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23 pages, 4615 KiB  
Article
Mitochondrial Antiviral Signaling Protein Activation by Retinoic Acid-Inducible Gene I Agonist Triggers Potent Antiviral Defense in Umbilical Cord Mesenchymal Stromal Cells Without Compromising Mitochondrial Function
by Sebastián Castillo-Galán, Felipe Grünenwald, Yessia Hidalgo, J César Cárdenas, Maria Ignacia Cadiz, Francisca Alcayaga-Miranda, Maroun Khoury and Jimena Cuenca
Int. J. Mol. Sci. 2025, 26(10), 4686; https://doi.org/10.3390/ijms26104686 - 14 May 2025
Viewed by 756
Abstract
Mesenchymal stromal cells (MSCs) represent a promising therapeutic approach in viral infection management. However, their interaction with viruses remains poorly understood. MSCs can support antiviral immune responses and act as viral reservoirs, potentially compromising their therapeutic potential. Innate immune system recognition of viral [...] Read more.
Mesenchymal stromal cells (MSCs) represent a promising therapeutic approach in viral infection management. However, their interaction with viruses remains poorly understood. MSCs can support antiviral immune responses and act as viral reservoirs, potentially compromising their therapeutic potential. Innate immune system recognition of viral pathogens involves pattern recognition receptors (PRRs), including RIG-I-like receptors (RLRs), which activate mitochondrial antiviral signaling protein (MAVS). MAVS triggers antiviral pathways like IRF3 and NF-κB, leading to interferon (IFN) production and pro-inflammatory responses. This study explores the antiviral response in umbilical cord-derived MSCs (UC-MSCs) through targeted stimulation with influenza A virus-derived 5′triphosphate-RNA (3p-hpRNA), a RIG-I agonist. By investigating MAVS activation, we provide mechanistic insights into the immune response at the molecular level. Our findings reveal that 3p-hpRNA stimulation triggers immune activation of the IRF3 and NF-κB pathways through MAVS. Subsequently, this leads to the induction of type I and III IFNs, IFN-stimulated genes (ISGs), and pro-inflammatory cytokines. Critically, this immune activation occurs without compromising mitochondrial integrity. UC-MSCs retain their capacity for mitochondrial transfer to recipient cells. These results highlight the adaptability of UC-MSCs, offering a nuanced understanding of immune responses balancing activation with metabolic integrity. Finally, our research provides mechanistic evidence for MSC-based interventions against viral infections. Full article
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39 pages, 3256 KiB  
Review
zDHHC-Mediated S-Palmitoylation in Skin Health and Its Targeting as a Treatment Perspective
by Farah A. Abdulrahman, King A. Benford, Gregory T. Lin, Andrew J. Maroun, Caleb Sammons, Darya N. Shirzad, Harrison Tsai, Vincent L. Van Brunt, Zack Jones, Jafet E. Marquez, Evan C. Ratkus, Abdulrahman K. Shehadeh, Hugo Abasto Valle, Dea Fejzo, Ashlynn E. Gilbert, Catherine A. McWee, Lexie F. Underwood, Ethny Indico, Brittany B. Rork and Meera Nanjundan
Int. J. Mol. Sci. 2025, 26(4), 1673; https://doi.org/10.3390/ijms26041673 - 15 Feb 2025
Viewed by 2694
Abstract
S-acylation, which includes S-palmitoylation, is the only known reversible lipid-based post-translational protein modification. S-palmitoylation is mediated by palmitoyl acyltransferases (PATs), a family of 23 enzymes commonly referred to as zDHHCs, which catalyze the addition of palmitate to cysteine residues on specific target proteins. [...] Read more.
