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101. Stratifying risk of infection and response to therapy in patients with myeloma: a prognostic study

Author

Chicca, Ilaria J, primary, Heaney, Jennifer LJ, additional, Iqbal, Gulnaz, additional, Dunn, Janet A, additional, Bowcock, Stella, additional, Planche, Tim, additional, Pratt, Guy, additional, Yong, Kwee, additional, Low, Eric, additional, Wood, Jill, additional, Raynes, Kerry, additional, Higgins, Helen, additional, and Drayson, Mark T, additional

Published
2020
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102. Comparison of Whole-Body MRI, CT, and Bone Scintigraphy for Response Evaluation of Cancer Therapeutics in Metastatic Breast Cancer to Bone

Author

Kosmin, Michael, primary, Padhani, Anwar R., additional, Gogbashian, Andrew, additional, Woolf, David, additional, Ah-See, Mei-Lin, additional, Ostler, Peter, additional, Sutherland, Stephanie, additional, Miles, David, additional, Noble, Jillian, additional, Koh, Dow-Mu, additional, Marshall, Andrea, additional, Dunn, Janet, additional, and Makris, Andreas, additional

Published
2020
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105. Six versus 12 months’ adjuvant trastuzumab in patients with HER2-positive early breast cancer: the PERSEPHONE non-inferiority RCT

Author

Earl, Helena, primary, Hiller, Louise, additional, Vallier, Anne-Laure, additional, Loi, Shrushma, additional, McAdam, Karen, additional, Hughes-Davies, Luke, additional, Rea, Daniel, additional, Howe, Donna, additional, Raynes, Kerry, additional, Higgins, Helen B, additional, Wilcox, Maggie, additional, Plummer, Chris, additional, Mahler-Araujo, Betania, additional, Provenzano, Elena, additional, Chhabra, Anita, additional, Gasson, Sophie, additional, Balmer, Claire, additional, Abraham, Jean E, additional, Caldas, Carlos, additional, Hall, Peter, additional, Shinkins, Bethany, additional, McCabe, Christopher, additional, Hulme, Claire, additional, Miles, David, additional, Wardley, Andrew M, additional, Cameron, David A, additional, and Dunn, Janet A, additional

Published
2020
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106. Abstract OT3-17-01: OPTIMA: A prospective randomized trial to validate the clinical utility and cost-effectiveness of gene expression test-directed chemotherapy decisions in mostly node-positive early breast cancer

Author

Stein, Robert C, primary, Marshall, Andrea, additional, Makris, Andreas, additional, Hughes-Davies, Luke, additional, MacPherson, Iain R, additional, Conefrey, Carmel, additional, Rooshenas, Leila, additional, Pinder, Sarah E, additional, Shaaban, Abeer M, additional, Naume, Bjørn, additional, Cameron, David A, additional, Rea, Daniel W, additional, Earl, Helena M, additional, Poole, Christopher J, additional, Hall, Peter S, additional, Dotchin, Georgina, additional, McIntosh, Stuart A, additional, Harmer, Victoria, additional, Morgan, Adrienne, additional, Shinkins, Bethany, additional, Stallard, Nigel, additional, McCabe, Christopher, additional, Donovan, Jenny L, additional, Bartlett, John MS, additional, and Dunn, Janet A, additional

Published
2020
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114. Cabazitaxel in platinum pre-treated patients with locally advanced or metastatic transitional cell carcinoma who developed disease progression after platinum based chemotherapy : results of the phase II CAB-B1 trial

Author

Zarkar, A., Marshall, Andrea, Davies, A., Ford, D., James, N. D., and Dunn, Janet A.

Subjects
RM, fungi, food and beverages, RC
Abstract

There is a paucity of chemotherapy options for patients with urothelial cancers who have relapsed following platinum based chemotherapy (CT).\ud CAB-B1 was a single centre phase II randomised controlled trial of Cabazitaxel (CAB; 25mg/m2 q3 week for 6 cycles) versus\ud best supportive care (BSC) in patients with histologically proven transitional cell carcinoma (TCC), locally advanced or\ud metastatic, who had recurred after receiving platinum based treatment. Primary outcome was overall response rate (ORR)\ud using RESIST. Secondary outcomes included Progression Free Survival (PFS) and Overall Survival (OS).\ud Between January 2013 and October 2016, 20 patients were randomised (10 on each arm). BSC included paclitaxel CT for 9\ud patients and radiotherapy for 1 patient. 8 patients completed 6 cycles of CT (3 on CAB; 5 on BSC). 2 patients had an ORR\ud on CAB and 1 patient on BSC. Median OS was 5.8 months (95% confidence interval (CI) 0.7-14.6) for CAB patients and\ud 7.5 months (95% CI 1.0-10.8) for BSC patients. Median PFS was 4.8 months (95% CI 0.7-8.3) for CAB patients and 3.7\ud months (95% CI 1.0-7.0) for BSC patients.\ud CAB-B1 successfully reached the efficacy target for 1st stage, showing that there could be a role for CAB in these patients.

Published
2019

115. Can mammogram readers swiftly and effectively learn to interpret first post-contrast acquisition subtracted (FAST) MRI, a type of abbreviated breast MRI?: a single centre data-interpretation study

Author

Jones, Lyn I., Geach, Rebecca, Harding, Sam A., Foy, Christopher, Taylor, Victoria, Marshall, Andrea, Taylor-Phillips, Sian, Dunn, Janet A., and HASH(0x5651c9de1ef0)

Subjects
medicine.medical_specialty, Time Factors, media_common.quotation_subject, Contrast Media, Breast Neoplasms, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Radiologists, medicine, Confidence Intervals, Breast MRI, Breast screening, Contrast (vision), Humans, Radiology, Nuclear Medicine and imaging, Fast mri, Breast, Prospective Studies, media_common, medicine.diagnostic_test, Full Paper, business.industry, Data interpretation, General Medicine, Reference Standards, Magnetic Resonance Imaging, Data Accuracy, Single centre, 030220 oncology & carcinogenesis, Female, Radiology, RG, business, RA, RC, Mammography
Abstract

