350 results on '"Robert G. Uzzo"'
Search Results
2. Human Gut Mycobiome and Fungal Community Interaction: The Unknown Musketeer in the Chemotherapy Response Status in Bladder Cancer
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Laura Bukavina, Megan Prunty, Ilaha Isali, Adam Calaway, Rashida Ginwala, Mohit Sindhani, Mahmoud Ghannoum, Kirtishri Mishra, Alexander Kutikov, Robert G. Uzzo, Lee E. Ponsky, and Philip H. Abbosh
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Mycobiome ,Bladder cancer ,Urothelial cancer ,Microbiome ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Until recently, the properties of microbiome and mycobiome in humans and its relevance to disease have largely been unexplored. While the interest of microbiome and malignancy over the past few years have burgeoned with advent of new technologies, no research describing the composition of mycobiome in bladder cancer has been done. Deciphering of the metagenome and its aggregate genetic information can be used to understand the functional properties and relationships between the bacteria, fungi, and cancer. Objective: The aim of this project is to characterize the compositional range of the normal versus bladder cancer mycobiome of the gut. Design, setting, and participants: An internal transcribed spacer (ITS) survey of 52 fecal samples was performed to evaluate the gut mycobiome differences between noncancer controls and bladder cancer patients. Outcome measurements and statistical analysis: Our study evaluated the differences in mycobiome among patients with bladder cancer, versus matched controls. Our secondary analysis evaluated compositional differences in the gut as a function of response status with neoadjuvant chemotherapy. Data demultiplexing and classification were performed using the QIIME v.1.1.1.1 platform. The Ion Torrent–generated fungal ITS sequence data were processed using QIIME (v.1.9.1), and the reads were demultiplexed, quality filtered, and clustered into operation taxonomic units using default parameters. Alpha and beta diversity were computed and plotted in Phyloseq, principal coordinate analysis was performed on Bray-Curtis dissimilarity indices, and a one-way permutational multivariate analysis of variance was used to test for significant differences between cohorts. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) was applied to infer functional categories associated with taxonomic composition. Results and limitations: We found distinctive mycobiome differences between control group (n = 32) and bladder cancer (n = 29) gut flora, and identified an increasing abundance of Tremellales, Hypocreales, and Dothideales. Significant differences in alpha and beta diversity were present between the groups (control vs bladder; p = 0.002), noting distinct compositions within each cohort. A subgroup analysis by sex and neoadjuvant chemotherapy status did not show any further differences in mycobiome composition and diversity. Our results indicate that the gut mycobiome may modulate tumor response to preoperative chemotherapy in bladder cancer patients. We propose that patients with a “favorable” mycobiome composition (eg, high diversity, and low abundance of Agaricomycetes and Saccharomycetes) may have enhanced systemic immune response to chemotherapy through antigen presentation. Conclusions: Our study is the first to characterize the enteric mycobiome in patients with bladder cancer and describe complex ecological network alterations, indicating complex bacteria-fungi interactions, particularly highlighted among patients with complete neoadjuvant chemotherapy response. Patient summary: Our study has demonstrated that the composition of stool mycobiome (fungal inhabitants of the gastrointestinal tract) in patients with bladder cancer is different from that in noncancer individuals. Furthermore, when evaluating how patients respond to chemotherapy given prior to their surgery, our study noted significant differences between patients who responded and those who did not.
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- 2022
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3. PBRM1 acts as a p53 lysine-acetylation reader to suppress renal tumor growth
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Weijia Cai, Liya Su, Lili Liao, Zongzhi Z. Liu, Lauren Langbein, Essel Dulaimi, Joseph R. Testa, Robert G. Uzzo, Zhijiu Zhong, Wei Jiang, Qin Yan, Qing Zhang, and Haifeng Yang
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Science - Abstract
Acetylation of p53 is critical for its transcriptional activity and its tumour suppressive function. Here, the authors show that PBRM1 is a reader protein for p53′s C-terminal domain acetylation on lysine 382 through its bromodomain 4 and that mutations in this domain leads to compromised tumour suppressive function and renal tumour growth.
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- 2019
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4. Combination of serum histidine and plasma tryptophan as a potential biomarker to detect clear cell renal cell carcinoma
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Hyung-Ok Lee, Robert G. Uzzo, Debra Kister, and Warren D. Kruger
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Kidney cancer ,Biomarker ,Serum ,Plasma ,Amino acids ,Medicine - Abstract
Abstract Background In previous work, we showed that serum-free amino acid (SFAA) profiles were different between kidney cancer patients and age and sex matched controls. The goals of the current study are to: (1) confirm our initial observation on an independent sample set; (2) examine if there were similar differences in plasma-free amino acids (PFAA); and (3) determine if removal of tumors changed SFAA and PFAA profiles. Methods SFAA and PFAA profiles were measured in 484 samples taken from 124 healthy controls and 56 clear cell renal cell carcinoma (ccRCC) patients both before and after resection of renal tumors. Results SFAA and PFAA profiles taken from identical blood samples were remarkably different, with the mean individual amino acid concentrations being 40% less in plasma compared to serum. Both SFAA and PFAA profiles differed significantly between ccRCC patients and controls, but the individual amino acids that differed the most, and the direction of the changes, were quite different between the two blood components. Removal of the tumor had almost no effect on either the SFAA or PFAA profiles. A logistic regression model using serum histidine and plasma tryptophan correctly classified 85.5% of control and 84.7% of case samples. Conclusions Our findings show that that tumor mass is not directly linked to alterations in blood amino acid levels, and that a combination of serum histidine and plasma tryptophan may be useful as a biomarker to detect ccRCC.
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- 2017
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5. Biology is Destiny: A Case of Adrenocortical Carcinoma Diagnosed and Resected at Inception in a Patient Under Close Surveillance for Lung Cancer
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Benjamin Miron, Benjamin T. Ristau, Jeffrey J. Tomaszewski, Josh Jones, Bart Milestone, Yu-Ning Wong, Robert G. Uzzo, Donna Edmondson, Walter Scott, and Alexander Kutikov
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Adrenocortical carcinoma ,Adrenal cancer ,Incidental adrenal mass ,Incidentaloma ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Adrenocortical carcinoma (ACC) is a rare malignancy that is generally associated with a poor prognosis whose existence dictates the management of incidental renal masses. We report a case of ACC diagnosed and treated at its apparent inception in a patient undergoing close surveillance imaging of a prior malignancy. Despite timely detection and resection of a localized ACC this patient rapidly progressed to systemic disease. This case highlights the rapid growth kinetics of ACC and puts into perspective the challenges associated with the established treatment paradigm for patients diagnosed with an adrenal mass.
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- 2016
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6. The correlation between gain of chromosome 8q and survival in patients with clear and papillary renal cell carcinoma
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Reza Mehrazin, Essel Dulaimi, Robert G. Uzzo, Karthik Devarjan, Jianming Pei, Marc C. Smaldone, Alexander Kutikov, Joseph R. Testa, and Tahseen Al-Saleem
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background: The proto-oncogene c-MYC , located on chromosome 8q, can be upregulated through gain of 8q, causing alteration in biology of renal cell carcinoma (RCC). The aim of this study was to evaluate the prevalence of c-MYC through chromosome 8q gain and to correlate findings with cancer-specific mortality (CSM), and overall survival (OS). Methods: Cytogenetic analysis by conventional or Chromosomal Genomic Microarray Analysis (CMA) was performed on 414 renal tumors. Nonclear and nonpapillary RCC were excluded. Impact of gain in chromosome 8q status on CSM, OS, and its correlation with clinicopathological variables were evaluated. CSM and OS were assessed using log-rank test and the Cox proportional hazards model. Results: A total of 297 RCC tumors with cytogenetic analysis were included. Gain of 8q was detected in 18 (6.1%) tumors (9 clear cell and 9 papillary RCC), using conventional method ( n = 11) or CMA ( n = 7). Gain of 8q was associated with higher T stage ( p < 0.001), grade ( p < 0.001), nodal involvement ( p = 0.005), and distant metastasis ( p < 0.001). No association between gain of 8q and age ( p = 0.23), sex ( p = 0.46), and Charlson comorbidity index (CCI, p = 0.59) were seen. Gain of 8q was associated with an 8.38-fold [95% confidence interval (CI), 3.83–18.34, p < 0.001] and 3.31-fold (95% CI, 1.56–7.04, p = 0.001) increase in CSM and decrease in OS, respectively, at a median follow up of 56 months. Conclusion: Chromosome 8q harbors the proto-oncogene c-MYC , which can be upregulated by gain of 8q. Our findings suggest that gain of 8q, can predict aggressive tumor phenotype and inferior survival in RCC.
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- 2018
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7. Heterogeneity and renal mass biopsy: a review of its role and reliability
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Jeffrey J. Tomaszewski, Robert G. Uzzo, and Marc C. Smaldone
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Renal cell carcinoma (RCC) ,renal mass biopsy (RMB) ,tumor heterogeneity ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Increased abdominal imaging has led to an increase in the detection of the incidental small renal mass (SRM). With increasing recognition that the malignant potential of SRMs is heterogeneous, ranging from benign (15%-20%) to aggressive (20%), enthusiasm for more conservative management strategies in the elderly and infirmed, such as active surveillance (AS), have grown considerably. As the management of the SRM evolves to incorporate ablative techniques and AS for low risk disease, the role of renal mass biopsy (RMB) to help guide individualized therapy is evolving. Historically, the role of RMB was limited to the evaluation of suspected metastatic disease, renal abscess, or lymphoma. However, in the contemporary era, the role of biopsy has grown, most notably to identify patients who harbor benign lesions and for whom treatment, particularly the elderly or frail, may be avoided. When performing a RMB to guide initial clinical decision making for small, localized tumors, the most relevant questions are often relegated to proof of malignancy and documentation (if possible) of grade. However, significant intratumoral heterogeneity has been identified in clear cell renal cell carcinoma (ccRCC) that may lead to an underestimation of the genetic complexity of a tumor when single-biopsy procedures are used. Heterogeneous genomic landscapes and branched parallel evolution of ccRCCs with spatially separated subclones creates an illusion of clonal dominance when assessed by single biopsies and raises important questions regarding how tumors can be optimally sampled and whether future evolutionary tumor branches might be predictable and ultimately targetable. This work raises profound questions concerning the genetic landscape of cancer and how tumor heterogeneity may affect, and possibly confound, targeted diagnostic and therapeutic interventions. In this review, we discuss the current role of RMB, the implications of tumor heterogeneity on diagnostic accuracy, and highlight promising future directions.