S-acylation, which includes S-palmitoylation, is the only known reversible lipid-based post-translational protein modification. S-palmitoylation is mediated by palmitoyl acyltransferases (PATs), a family of 23 enzymes commonly referred to as zDHHCs, which catalyze the addition of palmitate to cysteine residues on specific target proteins. Aberrant S-palmitoylation events have been linked to the pathogenesis of multiple human diseases. While there have been advances in elucidating the molecular mechanisms underlying the pathogenesis of various skin conditions, there remain gaps in the knowledge, specifically with respect to the contribution of S-palmitoylation to the maintenance of skin barrier function. Towards this goal, we performed PubMed literature searches relevant to S-palmitoylation in skin to define current knowledge and areas that may benefit from further research studies. Furthermore, to identify alterations in gene products that are S-palmitoylated, we utilized bioinformatic tools such as SwissPalm and analyzed relevant data from publicly available databases such as cBioportal. Since the targeting of S-palmitoylated targets may offer an innovative treatment perspective, we surveyed small molecules inhibiting zDHHCs, including 2-bromopalmitate (2-BP) which is associated with off-target effects, and other targeting strategies. Collectively, our work aims to advance both basic and clinical research on skin barrier function with a focus on zDHHCs and relevant protein targets that may contribute to the pathogenesis of skin conditions such as atopic dermatitis, psoriasis, and skin cancers including melanoma. Full article
(This article belongs to the Special Issue Dermatology: Advances in Pathophysiology and Therapies (2nd Edition))
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15 pages, 5403 KiB  
Article
Optimization of Polyphenols’ Recovery from Purple Corn Cobs Assisted by Infrared Technology and Use of Extracted Anthocyanins as a Natural Colorant in Pickled Turnip
by Francisco J. Barba, Hiba N. Rajha, Espérance Debs, Anna-Maria Abi-Khattar, Stéphanie Khabbaz, Basharat Nabi Dar, Mario J. Simirgiotis, Juan Manuel Castagnini, Richard G. Maroun and Nicolas Louka
Molecules 2022, 27(16), 5222; https://doi.org/10.3390/molecules27165222 - 16 Aug 2022
Cited by 25 | Viewed by 3487
Abstract
An ecofriendly extraction technology using infrared (IR) irradiation Ired-Irrad® was applied to purple corn cobs to enhance polyphenol recovery for the first time. The IR extraction efficiency was compared to that of the water bath (WB) method. Response surface methodology (RSM) using [...] Read more.
An ecofriendly extraction technology using infrared (IR) irradiation Ired-Irrad® was applied to purple corn cobs to enhance polyphenol recovery for the first time. The IR extraction efficiency was compared to that of the water bath (WB) method. Response surface methodology (RSM) using a central composite design was conducted to determine the effect of the experimental conditions (extraction time and treatment temperature) and their interactions on the total polyphenol and anthocyanin yields. Optimal extraction of total phenolic compounds (37 mg GAE/g DM) and total monomeric anthocyanins (14 mg C3G/g DM) were obtained at 63 °C for 77 min using IR as an extraction technique and water as a solvent. HPLC revealed that the recovery of peonidin 3-O-glucoside and cyanidin 3-O-glucoside was enhanced by 26% and 34%, respectively, when using IR. Finally, purple corn cobs’ spray-dried extract was proven to be an important natural colorant of pickled turnip. It offers great potential for use as a healthy alternative to the carcinogenic rhodamine B synthetic dye, which was banned. Full article
(This article belongs to the Special Issue Advances in Natural Products and Their Biological Activities)
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10 pages, 743 KiB  
Article
Risk of Iodine Deficiency in Extremely Low Gestational Age Newborns on Parenteral Nutrition
by Neelakanta Kanike, Sharon Groh-Wargo, Megan Thomas, Edward K. Chien, Maroun Mhanna, Deepak Kumar, Sarah Worley, Ravinder J. Singh and Prem S. Shekhawat
Nutrients 2020, 12(6), 1636; https://doi.org/10.3390/nu12061636 - 1 Jun 2020
Cited by 9 | Viewed by 4128
Abstract
Iodine is an essential component of thyroid hormones, which play a critical role in neurodevelopment. The iodine status of pregnant women and their newborns is not checked routinely. Extremely Low Gestational Age Newborns do not receive Iodine supplementation while on parenteral nutrition (PN). [...] Read more.
