المؤلفون: Hussain, Zeshan, Lam, Barbara D., Acosta-Perez, Fernando A., Riaz, Irbaz Bin, Jacobs, Maia, Yee, Andrew J., Sontag, David

مصطلحات موضوعية: Computer Science - Human-Computer Interaction

الوصف: We evaluated how clinicians approach clinical decision-making when given findings from both randomized controlled trials (RCTs) and machine learning (ML) models. To do so, we designed a clinical decision support system (CDSS) that displays survival curves and adverse event information from a synthetic RCT and ML model for 12 patients with multiple myeloma. We conducted an interventional study in a simulated setting to evaluate how clinicians synthesized the available data to make treatment decisions. Participants were invited to participate in a follow-up interview to discuss their choices in an open-ended format. When ML model results were concordant with RCT results, physicians had increased confidence in treatment choice compared to when they were given RCT results alone. When ML model results were discordant with RCT results, the majority of physicians followed the ML model recommendation in their treatment selection. Perceived reliability of the ML model was consistently higher after physicians were provided with data on how it was trained and validated. Follow-up interviews revealed four major themes: (1) variability in what variables participants used for decision-making, (2) perceived advantages to an ML model over RCT data, (3) uncertainty around decision-making when the ML model quality was poor, and (4) perception that this type of study is an important thought exercise for clinicians. Overall, ML-based CDSSs have the potential to change treatment decisions in cancer management. However, meticulous development and validation of these systems as well as clinician training are required before deployment.
Comment: First two listed authors are co-first authors

الوصول الحر: http://arxiv.org/abs/2404.15187Test

المؤلفون: Boulanger, Mary C., Tieger, Marisa G., Eliott, Dean, Yee, Andrew J.

المصدر: eJHaem ; volume 5, issue 2, page 421-422 ; ISSN 2688-6146 2688-6146

الإتاحة: https://doi.org/10.1002/jha2.883Test

المؤلفون: Al Jurdi, Ayman, Cohen Bucay, Abraham, Riella, Leonardo V., Yee, Andrew J., Abdelmalek, Cherif, Klepeis, Veronica, Kimura, Shoko, Safa, Kassem

المصدر: Transplantation Direct ; volume 10, issue 5, page e1616 ; ISSN 2373-8731

الإتاحة: https://doi.org/10.1097/txd.0000000000001616Test

المؤلفون: Mo, Clifton C., Yee, Andrew J., Midha, Shonali, Hartley‐Brown, Monique A., Nadeem, Omar, O'Donnell, Elizabeth K., Bianchi, Giada, Sperling, Adam S., Laubach, Jacob P., Richardson, Paul G.

المساهمون: Dana-Farber Cancer Institute

المصدر: eJHaem ; volume 4, issue 3, page 792-810 ; ISSN 2688-6146 2688-6146

الوصف: Selinexor is an orally bioavailable selective inhibitor of nuclear export compound that inhibits exportin‐1 (XPO1), a novel therapeutic target that is overexpressed in multiple myeloma (MM) and is responsible for the transport of ∼220 nuclear proteins to the cytoplasm, including tumour suppressor proteins. Inhibition of this process has demonstrated substantial antimyeloma activity in preclinical studies, both alone and in combination with established MM therapeutics. Based on a clinical trial programme encompassing multiple combination regimens, selinexor‐based therapy has been approved for the treatment of relapsed/refractory MM (RRMM), with selinexor‐dexamethasone approved in the later‐relapse setting for penta‐refractory patients and selinexor‐bortezomib‐dexamethasone approved for patients who have received ≥1 prior therapy. Here, we provide a comprehensive review of the clinical data on selinexor‐based regimens, including recent updates from the 2022 American Society of Hematology annual meeting, and summarise ongoing studies of this novel targeted agent in newly diagnosed MM and RRMM.

الإتاحة: https://doi.org/10.1002/jha2.709Test

المؤلفون: Wong, Sandy W., Bar, Noffar, Victoria Mateos, María, Ribas, Paz, Hansson, Markus, Paris, Laura, Hofmeister, Craig, Rodriguez-Otero, Paula, Aranzazu Bermúdez, Maria, Santoro, Armando, Yee, Andrew J., Creignou, Maria, Encinas, Cristina, Cerchione, Claudio, de la Rubia, Javier, Oriol, Albert, Ferstl, Barbara, Besemer, Britta, Chen, Jinjie, Chung, Alexander, Boss, Isaac W., Gaudy, Allison, LI, Shaoyi, Hsu, Kevin, Godwin, Colin, Burgess, Michael R., San-Miguel, Jesús, Jose Costa, Luciano