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- 2014
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8. Computer-Generated R.E.N.A.L. Nephrometry Scores Yield Comparable Predictive Results to Those of Human-Expert Scores in Predicting Oncologic and Perioperative Outcomes
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Nicholas Heller, Resha Tejpaul, Fabian Isensee, Tarik Benidir, Martin Hofmann, P. Blake, Zachary Rengal, Keenan Moore, Niranjan Sathianathen, Arveen Adith Kalapara, J. Rosenberg, Sarah Chan, Edward Walczak, Alexander Kutikov, Robert G. Uzzo, Diego Aguilar Palacios, Erick M. Remer, Steven C. Campbell, Nikolaos Papanikolopoulos, and Christopher J. Weight
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Necrosis ,Artificial Intelligence ,Computers ,Urology ,Humans ,Female ,Middle Aged ,Nephrectomy ,Article ,Kidney Neoplasms ,Retrospective Studies - Abstract
We sought to automate R.E.N.A.L. (for radius, exophytic/endophytic, nearness of tumor to collecting system, anterior/posterior, location relative to polar line) nephrometry scoring of preoperative computerized tomography scans and create an artificial intelligence-generated score (AI-score). Subsequently, we aimed to evaluate its ability to predict meaningful oncologic and perioperative outcomes as compared to expert human-generated nephrometry scores (H-scores).A total of 300 patients with preoperative computerized tomography were identified from a cohort of 544 consecutive patients undergoing surgical extirpation for suspected renal cancer at a single institution. A deep neural network approach was used to automatically segment kidneys and tumors, and geometric algorithms were developed to estimate components of R.E.N.A.L. nephrometry score. Tumors were independently scored by medical personnel blinded to AI-scores. AI- and H-score agreement was assessed using Lin's concordance correlation and their predictive abilities for both oncologic and perioperative outcomes were assessed using areas under the curve.Median age was 60 years (IQE 51-68), and 40% were female. Median tumor size was 4.2 cm and 91.3% had malignant tumors, including 27%, 37% and 24% with high stage, grade and necrosis, respectively. There was significant agreement between H-scores and AI-scores (Lin's ⍴=0.59). Both AI- and H-scores similarly predicted meaningful oncologic outcomes (p0.001) including presence of malignancy, necrosis, and high-grade and -stage disease (p0.003). They also predicted surgical approach (p0.004) and specific perioperative outcomes (p0.05).Fully automated AI-generated R.E.N.A.L. scores are comparable to human-generated R.E.N.A.L. scores and predict a wide variety of meaningful patient-centered outcomes. This unambiguous artificial intelligence-based scoring is intended to facilitate wider adoption of the R.E.N.A.L. score.
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- 2023
9. The Role of Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma: A Real-World Multi-Institutional Analysis
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Pooja Ghatalia, Elizabeth A. Handorf, Daniel M. Geynisman, Mengying Deng, Matthew R. Zibelman, Philip Abbosh, Fern Anari, Richard E. Greenberg, Rosalia Viterbo, David Chen, Marc C. Smaldone, Alexander Kutikov, and Robert G. Uzzo
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Urology ,Humans ,Cytoreduction Surgical Procedures ,Carcinoma, Renal Cell ,Nephrectomy ,Kidney Neoplasms ,Article ,Retrospective Studies - Abstract
The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) was challenged by the results of the CARMENA trial. Here we evaluate the role of CN in mRCC patients, including those receiving modern therapies.We included patients with synchronous mRCC between 2011-2020 from the de-identified nationwide Flatiron Health database. We evaluated 3 groups: systemic therapy alone, CN followed by systemic therapy (up-front CN [uCN]) and systemic therapy followed by CN (deferred CN [dCN]). The primary outcome was median overall survival (mOS) in patients receiving systemic therapy alone vs uCN. Secondary outcome was overall survival in patients receiving uCN vs dCN. First-treatment, landmark and time-varying covariate analyses were conducted to overcome immortal time bias. Weighted Kaplan-Meier curves, log-rank tests and Cox proportional hazards regressions were used to assess the effect of therapy on survival.Of 1,910 patients with mRCC, 972 (57%) received systemic therapy, 605 (32%) received uCN, 142 (8%) dCN and 191 (10%) CN alone; 433 (23%) patients received immunotherapy-based therapy. The adjusted mOS was significantly improved in first-treatment, landmark and time-varying covariate analysis (mOS 26.6 vs 14.6 months, 36.3 vs 21.1 months and 26.1 vs 12.2 months, respectively) in patients undergoing CN. Among patients receiving CN and systemic therapy, the timing of systemic therapy relative to CN was not significantly related to overall survival (HR=1.0, 95% CI 0.76-1.32, p=0.99).Our findings support an oncologic role for CN in select mRCC patients. In patients receiving both CN and systemic therapy, the survival benefit compared to systemic alone was similar for up-front and deferred CN.
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- 2022
10. Supplementary Figure 1 from PD-1 Expression on Peripheral Blood Cells Increases with Stage in Renal Cell Carcinoma Patients and Is Rapidly Reduced after Surgical Tumor Resection
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Kerry S. Campbell, Tahseen Al-Saleem, Essel Dulaimi, Samuel Litwin, Robert G. Uzzo, Gary R. Hudes, Elizabeth R. Plimack, Mowafaq Jillab, and Alexander W. MacFarlane
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PDF file - 4006K, Myeloid cell gating strategy. The myeloid cell gating strategy used in these experiments is shown with representative data from a healthy control donor. A. Forward scatter area and height were used to exclude aggregates and clusters of cells. B. Dead cells were excluded by propidium iodode staining. C. CD45+ Leukocytes were divided into lymphocyte and myeloid gates based on side scatter. D. T cells and NK cells were excluded from the myeloid cell analysis by CD3 and CD56 expression. E. Cells that express neither CD14 nor CD16 were excluded from the myeloid analysis (mostly B cells at this point in the gating). F. Myeloid cells were sub-gated into Classical Monocytes (CD14bright CD16-), Intermediate Monocytes (CD14bright CD16dim), Non-classical Monocytes (CD14dim CD16dim), CD14bright CD16bright myeloid cells, and Neutrophils (CD14dim CD16bright). Note that most of the neutrophils were removed along with the erythrocytes during gradient centrifugation on Lympoprep).
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- 2023
11. Supplementary Figure 3 from PD-1 Expression on Peripheral Blood Cells Increases with Stage in Renal Cell Carcinoma Patients and Is Rapidly Reduced after Surgical Tumor Resection
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Kerry S. Campbell, Tahseen Al-Saleem, Essel Dulaimi, Samuel Litwin, Robert G. Uzzo, Gary R. Hudes, Elizabeth R. Plimack, Mowafaq Jillab, and Alexander W. MacFarlane
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PDF file - 471K, Correlation between PD-1 expression and CD69 expression on T cells in pre-operative blood samples. Correlation of PD-1 expression on T cells (x-axis) to CD69 expression T cells (y-axis) is shown. A vertical line marks the median PD-1 expression on and the median CD69 expression is marked by a horizontal line. Statistical significance was calculated by a Spearman correlation. A least squares linear fit is shown as a thick black line.
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- 2023
12. Supplementary Figure 2 from PD-1 Expression on Peripheral Blood Cells Increases with Stage in Renal Cell Carcinoma Patients and Is Rapidly Reduced after Surgical Tumor Resection
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Kerry S. Campbell, Tahseen Al-Saleem, Essel Dulaimi, Samuel Litwin, Robert G. Uzzo, Gary R. Hudes, Elizabeth R. Plimack, Mowafaq Jillab, and Alexander W. MacFarlane
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PDF file - 5296K, Lymphocyte gating strategy. A. Leukocytes were gated as described in Supplemental Figure 1. B. T Cells were identified as CD3+ lymphocytes and NK cells as (CD3- CD56+) lymphocytes. C. T cells were sub-divided by CD4 and CD8 expression. D. CD8+ T cells were divided into subsets of Naive (CD45RA+ CD62L+), Effector (CD45RA+ CD62L-), Central Memory (CD45RA- CD62L+), and Effector Memory (CD45RA- CD62L-). E. CD4+ T Cells were sub-divided as for CD8+ T cells. F. B cells were identified as CD19+ lymphocytes. G. NK Cells were further divided into CD56bright and CD56dim phenotypes. H. B Cells were sub-divided into Naive (CD20+ CD27-), Memory (CD20+ CD27+), and plasmacytoid (CD20- CD27+). Fully differentiated plasma cells fall outside these gates because they are CD45-.
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- 2023
13. Supplementary Figure 4 from PD-1 Expression on Peripheral Blood Cells Increases with Stage in Renal Cell Carcinoma Patients and Is Rapidly Reduced after Surgical Tumor Resection
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Kerry S. Campbell, Tahseen Al-Saleem, Essel Dulaimi, Samuel Litwin, Robert G. Uzzo, Gary R. Hudes, Elizabeth R. Plimack, Mowafaq Jillab, and Alexander W. MacFarlane
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PDF file - 3477K, Effect of surgery on cellular activation markers. Pre-surgical (time point zero) and post-surgical (at designated weeks after surgery) measurements on the same patients are connected by a line and the statistical significance is calculated by a paired Wilcoxon rank-sum test. Data points from stage 4 patients are marked with black filled diamonds and the data from the single stage 3 patient is shown in grey. Sub-panels are as follows: A) CD69 on T Cells (CD3+ CD45+ CD56-), B) Perforin in CD8+ T Cells, C) Granzyme B in CD8+ T Cells, D) Perforin in CD4+ T Cells, E) Granzyme B in CD56dim NK Cells, F) Perforin in CD56dim NK Cells.