Objectives: To assess whether NHS breast screening programme (NHSBSP) mammogram readers could effectively interpret first post-contrast acquisition subtracted (FAST) MRI, for intended use in screening for breast cancer. Methods: Eight NHSBSP mammogram readers from a single centre (four who also read breast MRI (Group 1) and four who do not (Group 2)) were given structured FAST MRI reader training (median 4 h: 32 min). They then prospectively interpreted 125 FAST MRIs (250 breasts: 194 normal and 56 cancer) comprising a consecutive series of screening MRIs enriched with additional cancer cases from 2015, providing 2000 interpretations. Readers were blinded to other readers’ opinions and to clinical information. Categorisation followed the NHSBSP MRI reporting categorisation, with categories 4 and 5 considered indicative of cancer. Diagnostic accuracy (reference standard: histology or 2 years’ follow-up) and agreement between readers were determined. Results: The accuracy achieved by Group 2 (847/1000 (85%; 95% confidence interval (CI) 82–87%)) was 5% less than that of Group 1 (898/1000 (90%; 95% CI 88–92)). Good inter-reader agreement was seen between both Group 1 readers (κ = 0.66; 95% CI 0.61–0.71) and Group 2 readers (κ = 0.63; 95% CI 0.58–0.68). The median time taken to interpret each FAST MRI was Group 1: 34 s (range 3–351) and Group 2: 77 s (range 11–321). Conclusion: Brief structured training enabled multiprofessional mammogram readers to achieve similar accuracy at FAST MRI interpretation to consultant radiologists experienced at breast MRI interpretation. Advances in knowledge: FAST MRI could be feasible from a training-the-workforce perspective for screening within NHSBSP.

Published
2019

116. 6 versus 12 months of adjuvant trastuzumab for HER2-positive early breast cancer (PERSEPHONE): 4-year disease-free survival results of a randomised phase 3 non-inferiority trial

Author

Earl, Helena M, Hiller, Louise, Vallier, Anne-Laure, Loi, Shrushma, McAdam, Karen, Hughes-Davies, Luke, Harnett, Adrian N, Ah-See, Mei-Lin, Simcock, Richard, Rea, Daniel, Raj, Sanjay, Woodings, Pamela, Harries, Mark, Howe, Donna, Raynes, Kerry, Higgins, Helen B, Wilcox, Maggie, Plummer, Chris, Mansi, Janine, Gounaris, Ioannis, Mahler-Araujo, Betania, Provenzano, Elena, Chhabra, Anita, Abraham, Jean E, Caldas, Carlos, Hall, Peter S, McCabe, Christopher, Hulme, Claire, Miles, David, Wardley, Andrew M, Cameron, David A, Dunn, Janet A, PERSEPHONE Steering Committee And Trial Investigators, Earl, Helena [0000-0003-1549-8094], Abraham, Jean [0000-0003-0688-4807], Caldas, Carlos [0000-0003-3547-1489], and Apollo - University of Cambridge Repository

Subjects
Adult, Aged, 80 and over, Receptor, ErbB-2, Injections, Subcutaneous, Breast Neoplasms, Middle Aged, Trastuzumab, Disease-Free Survival, Drug Administration Schedule, United Kingdom, Young Adult, Antineoplastic Agents, Immunological, Treatment Outcome, Chemotherapy, Adjuvant, Humans, Female, Prospective Studies, Infusions, Intravenous, Aged
Abstract

BACKGROUND: Adjuvant trastuzumab significantly improves outcomes for patients with HER2-positive early breast cancer. The standard treatment duration is 12 months but shorter treatment could provide similar efficacy while reducing toxicities and cost. We aimed to investigate whether 6-month adjuvant trastuzumab treatment is non-inferior to the standard 12-month treatment regarding disease-free survival. METHODS: This study is an open-label, randomised phase 3 non-inferiority trial. Patients were recruited from 152 centres in the UK. We randomly assigned patients with HER2-positive early breast cancer, aged 18 years or older, and with a clear indication for chemotherapy, by a computerised minimisation process (1:1), to receive either 6-month or 12-month trastuzumab delivered every 3 weeks intravenously (loading dose of 8 mg/kg followed by maintenance doses of 6 mg/kg) or subcutaneously (600 mg), given in combination with chemotherapy (concurrently or sequentially). The primary endpoint was disease-free survival, analysed by intention to treat, with a non-inferiority margin of 3% for 4-year disease-free survival. Safety was analysed in all patients who received trastuzumab. This trial is registered with EudraCT (number 2006-007018-39), ISRCTN (number 52968807), and ClinicalTrials.gov (number NCT00712140). FINDINGS: Between Oct 4, 2007, and July 31, 2015, 2045 patients were assigned to 12-month trastuzumab treatment and 2044 to 6-month treatment (one patient was excluded because they were double randomised). Median follow-up was 5·4 years (IQR 3·6-6·7) for both treatment groups, during which a disease-free survival event occurred in 265 (13%) of 2043 patients in the 6-month group and 247 (12%) of 2045 patients in the 12-month group. 4-year disease-free survival was 89·4% (95% CI 87·9-90·7) in the 6-month group and 89·8% (88·3-91·1) in the 12-month group (hazard ratio 1·07 [90% CI 0·93-1·24], non-inferiority p=0·011), showing non-inferiority of the 6-month treatment. 6-month trastuzumab treatment resulted in fewer patients reporting severe adverse events (373 [19%] of 1939 patients vs 459 [24%] of 1894 patients, p=0·0002) or stopping early because of cardiotoxicity (61 [3%] of 1939 patients vs 146 [8%] of 1894 patients, p

Published
2019
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117. The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation

Author

L, Rooshenas, LJ, Scott, JM, Blazeby, CA, Rogers, KM, Tilling, S, Husbands, C, Conefrey, N, Mills, RC, Stein, C, Metcalfe, AJ, Carr, DJ, Beard, T., Davis, S, Paramasivan, M, Jepson, K, Avery, D, Elliott, C, Wilson, JL, Donovan, Rogers, Chris A., Andrews, Robert, Blazeby, Jane M., Byrne, James, Donovan, Jenny L., Kelly, Jamie, Mazza, Graziella, Mahon, David, Noble, Hamish, Reeves, Barnaby C., Thompson, Janice L., Wordsworth, Sarah, Welbourn, Richard, Beard, David, Carr, Andrew, Cook, Jonathan, Cooper, Cushla, Dean, Benjamin, Gray, Alastair, Gwilym, Stephen, Judge, Andrew, Merritt, Naomi, Moser, Jane, Rees, Jonathan, Rombach, Ines, Savulescu, Julian, Tracey, Irene, Wartolowska, Karolina, Tan, Wei, Mills, Nicola, Karantana, Alexia, Sprange, Kirsty, Duley, Lelia, Elliott, Daisy, Hollingworth, William, Montgomery, Alan A., Davis, Tim, Stein, Rob, Bartlett, John, Cameron, David, Campbell, Amy, Canney, Peter, Dunn, Janet, Earl, Helena, Falzon, Mary, Francis, Adele, Hall, Peter, Harmer, Victoria, Higgins, Helen, Hiller, Louise, Hughes-Davies, Luke, Hulme, Claire, Macpherson, Iain, Makris, Andreas, Marshall, Andrea, McCabe, Christopher, Morgan, Adrienne, Pinder, Sarah, Poole, Christopher, Provenzano, Elena, Rea, Daniel, Stallard, Nigel, Avery, Kerry NL., Barham, C Paul, Berrisford, Richard, Elliott, Jackie, Falk, Stephen J., Goldin, Rob, Hanna, George, Hollowood, Andrew A., Krysztopik, Richard, Metcalfe, Chris, Noble, Sian, Sanders, Grant, Streets, Christopher G., Titcomb, Dan R., and Wheatley, Tim