Iodine is an essential component of thyroid hormones, which play a critical role in neurodevelopment. The iodine status of pregnant women and their newborns is not checked routinely. Extremely Low Gestational Age Newborns do not receive Iodine supplementation while on parenteral nutrition (PN). We measured urine iodine levels and thyroid function tests in 50 mother–infant dyads at birth, at 1 week, 1, 2, 3 months and near discharge. We correlated maternal and neonatal urine iodine levels with thyroid functions and measured iodine levels in milk and PN. In our study, 64% of mothers were iodine deficient at the time of delivery, their free T4 levels were 0.48 (0.41–0.54) ng/dL with normal thyroid-stimulating hormone (TSH). Iodine levels were thirty-fold higher in extremely low gestational age newborns (ELGAN) exposed to iodine comparing to full terms (p < 0.001), but this effect lasted <1 week. At 1 month of age, ELGAN on PN developed iodine deficiency (p = 0.017) and had high thyroglobulin levels of 187 (156–271) ng/mL. Iodine levels improved with enteral feeds by 2 months of age (p = 0.01). Iodine deficiency is prevalent among pregnant women and ELGAN; in particular, those on PN are at risk of hypothyroidism. Iodine supplementation during pregnancy and postnatally should be considered to avoid iodine deficiency. Full article
(This article belongs to the Section Nutrition and Metabolism)
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11 pages, 896 KiB  
Article
Breakthrough Bloodstream Infections Caused by Echinocandin-Resistant Candida tropicalis: An Emerging Threat to Immunocompromised Patients with Hematological Malignancies
by Maroun M. Sfeir, Cristina Jiménez-Ortigosa, Maria N. Gamaletsou, Audrey N. Schuetz, Rosemary Soave, Koen Van Besien, Catherine B. Small, David S. Perlin and Thomas J. Walsh
J. Fungi 2020, 6(1), 20; https://doi.org/10.3390/jof6010020 - 31 Jan 2020
Cited by 14 | Viewed by 3779
Abstract
Background. Candida tropicalis is a virulent fungal pathogen for which echinocandins are the primary therapy. Emergence of resistance to echinocandins of C. tropicalis carries potentially ominous therapeutic implications. Methods. We describe herein two patients with breakthrough C. tropicalis fungemia during echinocandin therapy, characterize [...] Read more.
Background. Candida tropicalis is a virulent fungal pathogen for which echinocandins are the primary therapy. Emergence of resistance to echinocandins of C. tropicalis carries potentially ominous therapeutic implications. Methods. We describe herein two patients with breakthrough C. tropicalis fungemia during echinocandin therapy, characterize their molecular mechanism of resistance, and systematically review 13 previously reported cases of echinocandin-resistant C. tropicalis bloodstream infections (BSIs) and other diseases. Results. Among these 15 patients with echinocandin-resistant C. tropicalis infections, the median age was 61 years (ages 28–84 years) and 13 (86%) were immunocompromised. Thirteen (86%) of all patients had a history of pervious or concurrent exposure to echinocandins. Isolates of C. tropicalis from 11 cases, including the two index cases, underwent DNA sequencing of the FKS1 gene for mutations known to confer echinocandin resistance. The amino acid substitution Ser654Pro was shown in four cases, while other FKS1 mutations encoded Ser80S/Pro, Phe641Leu, Phe641Ser, Ser80S/Pro substitutions. These mutational events were not associated with collateral increases in minimum inhibitory concentrations to antifungal triazoles and amphotericin B. Overall mortality in patients with echinocandin-resistant C. tropicalis infections was 40%. Among those six patients who died, two received monotherapy with voriconazole, one was treated with fluconazole, one remained on caspofungin, and two were switched to liposomal amphotericin B. Nine patients (60%) survived after being treated with an antifungal agent other than an echinocandin. Conclusions. Emergence of resistance to echinocandins by C. tropicalis, occurs during antifungal therapy, is associated with high mortality, is mediated by a diverse range of FKS1 mutations, retains in vitro susceptibility to triazoles and amphotericin B, and constitutes an emerging threat to patients with hematological malignancies. Full article
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7 pages, 312 KiB  
Article
A Retrospective Observational Study to Estimate the Attrition of Patients across Lines of Systemic Treatment for Metastatic Colorectal Cancer in Canada
by Hagen Kennecke, S. Berry, J. Maroun, P. Kavan, N. Aucoin, F. Couture, M. Poulin-Costello and B. Gillesby
Curr. Oncol. 2019, 26(6), 748-754; https://doi.org/10.3747/co.26.4861 - 1 Dec 2019
Cited by 17 | Viewed by 1330
Abstract
Background: Selection and sequencing of treatment regimens for individual patients with metastatic colorectal cancer (mcrc) is driven by maintaining reasonable quality of life and extending survival, as well as by access to and cost of therapies. The objectives of the [...] Read more.