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- 2023
14. Supplementary Tables 1 - 3 from PD-1 Expression on Peripheral Blood Cells Increases with Stage in Renal Cell Carcinoma Patients and Is Rapidly Reduced after Surgical Tumor Resection
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Kerry S. Campbell, Tahseen Al-Saleem, Essel Dulaimi, Samuel Litwin, Robert G. Uzzo, Gary R. Hudes, Elizabeth R. Plimack, Mowafaq Jillab, and Alexander W. MacFarlane
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PDF file - 79K, Supplemental Table S1. Donor Characteristics. Supplemental Table S2. Antibody staining panel. Supplemental Table S3. Specific immune parameters analyzed.
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- 2023
15. Data from PD-1 Expression on Peripheral Blood Cells Increases with Stage in Renal Cell Carcinoma Patients and Is Rapidly Reduced after Surgical Tumor Resection
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Kerry S. Campbell, Tahseen Al-Saleem, Essel Dulaimi, Samuel Litwin, Robert G. Uzzo, Gary R. Hudes, Elizabeth R. Plimack, Mowafaq Jillab, and Alexander W. MacFarlane
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Programmed death-1 (PD-1) receptor is an inhibitory receptor on hematopoietic cells that can negatively regulate immune responses, particularly responses to tumors, which often upregulate PD-1 ligands. PD-1/PD-1 ligand blocking antibodies can reverse the inhibition and show significant therapeutic promise in treating renal cell carcinoma (RCC), lung cancer, and melanoma. While PD-1 expression on tumor-infiltrating lymphocytes has been associated with poor outcome in RCC, we sought to define immune cell biomarkers, including PD-1, on peripheral blood mononuclear cells (PBMC) that could predict disease progression of RCC patients before and after nephrectomy. We analyzed expression of numerous immune cell markers on fresh PBMCs from 90 RCC patients preoperatively and 25 age-matched healthy controls by 10-color flow cytometry. Postoperative blood samples were also analyzed from 23 members of the RCC patient cohort. The most striking phenotypic immune biomarker in RCC patients was a significant increase in PD-1 expression on certain PBMCs in a subset of patients. Increased PD-1 expression on CD14bright myelomonocytic cells, effector T cells, and natural killer (NK) cells correlated to disease stage, and expression was significantly reduced on all cell types soon after surgical resection of the primary tumor. The results indicate that PD-1 expression on fresh peripheral blood leukocytes may provide a useful indicator of RCC disease progression. Furthermore, measuring PD-1 levels in peripheral blood may assist in identifying patients likely to respond to PD-1 blocking antibodies, and these therapies may be most effective before and immediately after surgical resection of the primary tumor, when PD-1 expression is most prominent. Cancer Immunol Res; 2(4); 320–31. ©2013 AACR.
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- 2023
16. Table S1 from Results of the ADAPT Phase 3 Study of Rocapuldencel-T in Combination with Sunitinib as First-Line Therapy in Patients with Metastatic Renal Cell Carcinoma
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Christopher G. Wood, Charles A. Nicolette, Irina Y. Tcherepanova, Joe Horvatinovich, Marcus S. Norris, Ana Plachco, Alicia Gamble, Mark DeBenedette, Gennady Bratslavsky, William Lowrance, Daniel Vaena, Anil Kapoor, Viraj Master, David Y.T. Chen, Scott S. Tykodi, Robert G. Uzzo, Nizar M. Tannir, and Robert A. Figlin
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subsequent standard of care treaments
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- 2023
17. Figure 1S from Results of the ADAPT Phase 3 Study of Rocapuldencel-T in Combination with Sunitinib as First-Line Therapy in Patients with Metastatic Renal Cell Carcinoma
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Christopher G. Wood, Charles A. Nicolette, Irina Y. Tcherepanova, Joe Horvatinovich, Marcus S. Norris, Ana Plachco, Alicia Gamble, Mark DeBenedette, Gennady Bratslavsky, William Lowrance, Daniel Vaena, Anil Kapoor, Viraj Master, David Y.T. Chen, Scott S. Tykodi, Robert G. Uzzo, Nizar M. Tannir, and Robert A. Figlin
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Consort diagram
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- 2023
18. Supplementary figure 1 legend from Results of the ADAPT Phase 3 Study of Rocapuldencel-T in Combination with Sunitinib as First-Line Therapy in Patients with Metastatic Renal Cell Carcinoma
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Christopher G. Wood, Charles A. Nicolette, Irina Y. Tcherepanova, Joe Horvatinovich, Marcus S. Norris, Ana Plachco, Alicia Gamble, Mark DeBenedette, Gennady Bratslavsky, William Lowrance, Daniel Vaena, Anil Kapoor, Viraj Master, David Y.T. Chen, Scott S. Tykodi, Robert G. Uzzo, Nizar M. Tannir, and Robert A. Figlin
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supplementary figure 1 legend
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- 2023
19. Supplementary Tables 1-2 from Assessing the Clinical Role of Genetic Markers of Early-Onset Prostate Cancer among High-Risk Men Enrolled in Prostate Cancer Early Detection
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Veda N. Giri, Timothy R. Rebbeck, Rosalia Viterbo, David Y.T. Chen, Robert G. Uzzo, Laura Gross, Eric Ross, Fang Zhu, and Lucinda Hughes
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PDF file - 95K
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- 2023
20. Data from Effects of Adjuvant Sorafenib and Sunitinib on Cardiac Function in Renal Cell Carcinoma Patients without Overt Metastases: Results from ASSURE, ECOG 2805
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Robert S. DiPaola, George Wilding, Janice J. Dutcher, Michael B. Atkins, Christopher G. Wood, Lori Wood, Michael Jewett, Christopher J. Kane, Robert G. Uzzo, Keith T. Flaherty, Bonnie Ky, Judith Manola, and Naomi B. Haas
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Purpose: Sunitinib and sorafenib are used widely in the treatment of renal cell carcinoma (RCC). These agents are associated with a significant incidence of cardiovascular (CV) dysfunction and left ventricular ejection fraction (LVEF) declines, observed largely in the metastatic setting. However, in the adjuvant population, the CV effects of these agents remain unknown. We prospectively defined the incidence of cardiotoxicity among resected, high-risk RCC patients treated with these agents.Experimental Design: Sunitinib, sorafenib, or placebo was administered for up to 12 months in patients with high-risk, resected RCC. LVEF was measured by multigated acquisition (MUGA) scans at standard intervals. Additional CV adverse events were reported according to NCI Common Terminology Criteria for Adverse Events (CTCAE).Results: Among 1,943 patients randomized, 1,599 had at least 1 post-baseline MUGA. Within 6 months, 21 patients (1.3%) experienced a cardiac event, defined as an LVEF decline from baseline that was >15% and below the institutional lower limit of normal. Nine of 513 patients (1.8%) were on sunitinib, 7 of 508 (1.4%) on sorafenib, and 5 of 578 (0.9%) on placebo (P = 0.28 and 0.56 comparing sunitinib and sorafenib to placebo, respectively). With dose interruption or adjustment, 16 of the 21 recovered their LVEF to >50%. The incidence of symptomatic heart failure, arrhythmia, or myocardial ischemia did not differ among groups.Conclusions: In the adjuvant setting, we prospectively define low incidence of cardiotoxicity with sunitinib and sorafenib. These findings may be related to close CV monitoring, or potentially to fewer CV comorbidities in our nonmetastatic population. Clin Cancer Res; 21(18); 4048–54. ©2015 AACR.
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- 2023
21. Data from Angiogenic Factor and Cytokine Analysis among Patients Treated with Adjuvant VEGFR TKIs in Resected Renal Cell Carcinoma
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Rupal S. Bhatt, Robert S. DiPaola, Janice P. Dutcher, Robert G. Uzzo, Keith Flaherty, Naomi B. Haas, Michael B. Atkins, David F. McDermott, Daniel Tamasauskas, Andrea J. Bullock, Judith Manola, Maneka Puligandla, and Wenxin Xu
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Purpose:The use of VEGFR TKIs for the adjuvant treatment of renal cell carcinoma (RCC) remains controversial. We investigated the effects of adjuvant VEGFR TKIs on circulating cytokines in the ECOG-ACRIN 2805 (ASSURE) trial.Experimental Design:Patients with resected high-risk RCC were randomized to sunitinib, sorafenib, or placebo. Plasma from 413 patients was analyzed from post-nephrectomy baseline, 4 weeks, and 6 weeks after treatment initiation. Mixed effects and Cox proportional hazards models were used to test for changes in circulating cytokines and associations between disease-free survival (DFS) and cytokine levels.Results:VEGF and PlGF increased after 4 weeks on sunitinib or sorafenib (P < 0.0001 for both) and returned to baseline at 6 weeks on sunitinib (corresponding to the break in the sunitinib schedule) but not sorafenib (which was administered continuously). sFLT-1 decreased after 4 weeks on sunitinib and 6 weeks on sorafenib (P < 0.0001). sVEGFR-2 decreased after both 4 and 6 weeks of treatment on sunitinib or sorafenib (P < 0.0001). Patients receiving placebo had no significant changes in cytokine levels. CXCL10 was elevated at 4 and 6 weeks on sunitinib and sorafenib but not on placebo. Higher baseline CXCL10 was associated with worse DFS (HR 1.41 per log increase in CXCL10, Bonferroni-adjusted P = 0.003). This remained significant after adjustment for T-stage, Fuhrman grade, and ECOG performance status.Conclusions:Among patients treated with adjuvant VEGFR TKIs for RCC, drug–host interactions mediate changes in circulating cytokines. Elevated baseline CXCL10 was associated with worse DFS. Studies to understand functional consequences of these changes are under way.