Subjects
Clinical trial, Qualitative research, Communication, Randomized Controlled Trial, Recruitment, Training healthcare professionals
Abstract

ObjectiveTo evaluate the impact of the Quintet Recruitment Intervention (QRI) on recruitment in challenging randomized controlled trials (RCTs) that have applied the intervention. The QRI aims to understand recruitment difficulties, and then implements ‘QRI-actions’ to address these as recruitment proceeds.Study Design and SettingA mixed-methods study, comprising: a) before-and-after comparisons of recruitment rates and numbers of patients approached, and b) qualitative case studies, including documentary analysis and interviews with RCT investigators.ResultsFive UK-based publicly-funded RCTs were included in the evaluation. All recruited to target. RCT2 and RCT5 both received up-front pre-recruitment training before the intervention was applied. RCT2 did not encounter recruitment issues and recruited above target from its outset. Recruitment difficulties, particularly communication issues, were identified and addressed through QRI-actions in RCTs 1, 3, 4 and 5. Randomization rates significantly improved post-QRI-action in RCTs 1,3, and 4. QRI-actions addressed issues with approaching eligible patients in RCTs 3 and 5, which both saw significant increases in patients approached. Trial investigators reported that the QRI had unearthed issues they had been unaware of, and reportedly changed their practices post QRI-action.ConclusionThere is promising evidence to suggest the QRI can support recruitment to difficult RCTs. This needs to be substantiated with future controlled evaluations.

Published
2019

128. Options for early breast cancer follow-up in primary and secondary care - a systematic review

Author

Taggart Frances, Donnelly Peter, and Dunn Janet

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Both incidence of breast cancer and survival have increased in recent years and there is a need to review follow up strategies. This study aims to assess the evidence for benefits of follow-up in different settings for women who have had treatment for early breast cancer. Method A systematic review to identify key criteria for follow up and then address research questions. Key criteria were: 1) Risk of second breast cancer over time - incidence compared to general population. 2) Incidence and method of detection of local recurrence and second ipsi and contra-lateral breast cancer. 3) Level 1–4 evidence of the benefits of hospital or alternative setting follow-up for survival and well-being. Data sources to identify criteria were MEDLINE, EMBASE, AMED, CINAHL, PSYCHINFO, ZETOC, Health Management Information Consortium, Science Direct. For the systematic review to address research questions searches were performed using MEDLINE (2011). Studies included were population studies using cancer registry data for incidence of new cancers, cohort studies with long term follow up for recurrence and detection of new primaries and RCTs not restricted to special populations for trials of alternative follow up and lifestyle interventions. Results Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival. Conclusions Long term support, surveillance mammography and fast access to medical treatment at point of need may be better than hospital based surveillance limited to five years but further large, randomised controlled trials are needed.

Published
2012
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129. UK ethnicity data collection for healthcare statistics: the South Asian perspective

Author

Iqbal Gulnaz, Johnson Mark RD, Szczepura Ala, Wilson Sue, Gumber Anil, and Dunn Janet A

Subjects
Ethnicity, Data collection, Perspectives, South Asians, Focus groups, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Ethnicity data collection has been proven to be important in health care but despite government initiatives remains incomplete and mostly un-validated in the UK. Accurate self-reported ethnicity data would enable experts to assess inequalities in health and access to services and help to ensure resources are targeted appropriately. The aim of this paper is to explore the reasons for the observed gap in ethnicity data by examining the perceptions and experiences of healthy South Asian volunteers. South Asians are the largest ethnic minority group accounting for 50% of all ethnic minorities in the UK 2001 census. Methods Five focus groups, conducted by trained facilitators in the native language of each group, recruited 36 South Asian volunteers from local community centres and places of worship. The topic guide focused on five key areas:1) general opinions on the collection of ethnicity, 2) experiences of providing ethnicity information, 3) categories used in practice, 4) opinions of other indicators of ethnicity e.g. language, religion and culture and 5) views on how should this information be collected. The translated transcripts were analysed using a qualitative thematic approach. Results The findings of this Cancer Research UK commissioned study revealed that participants felt that accurate recording of ethnicity data was important in healthcare with several stating the increased prevalence of certain diseases in minority ethnic groups as an appropriate justification to improve this data. The overwhelming majority raised no objections to providing this data when the purpose of data collection is fully explained. Conclusions This study confirmed that the collection of patients' ethnicity data is deemed important by potential patients but there remains uncertainty and unease as to how the data may be used. A common theme running through the focus groups was the willingness to provide these data, strongly accompanied by a desire to have more information with regard to its use.

Published
2012
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130. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV) : an open-label randomised controlled phase 3 trial

Author

Mehanna, Hisham M., Robinson, Max, Hartley, Andrew, Kong, Anthony, Foran, Bernadette, Fulton-Lieuw, Tessa, Dalby, Matthew, Mistry, Pankaj, Sen, Mehmet, O'Toole, Lorcan, Al Booz, Hoda, Dyker, Karen, Moleron, Rafael, Whitaker, Stephen, Brennan, Sinéad, Cook, Audrey, Griffin, Matthew, Aynsley, Eleanor, Rolles, Martin, De Winton, Emma, Chan, Andrew, Srinivasan, Devraj, Nixon, Ioanna, Grumett, Joanne, Leemans, C René, Buter, Jan, Henderson, Julia, McConkey, Christopher C., Gray, Alastair, Dunn, Janet A., McArdle, Orla, Husband, David, Loo, Vivienne, Soe, Win, Sridhar, Thiagarajan, Jankowska, Petra, Joseph, Mano, Geropantas, Konstantinos, Vaidya, Deepali, Vijayan, Rengarajan, Hwang, David, Harrington, Kevin, Pettit, Laura, Mendes, Ruheena, Forster, Martin, Evans, Mererid, Nankivell, Paul, Bryant, Jennifer, Sharma, Neil, Spruce, Rachel, Brooks, Jill, Batis, Nikos, Roques, Tom, Bidmead, Margaret, Yang, Huiqi, Nutting, Christopher, Tyler, Justine, Baines, Helen, Gasnier, Anne, Miles, Elizabeth, and Clark, Catharine

