8 results on '"Fyles, Anthony W"'
Search Results
2. Effect of Positron Emission Tomography Imaging in Women With Locally Advanced Cervical Cancer
- Author
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Elit, Lorraine M., primary, Fyles, Anthony W., additional, Gu, Chu-Shu, additional, Pond, Gregory R., additional, D’Souza, David, additional, Samant, Rajiv, additional, Anthes, Margaret, additional, Thomas, Gillian, additional, Filion, Marc, additional, Arsenault, Julie, additional, Dayes, Ian, additional, Whelan, Timothy J., additional, Gulenchyn, Karen Y., additional, Metser, Ur, additional, Dhamanaskar, Kavita, additional, and Levine, Mark N., additional
- Published
- 2018
- Full Text
- View/download PDF
3. Simulation Modeling of Cancer Clinical Trials: Application to Omitting Radiotherapy in Low-risk Breast Cancer.
- Author
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Jayasekera, Jinani, Li, Yisheng, Schechter, Clyde B, Jagsi, Reshma, Song, Juhee, White, Julia, Luta, George, Chapman, Judith-Anne W, Feuer, Eric J, Zellars, Richard C, Stout, Natasha, Julian, Thomas B, Whelan, Timothy, Huang, Xuelin, Hwang, E Shelley, Hopkins, Judith O, Sparano, Joseph A, Anderson, Stewart J, Fyles, Anthony W, and Gray, Robert
- Subjects
CLINICAL trials ,BREAST cancer treatment ,RADIOTHERAPY ,HORMONE therapy ,EPIDERMAL growth factor receptors - Abstract
Background: We used two models to simulate a proposed noninferiority trial of radiotherapy (RT) omission in low-risk invasive breast cancer to illustrate how modeling could be used to predict the trial's outcomes, inform trial design, and contribute to practice debates.Methods: The proposed trial was a prospective randomized trial of no-RT vs RT in women age 40 to 74 years undergoing lumpectomy and endocrine therapy for hormone receptor-positive, human epidermal growth factor receptor 2-negative, stage I breast cancer with an Oncotype DX score of 18 or lower. The primary endpoint was recurrence-free interval (RFI), including locoregional recurrence, distant recurrence, and breast cancer death. Noninferiority required the two-sided 90% confidence interval of the RFI hazard ratio (HR) for no-RT vs RT to be entirely below 1.7. Model inputs included published data. The trial was simulated 1000 times, and results were summarized as percent concluding noninferiority and mean (standard deviation) of hazard ratios for Model GE and Model M, respectively.Results: Noninferiority was demonstrated in 18.0% and 3.7% for the two models. The respective means (SD) of the RFI hazard ratios were 1.8 (0.7) and 2.4 (0.9); most were locoregional recurrences. The mean five-year RFI rates for no-RT vs RT (SD) were 92.7% (2.9%) vs 95.5% (2.2%) and 88.4% (2.0%) vs 94.5% (1.6%). Both models showed little or no difference in breast cancer-specific or overall survival. Alternative definitions of low risk based on combinations of age and grade produced similar results.Conclusions: The proposed trial was unlikely to show noninferiority of omitting radiotherapy even using alternative definitions of low-risk, as the endpoint included local recurrence. Future trials regarding radiotherapy should address absolute reduction in recurrence and impact of type of recurrence on the patient. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
4. Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer.