Background: Selection and sequencing of treatment regimens for individual patients with metastatic colorectal cancer (mcrc) is driven by maintaining reasonable quality of life and extending survival, as well as by access to and cost of therapies. The objectives of the present study were to describe, for patients with mcrc, attrition across lines of systemic therapy, patterns of therapy and their timing, and KRAS status. Methods: A retrospective chart review at 6 Canadian academic centres included sequential patients who were diagnosed with mcrc from 1 January 2009 onward and who initiated first-line systemic treatment for mcrc between 1 January and 31 December 2009. Death was included as a competing risk in the analysis. Results: The analysis included 200 patients who started first-line therapy. The proportions of patients who started second-, third-, and fourth-line systemic therapy were 70%, 30%, and 15% respectively. Chemotherapy plus bevacizumab was the most common first-line combination (66%). The most common first-line regimen was folfiri plus bevacizumab. KRAS testing was performed in 103 patients (52%), and 38 of 68 patients (56%, 19% overall) with confirmed KRAS wild-type tumours received an epidermal growth factor receptor inhibitor (egfri), which was more common in later lines. Most KRAS testing occurred after initiation of second-line therapy. Conclusions: In the modern treatment era, a high proportion of patients receive at least two lines of therapy for mcrc, but only 19% receive egfri therapy. Earlier KRAS testing and therapy with an egfri might allow a greater proportion of patients to access all 5 active treatment agents. Full article
1 pages, 65 KiB  
Correction
Corrigendum: Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014
by E. Tsvetkova, S. Sud, N. Aucoin, J. Biagi, R. Burkes, B. Samson, S. Brule, C. Cripps, B. Colwell, C. Falkson, M. Dorreen, R. Goel, F. Halwani, C. Marginean, J. Maroun, N. Michaud, M. Tehfe, M. Thirlwell, M. Vickers and T. Asmis
Curr. Oncol. 2016, 23(4), 435; https://doi.org/10.3747/co.23.3283 - 1 Aug 2016
Viewed by 747
Abstract
It came to our attention that, over the course of putting together this article[...] Full article
4 pages, 174 KiB  
Article
Eastern Canadian Colorectal Cancer Consensus Conference 2013: Emerging Therapies in the Treatment of Pancreatic, Rectal, and Colorectal Cancers
by T. Di Valentin, T. Asmis, J. Asselah, F. Aubin, N. Aucoin, S. Berry, J. Biagi, C.M. Booth, R. Burkes, N. Coburn, B. Colwell, C. Cripps, L.A. Dawson, M. Dorreen, D. Frechette, R. Goel, S. Gray, N. Hammad, D. Jonker, P. Kavan, J. Maroun, S. Nanji, D. Roberge, B. Samson, M. Seal, W. Shabana, M. Simunovic, S. Snow, M. Tehfe, M. Thirlwell, E. Tsvetkova, M. Vickers, T. Vuong and R. Goodwinadd Show full author list remove Hide full author list
Curr. Oncol. 2016, 23(1), 52-55; https://doi.org/10.3747/co.23.2897 - 1 Feb 2016
Cited by 2 | Viewed by 805
Abstract
The annual Eastern Canadian Colorectal Cancer Consensus Conference held in Montreal, Quebec, 17–19 October 2013, marked the 10-year anniversary of this meeting that is attended by leaders in medical, radiation, and surgical oncology. The goal of the attendees is to improve the care [...] Read more.
The annual Eastern Canadian Colorectal Cancer Consensus Conference held in Montreal, Quebec, 17–19 October 2013, marked the 10-year anniversary of this meeting that is attended by leaders in medical, radiation, and surgical oncology. The goal of the attendees is to improve the care of patients affected by gastrointestinal malignancies. Topics discussed during the conference included pancreatic cancer, rectal cancer, and metastatic colorectal cancer. Full article
11 pages, 293 KiB  
Article
Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014
by E. Tsvetkova, S. Sud, N. Aucoin, J. Biagi, R. Burkes, B. Samson, S. Brule, C. Cripps, B. Colwell, C. Falkson, M. Dorreen, R. Goel, F. Halwani, J. Maroun, N. Michaud, M. Tehfe, M. Thirlwell, M. Vickers and T. Asmis
Curr. Oncol. 2015, 22(4), 305-315; https://doi.org/10.3747/co.22.2603 - 1 Aug 2015
Cited by 1 | Viewed by 983
Abstract
The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Montreal, Quebec, 23–25 October 2014. Expert radiation, medical, and surgical oncologists and pathologists involved in the management of patients with gastrointestinal malignancies participated in presentations and discussions resulting in consensus statements on [...] Read more.
