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1. Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study

Author

David J Pinato, Josep Tabernero, Mark Bower, Lorenza Scotti, Meera Patel, Emeline Colomba, Saoirse Dolly, Angela Loizidou, John Chester, Uma Mukherjee, Alberto Zambelli, Alessia Dalla Pria, Juan Aguilar-Company, Diego Ottaviani, Amani Chowdhury, Eve Merry, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Matteo Lambertini, Marco Tagliamento, Anna Pous, Ailsa Sita-Lumsden, Krishnie Srikandarajah, Johann Colomba, Fanny Pommeret, Elia Seguí, Daniele Generali, Salvatore Grisanti, Paolo Pedrazzoli, Gianpiero Rizzo, Michela Libertini, Charlotte Moss, Joanne S Evans, Beth Russell, Nadia Harbeck, Bruno Vincenzi, Federica Biello, Rossella Bertulli, Raquel Liñan, Sabrina Rossi, Maria Carmen Carmona-García, Carlo Tondini, Laura Fox, Alice Baggi, Vittoria Fotia, Alessandro Parisi, Giampero Porzio, Maristella Saponara, Claudia Andrea Cruz, David García-Illescas, Eudald Felip, Ariadna Roqué Lloveras, Rachel Sharkey, Elisa Roldán, Roxana Reyes, Irina Earnshaw, Daniela Ferrante, Javier Marco-Hernández, Isabel Ruiz-Camps, Gianluca Gaidano, Andrea Patriarca, Riccardo Bruna, Anna Sureda, Clara Martinez-Vila, Ana Sanchez de Torre, Luca Cantini, Marco Filetti, Lorenza Rimassa, Lorenzo Chiudinelli, Michela Franchi, Marco Krengli, Armando Santoro, Aleix Prat, Mieke Van Hemelrijck, Nikolaos Diamantis, Thomas Newsom-Davis, Alessandra Gennari, Alessio Cortellini, Judith Swallow, Chris Chung, Gino Dettorre, Neha Chopra, Alvin JX Lee, Christopher CT Sng, Yien Ning Sophia Wong, Myria Galazi, Sarah Benafif, Palma Dileo, Grisma Patel, Anjui Wu, Alasdair Sinclair, Gehan Soosaipillai, Eleanor Jones, Amanda Jackson, Martine Piccart, Emeline Colomba-Blameble, Claudia A Cruz, Elia Segui, David Garcia Illescas, Oriol Mirallas, Anna Carbó, Isabel Garcia, Rachel Wuerstlein, Ricard Mesia, Clara Maluquer, Francesca D'Avanzo, Giuseppe Tonini, Salvatore Provenzano, Valeria Tovazzi, Corrado Ficorella, Paola Queirolo, Raffaele Giusti, Francesca Mazzoni, Federica Zoratto, Marco Tucci, Rossana Berardi, Annalisa Guida, Sergio Bracarda, Maria Iglesias, Pinato, D. J., Tabernero, J., Bower, M., Scotti, L., Patel, M., Colomba, E., Dolly, S., Loizidou, A., Chester, J., Mukherjee, U., Zambelli, A., Dalla Pria, A., Aguilar-Company, J., Ottaviani, D., Chowdhury, A., Merry, E., Salazar, R., Bertuzzi, A., Brunet, J., Lambertini, M., Tagliamento, M., Pous, A., Sita-Lumsden, A., Srikandarajah, K., Colomba, J., Pommeret, F., Segui, E., Generali, D., Grisanti, S., Pedrazzoli, P., Rizzo, G., Libertini, M., Moss, C., Evans, J. S., Russell, B., Harbeck, N., Vincenzi, B., Biello, F., Bertulli, R., Linan, R., Rossi, S., Carmona-Garcia, M. C., Tondini, C., Fox, L., Baggi, A., Fotia, V., Parisi, A., Porzio, G., Saponara, M., Cruz, C. A., Garcia-Illescas, D., Felip, E., Roque Lloveras, A., Sharkey, R., Roldan, E., Reyes, R., Earnshaw, I., Ferrante, D., Marco-Hernandez, J., Ruiz-Camps, I., Gaidano, G., Patriarca, A., Bruna, R., Sureda, A., Martinez-Vila, C., Sanchez de Torre, A., Cantini, L., Filetti, M., Rimassa, L., Chiudinelli, L., Franchi, M., Krengli, M., Santoro, A., Prat, A., Van Hemelrijck, M., Diamantis, N., Newsom-Davis, T., Gennari, A., Cortellini, A., Swallow, J., Chung, C., Dettorre, G., Chopra, N., Lee, A. J., Sng, C. C., Wong, Y. N. S., Galazi, M., Benafif, S., Dileo, P., Patel, G., Wu, A., Sinclair, A., Soosaipillai, G., Jones, E., Jackson, A., Piccart, M., Colomba-Blameble, E., Garcia Illescas, D., Mirallas, O., Carbo, A., Garcia, I., Wuerstlein, R., Mesia, R., Maluquer, C., D'Avanzo, F., Tonini, G., Provenzano, S., Tovazzi, V., Ficorella, C., Queirolo, P., Giusti, R., Mazzoni, F., Zoratto, F., Tucci, M., Berardi, R., Guida, A., Bracarda, S., and Iglesias, M.