Subjects
RC0254, RM
Abstract

Background\ud \ud The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer, a disease affecting younger patients, is rapidly increasing. Cetuximab, an epidermal growth factor receptor inhibitor, has been proposed for treatment de-escalation in this setting to reduce the toxicity of standard cisplatin treatment, but no randomised evidence exists for the efficacy of this strategy.\ud \ud Methods\ud \ud We did an open-label randomised controlled phase 3 trial at 32 head and neck treatment centres in Ireland, the Netherlands, and the UK, in patients aged 18 years or older with HPV-positive low-risk oropharyngeal cancer (non-smokers or lifetime smokers with a smoking history of

Published
2018

131. OPTIMA: A prospective randomized trial to validate the predictive utility and cost-effectiveness of gene expression test-directed chemotherapy decisions in early breast cancer

Author

Stein, Robert C, Makris, Andreas, Hughes-Davies, Luke, Macpherson, Iain R, Hall, Peter S, Cameron, David A, Earl, Helena M, Pinder, Sarah E, Poole, Christopher J, Rea, Daniel W, McIntosh, Stuart, Harmer, Victoria, Morgan, Adrienne, Rooshenas, Leila, Conefrey, Carmel, Donovan, Jenny L, Hulme, Claire, McCabe, Christopher, Stallard, Nigel, Campbell, Amy, Higgins, Helen, Bartlett, John MS, Marshall, Andrea, and Dunn, Janet A

Subjects
skin and connective tissue diseases
Abstract

Background: Multi-parameter gene expression assays (MPAs) are widely used to estimate individual patient residual risk in hormone-sensitive HER2-negative node-negative early breast cancer, allowing patients with low risk to safely avoid chemotherapy. Evidence for MPA use in node-positive breast cancer is limited. OPTIMA (Optimal Personalised Treatment of early breast cancer usIng Multi-parameter Analysis) aims to validate MPA’s as predictors of chemotherapy sensitivity in a largely node-positive breast cancer population.

Published
2018
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132. Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with Venous Thromboembolism: Results of a randomized trial (SELECT-D)

Author

Young, Annie M., Marshall, Andrea, Thirlwall, Jenny, Chapman, Oliver, Lokare, Anand, Hill, Catherine, Hale, Danielle, Dunn, Janet A., Lyman, Gary H., Hutchinson, Charles, MacCallum, Peter, Kakkar, Ajay, Hobbs, F. D. Richard, Petrou, Stavros, Dale, Jeremy, Poole, Christopher J., Maraveyas, Anthony, Levine, Mark, and HASH(0x5651c9dbb470)

Subjects
Cancer Research, medicine.medical_specialty, medicine.drug_mechanism_of_action, medicine.drug_class, Deep vein, Factor Xa Inhibitor, Low molecular weight heparin, 030204 cardiovascular system & hematology, law.invention, RC0254, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Rivaroxaban, business.industry, Standard treatment, medicine.disease, Pulmonary embolism, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, business, Fibrinolytic agent, medicine.drug
Abstract

Purpose Venous thromboembolism (VTE) is common in patients with cancer. Long-term daily subcutaneous low molecular weight heparin has been standard treatment for such patients. The purpose of this study was to assess if an oral factor Xa inhibitor, rivaroxaban, would offer an alternative treatment for VTE in patients with cancer. Patient and Methods In this multicenter, randomized, open-label, pilot trial in the United Kingdom, patients with active cancer who had symptomatic pulmonary embolism (PE), incidental PE, or symptomatic lower-extremity proximal deep vein thrombosis (DVT) were recruited. Allocation was to dalteparin (200 IU/kg daily during month 1, then 150 IU/kg daily for months 2-6) or rivaroxaban (15 mg twice daily for 3 weeks, then 20 mg once daily for a total of 6 months). The primary outcome was VTE recurrence over 6 months. Safety was assessed by major bleeding and clinically relevant nonmajor bleeding (CRNMB). A sample size of 400 patients would provide estimates of VTE recurrence to within ± 4.5%, assuming a VTE recurrence rate at 6 months of 10%. Results A total of 203 patients were randomly assigned to each group, 58% of whom had metastases. Twenty-six patients experienced recurrent VTE (dalteparin, n = 18; rivaroxaban, n = 8). The 6-month cumulative VTE recurrence rate was 11% (95% CI, 7% to 16%) with dalteparin and 4% (95% CI, 2% to 9%) with rivaroxaban (hazard ratio [HR], 0.43; 95% CI, 0.19 to 0.99). The 6-month cumulative rate of major bleeding was 4% (95% CI, 2% to 8%) for dalteparin and 6% (95% CI, 3% to 11%) for rivaroxaban (HR, 1.83; 95% CI, 0.68 to 4.96). Corresponding rates of CRNMB were 4% (95% CI, 2% to 9%) and 13% (95% CI, 9% to 19%), respectively (HR, 3.76; 95% CI, 1.63 to 8.69). Conclusion Rivaroxaban was associated with relatively low VTE recurrence but higher CRNMB compared with dalteparin.