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- 2023
22. Supplementary Figure from Effects of Adjuvant Sorafenib and Sunitinib on Cardiac Function in Renal Cell Carcinoma Patients without Overt Metastases: Results from ASSURE, ECOG 2805
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Robert S. DiPaola, George Wilding, Janice J. Dutcher, Michael B. Atkins, Christopher G. Wood, Lori Wood, Michael Jewett, Christopher J. Kane, Robert G. Uzzo, Keith T. Flaherty, Bonnie Ky, Judith Manola, and Naomi B. Haas
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Supplementary Figure: Consort diagram of patients participating in cardiac sub study
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- 2023
23. Supplemental Figure S1 from Plasma KIM-1 Is Associated with Recurrence Risk after Nephrectomy for Localized Renal Cell Carcinoma: A Trial of the ECOG-ACRIN Research Group (E2805)
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Rupal S. Bhatt, Venkata Sabbisetti, Robert S. DiPaola, Janice P. Dutcher, Robert G. Uzzo, Keith T. Flaherty, Naomi B. Haas, Brian Halbert, Mäneka Puligandla, and Wenxin Xu
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Distribution of baseline KIM-1 values
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- 2023
24. Data from Plasma KIM-1 Is Associated with Recurrence Risk after Nephrectomy for Localized Renal Cell Carcinoma: A Trial of the ECOG-ACRIN Research Group (E2805)
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Rupal S. Bhatt, Venkata Sabbisetti, Robert S. DiPaola, Janice P. Dutcher, Robert G. Uzzo, Keith T. Flaherty, Naomi B. Haas, Brian Halbert, Mäneka Puligandla, and Wenxin Xu
- Abstract
Purpose:No circulating biomarkers are currently available to identify patients at highest risk of recurrence after nephrectomy for renal cell carcinoma (RCC). Kidney injury molecule-1 (KIM-1) is overexpressed in RCC and its ectodomain circulates in plasma. We investigated whether plasma KIM-1 is a prognostic biomarker in patients with localized RCC after nephrectomy.Experimental Design:The ECOG-ACRIN E2805 (ASSURE) trial evaluated adjuvant sunitinib, sorafenib, or placebo in resected high-risk RCC. KIM-1 levels were measured from banked plasma at trial enrollment 4–12 weeks after nephrectomy. Lognormal accelerated failure time models were used to test for association between KIM-1 and disease-free survival (DFS) as well as overall survival (OS).Results:Plasma from 418 patients was analyzed. Higher post-nephrectomy KIM-1 was associated with worse DFS across all study arms after adjustment for Fuhrman grade, T stage, N stage, and tumor histology [survival time ratio 0.56 for 75th vs. 25th percentile of KIM-1; 95% confidence interval (CI), 0.42–0.73; P < 0.001]. The association between KIM-1 and DFS was stronger among patients with pathologic nodal involvement (Pinteraction = 0.0086). The addition of post-nephrectomy KIM-1 improved the concordance of clinical prognostic models [Stage, Size, Grade, and Necrosis (SSIGN) concordance 0.57 vs. 0.43, P = 0.05; UCLA International Staging System (UISS) concordance 0.60 vs. 0.40, P = 0.0005]. Higher post-nephrectomy KIM-1 was also associated with worse OS after multivariable adjustment (survival time ratio 0.71 for 75th vs. 25th percentile of KIM-1; 95% CI, 0.56–0.91; P < 0.001).Conclusions:Post-nephrectomy plasma KIM-1 is associated with DFS and OS in RCC, and may be a biomarker for microscopic residual disease.
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- 2023
25. Data from Assessing the Clinical Role of Genetic Markers of Early-Onset Prostate Cancer among High-Risk Men Enrolled in Prostate Cancer Early Detection
- Author
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Veda N. Giri, Timothy R. Rebbeck, Rosalia Viterbo, David Y.T. Chen, Robert G. Uzzo, Laura Gross, Eric Ross, Fang Zhu, and Lucinda Hughes
- Abstract
Background: Men with familial prostate cancer and African American men are at risk for developing prostate cancer at younger ages. Genetic markers predicting early-onset prostate cancer may provide clinically useful information to guide screening strategies for high-risk men. We evaluated clinical information from six polymorphisms associated with early-onset prostate cancer in a longitudinal cohort of high-risk men enrolled in prostate cancer early detection with significant African American participation.Methods: Eligibility criteria include ages 35 to 69 with a family history of prostate cancer or African American race. Participants undergo screening and biopsy per study criteria. Six markers associated with early-onset prostate cancer [rs2171492 (7q32), rs6983561 (8q24), rs10993994 (10q11), rs4430796 (17q12), rs1799950 (17q21), and rs266849 (19q13)] were genotyped. Cox models were used to evaluate time to prostate cancer diagnosis and prostate-specific antigen (PSA) prediction for prostate cancer by genotype. Harrell's concordance index was used to evaluate predictive accuracy for prostate cancer by PSA and genetic markers.Results: Four hundred and sixty participants with complete data and ≥1 follow-up visit were included. Fifty-six percent were African American. Among African American men, rs6983561 genotype was significantly associated with earlier time to prostate cancer diagnosis (P = 0.005) and influenced prediction for prostate cancer by the PSA (P < 0.001). When combined with PSA, rs6983561 improved predictive accuracy for prostate cancer compared with PSA alone among African American men (PSA = 0.57 vs. PSA + rs6983561 = 0.75, P = 0.03).Conclusions: Early-onset marker rs6983561 adds potentially useful clinical information for African American men undergoing prostate cancer risk assessment. Further study is warranted to validate these findings.Impact: Genetic markers of early-onset prostate cancer have potential to refine and personalize prostate cancer early detection for high-risk men. Cancer Epidemiol Biomarkers Prev; 21(1); 53–60. ©2011 AACR.
- Published
- 2023
26. Tables S1, S2, S3, S4, S5. Figures S1, S2. from Angiogenic Factor and Cytokine Analysis among Patients Treated with Adjuvant VEGFR TKIs in Resected Renal Cell Carcinoma
- Author
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Rupal S. Bhatt, Robert S. DiPaola, Janice P. Dutcher, Robert G. Uzzo, Keith Flaherty, Naomi B. Haas, Michael B. Atkins, David F. McDermott, Daniel Tamasauskas, Andrea J. Bullock, Judith Manola, Maneka Puligandla, and Wenxin Xu
- Abstract
Supplemental Table 1: Catalog numbers for MSD assays Supplemental Figure 1: Hazard ratio for CXCL10 and DFS by treatment arm Supplemental Figure 2: Assessment of log-linearity for relationship between IP-10 and recurrence risk Supplemental Table 2: Median changes in cytokines at weeks 4 and 6 Supplemental Table 3: Relationship between on-treatment cytokine levels and DFS Supplemental Table 4: Subset analysis for cytokine changes among patients who did not recur Supplemental Table 5: Evaluation for interaction effects between treatment arm and the association between baseline CXCL10 and DFS
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- 2023
27. Data from Results of the ADAPT Phase 3 Study of Rocapuldencel-T in Combination with Sunitinib as First-Line Therapy in Patients with Metastatic Renal Cell Carcinoma
- Author
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Christopher G. Wood, Charles A. Nicolette, Irina Y. Tcherepanova, Joe Horvatinovich, Marcus S. Norris, Ana Plachco, Alicia Gamble, Mark DeBenedette, Gennady Bratslavsky, William Lowrance, Daniel Vaena, Anil Kapoor, Viraj Master, David Y.T. Chen, Scott S. Tykodi, Robert G. Uzzo, Nizar M. Tannir, and Robert A. Figlin
- Abstract
Purpose:Rocapuldencel-T is an autologous immunotherapy prepared from mature monocyte-derived dendritic cells (DC), coelectroporated with amplified tumor RNA plus CD40L RNA. This pivotal phase III trial was initiated to investigate the safety and efficacy of a combination therapy dosing regimen of Rocapuldencel-T plus sunitinib in patients with metastatic renal cell carcinoma (mRCC).Patients and Methods:Patients received either Rocapuldencel-T plus standard of care (SOC) or SOC treatment alone. The primary objective compared overall survival (OS) between groups. Secondary objectives included safety assessments, progression-free survival (PFS), and tumor responses based on RECIST 1.1 criteria. Exploratory analyses included immunologic assessments and correlates with OS.Results:Between 2013 and 2016, 462 patients were randomized 2:1, 307 to the combination group and 155 to the SOC group. Median OS in the combination group was 27.7 months [95% confidence interval (CI) 23.0–35.9] and 32.4 months (95% CI, 22.5–) in the SOC group HR of 1.10 (95% CI, 0.83–1.40). PFS was 6.0 months and 7.83 months for the combination and SOC groups, respectively [HR = 1.15 (95% CI, 0.92–1.44)]. The ORR was 42.7% (95% CI, 37.1–48.4) for the combination group and 39.4% (95% CI, 31.6–47.5) for the SOC group. Median follow up was 29 months (0.4–47.7 months). On the basis of the lack of clinical efficacy, the ADAPT trial was terminated on February 17, 2017. Immune responses were detected in 70% of patients treated with Rocapuldencel-T, and the magnitude of the immune response positively correlated with OS. In addition, we report the survival-predictive value of measuring IL-12 produced by the DC vaccine and the observation that high baseline numbers of T regulatory cells are associated with improved outcomes in DC-treated patients, but are associated with poor outcomes in patients receiving SOC treatment. No serious adverse events attributed to the study medication have been reported to date.Conclusions:Rocapuldencel-T did not improve OS in patients treated with combination therapy, although the induced immune response correlated with OS. Moreover, we identified two potential survival-predictive biomarkers for patients receiving DC based immunotherapy, IL-12 produced by the DC vaccine and higher numbers of T regulatory cells present in the peripheral blood of patients with advanced RCC.