The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Montreal, Quebec, 23–25 October 2014. Expert radiation, medical, and surgical oncologists and pathologists involved in the management of patients with gastrointestinal malignancies participated in presentations and discussions resulting in consensus statements on such hot topics as management of neuroendocrine tumours, advanced and metastatic pancreatic cancer, and metastatic colorectal cancer. Full article
10 pages, 514 KiB  
Review
Eastern Canadian Colorectal Cancer Consensus Conference: Standards of Care for the Treatment of Patients with Rectal, Pancreatic, and Gastrointestinal Stromal Tumours and Pancreatic Neuroendocrine Tumours
by T. Di Valentin, J. Biagi, S. Bourque, R. Butt, P. Champion, V. Chaput, B. Colwell, C. Cripps, M. Dorreen, S. Edwards, C. Falkson, D. Frechette, S. Gill, R. Goel, D. Grant, N. Hammad, A. Jeyakumar, M. L’Espérance, C. Marginean, J. Maroun, M. Nantais, N. Perrin, C. Quinton, M. Rother, B. Samson, J. Siddiqui, S. Singh, S. Snow, E. St-Hilaire, M. Tehfe, M. Thirlwell, S. Welch, L. Williams, F. Wright and R. Goodwinadd Show full author list remove Hide full author list
Curr. Oncol. 2013, 20(5), 455-464; https://doi.org/10.3747/co.20.1638 - 1 Oct 2013
Cited by 5 | Viewed by 908
Abstract
The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Halifax, Nova Scotia, October 20–22, 2011. Health care professionals involved in the care of patients with colorectal cancer participated in presentation and discussion sessions for the purposes of developing the recommendations presented [...] Read more.
The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Halifax, Nova Scotia, October 20–22, 2011. Health care professionals involved in the care of patients with colorectal cancer participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management of rectal cancer, including pathology reporting, neoadjuvant systemic and radiation therapy, surgical techniques, and palliative care of rectal cancer patients. Other topics discussed include multidisciplinary cancer conferences, treatment of gastrointestinal stromal tumours and pancreatic neuroendocrine tumours, the use of folfirinox in pancreatic cancer, and treatment of stage ii colon cancer. Full article
6 pages, 389 KiB  
Article
Eastern Canadian Colorectal Cancer Consensus Conference: Application of New Modalities of Staging and Treatment of Gastrointestinal Cancers
by T. Di Valentin, Y. Alam, A. Ali Alsharm, S. Arif, F. Aubin, J. Biagi, C.M. Booth, S. Bourque, R. Burkes, P. Champion, B. Colwell, C. Cripps, M. Dallaire, M. Dorreen, N. Finn, D. Frechette, S. Gallinger, J. Gapski, C. Giacomantonio, S. Gill, R. Goel, R. Goodwin, L. Grimard, A. Grothey, N. Hammad, D. Hedley, K. Jhaveri, D. Jonker, Y. Ko, M. L’Espérance, J. Maroun, H. Ostic, N. Perrin, M. Rother, E. St-Hilaire, M. Tehfe, M. Thirlwell, S. Welch, N. Yarom and T. Asmisadd Show full author list remove Hide full author list
Curr. Oncol. 2012, 19(3), 169-174; https://doi.org/10.3747/co.19.931 - 1 Jun 2012
Cited by 4 | Viewed by 960
Abstract
The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Ottawa, Ontario, October 22–23, 2010. Health care professionals involved in the care of patients with colorectal cancer participated in presentation and discussion sessions for the purpose of developing the recommendations presented here. [...] Read more.