Published
2018

134. Prophylactic levofloxacin to prevent infections in newly diagnosed symptomatic myeloma: the TEAMM RCT

Author

Drayson, Mark T, primary, Bowcock, Stella, additional, Planche, Tim, additional, Iqbal, Gulnaz, additional, Pratt, Guy, additional, Yong, Kwee, additional, Wood, Jill, additional, Raynes, Kerry, additional, Higgins, Helen, additional, Dawkins, Bryony, additional, Meads, David, additional, Hulme, Claire T, additional, Whittaker, Anna C, additional, Hawkey, Peter, additional, Low, Eric, additional, and Dunn, Janet A, additional

Published
2019
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135. 6 versus 12 months of adjuvant trastuzumab for HER2-positive early breast cancer (PERSEPHONE): 4-year disease-free survival results of a randomised phase 3 non-inferiority trial

Author

Earl, Helena M, primary, Hiller, Louise, additional, Vallier, Anne-Laure, additional, Loi, Shrushma, additional, McAdam, Karen, additional, Hughes-Davies, Luke, additional, Harnett, Adrian N, additional, Ah-See, Mei-Lin, additional, Simcock, Richard, additional, Rea, Daniel, additional, Raj, Sanjay, additional, Woodings, Pamela, additional, Harries, Mark, additional, Howe, Donna, additional, Raynes, Kerry, additional, Higgins, Helen B, additional, Wilcox, Maggie, additional, Plummer, Chris, additional, Mansi, Janine, additional, Gounaris, Ioannis, additional, Mahler–Araujo, Betania, additional, Provenzano, Elena, additional, Chhabra, Anita, additional, Abraham, Jean E, additional, Caldas, Carlos, additional, Hall, Peter S, additional, McCabe, Christopher, additional, Hulme, Claire, additional, Miles, David, additional, Wardley, Andrew M, additional, Cameron, David A, additional, Dunn, Janet A, additional, Agarwal, Roshan, additional, Algurafi, Hafiz, additional, Allerton, Rozenn, additional, Archer, Caroline, additional, Armstrong, Anne, additional, Bale, Catherine, additional, Barraclough, Lisa, additional, Barthakur, Urmila, additional, Bedi, Carolyn, additional, Benstead, Kim, additional, Bloomfield, David, additional, Bowen, Rebecca, additional, Bradley, Chris, additional, Brown, Jane, additional, Butt, Mohammad, additional, Churn, Mark, additional, Cleator, Susan, additional, Cliff, Joanne, additional, Crellin, Perric, additional, Daly, Margaret, additional, De Silva-Minor, Shiroma, additional, Dhadda, Amandeep, additional, Din, Omar, additional, Down, Sue, additional, Earl, Helena, additional, Eaton, David, additional, Eichholz, Andrew, additional, Epurescu, Daniel, additional, Goh, Chee, additional, Goodman, Andrew, additional, Grieve, Robert, additional, Hadaki, Maher, additional, Harper-Wynne, Catherine, additional, Hayward, Larry, additional, Humphreys, Alison, additional, Innes, Helen, additional, Jafri, Mariam, additional, Jegannathen, Apurna, additional, Kelleher, Muireann, additional, Kristeleit, Hartmut, additional, Lee, Daniela, additional, Lupton, Susan, additional, MacGregor, Carol, additional, Malik, Zafar, additional, Marshall, Jennifer, additional, McGolick, Trevor, additional, Mehra, Rakesh, additional, Mithal, Natasha, additional, Moss, Charlotte, additional, Moss, Aian, additional, Mukesh, Mukesh, additional, Neal, Anthony, additional, Nelmes, Daniel, additional, Neville-Webbe, Helen, additional, Newby, Jacqueline, additional, O'Reilly, Susan, additional, Ostler, Peter, additional, Persic, Mojca, additional, Pettit, Laura, additional, Raja, Fharat, additional, Reed, Catherine, additional, Rigg, Anne, additional, Roe, Helen, additional, Shah, Nihal, additional, Simmonds, Peter, additional, Sims, Eliot, additional, Smith, Sarah, additional, Storey, Nicola, additional, Taylor, Wendy, additional, Thanvi, Narottam, additional, Tipples, Karen, additional, Vaidya, Jayant, additional, Varughese, Mohini, additional, Vinayan, Anup, additional, Walji, Nawaz, additional, Waters, Simon, additional, Wright, Kathryn, additional, and Yahya, Sundus, additional

Published
2019
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136. The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation

Author

Rooshenas, Leila, primary, Scott, Lauren J., additional, Blazeby, Jane M., additional, Rogers, Chris A., additional, Tilling, Kate M., additional, Husbands, Samantha, additional, Conefrey, Carmel, additional, Mills, Nicola, additional, Stein, Robert C., additional, Metcalfe, Chris, additional, Carr, Andrew J., additional, Beard, David J., additional, Davis, Tim, additional, Paramasivan, Sangeetha, additional, Jepson, Marcus, additional, Avery, Kerry, additional, Elliott, Daisy, additional, Wilson, Caroline, additional, Donovan, Jenny L., additional, Andrews, Robert, additional, Byrne, James, additional, Kelly, Jamie, additional, Mazza, Graziella, additional, Mahon, David, additional, Noble, Hamish, additional, Reeves, Barnaby C., additional, Thompson, Janice L., additional, Wordsworth, Sarah, additional, Welbourn, Richard, additional, Beard, David, additional, Carr, Andrew, additional, Cook, Jonathan, additional, Cooper, Cushla, additional, Dean, Benjamin, additional, Gray, Alastair, additional, Gwilym, Stephen, additional, Judge, Andrew, additional, Merritt, Naomi, additional, Moser, Jane, additional, Rees, Jonathan, additional, Rombach, Ines, additional, Savulescu, Julian, additional, Tracey, Irene, additional, Wartolowska, Karolina, additional, Harrison, Eleanor, additional, Tan, Wei, additional, Karantana, Alexia, additional, Sprange, Kirsty, additional, Duley, Lelia, additional, Hollingworth, William, additional, Montgomery, Alan A., additional, Stein, Rob, additional, Bartlett, John, additional, Cameron, David, additional, Campbell, Amy, additional, Canney, Peter, additional, Dunn, Janet, additional, Earl, Helena, additional, Falzon, Mary, additional, Francis, Adele, additional, Hall, Peter, additional, Harmer, Victoria, additional, Higgins, Helen, additional, Hiller, Louise, additional, Hughes-Davies, Luke, additional, Hulme, Claire, additional, Macpherson, Iain, additional, Makris, Andreas, additional, Marshall, Andrea, additional, McCabe, Christopher, additional, Morgan, Adrienne, additional, Pinder, Sarah, additional, Poole, Christopher, additional, Provenzano, Elena, additional, Rea, Daniel, additional, Stallard, Nigel, additional, Avery, Kerry N.L., additional, Barham, C. Paul, additional, Berrisford, Richard, additional, Elliott, Jackie, additional, Falk, Stephen J., additional, Goldin, Rob, additional, Hanna, George, additional, Hollowood, Andrew A., additional, Krysztopik, Richard, additional, Noble, Sian, additional, Sanders, Grant, additional, Streets, Christopher G., additional, Titcomb, Dan R., additional, and Wheatley, Tim, additional