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- 2023
28. Supplementary Tables 1-5, Figures 1-3 from Effects of Adjuvant Sorafenib and Sunitinib on Cardiac Function in Renal Cell Carcinoma Patients without Overt Metastases: Results from ASSURE, ECOG 2805
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Robert S. DiPaola, George Wilding, Janice J. Dutcher, Michael B. Atkins, Christopher G. Wood, Lori Wood, Michael Jewett, Christopher J. Kane, Robert G. Uzzo, Keith T. Flaherty, Bonnie Ky, Judith Manola, and Naomi B. Haas
- Abstract
Supplementary Tables 1-5, Figures 1-3. Supplemental Table 1: Events per person-year of follow-up Supplemental Table 2: Event rates among patients randomized to sorafenib or sunitinib who started at reduced vs. full dose Supplemental Table 3a. Event rates among patients who did or did not discontinue treatment due to adverse events, and among patients with ECOG PS 0 vs. 1 Supplemental Table 3b: Baseline LVEF and change in LVEF among patients who did or did not discontinue treatment due to adverse events Supplemental Table 4: Relationship among treatment duration, baseline LVEF by MUGA, and probability of an event by any definition Supplemental Table 5: Relationship among treatment duration, baseline LVEF by MUGA, and probability of an event by the definition "Per Protocol Including Other" Supplemental Figure 1: Relationship among baseline LVEF by MUGA, treatment duration, and event status, where event is defined by any of the criteria Supplemental Figure 2: Relationship among baseline LVEF by MUGA, treatment duration, and event status, where event is defined as a decline in LVEF of 16% or more to below the lower limit of normal, or a grade 3 or higher cardiac adverse event Supplemental Figure 3: Algorithm for management of study drug-induced hypertension
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- 2023
29. Appendix from Results of the ADAPT Phase 3 Study of Rocapuldencel-T in Combination with Sunitinib as First-Line Therapy in Patients with Metastatic Renal Cell Carcinoma
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Christopher G. Wood, Charles A. Nicolette, Irina Y. Tcherepanova, Joe Horvatinovich, Marcus S. Norris, Ana Plachco, Alicia Gamble, Mark DeBenedette, Gennady Bratslavsky, William Lowrance, Daniel Vaena, Anil Kapoor, Viraj Master, David Y.T. Chen, Scott S. Tykodi, Robert G. Uzzo, Nizar M. Tannir, and Robert A. Figlin
- Abstract
ADAPT study group and participating centers
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- 2023
30. Supplemental Table S1 from Plasma KIM-1 Is Associated with Recurrence Risk after Nephrectomy for Localized Renal Cell Carcinoma: A Trial of the ECOG-ACRIN Research Group (E2805)
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Rupal S. Bhatt, Venkata Sabbisetti, Robert S. DiPaola, Janice P. Dutcher, Robert G. Uzzo, Keith T. Flaherty, Naomi B. Haas, Brian Halbert, Mäneka Puligandla, and Wenxin Xu
- Abstract
Sensitivity analysis AFT model for DFS with imputation of KIM-1 levels below lower limit of detection (9.1 pg/mL)
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- 2023
31. Supplementary Legend S1 from Identification of Novel Target Genes by an Epigenetic Reactivation Screen of Renal Cancer
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Paul Cairns, Robert G. Uzzo, Tahseen Al-Saleem, Amanda M. Hoffman, Essel Dulaimi, and Inmaculada Ibanez de Caceres
- Abstract
Supplementary Legend S1 from Identification of Novel Target Genes by an Epigenetic Reactivation Screen of Renal Cancer
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- 2023
32. Data from Identification of Novel Target Genes by an Epigenetic Reactivation Screen of Renal Cancer
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Paul Cairns, Robert G. Uzzo, Tahseen Al-Saleem, Amanda M. Hoffman, Essel Dulaimi, and Inmaculada Ibanez de Caceres
- Abstract
Aberrant promoter hypermethylation is a common mechanism for inactivation of tumor suppressor genes in cancer cells. To generate a global profile of genes silenced by hypermethylation in renal cell cancer (RCC), we did an expression microarray-based analysis of genes reactivated in the 786-0, ACHN, HRC51, and HRC59 RCC lines after treatment with the demethylating drug 5-aza-2 deoxycytidine and histone deacetylation inhibiting drug trichostatin A. Between 111 to 170 genes were found to have at least 3-fold up-regulation of expression after treatment in each cell line. To establish the specificity of the screen for identification of genes, epigenetically silenced in cancer cells, we validated a subset of 12 up-regulated genes. Three genes (IGFBP1, IGFBP3, and COL1A1) showed promoter methylation in tumor DNA but were unmethylated in normal cell DNA. One gene (GDF15) was methylated in normal cells but more densely methylated in tumor cells. One gene (PLAU) showed cancer cell–specific methylation that did not correlate well with expression status. The remaining seven genes had unmethylated promoters, although at least one of these genes (TGM2) may be regulated by RASSF1A, which was methylated in the RCC lines. Thus, we were able to show that up-regulation of at least 6 of the 12 genes examined was due to epigenetic reactivation. The IGFBP1, IGFBP3, and COL1A1 gene promoter regions were found to be frequently methylated in primary renal cell tumors, and further study will provide insight into the biology of the disease and facilitate translational studies in renal cancer. (Cancer Res 2006; 66(10): 5021-8)
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- 2023
33. Supplementary Figure S1 from Identification of Novel Target Genes by an Epigenetic Reactivation Screen of Renal Cancer
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Paul Cairns, Robert G. Uzzo, Tahseen Al-Saleem, Amanda M. Hoffman, Essel Dulaimi, and Inmaculada Ibanez de Caceres
- Abstract
Supplementary Figure S1 from Identification of Novel Target Genes by an Epigenetic Reactivation Screen of Renal Cancer
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- 2023
34. Adverse Events Reported by Patients With Cancer After Administration of a 2-Dose mRNA COVID-19 Vaccine
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Rebecca M. Shulman, David S. Weinberg, Eric A. Ross, Karen Ruth, Glenn F. Rall, Anthony J. Olszanski, James Helstrom, Michael J. Hall, Julia Judd, David Y.T. Chen, Robert G. Uzzo, Timothy P. Dougherty, Riley Williams, Daniel M. Geynisman, Carolyn Y. Fang, Richard I. Fisher, Marshall Strother, Erica Huelsmann, Sunil Adige, Peter D. Whooley, Kevin Zarrabi, Brinda Gupta, Pritish Iyer, Melissa McShane, Hilario Yankey, Charles T. Lee, Nina Burbure, Lauren E. Laderman, Julie Giurintano, Samuel Reiss, and Eric M. Horwitz
- Subjects
COVID-19 Vaccines ,Oncology ,SARS-CoV-2 ,Neoplasms ,COVID-19 ,Humans ,Prospective Studies ,RNA, Messenger ,BNT162 Vaccine ,Article - Abstract
Background: Most safety and efficacy trials of the SARS-CoV-2 vaccines excluded patients with cancer, yet these patients are more likely than healthy individuals to contract SARS-CoV-2 and more likely to become seriously ill after infection. Our objective was to record short-term adverse reactions to the COVID-19 vaccine in patients with cancer, to compare the magnitude and duration of these reactions with those of patients without cancer, and to determine whether adverse reactions are related to active cancer therapy. Patients and Methods: A prospective, single-institution observational study was performed at an NCI-designated Comprehensive Cancer Center. All study participants received 2 doses of the Pfizer BNT162b2 vaccine separated by approximately 3 weeks. A report of adverse reactions to dose 1 of the vaccine was completed upon return to the clinic for dose 2. Participants completed an identical survey either online or by telephone 2 weeks after the second vaccine dose. Results: The cohort of 1,753 patients included 67.5% who had a history of cancer and 12.0% who were receiving active cancer treatment. Local pain at the injection site was the most frequently reported symptom for all respondents and did not distinguish patients with cancer from those without cancer after either dose 1 (39.3% vs 43.9%; P=.07) or dose 2 (42.5% vs 40.3%; P=.45). Among patients with cancer, those receiving active treatment were less likely to report pain at the injection site after dose 1 compared with those not receiving active treatment (30.0% vs 41.4%; P=.002). The onset and duration of adverse events was otherwise unrelated to active cancer treatment. Conclusions: When patients with cancer were compared with those without cancer, few differences in reported adverse events were noted. Active cancer treatment had little impact on adverse event profiles.
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- 2022
35. Preventing Prostate Biopsy Complications: to Augment or to Swab?
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Mark Mann, Kanata Syed, Jay D. Raman, Timothy M. Han, Robert G. Uzzo, Thomas J. Guzzo, John Danella, Lydia Glick, Sage Vincent, Eric A. Singer, Jeffrey J. Tomaszweski, Marc Smaldone, Bruce L. Jacobs, Adam C. Reese, Edouard J. Trabulsi, Leonard G. Gomella, Serge Ginzburg, Thomas Lanchoney, and Danielle Squadron
- Subjects
Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Prostate biopsy ,medicine.drug_class ,Urology ,Antibiotics ,030232 urology & nephrology ,Risk Assessment ,Sepsis ,03 medical and health sciences ,Prostate cancer ,Postoperative Complications ,0302 clinical medicine ,Prostate ,Internal medicine ,Biopsy ,medicine ,Humans ,Antibiotic prophylaxis ,Ultrasonography, Interventional ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Rectum ,Bacterial Infections ,Odds ratio ,Antibiotic Prophylaxis ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business - Abstract
To use data from a large, prospectively- acquired regional collaborative database to compare the risk of infectious complications associated with three American Urologic Association- recommended antibiotic prophylaxis pathways, including culture-directed or augmented antibiotics, following prostate biopsy.Data on prostate biopsies and outcomes were collected from the Pennsylvania Urologic Regional Collaborative, a regional quality collaborative working to improve the diagnosis and treatment of prostate cancer. Patients were categorized as receiving one of three prophylaxis pathways: culture-directed, augmented, or provider-discretion. Infectious complications included fever, urinary tract infections or sepsis within one month of biopsy. Odds ratios of infectious complication by pathway were determined, and univariate and multivariate analyses of patient and biopsy characteristics were performed.11,940 biopsies were included, 120 of which resulted in infectious outcomes. Of the total biopsies, 3246 used "culture-directed", 1446 used "augmented" and 7207 used "provider-discretion" prophylaxis. Compared to provider-discretion, the culture-directed pathway had 84% less chance of any infectious outcome (OR= 0.159, 95% CI = [0.074, 0.344], P0.001). There was no difference in infectious complications between augmented and provider-discretion pathways.The culture-directed pathway for transrectal prostate biopsy resulted in significantly fewer infectious complications compared to other prophylaxis strategies. Tailoring antibiotics addresses antibiotic-resistant bacteria and reduces future risk of resistance. These findings make a strong case for incorporating culture-directed antibiotic prophylaxis into clinical practice guidelines to reduce infection following prostate biopsies.