- Author
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Jayasekera, Jinani, Schechter, Clyde B, Sparano, Joseph A, Jagsi, Reshma, White, Julia, Chapman, Judith-Anne W, Whelan, Timothy, Anderson, Stewart J, Fyles, Anthony W, Sauerbrei, Willi, Zellars, Richard C, Li, Yisheng, Song, Juhee, Huang, Xuelin, Julian, Thomas B, Luta, George, Berry, Donald A, Feuer, Eric J, Mandelblatt, Jeanne, and Group, CISNET-BOLD Collaborative
- Subjects
RADIOTHERAPY ,BREAST cancer treatment ,HORMONES ,GENE expression ,MEDICAL care - Abstract
Background: Radiotherapy after breast conservation has become the standard of care. Prior meta-analyses on effects of radiotherapy predated availability of gene expression profiling (GEP) to assess recurrence risk and/or did not include all relevant outcomes. This analysis used GEP information with pooled individual-level data to evaluate the impact of omitting radiotherapy on recurrence and mortality.Methods: We considered trials that evaluated or administered radiotherapy after lumpectomy in women with low-risk breast cancer. Women included had undergone lumpectomy and were treated with hormonal therapy for stage I, ER+ and/or PR+, HER2- breast cancer with Oncotype scores no greater than 18. Recurrence-free interval (RFI), type of RFI (locoregional or distant), and breast cancer-specific and overall survival were compared between no radiotherapy and radiotherapy using adjusted Cox models. All statistical tests were two-sided.Results: The final sample included 1778 women from seven trials. Omission of radiotherapy was associated with an overall adjusted hazard ratio of 2.59 (95% confidence interval [CI] = 1.38 to 4.89, P = .003) for RFI. There was a statistically significant increase in any first locoregional recurrence (P = .001), but not distant recurrence events (P = .90), or breast cancer-specific (P = .85) or overall survival (P = .61). Five-year RFI rate was high (93.5% for no radiotherapy vs 97.9% for radiotherapy; absolute reduction = 4.4%, 95% CI = 0.7% to 8.1%, P = .03). The effects of radiotherapy varied across subgroups, with lower RFI rates for those with Oncotype scores of less than 11 (vs 11-18), older (vs younger), and ER+/PR+ status (vs other).Conclusions: Omission of radiotherapy in hormone-sensitive patients with low recurrence risk may lead to a modest increase in locoregional recurrence event rates, but does not appear to increase the rate of distant recurrence or death. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
5. Association between Metformin Use and Mortality after Cervical Cancer in Older Women with Diabetes
- Author
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Han, Kathy, primary, Pintilie, Melania, additional, Lipscombe, Lorraine L., additional, Lega, Iliana C., additional, Milosevic, Michael F., additional, and Fyles, Anthony W., additional
- Published
- 2016
- Full Text
- View/download PDF
6. Abstract 2059: The role of microRNA-196b in cervical cancer
- Author
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How, Christine, primary, Hui, Angela B., additional, Fyles, Anthony W., additional, and Liu, Fei-Fei, additional
- Published
- 2010
- Full Text
- View/download PDF
7. Simulation Modeling of Cancer Clinical Trials: Application to Omitting Radiotherapy in Low-risk Breast Cancer.
- Author
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Jayasekera J, Li Y, Schechter CB, Jagsi R, Song J, White J, Luta G, Chapman JW, Feuer EJ, Zellars RC, Stout N, Julian TB, Whelan T, Huang X, Shelley Hwang E, Hopkins JO, Sparano JA, Anderson SJ, Fyles AW, Gray R, Sauerbrei W, Mandelblatt J, and Berry DA
- Subjects
- Adult, Aged, Breast Neoplasms diagnosis, Breast Neoplasms mortality, Breast Neoplasms therapy, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Models, Statistical, Neoplasm Grading, Neoplasm Recurrence, Local, Neoplasm Staging, Proportional Hazards Models, Radiotherapy, Adjuvant, Treatment Outcome, Breast Neoplasms epidemiology, Clinical Trials as Topic, Models, Theoretical
- Abstract