Published
2019
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138. A prospective study to assess the value of MMP-9 in improving the appropriateness of urgent referrals for colorectal cancer

Author

Hobbs Richard FD, Dunn Janet A, Warmington Sally A, Wakelam Michael JO, Wilson Sue, Ryan Angela V, Martin Ashley, and Ismail Tariq

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Bowel cancer is common and is a major cause of death. Most people with bowel symptoms who meet the criteria for urgent referral to secondary care will not be found to have bowel cancer, and some people who are found to have cancer will have been referred routinely rather than urgently. If general practitioners could better identify people who were likely to have bowel cancer or conditions that may lead to bowel cancer, the pressure on hospital clinics may be reduced, enabling these patients to be seen more quickly. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP-9) have been found to be associated with such conditions, and this can be measured from a blood sample. This study aims to find out whether measuring MMP-9 levels could improve the appropriateness of urgent referrals for patients with bowel symptoms. Methods People aged 18 years or older referred to a colorectal clinic will be asked to complete a questionnaire about symptoms, recent injuries or chronic illnesses (these can increase the level of matrix metalloproteinases) and family history of bowel cancer. A blood sample will be taken from people who consent to take part to assess MMP-9 levels, and the results of examination at the clinic and/or investigations arising from the clinic visit will be collected from hospital records. The accuracy of MMP-9 will be assessed by comparing the MMP-9 level with the resulting diagnosis. The combination of factors (e.g. symptoms and MMP-9 level) that best predict a diagnosis of malignancy (invasive disease or polyps) will be determined. Discussion Although guidelines are in place to facilitate referrals to colorectal clinics, symptoms alone do not adequately distinguish people with malignancy from people with benign conditions. This study will establish whether MMP-9 could assist this process. If this were the case, measurement of MMP-9 levels could be used by general practitioners to assist in the identification of people who were most likely to have bowel cancer or conditions that may lead to bowel cancer, and who should, therefore, be referred most urgently to secondary care.

Published
2006
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139. Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population

Author

Colbourne Lynne, Patrick Fiona, Redman Val D, Dunn Janet A, Ryan Angela V, Hobbs Richard FD, Wakelam Michael JO, Wilson Sue, Martin Ashley, and Ismail Tariq

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Bowel cancer is common and is a major cause of death. Meta-analysis of randomised controlled trials estimates that screening for colorectal cancer using faecal occult blood (FOB) test reduces mortality from colorectal cancer by 16%. However, FOB testing has a low positive predictive value, with associated unnecessary cost, risk and anxiety from subsequent investigation, and is unacceptable to a proportion of the target population. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP-9) have been found to be associated with colorectal cancer, and this can be measured from a blood sample. Serum MMP-9 is potentially an accurate, low risk and cost-effective population screening tool. This study aims to evaluate the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population. Methods/Design People aged 50 to 69 years, who registered in participating general practices in the West Midlands Region, will be asked to complete a questionnaire that asks about symptoms. Respondents who describe any colorectal symptoms (except only abdominal bloating and/or anal symptoms) and are prepared to provide a blood sample for MMP9 estimation and undergo a colonoscopy (current gold standard investigation) will be recruited at GP based clinics by a research nurse. Those unfit for colonoscopy will be excluded. Colonoscopies will be undertaken in dedicated research clinics. The accuracy of MMP-9 will be assessed by comparing the MMP-9 level with the colonoscopy findings, and the combination of factors (e.g. symptoms and MMP-9 level) that best predict a diagnosis of malignancy (invasive disease or polyps) will be determined. Discussion Colorectal cancer is a major cause of morbidity and mortality. Most colorectal cancers arise from adenomas and there is a period for early detection by screening, but available tests have risks, are unacceptable to many, have high false positive rates or are expensive. This study will establish the potential of serum MMP-9 as a screening test for colorectal cancer. If it is confirmed as accurate and acceptable, this serum marker has the potential to assist with reducing the morbidity and mortality from colorectal cancer.

Published
2006
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141. Diagnostic pathways in multiple myeloma and their relationship to end organ damage: an analysis from the Tackling Early Morbidity and Mortality in Myeloma (TEAMM) trial.

Author

Atkin, Catherine, Iqbal, Gulnaz, Planche, Tim, Pratt, Guy, Yong, Kwee, Wood, Jill, Raynes, Kerry, Low, Eric, Higgins, Helen, Neal, Richard D., Dunn, Janet, Drayson, Mark T, and Bowcock, Stella

Subjects
MULTIPLE myeloma, DIAGNOSIS, SECONDARY care (Medicine), COMORBIDITY, MORTALITY
Abstract

Summary: Multiple myeloma is associated with significant early morbidity and mortality, with considerable end organ damage often present at diagnosis. The Tackling EArly Morbidity and Mortality in Multiple Myeloma (TEAMM) trial was used to evaluate routes to diagnosis in patients with myeloma and the relationship between diagnostic pathways, time to diagnosis and disease severity. A total of 915 participants were included in the study. Fifty‐one per cent were diagnosed by direct referral from primary care to haematology; 29% were diagnosed via acute services and 20% were referred via other secondary care specialties. Patients diagnosed via other secondary care specialties had a longer diagnostic interval (median 120 days vs. 59 days) without an increase in features of severe disease, suggesting they had a relatively indolent disease. Marked intrahospital delay suggests possible scope for improvement. A quarter of those diagnosed through acute services reported >30 days from initial hospital consultation to haematology assessment. Participants diagnosed through acute services had poorer performance status (P < 0·0001) and higher burden of end organ damage (P < 0·0001) with no difference in the overall length of diagnostic pathway compared to those diagnosed by direct referral (median 59 days). This suggests that advanced disease in patients presenting through acute services predominantly reflects disease aggression. [ABSTRACT FROM AUTHOR]

Published
2021
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142. Cigarette smoking and pancreas cancer: a case-control study based on direct interviews

Author

Silverman, Debra T., Dunn, Janet A., Hoover, Robert N., Schiffman, Mark, Lillemoe, Keith D., Schoenberg, Janet B., Brown, Linda M., Greenberg, Raymond S., Hayes, Richard B., Swanson, G. Marie, Wacholder, Sholom, Schwartz, Ann G., Liff, Jonathan M., and Pottern, Linda M.