المصدر: HemaSphere ; volume 7, issue S3, page e1220745 ; ISSN 2572-9241

الإتاحة: https://doi.org/10.1097/01.hs9.0000970436.12207.45Test

المؤلفون: Hassoun, Hani, Jacobus, Susanna J, Richardson, Paul G., Zonder, Jeffrey, Voorhees, Peter M., Kaufman, Jonathan L., Yee, Andrew J, Scott, Emma C, Torka, Pallawi, Libby, Edward N., Reeves, Brandi, Wang, Michael L., Anderson, Larry D., Milner, Carter, Gasparetto, Cristina, Agha, Mounzer, Khan, Dr. Abdullah, Hurd, David D, Avigan, David E., Costello, Caitlin, Jakubowiak, Andrzej, Lonial, Sagar, Raje, Noopur S, Medvedova, Eva, McCarthy, Dr. Philip L., Orlowski, Robert Z., Nadeem, Omar, Laubach, Jacob, Pasquini, Marcelo, Giralt, Sergio, Masone, Kelly, Samur, Mehmet, Perrot, Aurore, Moreau, Philippe, Avet-Loiseau, Hervé, Weller, Edie, Munshi, Nikhil C., Anderson, Kenneth C.

المصدر: Transplantation and Cellular Therapy ; volume 29, issue 2, page S396-S397 ; ISSN 2666-6367

مصطلحات موضوعية: Transplantation, Cell Biology, Hematology, Molecular Medicine, Immunology and Allergy

الإتاحة: https://doi.org/10.1016/s2666-6367Test(23)00598-5
https://api.elsevier.com/content/article/PII:S2666636723005985?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2666636723005985?httpAccept=text/plainTest

المؤلفون: Katznelson, Ethan, Jerosch-Herold, Michael, Cuddy, Sarah A. M., Clerc, Olivier F., Benz, Dominik C., Taylor, Alexandra, Rao, Shivani, Kijewski, Marie Foley, Ronglih Liao, Landau, Heather, Yee, Andrew J., Ruberg, Frederick L., Di Carli, Marcelo F., Falk, Rodney H., Kwong, Raymond Y., Dorbala, Sharmila

المصدر: Frontiers in Cardiovascular Medicine; 2024, p1-12, 12p

المؤلفون: Datar, Yesh, Clerc, Olivier F, Cuddy, Sarah A M, Kim, Sirwoo, Taylor, Alexandra, Neri, Jocelyn Canseco, Benz, Dominik C, Bianchi, Giada, Yee, Andrew J, Sanchorawala, Vaishali, Ruberg, Frederick L, Landau, Heather, Liao, Ronglih, Kijewski, Marie Foley, Jerosch-Herold, Michael, Kwong, Raymond Y, Carli, Marcelo F Di, Falk, Rodney H, Dorbala, Sharmila

المصدر: European Heart Journal - Cardiovascular Imaging; May2024, Vol. 25 Issue 5, p687-697, 11p

مصطلحات موضوعية: CARDIAC amyloidosis, IMMUNOGLOBULIN light chains, CARDIOMYOPATHIES, RESEARCH funding, COMPUTED tomography, TREATMENT effectiveness, DESCRIPTIVE statistics, PEPTIDE hormones, MULTIVARIATE analysis, AMYLOIDOSIS, LUNGS, LONGITUDINAL method, RIGHT ventricular dysfunction, EMISSION-computed tomography, RIGHT heart ventricle, ECHOCARDIOGRAPHY, EVALUATION

مستخلص: Aims In systemic light-chain (AL) amyloidosis, quantification of right ventricular (RV) amyloid burden has been limited and the pathogenesis of RV dysfunction is poorly understood. Using ¹⁸F-florbetapir positron emission tomography/computed tomography (PET/CT), we aimed to quantify RV amyloid; correlate RV amyloid with RV structure and function; determine the independent contributions of RV, left ventricular (LV), and lung amyloid to RV function; and associate RV amyloid with major adverse cardiac events (MACE: death, heart failure hospitalization, cardiac transplantation). Methods and results We prospectively enrolled 106 participants with AL amyloidosis (median age 62 years, 55% males) who underwent ¹⁸F-florbetapir PET/CT, magnetic resonance imaging, and echocardiography. ¹⁸F-florbetapir PET/CT identified RV amyloid in 63% of those with and 40% of those without cardiac involvement by conventional criteria. RV amyloid burden correlated with RV ejection fraction (EF), RV free wall longitudinal strain (FWLS), RV wall thickness, RV mass index, N-terminal pro-brain natriuretic peptide, troponin T, LV amyloid, and lung amyloid (each P < 0.001). In multivariable analysis, RV amyloid burden, but not LV or lung amyloid burden, predicted RV dysfunction (EF P = 0.014; FWLS P < 0.001). During a median follow-up of 28 months, RV amyloid burden predicted MACE (P < 0.001). Conclusion This study shows for the first time that ¹⁸F-florbetapir PET/CT identifies early RV amyloid in systemic AL amyloidosis prior to alterations in RV structure and function. Increasing RV amyloid on ¹⁸F-florbetapir PET/CT is associated with worse RV structure and function, predicts RV dysfunction, and predicts MACE. These results imply a central role for RV amyloid in the pathogenesis of RV dysfunction. [ABSTRACT FROM AUTHOR]