Subjects
Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Belgium, COVID-19, Disease Progression, Female, France, Germany, Hospitalization, Humans, Italy, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasms, Prevalence, Registries, Retrospective Studies, Spain, United Kingdom, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Registry study, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), OnCovid, cancer treatment, Post-Acute COVID-19 Syndrome, Internal medicine, medicine, 80 and over, In patient, business.industry, Cancer, Retrospective cohort study, Articles, medicine.disease, Oncology, Research centre, Population study, business
Abstract

Background: The medium-term and long-term impact of COVID-19 in patients with cancer is not yet known. In this study, we aimed to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. We also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection. Methods: OnCovid is an active European registry study enrolling consecutive patients aged 18 years or older with a history of solid or haematological malignancy and who had a diagnosis of RT-PCR confirmed SARS-CoV-2 infection. For this retrospective study, patients were enrolled from 35 institutions across Belgium, France, Germany, Italy, Spain, and the UK. Patients who were diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, and entered into the registry at the point of data lock (March 1, 2021), were eligible for analysis. The present analysis was focused on COVID-19 survivors who underwent clinical reassessment at each participating institution. We documented prevalence of COVID-19 sequelae and described factors associated with their development and their association with post-COVID-19 survival, which was defined as the interval from post-COVID-19 reassessment to the patients’ death or last follow-up. We also evaluated resumption of systemic anti-cancer therapy in patients treated within 4 weeks of COVID-19 diagnosis. The OnCovid study is registered in ClinicalTrials.gov, NCT04393974. Findings: 2795 patients diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, were entered into the study by the time of the data lock on March 1, 2021. After the exclusion of ineligible patients, the final study population consisted of 2634 patients. 1557 COVID-19 survivors underwent a formal clinical reassessment after a median of 22·1 months (IQR 8·4–57·8) from cancer diagnosis and 44 days (28–329) from COVID-19 diagnosis. 234 (15·0%) patients reported COVID-19 sequelae, including respiratory symptoms (116 [49·6%]) and residual fatigue (96 [41·0%]). Sequelae were more common in men (vs women; p=0·041), patients aged 65 years or older (vs other age groups; p=0·048), patients with two or more comorbidities (vs one or none; p=0·0006), and patients with a history of smoking (vs no smoking history; p=0·0004). Sequelae were associated with hospitalisation for COVID-19 (p