Subjects
Pancreatic cancer -- Risk factors, Smoking -- Health aspects, Health
Abstract

Background: Cigarette smoking is the most consistently reported risk factor for pancreas cancer, yet the dose-response relationship in many pancreas cancer studies is weak. Because of the poor prognosis for pancreas cancer, many case-control studies have been based largely on interviews with proxy respondents, who are known to report less reliable information on detailed smoking habits than original subjects. Purpose: Our purpose was to evaluate cigarette smoking as a risk factor for pancreas cancer based on data obtained only from direct interviews and to estimate the effects of quitting smoking and of switching from nonfiltered to filtered cigarettes on risk. Our objective also was to estimate the contribution of cigarette smoking toward explaining the higher pancreas cancer incidence experienced by black Americans compared with white Americans. Methods: A population-based, case-control study of pancreas cancer was conducted during 1986-1989 in Atlanta, Ga., Detroit, Mich., and 10 counties in New Jersey. Direct interviews were successfully completed with 526 case patients and 2153 control subjects aged 30-79 years, making this the largest population-based, case-control study of pancreas cancer to date based only on direct interviews. Results: Cigarette smokers had a significant, 70% increased risk of pancreas cancer compared with the risk in nonsmokers. A significant, positive trend in risk with increasing duration smoked was apparent (P

Published
1994

144. Multiple myeloma

Author

MacLennan, Ian C.M., Drayson, Mark, and Dunn, Janet

Subjects
Multiple myeloma -- Care and treatment, Health, Care and treatment
Abstract

Current Issues in Cancer Multiple myeloma occurs in over 2000 new patients in England and Wales each year. It presents most frequently as bone pain and patients tend to become [...]

Published
1994

146. Discrepancies in central review re-testing of patients with ER-positive and HER2-negative breast cancer in the OPTIMA prelim randomised clinical trial

Author

Pinder, S. E., Campbell, Amy, Bartlett, J. M. S., Marshall, A. (Andrea)‏, Allen, D., Falzon, M., Dunn, Janet A., Makris, A., Hughes-Davies, L., Stein, R. C., and HASH(0x5651c9d1a1b8)

Subjects
0301 basic medicine, Oncology, Cancer Research, Cost effectiveness, Receptor, ErbB-2, Estrogen receptor, law.invention, Immunoenzyme Techniques, 0302 clinical medicine, Randomized controlled trial, law, Antineoplastic Combined Chemotherapy Protocols, Medicine, Prognosis, oestrogen receptor, Receptors, Estrogen, Chemotherapy, Adjuvant, Research Design, 030220 oncology & carcinogenesis, Female, medicine.drug, Adult, medicine.medical_specialty, Concordance, Breast Neoplasms, RC0254, 03 medical and health sciences, Breast cancer, breast cancer, Internal medicine, HER2, Biomarkers, Tumor, Medical Laboratory Science, Humans, Neoplasm Invasiveness, Neoplasm Staging, business.industry, Reproducibility of Results, medicine.disease, Decision Support Systems, Clinical, Confidence interval, Surgery, Clinical trial, 030104 developmental biology, Clinical Study, Feasibility Studies, business, Tamoxifen, Follow-Up Studies
Abstract

Background:\ud There is limited data on results of central re-testing of samples from patients with invasive breast cancer categorised in their local hospital laboratories as oestrogen receptor (ER) positive and human epidermal growth factor receptor homologue 2 (HER2) negative.\ud \ud Methods:\ud The Optimal Personalised Treatment of early breast cancer usIng Multiparameter Analysis preliminary study (OPTIMA prelim) was the feasibility phase of a randomised controlled trial to validate the use of multiparameter assay-directed chemotherapy decisions in the UK National Health Service (NHS). Eligibility criteria included ER positivity and HER2 negativity. Central re-testing of receptor status was mandatory.\ud \ud Results:\ud Of the 431 patients tested centrally, discrepant results between central and local laboratory results were identified in only 19 (4.4%; 95% confidence interval 2.5–6.3%) patients (with 21 tumours). On central review, seven patients had cancers that were ER-negative (1.6%) and 13 (3.0%) patients with 15 tumours had HER2-positive disease, including one tumour discrepant for both biomarkers.\ud \ud Conclusions:\ud Central re-testing of receptor status of invasive breast cancers in the UK NHS setting shows a high level of reproducibility in categorising tumours as ER-positive and HER2-negative, and raises questions regarding the cost effectiveness and clinical value of central re-testing in this sub-group of breast cancers in this setting.

Published
2017
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147. Low serum 1,25(OH)2D3in end-stage renal disease: is reduced 1α-hydroxylase the only problem?

Author

Huish, Sharon A, Jenkinson, Carl, Dunn, Janet A, Meredith, David J, Bland, Rosemary, and Hewison, Martin

Abstract

Low serum 1,25-dihydroxyvitamin D (1,25(OH)2D) in end-stage renal disease (ESRD) is considered a consequence of elevated fibroblast growth factor 23 (FGF23) and concomitant reduced activity of renal 1α-hydroxylase (CYP27B1). Current ESRD treatment strategies to increase serum calcium and suppress secondary hyperparathyroidism involve supplementation with vitamin D analogues that circumvent 1α-hydroxylase. This overlooks the potential importance of 25-hydroxyvitamin D (25(OH)D) deficiency as a contributor to low serum 1,25(OH)2D. We investigated the effects of vitamin D (cholecalciferol) supplementation (40,000 IU for 12 weeks and maintenance dose of 20,000 IU fortnightly), on multiple serum vitamin D metabolites (25(OH)D, 1,25(OH)2D3and 24,25(OH)2D3) in 55 haemodialysis patients. Baseline and 12 month data were compared using related-samples Wilcoxon signed rank test. All patients remained on active vitamin D analogues as part of routine ESRD care. 1,25(OH)2D3levels were low at baseline (normal range: 60–120 pmol/L). Cholecalciferol supplementation normalised both serum 25(OH)D and 1,25(OH)2D3. Median serum 25(OH)D increased from 35.1 nmol/L (IQR: 23.0–47.5 nmol/L) to 119.9 nmol/L (IQR: 99.5–143.3 nmol/L) (P< 0.001). Median serum 1,25(OH)2D3and 24,25(OH)2D3increased from 48.3 pmol/L (IQR: 35.9–57.9 pmol/L) and 3.8 nmol/L (IQR: 2.3–6.0 nmol/L) to 96.2 pmol/L (IQR: 77.1–130.6 pmol/L) and 12.3 nmol/L (IQR: 9–16.4 nmol/L), respectively (P< 0.001). A non-significant reduction in daily active vitamin D analogue dose occurred, 0.94 µmcg at baseline to 0.77 µmcg at 12 months (P= 0.73). The ability to synthesise 1,25(OH)2D3in ESRD is maintained but is substrate dependent, and serum 25(OH)D was a limiting factor at baseline. Therefore, 1,25(OH)2D3deficiency in ESRD is partly a consequence of 25(OH)D deficiency, rather than solely due to reduced 1α-hydroxylase activity as suggested by current treatment strategies.