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- 2021
36. Renal Mass and Localized Renal Cancer: Evaluation, Management, and Follow-Up: AUA Guideline: Part I
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Robert G. Uzzo, Jose A. Karam, Steven C. Campbell, Peter E. Clark, Lesley Souter, and Sam S. Chang
- Subjects
Ablation Techniques ,Counseling ,medicine.medical_specialty ,Evidence-Based Medicine ,Adult patients ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,Thermal ablation ,Cancer ,Antineoplastic Agents ,Guideline ,medicine.disease ,Nephrectomy ,Kidney Neoplasms ,Biopsy ,medicine ,Renal mass ,Humans ,business ,Kidney cancer - Abstract
This AUA Guideline focuses on evaluation/counseling/management of adult patients with clinically-localized renal masses suspicious for cancer, including solid-enhancing tumors and Bosniak 3/4 complex-cystic lesions.The Renal Mass and Localized Renal Cancer guideline underwent an update literature review which resulted in the 2021 amendment. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table 1[Table: see text]).Great progress has been made regarding the evaluation/management of clinically-localized renal masses. These guidelines provide updated, evidence-based recommendations regarding evaluation/counseling including the evolving role of renal-mass-biopsy (RMB). Given great variability of clinical/oncologic/functional characteristics, index patients are not utilized and the panel advocates individualized counseling/management. Options for intervention (partial-nephrectomy (PN), radical-nephrectomy (RN), and thermal-ablation (TA)) are reviewed including recent data about comparative-effectiveness/potential morbidities. Oncologic issues are prioritized while recognizing the importance of functional-outcomes for survivorship. Granular criteria for RN are provided to help reduce overutilization of RN while also avoiding imprudent PN. Priority for PN is recommended for clinical T1a lesions, along with selective utilization of TA, which has good efficacy for tumors≤3.0 cm. Recommendations for genetic-counseling have been revised and considerations for adjuvant-therapies are addressed. Active-surveillance and follow-up after intervention are discussed in an adjunctive article.Several factors require consideration during counseling/management of patients with clinically-localized renal masses including general health/comorbidities, oncologic-considerations, functional-consequences, and relative efficacy/potential morbidities of various management-strategies.
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- 2021
37. Safety of neoadjuvant chemotherapy in patients with muscle‐invasive bladder cancer and malignant ureteric obstruction
- Author
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Mengying Deng, David Y.T. Chen, Elizabeth R. Plimack, Bianca Lewis, Robert G. Uzzo, Richard E. Greenberg, Marc C. Smaldone, Pooja Ghatalia, Alexander Kutikov, Emily Bochner, Elizabeth Handorf, Rosalia Viterbo, Fern Anari, Matthew Zibelman, Marshall Strother, Daniel M. Geynisman, and Matthew Epstein
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Cystectomy ,urologic and male genital diseases ,Article ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Carcinoma ,Humans ,Neoplasm Invasiveness ,Ureteric stent ,Neoadjuvant therapy ,Retrospective Studies ,Chemotherapy ,Bladder cancer ,business.industry ,Muscles ,medicine.disease ,Neoadjuvant Therapy ,Discontinuation ,Urinary Bladder Neoplasms ,Percutaneous nephrostomy ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Female ,Cisplatin ,business ,Ureteral Obstruction - Abstract
OBJECTIVES To determine whether patients with carcinoma invading bladder muscle (MIBC) and ureteric obstruction can safely receive cisplatin-based neoadjuvant chemotherapy (C-NAC), and to determine whether such patients require relief of obstruction with a ureteric stent or percutaneous nephrostomy prior to beginning C-NAC. PATIENTS AND METHODS We performed a single-institution retrospective analysis of MIBC patients receiving C-NAC and falling into three groups: no ureteric obstruction (NO); relieved ureteric obstruction (RO); and unrelieved ureteric obstruction (URO). To address whether patients with obstruction can safely receive C-NAC, we compared patients with NO to those with RO, with the primary outcome of premature chemotherapy discontinuation. To investigate whether patients with obstruction should have the obstruction relieved prior to NAC, we compared RO to URO patients using a primary composite outcome of grade ≥ 3 adverse events, premature chemotherapy discontinuation, dose reduction, or dose interruption. The primary outcomes were compared using multivariable logistic regression. Sensitivity analyses were performed for the RO vs URO comparison, in which patients with only mild degrees of obstruction were excluded from the URO group. RESULTS A total of 193 patients with NO, 49 with RO, and 35 with URO were analysed. There were no statistically significant differences between those with NO and those with RO in chemotherapy discontinuation (15% vs 22%; P = 0.3) or any secondary outcome. There was no statistically significant difference between those with RO and URO in the primary composite outcome (51% vs 53%; P = 1) or any secondary outcome. CONCLUSION Patients with ureteric obstruction can safely receive C-NAC. Relief of obstruction was not associated with increased safety of C-NAC delivery.
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- 2021
38. Clinical Cancer Advances 2021: ASCO's Report on Progress Against Cancer
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Timothy J. Moynihan, Robert G. Uzzo, Merry Jennifer Markham, Noelle K. LoConte, Daniel A. Mulrooney, Melissa Lynne Johnson, Miriam A. Knoll, Jane L. Meisel, Nathan A. Pennell, Daniel J. George, Helen Mackay, Douglas E. Peterson, Kerri Wachter, Ryan J. Sullivan, Olatoyosi Odenike, Katherine E. Reeder-Hayes, Therese M. Mulvey, Sonali M. Smith, Johanna C. Bendell, Howard A. Burris, Robert Dreicer, Muhammad Shaalan Beg, Randall J. Kimple, Kathryn Finch Mileham, Vicki L. Keedy, Cardinale B. Smith, and Richard L. Schilsky
- Subjects
Cancer Research ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Biomedical Research ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Medical Oncology ,Neoplasms ,Pandemic ,medicine ,Humans ,Precision Medicine ,Intensive care medicine ,Pandemics ,Societies, Medical ,SARS-CoV-2 ,business.industry ,COVID-19 ,Cancer ,Precision medicine ,medicine.disease ,United States ,Oncology ,Neoplasms diagnosis ,business - Published
- 2021
39. CRISPR/Cas9 genome-wide loss-of-function screening identifies druggable cellular factors involved in sunitinib resistance in renal cell carcinoma
- Author
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Vladimir Khazak, Peter Makhov, Ilya G. Serebriiskii, Robert G. Uzzo, Ji A. Sohn, Vladimir Kolenko, Rushaniya Fazliyeva, and Yanis Boumber
- Subjects
Male ,Cancer Research ,Pyridines ,Farnesyltransferase ,Apoptosis ,chemistry.chemical_compound ,Mice ,Random Allocation ,0302 clinical medicine ,Piperidines ,Sunitinib ,CRISPR ,Drug Interactions ,Lonafarnib ,Molecular Targeted Therapy ,Enzyme Inhibitors ,RNA, Small Interfering ,biology ,Farnesyltransferase inhibitor ,Renal cell carcinoma ,Kidney Neoplasms ,Progression-Free Survival ,Oncology ,030220 oncology & carcinogenesis ,Drug Therapy, Combination ,Tyrosine kinase ,medicine.drug ,Antineoplastic Agents ,Urological cancer ,DNA Fragmentation ,Mechanistic Target of Rapamycin Complex 1 ,Article ,03 medical and health sciences ,Cell Line, Tumor ,medicine ,Animals ,Farnesyltranstransferase ,Humans ,Carcinoma, Renal Cell ,Protein Kinase Inhibitors ,Cas9 ,business.industry ,medicine.disease ,High-Throughput Screening Assays ,Clear cell renal cell carcinoma ,chemistry ,Drug Resistance, Neoplasm ,biology.protein ,Cancer research ,CRISPR-Cas Systems ,business ,Lysosomes ,Neoplasm Transplantation - Abstract
Background Multi-targeted tyrosine kinase inhibitors (TKIs) are the standard of care for patients with advanced clear cell renal cell carcinoma (ccRCC). However, a significant number of ccRCC patients are primarily refractory to targeted therapeutics, showing neither disease stabilisation nor clinical benefits. Methods We used CRISPR/Cas9-based high-throughput loss of function (LOF) screening to identify cellular factors involved in the resistance to sunitinib. Next, we validated druggable molecular factors that are synthetically lethal with sunitinib treatment using cell and animal models of ccRCC. Results Our screening identified farnesyltransferase among the top hits contributing to sunitinib resistance in ccRCC. Combined treatment with farnesyltransferase inhibitor lonafarnib potently augmented the anti-tumour efficacy of sunitinib both in vitro and in vivo. Conclusion CRISPR/Cas9 LOF screening presents a promising approach to identify and target cellular factors involved in the resistance to anti-cancer therapeutics.