Published
2021

2. Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective

Author

Gehan Soosaipillai, Anjui Wu, Gino M Dettorre, Nikolaos Diamantis, John Chester, Charlotte Moss, Juan Aguilar-Company, Mark Bower, Christopher CT Sng, Ramon Salazar, Joan Brunet, Eleanor Jones, Ricard Mesia, Amanda Jackson, Uma Mukherjee, Ailsa Sita-Lumsden, Elia Seguí, Diego Ottaviani, Anna Carbó, Sarah Benafif, Rachel Würstlein, Carme Carmona, Neha Chopra, Claudia Andrea Cruz, Judith Swallow, Nadia Saoudi, Eudald Felip, Myria Galazi, Isabel Garcia-Fructuoso, Alvin J. X. Lee, Thomas Newsom-Davis, Yien Ning Sophia Wong, Anna Sureda, Clara Maluquer, Isabel Ruiz-Camps, Alba Cabirta, Aleix Prat, Angela Loizidou, Alessandra Gennari, Daniela Ferrante, Josep Tabernero, Beth Russell, Mieke Van Hemelrijck, Saoirse Dolly, Nicholas J Hulbert-Williams, David J Pinato, Meritxell Mollà, Roxana Reyes, Javier Marco-Hernández, Riccardo Bruna, Federica Biello, Andrea Patriarca, Alberto Zambelli, Carlo Tondini, Vittoria Fotia, Lorenzo Chiudinelli, Michela Franchi, Daniele Generali, Salvatore Grisanti, Valeria Tovazzi, Alexia Bertuzzi, Andrea Marrari, Pavetha Seeva, Palma Dileo, Gianpiero Rizzo, Michela Libertini, Antonio Maconi, Marta Betti, Salvatore Provenzano, Nadia Harbeck, Bruno Vincenzi, Rossella Bertulli, Raquel Liñan, Ariadna Roqué, Oriol Mirallas, David García-Illescas, Lorenza Scotti, Alessia Dalla Pria, Francesca D’Avanzo, Maria Martinez, Joanne S Evans, Rachel Sharkey, Lorenza Rimassa, Armando Santoro, Gianluca Gaidano, Macarena Izuzquiza, Institut Català de la Salut, [Soosaipillai G] Cancer Division, University College London Hospitals, London, UK. [Wu A] Cancer Division, University College London Hospitals, London, UK UCL Cancer Institute, Fitzrovia, London, UK. [Dettorre GM] Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK. [Diamantis N] Medical Oncology, Barts Health NHS Trust, London, UK. [Chester J] Medical Oncology, School of Medicine, Cardiff University, Cardiff, UK. Medical Oncology, Velindre Cancer Centre, Cardiff, UK. [Moss C] Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK. [Aguilar-Company J] Servei d’Oncologia Mèdica, Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Saoudi N, Tabernero J] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Ruiz-Camps I] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Cabirta A] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Wellcome Trust, Cancer Treatment & Research Trust, and Imperial College Healthcare NHS Trust- BRC Funding

Subjects
medicine.medical_specialty, 2019-20 coronavirus outbreak, Palliative care, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Palliative treatment, COVID-19 (Malaltia), end-of-life (EOL), neoplasias [ENFERMEDADES], 03 medical and health sciences, 0302 clinical medicine, Therapeutics::Patient Care::Terminal Care::Hospice Care [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], 030502 gerontology, medicine, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], cancer, Symptom control, Intensive care medicine, Specialist palliative care, RC254-282, Otros calificadores::/terapia [Otros calificadores], Original Research, end-of life care (EOLC), business.industry, Càncer - Tractament, Perspective (graphical), speciality palliative care team (SPCT), Cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, COVID-19, Cancer patients, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Other subheadings::/therapy [Other subheadings], medicine.disease, 3. Good health, Malalts de càncer, Neoplasms [DISEASES], Oncology, 030220 oncology & carcinogenesis, Tractament pal·liatiu, terapéutica::asistencia al paciente::asistencia en fase terminal::cuidados paliativos al final de la vida [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], 0305 other medical science, business, End-of-life care
Abstract

COVID-19; Cancer; End-of life care (EOLC) COVID-19; Cáncer; Cuidados al final de la vida COVID-19; Càncer; Cures al final de la vida Background: Specialist palliative care team (SPCT) involvement has been shown to improve symptom control and end-of-life care for patients with cancer, but little is known as to how these have been impacted by the COVID-19 pandemic. Here, we report SPCT involvement during the first wave of the pandemic and compare outcomes for patients with cancer who received and did not receive SPCT input from multiple European cancer centres. Methods: From the OnCovid repository (N = 1318), we analysed cancer patients aged ⩾18 diagnosed with COVID-19 between 26 February and 22 June 2020 who had complete specialist palliative care team data (SPCT+ referred; SPCT− not referred). Results: Of 555 eligible patients, 317 were male (57.1%), with a median age of 70 years (IQR 20). At COVID-19 diagnosis, 44.7% were on anti-cancer therapy and 53.3% had ⩾1 co-morbidity. Two hundred and six patients received SPCT input for symptom control (80.1%), psychological support (54.4%) and/or advance care planning (51%). SPCT+ patients had more ‘Do not attempt cardio-pulmonary resuscitation’ orders completed prior to (12.6% versus 3.7%) and during admission (50% versus 22.1%, p