Published
2021
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148. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial

Author

Mehanna, Hisham, primary, Robinson, Max, additional, Hartley, Andrew, additional, Kong, Anthony, additional, Foran, Bernadette, additional, Fulton-Lieuw, Tessa, additional, Dalby, Matthew, additional, Mistry, Pankaj, additional, Sen, Mehmet, additional, O'Toole, Lorcan, additional, Al Booz, Hoda, additional, Dyker, Karen, additional, Moleron, Rafael, additional, Whitaker, Stephen, additional, Brennan, Sinead, additional, Cook, Audrey, additional, Griffin, Matthew, additional, Aynsley, Eleanor, additional, Rolles, Martin, additional, De Winton, Emma, additional, Chan, Andrew, additional, Srinivasan, Devraj, additional, Nixon, Ioanna, additional, Grumett, Joanne, additional, Leemans, C René, additional, Buter, Jan, additional, Henderson, Julia, additional, Harrington, Kevin, additional, McConkey, Christopher, additional, Gray, Alastair, additional, Dunn, Janet, additional, McArdle, Orla, additional, Husband, David, additional, Loo, Vivienne, additional, Soe, Win, additional, Sridhar, Thiagarajan, additional, Jankowska, Petra, additional, Joseph, Mano, additional, Geropantas, Konstantinos, additional, Vaidya, Deepali, additional, Vijayan, Rengarajan, additional, Hwang, David, additional, Pettit, Laura, additional, Brennan, Sinéad, additional, Mendes, Ruheena, additional, Forster, Martin, additional, Evans, Mererid, additional, Foran, Bernie, additional, Nankivell, Paul, additional, Bryant, Jennifer, additional, Sharma, Neil, additional, Spruce, Rachel, additional, Brooks, Jill, additional, Batis, Nikos, additional, Roques, Tom, additional, Bidmead, Margaret, additional, Yang, Huiqi, additional, Nutting, Christopher, additional, Tyler, Justine, additional, Baines, Helen, additional, Gasnier, Anne, additional, Miles, Elizabeth, additional, and Clark, Catharine, additional

Published
2019
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149. Levofloxacin Prophylaxis in Newly Diagnosed Myeloma Patients

Author

Drayson, Mark, primary, Bowcock, Stella, additional, Planche, Tim, additional, Iqbal, Gulnaz, additional, Pratt, Guy, additional, Yong, Kwee, additional, Wood, Jill, additional, Raynes, Kerry, additional, Higgins, Helen, additional, Dawkins, Bryony, additional, Meads, David, additional, Hulme, Claire T., additional, Monahan, Irene, additional, Karunanithi, Kamaraj, additional, Dignum, Helen, additional, Belsham, Edward, additional, Neilson, Jeff, additional, Harrison, Beth, additional, Lokare, Anand, additional, Campbell, Gavin, additional, Hamblin, Michael, additional, Hawkey, Peter, additional, Whittaker, Anna C., additional, Low, Eric, additional, Dunn, Janet A., additional, and Investigators, TEAMM Trial Management Group and Tr, additional

Published
2019
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150. An observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment

Author

Jepson, Marcus, primary, Elliott, Daisy, additional, Conefrey, Carmel, additional, Wade, Julia, additional, Rooshenas, Leila, additional, Wilson, Caroline, additional, Beard, David, additional, Blazeby, Jane M., additional, Birtle, Alison, additional, Halliday, Alison, additional, Stein, Rob, additional, Donovan, Jenny L., additional, Carr, Andrew, additional, Cook, Jonathan, additional, Cooper, Cushla, additional, Dean, Benjamin, additional, Gray, Alastair, additional, Gwilym, Stephen, additional, Judge, Andrew, additional, Merritt, Naomi, additional, Moser, Jane, additional, Rees, Jonathan, additional, Rombach, Ines, additional, Savulescu, Julian, additional, Tracey, Irene, additional, Wartolowska, Karolina, additional, Barham, Paul, additional, Brookes, Sara T., additional, Crosby, Tom, additional, Falk, Stephen J., additional, Griffin, S. Michael, additional, Hollingworth, William, additional, Hollowood, Andrew D., additional, Krysztopik, Richard, additional, Lewis, Wyn, additional, Nicklin, Jo, additional, Streets, Christopher, additional, Strong, Sean, additional, Titcomb, Dan, additional, Williams, Geraint, additional, Bryan, Rik, additional, Catto, James, additional, Chester, John, additional, French, Ann, additional, Hall, Emma, additional, Harris, Chris, additional, Johnson, Mark, additional, Jones, Rob, additional, Keeley, Francis, additional, Kirkbank, Tony, additional, Kockelbergh, Roger, additional, Lewis, Rebecca, additional, Newton, Michelle, additional, Powles, Thomas, additional, Waters, Rachel, additional, Winterbottom, Andrew, additional, Becquemin, Jean-Pierre, additional, Belli, Anna, additional, Bosiers, Marc, additional, Cao, Piergiorgio, additional, Davies, Christina, additional, Gough, Michael, additional, Hayter, Elizabeth, additional, Leopold, Peter, additional, McDonald, Sumaira, additional, Michaels, Jonathan, additional, Mihaylova, Borislava, additional, Peto, Richard, additional, Robertson, Steven, additional, Rothwell, Peter, additional, Scott, Rachael, additional, Thomas, Dafydd, additional, Vermassen, Frank, additional, Bartlett, John, additional, Cameron, David, additional, Campbell, Amy, additional, Canney, Peter, additional, Dunn, Janet, additional, Earl, Helena, additional, Falzon, Mary, additional, Francis, Adele, additional, Hall, Peter, additional, Harmer, Victoria, additional, Higgins, Helen, additional, Hiller, Louise, additional, Hughes-Davies, Luke, additional, Hulme, Claire, additional, Macpherson, Iain, additional, Makris, Andreas, additional, Marshall, Andrea, additional, McCabe, Christopher, additional, Morgan, Adrienne, additional, Pinder, Sarah, additional, Poole, Christopher, additional, Rea, Daniel, additional, and Stallard, Nigel, additional

Published
2018
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