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- 2020
40. Summary From the First Kidney Cancer Research Summit, September 12–13, 2019: A Focus on Translational Research
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Christopher G. Wood, Hans J. Hammers, Ziad Bakouny, Payal Kapur, Brian I. Rini, Charles G. Drake, Bryan Lewis, Kevin Pels, Maria I. Carlo, Robert G. Uzzo, Eric Jonasch, W. Marston Linehan, W. Kimryn Rathmell, Nizar M. Tannir, Toni K. Choueiri, Michael B. Atkins, Sabina Signoretti, Sumanta K. Pal, Michael J. Mitchell, and Susan Poteat
- Subjects
0303 health sciences ,Cancer Research ,medicine.medical_specialty ,geography ,Tumor microenvironment ,Summit ,geography.geographical_feature_category ,business.industry ,MEDLINE ,Translational research ,medicine.disease ,Immune checkpoint ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Single cell sequencing ,Renal cell carcinoma ,030220 oncology & carcinogenesis ,Commentary ,medicine ,Intensive care medicine ,business ,Kidney cancer ,030304 developmental biology - Abstract
Kidney cancer is one of the 10 most common cancers both in the United States and worldwide. Until this year, there had not previously been a conference focused on translational studies in the broad and heterogeneous group of kidney cancers. Therefore, a group of researchers, clinicians, and patient advocates dedicated to renal cell carcinoma launched the Kidney Cancer Research Summit (KCRS) to spur collaboration and further therapeutic advances in these tumors. This commentary aims to summarize the oral presentations and serve as a record for future iterations of this meeting. The KCRS sessions addressed the tumor microenvironment, novel methods of drug delivery, single cell sequencing strategies, novel immune checkpoint blockade and cellular therapies, predictive biomarkers, and rare variants of kidney cancers. In addition, the meeting included 2 sessions to promote scientific mentoring and kidney cancer research collaborations. A subsequent KCRS will be planned for the fall of 2020.
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- 2020
41. Predictive Value of Nephrometry Scores in Nephron-sparing Surgery: A Systematic Review and Meta-analysis
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Giacomo Novara, Lance J. Hampton, Alessandro Antonelli, Robert G. Uzzo, Riccardo Autorino, Vincenzo Mirone, Alexander Kutikov, Francesco Porpiglia, Vincenzo Ficarra, Claudio Simeone, Ithaar Derweesh, Alessandro Veccia, Veccia, A., Antonelli, A., Uzzo, R. G., Novara, G., Kutikov, A., Ficarra, V., Simeone, C., Mirone, V., Hampton, L. J., Derweesh, I., Porpiglia, F., and Autorino, R.
- Subjects
medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Renal function ,Context (language use) ,Nephrometry score, Partial nephrectomy, Radical nephrectomy, Tumor complexity ,Kidney ,Nephrectomy ,law.invention ,03 medical and health sciences ,Tumor complexity ,0302 clinical medicine ,Randomized controlled trial ,Predictive Value of Tests ,law ,Statistical significance ,medicine ,Humans ,Partial nephrectomy ,Radical nephrectomy ,business.industry ,General surgery ,Nephrometry score ,Nephrons ,Odds ratio ,Kidney Neoplasms ,Systematic review ,030220 oncology & carcinogenesis ,Meta-analysis ,business ,Organ Sparing Treatments ,Medical literature - Abstract
Context: Over the last decade, several nephrometry scores (NSs) have been introduced with the aim of facilitating preoperative decision making, planning, and counseling in the field of nephron-sparing surgery. However, their predictive role remains controversial. Objective: To describe currently available nephrometry scores and to determine their predictive role for different outcomes by performing a systematic review and meta-analysis of the literature. Evidence acquisition: PubMed, Embase®, and Web of Science were screened to identify eligible studies. Identification and selection of the reports were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A pooled analysis of NS predictive role of intraoperative, postoperative, oncological, and functional outcomes was performed. Odds ratio was considered the effect size. All the analyses were performed using Stata 15.0, and statistical significance was set at p ≤ 0.05. Evidence synthesis: Overall, 51 studies meeting our inclusion criteria were identified and considered for the analysis. Except for one prospective randomized trial, all the studies were retrospective. All the studies were found to be of intermediate quality, except for one of high quality. Most studies assessed the predictive role of the Radius-Exophytic/Endophytic-Nearness-Anterior/Posterior-Location (RENAL) and Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) scores, mostly regarding complications after nephron-sparing surgery. RENAL was an independent predictor of an on-clamp procedure (p < 0.001). Mayo Adhesive Probability score was related to adhesive perinephric fat (p = 0.005). Continuous and high-complexity RENAL scores were predictors of warm ischemia time (WIT; p = 0.006 and p < 0.001, respectively). Continuous (p < 0.001) and high-complexity (p < 0.001) PADUA scores were related to WIT. Continuous and high-complexity RENAL scores were predictors of overall complications (p = 0.002 and p < 0.001, respectively). PADUA score was related to complications both as continuous (p < 0.001) and as a categorical value (p < 0.002). The RENAL scores R = 3 (p = 0.008), E = 2 (p = 0.039), and hilar location (p = 0.006) were predictors of histological malignancy. Continuous and categorical RENAL scores were independent predictors of an estimated glomerular filtration rate (eGFR) increase (p = 0.006 and p < 0.001, respectively). The Diameter-Axial-Polar score (p = 0.018) and Peritumoral Artery Scoring System (PASS; p = 0.02) were also independent predictors. Conclusions: The literature regarding nephrometry scoring systems is sparse, and mostly focused on RENAL and PADUA, which are easy to calculate and have a good correlation with most outcomes. Renal Pelvic Score is the best predictor of pelvicalyceal entry/repair and urine leak, whereas Surgical Approach Renal Ranking and PASS strongly predict surgical approach and renal function variation, respectively. Other nephrometry scores based on mathematical models are limited by their complexity, and they lack evidence supporting their predictive value. Patient summary: We reviewed the medical literature regarding the use and value of so-called “nephrometry scores,” which are scoring systems based on radiological imaging and made to grade the complexity of a renal tumor. We analyzed whether these scoring systems can predict some of the outcomes of patients undergoing surgical removal of renal tumors. The literature on nephrometry scoring systems is sparse, and it is mostly focused on the Radius-Exophytic/Endophytic-Nearness-Anterior/Posterior-Location (RENAL) and Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) scores. The results of this study can aid in further research effort in this field and foster the development of better predictive tools
- Published
- 2020
42. PBRM1 acts as a p53 lysine-acetylation reader to suppress renal tumor growth
- Author
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Haifeng Yang, Robert G. Uzzo, Qing Zhang, Zongzhi Liu, Qin Yan, Lauren Langbein, Weijia Cai, Liya Su, Wei Jiang, Lili Liao, Essel Dulaimi, Joseph R. Testa, and Zhijiu Zhong
- Subjects
Male ,0301 basic medicine ,Mutant ,General Physics and Astronomy ,Kidney ,Biochemistry ,PBRM1 ,Gene Knockout Techniques ,Mice ,0302 clinical medicine ,Promoter Regions, Genetic ,lcsh:Science ,Cancer ,Regulation of gene expression ,Multidisciplinary ,Chemistry ,Acetylation ,Kidney Neoplasms ,3. Good health ,Cell biology ,DNA-Binding Proteins ,Gene Expression Regulation, Neoplastic ,Renal cancer ,030220 oncology & carcinogenesis ,Protein Binding ,Cyclin-Dependent Kinase Inhibitor p21 ,Tumor suppressor gene ,Science ,Urological cancer ,Article ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Protein Domains ,Cell Line, Tumor ,Animals ,Humans ,Lysine ,HEK 293 cells ,Promoter ,General Chemistry ,Xenograft Model Antitumor Assays ,Bromodomain ,HEK293 Cells ,030104 developmental biology ,Mutation ,lcsh:Q ,Tumor Suppressor Protein p53 ,Peptides ,Transcription Factors - Abstract
p53 acetylation is indispensable for its transcriptional activity and tumor suppressive function. However, the identity of reader protein(s) for p53 acetylation remains elusive. PBRM1, the second most highly mutated tumor suppressor gene in kidney cancer, encodes PBRM1. Here, we identify PBRM1 as a reader for p53 acetylation on lysine 382 (K382Ac) through its bromodomain 4 (BD4). Notably, mutations on key residues of BD4 disrupt recognition of p53 K382Ac. The mutation in BD4 also reduces p53 binding to promoters of target genes such as CDKN1A (p21). Consequently, the PBRM1 BD4 mutant fails to fully support p53 transcriptional activity and is defective as a tumor suppressor. We also find that expressions of PBRM1 and p21 correlate with each other in human kidney cancer samples. Our findings uncover a tumor suppressive mechanism of PBRM1 in kidney cancer and provide a mechanistic insight into the crosstalk between p53 and SWI/SNF complexes., Acetylation of p53 is critical for its transcriptional activity and its tumour suppressive function. Here, the authors show that PBRM1 is a reader protein for p53′s C-terminal domain acetylation on lysine 382 through its bromodomain 4 and that mutations in this domain leads to compromised tumour suppressive function and renal tumour growth.