Published
2021

3. COVID-19 in breast cancer patients: a subanalysis of the OnCovid registry

Author

Laia Garrigós, Cristina Saura, Clara Martinez-Vila, Alberto Zambelli, Mark Bower, Barbara Pistilli, Matteo Lambertini, Diego Ottaviani, Nikolaos Diamantis, Ailsa Lumsden, Sonia Pernas, Daniele Generali, Elia Seguí, Gemma Viñas, Eudald Felip, Ana Sanchez, Gianpiero Rizzo, Armando Santoro, Alessio Cortellini, Ylenia Perone, John Chester, Maria Iglesias, Marta Betti, Bruno Vincenzi, Michela Libertini, Francesca Mazzoni, Federica Zoratto, Rossana Berardi, Annalisa Guida, Rachel Wuerstlein, Angela Loizidou, Rachel Sharkey, Juan Aguilar Company, Marta Matas, Chiara Saggia, Lorenzo Chiudinelli, Emeline Colomba-Blameble, Myria Galazi, Uma Mukherjee, Mieke Van Hemelrijck, Mar Marin, Carla Strina, Aleix Prat, Helena Pla, Eva Maria Ciruelos, Alexia Bertuzzi, Lucia del Mastro, Giampiero Porzio, Thomas Newsom-Davis, Isabel Ruiz, Maria Belen Delany, Marco Krengli, Vittoria Fotia, Alessandro Viansone, Neha Chopra, Margarita Romeo, Ramon Salazar, Ignacio Perez, Francesca d’Avanzo, Michela Franchi, Manuela Milani, Fanny Pommeret, Marco Tucci, Paolo Pedrazzoli, Nadia Harbeck, Daniela Ferrante, David J. Pinato, Alessandra Gennari, Garrigos, L., Saura, C., Martinez-Vila, C., Zambelli, A., Bower, M., Pistilli, B., Lambertini, M., Ottaviani, D., Diamantis, N., Lumsden, A., Pernas, S., Generali, D., Segui, E., Vinas, G., Felip, E., Sanchez, A., Rizzo, G., Santoro, A., Cortellini, A., Perone, Y., Chester, J., Iglesias, M., Betti, M., Vincenzi, B., Libertini, M., Mazzoni, F., Zoratto, F., Berardi, R., Guida, A., Wuerstlein, R., Loizidou, A., Sharkey, R., Aguilar Company, J., Matas, M., Saggia, C., Chiudinelli, L., Colomba-Blameble, E., Galazi, M., Mukherjee, U., Van Hemelrijck, M., Marin, M., Strina, C., Prat, A., Pla, H., Ciruelos, E. M., Bertuzzi, A., del Mastro, L., Porzio, G., Newsom-Davis, T., Ruiz, I., Delany, M. B., Krengli, M., Fotia, V., Viansone, A., Chopra, N., Romeo, M., Salazar, R., Perez, I., D'Avanzo, F., Franchi, M., Milani, M., Pommeret, F., Tucci, M., Pedrazzoli, P., Harbeck, N., Ferrante, D., Pinato, D. J., Gennari, A., Institut Català de la Salut, [Garrigós L] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Saura C] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Head Breast Cancer Unit, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Martinez-Vila C] Department of Oncology, Hospital Althaia Manresa, Barcelona, Spain. [Zambelli A] Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy. [Bower M] Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK. [Pistilli B] Department of Medical Oncology, Institute Gustave-Roussy, Villejuif, France. [Aguilar Company J] Servei d’Oncologia Mèdica i Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Ruiz I] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Pla H] Departament d'Oncologia Institut Català d'Oncologia, Hospital Universitari de Girona Doctor Josep Trueta, Institut Català de la Salut (ICS), Girona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
medicine.medical_specialty, Outcome assessment (Medical care), breast cancer, COVID-19, COVID-19 outcomes, OnCovid, SARS-CoV-2, Neoplasms::Neoplasms by Site::Breast Neoplasms [DISEASES], Population, Context (language use), COVID-19 (Malaltia) - Mortalitat, Disease, técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::mortalidad [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Càncer de mama, Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores], Breast cancer, Mama - Càncer, Internal medicine, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Medicine, education, COVID-19 outcome, RC254-282, COVID-19 (Malaltia) - Complicacions, Original Research, education.field_of_study, neoplasias::neoplasias por localización::neoplasias de la mama [ENFERMEDADES], business.industry, Mortality rate, Cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], medicine.disease, Comorbidity, Oncology, Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Avaluació de resultats (Assistència mèdica), business, Complication, Other subheadings::Other subheadings::/complications [Other subheadings]
Abstract

