Heshiki ◽  
Balazs Dome ◽  
Judit Moldvay ◽  
...  

Abstract Background Cachexia is associated with decreased survival in cancer patients and has a prevalence of up to 80%. The etiology of cachexia is poorly understood, and limited treatment options exist. Here, we investigated the role of the human gut microbiome in the clinical setting by integrating shotgun metagenomics and plasma metabolomics of 38 lung cancer patients, with known cachexia status. Results The cachexia group showed significant differences in the gut microbial composition, functional pathways of the metagenome, and the related plasma metabolites compared to non-cachectic patients. Branched-chain amino acids (BCAAs), methylhistamine, as well as vitamins, were significantly depleted in the plasma of cachexia patients, which was also reflected in the depletion of relevant gut microbiota functional pathways. The enrichment of plasma BCAAs and 3-oxocholic acid in non-cachectic patients were positively correlated with the gut microbial species Prevotella copri and Lactobacillus gasseri, respectively. Furthermore, the gut microbiota capacity for lipopolysaccharides biosynthesis was significantly enriched in the cancer cachectic patients. The involvement of gut microbiome in cachexia was further observed in a high-performance machine learning model that uses solely gut microbial taxonomic and pathway features to differentiate cachectic from non-cachectic cancer patients. Conclusions Our study demonstrates the links between host metabolism and specific gut microbial species and functions in a clinical setting, suggesting that the gut microbiota could have an influence on cachexia with possible future therapeutic applications.


2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e19080-e19080 ◽  
Author(s):  
Takahisa Kawamura ◽  
Hirotsugu Kenmotsu ◽  
Kazushige Wakuda ◽  
Akira Ono ◽  
Tetsuhiko Taira ◽  
...  

Neoplasma ◽  
2018 ◽  
Vol 65 (04) ◽  
pp. 599-603 ◽  
Author(s):  
M. UNSELD ◽  
M. FILIP ◽  
S. SEIRL ◽  
A. GLEISS ◽  
D. BIANCONI ◽  
...  

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emilia Persson ◽  
Sevgi Emin ◽  
Jonas Scherman ◽  
Christian Jamtheim Gustafsson ◽  
Patrik Brynolfsson ◽  
...  

Abstract Background and purpose Inter-modality image registration between computed tomography (CT) and magnetic resonance (MR) images is associated with systematic uncertainties and the magnitude of these uncertainties is not well documented. The purpose of this study was to investigate the potential uncertainty of gold fiducial marker (GFM) registration for localized prostate cancer and to estimate the inter-observer bias in a clinical setting. Methods Four experienced observers registered CT and MR images for 42 prostate cancer patients. Manual GFM identification was followed by a landmark-based registration. The absolute difference between observers in GFM identification and the displacement of the clinical target volume (CTV) was investigated. The CTV center of mass (CoM) vector displacements, DICE-index and Hausdorff distances for the observer registrations were compared against a clinical baseline registration. The time allocated for the manual registrations was compared. Results Absolute difference in GFM identification between observers ranged from 0.0 to 3.0 mm. The maximum CTV CoM displacement from the clinical baseline was 3.1 mm. Displacements larger than or equal to 1 mm, 2 mm and 3 mm were 46%, 18% and 4%, respectively. No statistically significant difference was detected between observers in terms of CTV displacement. Median DICE-index and Hausdorff distance for the CTV, with their respective ranges were 0.94 [0.70–1.00] and 2.5 mm [0.7–8.7]. Conclusions Registration of CT and MR images using GFMs for localized prostate cancer patients was subject to inter-observer bias on an individual patient level. A CTV displacement as large as 3 mm occurred for individual patients. These results show that GFM registration in a clinical setting is associated with uncertainties, which motivates the removal of inter-modality registrations in the radiotherapy workflow and a transition to an MRI-only workflow for localized prostate cancer.


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