The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Ottawa, Ontario, October 22–23, 2010. Health care professionals involved in the care of patients with colorectal cancer participated in presentation and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancer, such as the use of epidermal growth factor inhibitors in metastatic colon cancer, the benefit of calcium and magnesium with oxaliplatin chemotherapy, the role of microsatellites in treatment decisions for stage ii colon cancer, the staging and treatment of rectal cancer, and the management of colorectal and metastatic pancreatic cancers. Full article
288 KiB  
Erratum
Corrigendum: Progression-Free Survival in Advanced Ovarian Cancer: A Canadian Review and Expert Panel Perspective
by A. M. Oza, V. Castonguay, D. Tsoref, I. Diaz-Padilla, K. Karakasis, H. Mackay, S. Welch, J. Weberpals, P. Hoskins, M. Plante, D. Provencher, K. Tonkin, A. Covens, P. Ghatage, J. Gregoire, H. Hirte, D. Miller, B. Rosen, J. Bentley, J. Maroun, M. Buysse, C. Coens, M. F. Brady and G. C. E. Stuartadd Show full author list remove Hide full author list
Curr. Oncol. 2011, 18(6), 303; https://doi.org/10.3747/co.v18i6.998 - 1 Dec 2011
Cited by 2 | Viewed by 89
Abstract
AMO has participated on advisory boards for AstraZeneca, Celgene Corporation, and Sanofi–Aventis [...] Full article
1 pages, 288 KiB  
Correction
Corrigendum: Progression-Free Survival in Advanced Ovarian Cancer: A Canadian Review and Expert Panel Perspective
by A.M. Oza, V. Castonguay, D. Tsoref, I. Diaz–Padilla, K. Karakasis, H. Mackay, S. Welch, J. Weberpals, P. Hoskins, M. Plante, D. Provencher, K. Tonkin, A. Covens, P. Ghatage, J. Gregoire, H. Hirte, D. Miller, B. Rosen, J. Bentley, J. Maroun, M. Buyse, C. Coens, M.F. Brady and G.C.E. Stuartadd Show full author list remove Hide full author list
Curr. Oncol. 2011, 18(6), 303; https://doi.org/10.3747/co.v18is2.939 - 1 Dec 2011
Cited by 30 | Viewed by 1653
Abstract
In recent years, significant advances have been made in the management of metastatic colorectal cancer. Traditionally, an improvement in overall survival has been considered the “gold standard”—the most convincing measure of efficacy. However, overall survival requires larger patient numbers and longer follow-up and [...] Read more.
In recent years, significant advances have been made in the management of metastatic colorectal cancer. Traditionally, an improvement in overall survival has been considered the “gold standard”—the most convincing measure of efficacy. However, overall survival requires larger patient numbers and longer follow-up and may often be confounded by other factors, including subsequent therapies and crossover. Given the number of active therapies for potential investigation, demand for rapid evaluation and early availability of new therapies is growing. Progression-free survival is regarded as an important measure of treatment benefit and, compared with overall survival, can be evaluated earlier, with fewer patients and no confounding by subsequent lines of therapy. The present paper reviews the advantages, limitations, and relevance of progression-free survival as a primary endpoint in randomized trials of metastatic colorectal cancer. Full article
388 KiB  
Proceeding Paper
Progression-Free Survival in Advanced Ovarian Cancer: A Canadian Review and Expert Panel Perspective
by A. M. Oza, V. Castonguay, D. Tsoref, I. Diaz–Padilla, K. Karakasis, H. Mackay, S. Welch, J. Weberpals, P, Hoskins, M. Plante, D. Provencher, K, Tonkin, A. Covens, P. Ghatage, J. Gregoire, H. Hirte, D. Miller, B. Rosen, J. Maroun, M. Buyse, C. Coens, M. F. Brady and G. C. E. Stuartadd Show full author list remove Hide full author list
Curr. Oncol. 2011, 18(s2), 20-27; https://doi.org/10.3747/co.v18i0.939 - 1 Oct 2011
Cited by 14 | Viewed by 188
Abstract
Ovarian cancer is leading cause of gynecologic cancer mortality in Canada. To date, overall survival (os) has been the most-used endpoint in oncology trials because of its relevance and objectivity. However, as a result of various factors, including the pattern of sequential salvage [...] Read more.
Ovarian cancer is leading cause of gynecologic cancer mortality in Canada. To date, overall survival (os) has been the most-used endpoint in oncology trials because of its relevance and objectivity. However, as a result of various factors, including the pattern of sequential salvage therapies, measurement of os and collection of os data are becoming particularly challenging. Phase ii and iii trials have therefore adopted progression-free survival (pfs) as a more convenient surrogate endpoint; however, the clinical significance of pfs remains unclear. This position paper presents discussion topics and findings from a pan-Canadian meeting of experts that set out to 1. evaluate the relevance of pfs as a valid endpoint in ovarian cancer; 2. reach a Canadian consensus on the relevance of pfs in ovarian cancer; and 3. try to address how pfs translates into clinical benefit in ovarian cancer. Overall, the findings and the group consensus posit that future studies should 1. ensure that trials are designed to evaluate pfs, os, and other clinically relevant endpoints such as disease-related symptoms or quality of life; 2. incorporate interim futility analyses intended to stop accrual early when the experimental regimen is not active; 3. stop trials early to declare superiority only when compelling evidence suggests that a new treatment provides benefit for a pre-specified, clinically relevant endpoint such as os or symptom relief; and 4. discourage early release of secondary endpoint results when such a release might increase the frequency of crossover to the experimental intervention. Full article
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