Background: We used two models to simulate a proposed noninferiority trial of radiotherapy (RT) omission in low-risk invasive breast cancer to illustrate how modeling could be used to predict the trial's outcomes, inform trial design, and contribute to practice debates., Methods: The proposed trial was a prospective randomized trial of no-RT vs RT in women age 40 to 74 years undergoing lumpectomy and endocrine therapy for hormone receptor-positive, human epidermal growth factor receptor 2-negative, stage I breast cancer with an Oncotype DX score of 18 or lower. The primary endpoint was recurrence-free interval (RFI), including locoregional recurrence, distant recurrence, and breast cancer death. Noninferiority required the two-sided 90% confidence interval of the RFI hazard ratio (HR) for no-RT vs RT to be entirely below 1.7. Model inputs included published data. The trial was simulated 1000 times, and results were summarized as percent concluding noninferiority and mean (standard deviation) of hazard ratios for Model GE and Model M, respectively., Results: Noninferiority was demonstrated in 18.0% and 3.7% for the two models. The respective means (SD) of the RFI hazard ratios were 1.8 (0.7) and 2.4 (0.9); most were locoregional recurrences. The mean five-year RFI rates for no-RT vs RT (SD) were 92.7% (2.9%) vs 95.5% (2.2%) and 88.4% (2.0%) vs 94.5% (1.6%). Both models showed little or no difference in breast cancer-specific or overall survival. Alternative definitions of low risk based on combinations of age and grade produced similar results., Conclusions: The proposed trial was unlikely to show noninferiority of omitting radiotherapy even using alternative definitions of low-risk, as the endpoint included local recurrence. Future trials regarding radiotherapy should address absolute reduction in recurrence and impact of type of recurrence on the patient.
- Published
- 2018
- Full Text
- View/download PDF
8. Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer.
- Author
-
Jayasekera J, Schechter CB, Sparano JA, Jagsi R, White J, Chapman JW, Whelan T, Anderson SJ, Fyles AW, Sauerbrei W, Zellars RC, Li Y, Song J, Huang X, Julian TB, Luta G, Berry DA, Feuer EJ, and Mandelblatt J
- Subjects
- Aged, Aged, 80 and over, Antineoplastic Agents, Hormonal therapeutic use, Breast Neoplasms genetics, Breast Neoplasms mortality, Clinical Trials as Topic, Combined Modality Therapy, Female, Humans, Middle Aged, Neoplasm Grading, Neoplasm Recurrence, Local, Neoplasm Staging, Proportional Hazards Models, Radiotherapy, Adjuvant, Breast Neoplasms diagnosis, Breast Neoplasms radiotherapy
- Abstract
Background: Radiotherapy after breast conservation has become the standard of care. Prior meta-analyses on effects of radiotherapy predated availability of gene expression profiling (GEP) to assess recurrence risk and/or did not include all relevant outcomes. This analysis used GEP information with pooled individual-level data to evaluate the impact of omitting radiotherapy on recurrence and mortality., Methods: We considered trials that evaluated or administered radiotherapy after lumpectomy in women with low-risk breast cancer. Women included had undergone lumpectomy and were treated with hormonal therapy for stage I, ER+ and/or PR+, HER2- breast cancer with Oncotype scores no greater than 18. Recurrence-free interval (RFI), type of RFI (locoregional or distant), and breast cancer-specific and overall survival were compared between no radiotherapy and radiotherapy using adjusted Cox models. All statistical tests were two-sided., Results: The final sample included 1778 women from seven trials. Omission of radiotherapy was associated with an overall adjusted hazard ratio of 2.59 (95% confidence interval [CI] = 1.38 to 4.89, P = .003) for RFI. There was a statistically significant increase in any first locoregional recurrence (P = .001), but not distant recurrence events (P = .90), or breast cancer-specific (P = .85) or overall survival (P = .61). Five-year RFI rate was high (93.5% for no radiotherapy vs 97.9% for radiotherapy; absolute reduction = 4.4%, 95% CI = 0.7% to 8.1%, P = .03). The effects of radiotherapy varied across subgroups, with lower RFI rates for those with Oncotype scores of less than 11 (vs 11-18), older (vs younger), and ER+/PR+ status (vs other)., Conclusions: Omission of radiotherapy in hormone-sensitive patients with low recurrence risk may lead to a modest increase in locoregional recurrence event rates, but does not appear to increase the rate of distant recurrence or death.
- Published
- 2018
- Full Text
- View/download PDF
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