- Published
- 2019
43. Predictors of Positive Surgical Margins after Robot-Assisted Partial Nephrectomy for Localized Renal Tumors: Insights from a Large Multicenter International Prospective Observational Project (The Surface-Intermediate-Base Margin Score Consortium)
- Author
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Fabrizio, Di Maida, Riccardo, Campi, Brian R, Lane, Ottavio, De Cobelli, Francesco, Sanguedolce, Georgios, Hatzichristodoulou, Alessandro, Antonelli, Antonio Andrea, Grosso, Sabrina, Noyes, Oscar, Rodriguez-Faba, Frank X, Keeley, Johan, Langenhuijsen, Gennaro, Musi, Tobias, Klatte, Marco, Roscigno, Bulent, Akdogan, Maria, Furlan, Claudio, Simeone, Nihat, Karakoyunlu, Martin, Marszalek, Umberto, Capitanio, Alessandro, Volpe, Sabine, Brookman-May, Jürgen E, Gschwend, Marc C, Smaldone, Robert G, Uzzo, Alexander, Kutikov, Andrea, Minervini, and Sib International Consortium
- Subjects
robotics ,All institutes and research themes of the Radboud University Medical Center ,partial nephrectomy ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,positive surgical margins ,renal tumor ,SIB score ,Article ,General Medicine ,ddc - Abstract
Background: To explore predictors of positive surgical margins (PSM) after robotic partial nephrectomy (PN) in a large multicenter international observational project, harnessing the Surface-Intermediate-Base (SIB) margin score to report the resection technique after PN in a standardized way. Methods: Data from consecutive patients with cT1-2N0M0 renal masses treated with PN from September 2014 to March 2015 at 16 tertiary referral centers and included in the SIB margin score International Consortium were prospectively collected. For the present study, only patients treated with robotic PN were included. Uni- and multivariable analysis were fitted to explore clinical and surgical predictors of PSMs after PN. Results: Overall, 289 patients were enrolled. Median (IQR) preoperative tumor size was 3.0 (2.3–4.2) cm and median (IQR) PADUA score was 8 (7–9). SIB scores of 0–2 (enucleation), 3–4 (enucleoresection) and 5 (resection) were reported in 53.3%, 27.3% and 19.4% of cases, respectively. A PSM was recorded in 18 (6.2%) patients. PSM rate was 4.5%, 11.4% and 3.6% in case of enucleation, enucleoresection and resection, respectively. Patients with PSMs had tumors with a higher rate of contact with the urinary collecting system (55.6% vs. 27.3%; p < 0.001) and a longer median warm ischemia time (22 vs. 16 min; p = 0.02) compared with patients with negative surgical margins, while no differences emerged between the two groups in terms of other tumor features (i.e., pathological diameter, PADUA score). In multivariable analysis, only enucleoresection (SIB score 3–4) versus enucleation (SIB score 0–2) was found to be an independent predictor of PSM at final pathology (HR: 2.68; 95% CI: 1.25–7.63; p = 0.04), while resection (SIB score 5) was not. Conclusions: In our experience, enucleoresection led to a higher risk of PSMs as compared to enucleation. Further studies are needed to assess the differential impacts of resection technique and surgeon’s experience on margin status after robotic PN.
- Published
- 2021
44. Acetyl-CoA Counteracts the Inhibitory Effect of Antiandrogens on Androgen Receptor Signaling in Prostate Cancer Cells
- Author
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Peter Makhov, Rushaniya Fazliyeva, Antonio Tufano, Robert G. Uzzo, Kathy Q. Cai, Ilya Serebriiskii, Nathaniel W. Snyder, Andrew J. Andrews, and Vladimir M. Kolenko
- Subjects
Cancer Research ,Oncology ,prostate cancer ,androgen receptor ,enzalutamide ,abiraterone ,acetyl-coenzyme A - Abstract
The commonly used therapeutic management of PC involves androgen deprivation therapy (ADT) followed by treatment with AR signaling inhibitors (ARSI). However, nearly all patients develop drug-resistant disease, with a median progression-free survival of less than 2 years in chemotherapy-naïve men. Acetyl-coenzyme A (acetyl-CoA) is a central metabolic signaling molecule with key roles in biosynthetic processes and cancer signaling. In signaling, acetyl-CoA serves as the acetyl donor for acetylation, a critical post-translational modification. Acetylation affects the androgen receptor (AR) both directly and indirectly increasing expression of AR dependent genes. Our studies reveal that PC cells respond to the treatment with ARSI by increasing expression of ATP-citrate lyase (ACLY), a major enzyme responsible for cytosolic acetyl-CoA synthesis, and up-regulation of acetyl-CoA intracellular levels. Inhibition of ACLY results in a significant suppression of ligand-dependent and -independent routes of AR activation. Accordingly, the addition of exogenous acetyl-CoA, or its precursor acetate, augments AR transcriptional activity and diminishes the anti-AR activity of ARSI. Taken together, our findings suggest that PC cells respond to antiandrogens by increasing activity of the acetyl-coA pathway in order to reinstate AR signaling.
- Published
- 2022
45. MP05-04 CLINICALLY SIGNIFICANT PROSTATE CANCER DETECTION RATES ON MRI GUIDED FUSION NEEDLE BIOPSY - EXPERIENCE FROM THE PENNSYLVANIA UROLOGIC REGIONAL COLLABORATIVE
- Author
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Ako Adams Ako, Laurence Belkoff, Robert G. Uzzo, Bruce L. Jacobs, Serge Ginzburg, Edouard J. Trabulsi, John Danella, Jay D. Raman, Adam C. Reese, Eric A. Singer, Claudette Fonshell, Thomas J. Guzzo, and Jeffery Tomaszewski
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,030232 urology & nephrology ,Magnetic resonance imaging ,medicine.disease ,3. Good health ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Needle biopsy ,medicine ,Radiology ,Detection rate ,business ,Systematic biopsy ,Mri guided - Abstract
INTRODUCTION AND OBJECTIVE:Magnetic resonance imaging (MRI) fusion needle biopsy has been shown to outperform systematic biopsy in detecting clinically significant prostate cancer. This study sough...
- Published
- 2021
46. MP45-10 PERSPECTIVES ON THE ROLE OF BIOPSY FOR MANAGEMENT OF T1 RENAL MASSES: RESULTS FROM TWO QUALITY IMPROVEMENT COLLABORATIVES
- Author
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Robert G. Uzzo, Brian R. Lane, Amit R. Patel, Jay D. Raman, Zachary J. Prebay, Anna Johnson, Craig G. Rogers, Serge Ginzburg, and Claudette Fonshell
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medicine.medical_specialty ,Quality management ,medicine.diagnostic_test ,business.industry ,Urology ,Biopsy ,Renal mass ,Medicine ,business ,Intensive care medicine - Abstract
INTRODUCTION AND OBJECTIVE:Renal mass biopsy (RMB) has the potential to reduce unnecessary treatment by informing care, however, its utilization varies widely amongst providers and institutions. To...
- Published
- 2021
47. MP26-02 ROLE OF ANTERIOR PROSTATE SAMPLING USING A NOVEL PHILADELPHIA HYBRID ANATOMIC TRANSPERINEAL (PHAT) TEMPLATE: A SINGLE CENTER EXPERIENCE
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Adams Ako, Justin Friedlander, Serge Ginzburg, Jay Simhan, Joshua A. Cohn, Johnathan Drevik, Jeffrey L. Ellis, Steven Sterious, Robert G. Uzzo, and Phillip H. Abbosh
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medicine.medical_specialty ,medicine.anatomical_structure ,Prostate ,business.industry ,Urology ,medicine ,Sampling (statistics) ,Radiology ,Single Center ,business - Published
- 2021
48. MP42-03 COMPARISON OF SURVIVAL OUTCOMES AFTER RADICAL OR PARTIAL NEPHRECTOMY FOR COMPLEX RENAL MASS: ANALYSIS FROM THE ROSULA (ROBOTIC SURGERY FOR LARGE RENAL MASS) COLLABORATIVE GROUP
- Author
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Robert G. Uzzo, Benjamin Challacombe, Alexander Kutikov, Alexandre Mottrie, Devin Patel, Inderbir S. Gill, Margaret Meagher, Umberto Capitanio, Ithaar Derweesh, Francesco Porpiglia, Giuseppe Simone, Andrea Minervini, Chandru P. Sundaram, Francesco Montorsi, Carmen Mir, Umberto Carbonara, Bo Chang, Jihad H. Kaouk, Clayton Lau, Prokar Dasgupta, Daniel Eun, Alp Tuna Beksac, Akbar Ashrafi, Luigi Schips, Riccardo Autorino, Monish Aron, Wesley M. White, Joel Rosenberg, James Porter, Alessandro Larcher, Kenneth Jacobsohn, and Ottavio De Cobelli
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Collaborative group ,medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,Renal mass ,Robotic surgery ,business ,Nephrectomy ,Surgery - Published
- 2021
49. PD28-08 SAGACITY OF SAME DAY DISCHARGE: INCIDENCE AND TIMING OF POSTOPERATIVE ADVERSE EVENTS FOLLOWING MINIMALLY INVASIVE UROLOGIC SURGERY
- Author
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Alberto Andres Castro Bigalli, Richard N. Greenberg, Alexander Kutikov, Kevin Ginsburg, Rosalia Viterbo, Marc C. Smaldone, Robert G. Uzzo, David D. Y. Chen, and Andres Correa
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medicine.medical_specialty ,business.industry ,Urology ,Incidence (epidemiology) ,General surgery ,Medicine ,Urologic surgery ,Adverse effect ,business ,Same day discharge - Abstract
INTRODUCTION AND OBJECTIVE:In efforts to judiciously utilize resources and contain cost, there has been increasing efforts to reduce postoperative length of stay, resulting in several groups promot...
- Published
- 2021
50. PD63-11 ONCOLOGICAL OUTCOMES OF CT1 MICROPAPILLARY BLADDER CANCER COMPARED WITH CT2 CONVENTIONAL UROTHELIAL CARCINOMA TREATED WITH RADICAL CYSTECTOMY
- Author
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Akhil Chandra, Laura Bukavina, Rosalia Viterbo, Robert G. Uzzo, David D. Y. Chen, Andres Correa, Elizabeth Handorf, Richard N. Greenberg, Nicole Murray, Alexander Kutikov, Marc C. Smaldone, and Kevin Ginsburg
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Cystectomy ,medicine.medical_specialty ,Bladder cancer ,Invasive urothelial carcinoma ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,medicine.disease ,business ,Urothelial carcinoma - Abstract
INTRODUCTION AND OBJECTIVE:The management of patients with high risk non-muscle invasive urothelial carcinoma (UC) is complex due to the biological heterogeneity of the disease. The management of m...
- Published
- 2021
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