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المؤلفون: Vogl, Dan T, Dingli, David, Cornell, Robert Frank, Huff, Carol Ann, Jagannath, Sundar, Bhutani, Divaya, Zonder, Jeffrey, Baz, Rachid, Nooka, Ajay, Richter, Joshua, Cole, Craig, Vij, Ravi, Jakubowiak, Andrzej, Abonour, Rafat, Schiller, Gary, Parker, Terri L, Costa, Luciano J, Kaminetzky, David, Hoffman, James E, Yee, Andrew J, Chari, Ajai, Siegel, David, Fonseca, Rafael, Van Wier, Scott, Ahmann, Gregory, Lopez, Ilsel, Kauffman, Michael, Shacham, Sharon, Saint-Martin, Jean-Richard, Picklesimer, Carla D, Choe-Juliak, Cassandra, Stewart, A Keith

المصدر: Journal of Clinical Oncology. 36(9)

مصطلحات موضوعية: Hematology, Cancer, Clinical Research, Clinical Trials and Supportive Activities, Rare Diseases, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Active Transport, Cell Nucleus, Administration, Oral, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Dexamethasone, Dose-Response Relationship, Drug, Female, Humans, Hydrazines, Karyopherins, Male, Middle Aged, Multiple Myeloma, Progression-Free Survival, Receptors, Cytoplasmic and Nuclear, Triazoles, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis

الوصف: Purpose Selinexor, a first-in-class, oral, selective exportin 1 (XPO1) inhibitor, induces apoptosis in cancer cells through nuclear retention of tumor suppressor proteins and the glucocorticoid receptor, along with inhibition of translation of oncoprotein mRNAs. We studied selinexor in combination with low-dose dexamethasone in patients with multiple myeloma refractory to the most active available agents. Patients and Methods This phase II trial evaluated selinexor 80 mg and dexamethasone 20 mg, both orally and twice weekly, in patients with myeloma refractory to bortezomib, carfilzomib, lenalidomide, and pomalidomide (quad-refractory disease), with a subset also refractory to an anti-CD38 antibody (penta-refractory disease). The primary end point was overall response rate (ORR). Results Of 79 patients, 48 had quad-refractory and 31 had penta-refractory myeloma. Patients had received a median of seven prior regimens. The ORR was 21% and was similar for patients with quad-refractory (21%) and penta-refractory (20%) disease. Among patients with high-risk cytogenetics, including t(4;14), t(14;16), and del(17p), the ORR was 35% (six of 17 patients). The median duration of response was 5 months, and 65% of responding patients were alive at 12 months. The most common grade ≥ 3 adverse events were thrombocytopenia (59%), anemia (28%), neutropenia (23%), hyponatremia (22%), leukopenia (15%), and fatigue (15%). Dose interruptions for adverse events occurred in 41 patients (52%), dose reductions occurred in 29 patients (37%), and treatment discontinuation occurred in 14 patients (18%). Conclusion The combination of selinexor and dexamethasone has an ORR of 21% in patients with heavily pretreated, refractory myeloma with limited therapeutic options.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/198927fqTest

المؤلفون: O'Donnell, Elizabeth, Mo, Clifton, Yee, Andrew J, Nadeem, Omar, Laubach, Jacob, Rosenblatt, Jacalyn, Munshi, Nikhil, Midha, Shonali, Cirstea, Diana, Chrysafi, Pavlina, Horick, Nora, Richardson, Paul G, Raje, Noopur

المصدر: The Lancet Haematology; June 2024, Vol. 11 Issue: 6 pe415-e424, 10p

مستخلص: Isatuximab is a CD38 monoclonal antibody approved for relapsed or refractory multiple myeloma. We aimed to evaluate the addition of isatuximab to weekly carfilzomib (K), lenalidomide (R), and dexamethasone (d; Isa-KRd) in transplant-eligible patients with newly diagnosed multiple myeloma and stratified maintenance by cytogenetic risk.