COVID-19; SARS-CoV-2; Cáncer de mama COVID-19; SARS-CoV-2; Càncer de mama COVID-19; SARS-CoV-2; Breast cancer Background: Cancer patients are at higher risk of COVID-19 complications and mortality than the rest of the population. Breast cancer patients seem to have better prognosis when infected by SARS-CoV-2 than other cancer patients. Methods: We report a subanalysis of the OnCovid study providing more detailed information in the breast cancer population. Results: We included 495 breast cancer patients with a SARS-CoV-2 infection. Mean age was 62.6 years; 31.5% presented more than one comorbidity. The most frequent breast cancer subtype was luminal-like (n = 245, 49.5%) and 177 (35.8%) had metastatic disease. A total of 332 (67.1%) patients were receiving active treatment, with radical intent in 232 (47.6%) of them. Hospitalization rate was 58.2% and all-cause mortality rate was 20.3%. One hundred twenty-nine (26.1%) patients developed one COVID-19 complication, being acute respiratory failure the most common (n = 74, 15.0%). In the multivariable analysis, age older than 70 years, presence of COVID-19 complications, and metastatic disease were factors correlated with worse outcomes, while ongoing anticancer therapy at time of COVID-19 diagnosis appeared to be a protective factor. No particular oncological treatment was related to higher risk of complications. In the context of SARS-CoV-2 infection, 73 (18.3%) patients had some kind of modification on their oncologic treatment. At the first oncological reassessment (median time: 46.9 days ± 36.7), 255 (51.6%) patients reported to be fully recovered from the infection. There were 39 patients (7.9%) with long-term SARS-CoV-2-related complications. Conclusion: In the context of COVID-19, our data confirm that breast cancer patients appear to have lower complications and mortality rate than expected in other cancer populations. Most breast cancer patients can be safely treated for their neoplasm during SARS-CoV-2 pandemic. Oncological treatment has no impact on the risk of SARS-CoV-2 complications, and, especially in the curative setting, the treatment should be modified as little as possible. D.J. Pinato is supported by grant funding from the Wellcome Trust Strategic Fund (PS3416) and acknowledges grant support from the Cancer Treatment and Research Trust (CTRT), infrastructural and grant support by the Cancer Research UK Imperial Centre and the NIHR Imperial Biomedical Research Centre. A. Gennari is supported by the AIRC IG Grant, No. 14230, Associazione Italiana per la Ricerca sul Cancro Foundation, Milan, Italy and acknowledge also support from the UPO Aging Project.

Published
2021

4. Somatic cancer genetics in the UK: real-world data from phase I of the Cancer Research UK Stratified Medicine Programme

Author

Colin R. Lindsay, Emily C. Shaw, Fiona Blackhall, Kevin G. Blyth, James D. Brenton, Anshuman Chaturvedi, Noel Clarke, Craig Dick, Thomas R.J. Evans, Geoff Hall, Andrew M. Hanby, David J. Harrison, Stephen R.D. Johnston, Malcolm D. Mason, Dion Morton, Julia Newton-Bishop, Andrew G. Nicholson, Karin A. Oien, Sanjay Popat, Doris Rassl, Rowena Sharpe, Phillipe Taniere, Ian Walker, William A. Wallace, Nicholas P. West, Rachel Butler, David Gonzalez de Castro, Mike Griffiths, Peter W.M. Johnson, Pauline Rehal, Samantha Butler, Matthew Smith, Rachel Doak, Anna Tanska, Graham Halford, Lisa James, Chris Kotara, Gareth Masson, Sam Clokie, Jennie Bell, Fiona Macdonald, David Gonzalez De Castro, Lisa Thompson, Debbie Mair, Suzanne Lillis, Dorte Wren, Robert Hollifield, Keeda Dover, Manisha Maurya, Damian Brooks, Belen Gomez, Lisa Grady, Thomas Jones, Chantal Hooper, Daphne Webster, Jolyon Travis, Stephanie Ogwuru, Jana Gazdova, Denise Collins, Elaine Chapman, Lisa Leavey, Paula Proszek, Sanna Hulkki, V.Peter Collins, Ash Ibrahim, Kat Brown, Jo Burge, Karen Burnett, Ginny Devonshire, Ellen Moseley, Bev Haynes, Charlotte Hodgkin, Merche Jimenez-linan, Linda Jones, Gilly Kenyon, Betania Mahler-araujo, Karen Payne, Jo Piper, Sue Richardson, Ed Rytina, Anne Warren, Liz Coker, Gemma Godsall, Mark Arends, Amanda O’Neill, Katy Rintoul, Donna Goymer, Julie Taylor, Claire Matthews, Harshil Bhayani, Tina Osalador, Zakiya Niwaz, Anna Higgins, Olivia Bamsey, Janine Salter, Louise Renouf, Glenn Noel-Storr, Helen Roberts, Kasia Gierejko, Paola Knapman, Andrew Wotherspoon, Gordon Stamp, Ayoma Attygailye, Steve Hazell, Peter Osin, Ash Nerurkar, Steven Francis, Marion Runde, Jo Arch, Xavier Chitnis, Bernard Siu, Debra Townsend, Laura Hennelly, Natalie Taylor, Bernadette Johnson, Susie Banerjee, Lynda Pyle, Monica Hamill, Jenny Gyertson, Angela George, Krishna Patel, Karla Pearce, Kim Edmonds, Sarah Sarker, Rosalind Eeles, Liz Bancroft, Sarah Thomas, Yukie Kano, Lisa Rowland, Karen Brooks, Mary O’brien, Jaishree Bhosle, Kathy Priest, Bee Ayite, Jo Severn, Helen Beedham, Nicky Lucas, Kim Tye, Alison Lorentzos, Janine Webb, Sarah Kerr, Lisa Corestav, Diego Bottero, Laura Jell, Janet Thomas, Cheryl Marriott, Neil Rajah, Andy Cole, Dieu Ly, Philippe Taniere, Brendan O’sullivan, Clare Swift, Frances Hughes, Desley Neil, Andrew Hanby, Roz Banks, Dolapo Ajayi, Alison Barclay, Julia Newton Bishop, Debbie Beirne, Andrew Bernard, Maxine Berry, Jo Bentley, Tim Bishop, Amy Chambers, Jude Clarke, Anne Crossley, Narinder Gahir, Debbie Gibson, Rona Good, Konstantina Grosios, Pat Harnden, Kate Hasler, Damien Hindmarch, Sharon Jackson, Colin Johnstone, Anne-marie Jones, Gil Lambert, Sally Lane, Nicola Mcnicholas, Rebecca Millican-Slater, Cath Moriaty, Alex Newsham, Kara O’connell, Lisa Ripley, David Sebag-Montefiore, Mary Simpson, Val Speirs, Joh Sugden, Lauren Tate, Emma Tidswell, Chris Twelves, Christy Walker, Barry Waterhouse, Martin Waugh, Louise White, Elizabeth Wright, Jane Rogan, Garry Ashton, Caron Abbey, Michelle Greenhalgh, Daisuke Nonaka, Elwyn Shing, Carmen Gibbard, Georgina Burton, Naomi Fawkes, Angela Marsden, Rachael Waddington, Phil Harrison, Shahrzad Moghadam, Kate Murray, Sarah Brown, Christy Mitchinson, Richard Booton, Rajesh Shah, David Harrison, Anca Oniscu, William Wallace, Frances Rae, Craig Marshall, Linda Mcleod, Morag Charles, Sarah Jane Sutherland, Carol Dawson, Paul Mitchell, Alex Maclellan, Sandra Muir, Lynne Johnstone, John O’connor, Shirley Johnstone, Jim Mcpherson, Jane Hair, Massimo Pignatelli, Roma Armstrong, Karin Oien, Jeff Evans, Margaret Burgoyne, Karen Blessing, Fraser Duthie, Colin Moyes, Elizabeth Mallon, David Millan, Fiona Roberts, Morag Seywright, Siobhan Fraser, Ian Ford, Sharon Kean, Marion Flood, David Grant, Claire Mcdonald, Tom Moffat, Hugh Mclelland, Alistair Kyle, Graham Cameron, Martin Wright, Stephen Kenny, Karen Mcauslan, Andrew Jones, Ted Fitzsimons, Fiona Graham, Alexandra Bell, Phil Duffy, Alec Fisher, Alexis Smith, Elaine Shannon, Bryan Woods, Colin Hutchison, Angela Booth, Lyndsay Duffy, Gillian Mcculloch, Hudda Sadiq, Susan Deakin, Steven Haywood, Malcolm Mason, John Chester, Alison Parry-jones, Abby Macarthur, Suzanne Williams, David Griffiths, Fiona Morgan, Hazel Bailey, University of St Andrews. School of Medicine, and University of St Andrews. Cellular Medicine Division

Subjects
0301 basic medicine, Cancer Research, Colorectal cancer, stratified medicine, NDAS, Context (language use), cruk, lung, RC0254, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, SDG 3 - Good Health and Well-being, medicine, cancer, Lung cancer, Manchester Cancer Research Centre, Molecular pathology, business.industry, RC0254 Neoplasms. Tumors. Oncology (including Cancer), ResearchInstitutes_Networks_Beacons/mcrc, Cancer, medicine.disease, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Cancer research, Adenocarcinoma, genetic, Ovarian cancer, business
Abstract

This study was supported by Cancer Research UK, AstraZeneca and Pfizer UK. Introduction: Phase I of the Cancer Research UK Stratified Medicine Programme (SMP1) was designed to roll out molecular pathology testing nationwide at the point of cancer diagnosis, as well as facilitate an infrastructure where surplus cancer tissue could be used for research. It offered a non-trial setting to examine common UK cancer genetics in a real-world context. Methods: A total of 26 sites in England, Wales and Scotland, recruited samples from 7814 patients for genetic examination between 2011 and 2013. Tumour types involved were breast, colorectal, lung, prostate, ovarian cancer and malignant melanoma. Centralised molecular testing of surplus material from resections or biopsies of primary/metastatic tissue was performed, with samples examined for 3-5 genetic alterations deemed to be of key interest in site-specific cancers by the National Cancer Research Institute Clinical Study groups. Results: 10 754 patients (98% of those approached) consented to participate, from which 7814 tumour samples were genetically analysed. In total, 53% had at least one genetic aberration detected. From 1885 patients with lung cancer, KRAS mutation was noted to be highly prevalent in adenocarcinoma (37%). In breast cancer (1873 patients), there was a striking contrast in TP53 mutation incidence between patients with ductal cancer (27.3%) and lobular cancer (3.4%). Vast inter-tumour heterogeneity of colorectal cancer (1550 patients) was observed, including myriad double and triple combinations of genetic aberrations. Significant losses of important clinical information included smoking status in lung cancer and loss of distinction between low-grade and high-grade serous ovarian cancers. Conclusion: Nationwide molecular pathology testing in a non-trial setting is feasible. The experience with SMP1 has been used to inform ongoing CRUK flagship programmes such as the CRUK National Lung MATRIX trial and TRACERx. Publisher PDF

Published
2018

5. Emergency vascular surgery

Author

John Chester and Bruce C.V. Campbell

Subjects
Clinical governance, medicine.medical_specialty, business.industry, General Engineering, General Medicine, Vascular surgery, medicine.disease, Arterial surgery, General Earth and Planetary Sciences, Medicine, Medical emergency, business, Aortic rupture, General Environmental Science
Abstract

The services of vascular specialists are in demand to treat common vascular emergencies—patients with acute ischaemia of the limbs and leaking aortic aneurysms.1 2 3 4 The management of these problems has become increasingly complex, often involving a team approach with specialists in interventional vascular radiology.1 General surgeons who do not perform elective arterial surgery have become concerned about dealing with difficult vascular emergencies because clinical governance will no longer support surgeons practising outside their normal sphere of work. The public expects treatment by specialists, and in vascular emergencies this is justified by outcome data.1 2 3 4 Unfortunately, there are not enough vascular surgeons to provide formal emergency rotas in most hospitals, and the number required would far exceed those needed to do the elective vascular work. Many vascular surgeons have provided informal emergency cover at the expense of their family lives—some have made themselves available “one in two” or …

Published
2002

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